HOME & COMMUNITYPolicy No.: PM-3-100

SUPPORT SERVICESRevised: Aug 2009

--OF GREY-BRUCE--NEW: DEC./04

Page: 1 of 2

SECTION: PROGRAM MANUAL

TOPIC: DAY AWAY PROGRAM

POLICY TITLE: CLIENT ASSESSMENT & UNREGULATED CARE PROVIDERS

POLICY STATEMENT:

The Registered staff, in collaboration with other team members will decide whether or not it is appropriate for staff to perform activities that are traditionally viewed as being within the scope of nursing practise. These activities could include supervision and administration of medication; wound and skin care; foot and nail care, ostomy care; personal care; catheter care; thermometer use and basic diabetes monitoring.Documentation is required when Registered Staff have reviewed and assigned procedures to Unregulated Care Providers.

PROCEDURE:

  1. Initial client assessment will be completed by the Family Support Counsellor/Family & Client Care Co-ordinator. If nursing care as defined in our policy statement is required, a Registered staff will determine each individual client’s needs for care at the Day Away Program. This assessment will consider the clients’ condition, associated risks and environmental supports. If a Registered staff is not available at a Program, the Programs Director, with input from the Program Manager/Team Leader will seek assistance from our HCSS Registered staff or from a Community based Nursing Agency.
  1. A Plan for Nursing Carewill be developed including the activities to be performed, the steps or procedures to be taken, the conditions for performing the procedures and the general indicators for seeking assistance. The plan for nursing care will be noted in the client file by the Registered staff and will be part of the Individual Program Plan (IPP Form DA-9).
  1. The activities in the plan for nursing care may be assigned to staff who have received training specific to the individual client, and who demonstrate ongoing competence. These decisions will be guided by the Decision Tree set out by the College of Nurses of Ontario in regard to Activities Performed by Unregulated Care Providers. (see Appendix IDecision Tree) The Registered Nurse will document client specific and procedure specifictraining provided to the Unregulated Care Provider in Form DA – 24 Assisting with Medications at Day Away and Form DA - 23Procedures Performed at Day Away: A teaching Plan and a copy will be placed in the client chart. The Unregulated Care Provider who performs the activity will document that activity in the client’s chart.
  1. The Registered staff will:

a)Outline in detail the procedure for performing the activity.

b)Ensure that the Unregulated Care Provider knows when and how to report back to the Registered staff.

c)The Registered staff will provide ongoing assessment of the clients’ health care needs and evaluation of the client’s condition.

d)Provide ongoing assessment and evaluation of the staff’s competence to perform the assigned procedures.

e)Document the procedure on Form DA-23 and or Form DA-24 to be kept in the client file.

  1. The Registered Staff is responsible for the ongoing evaluation of the client’s health status. In the absence of Registered staff, the UCP’s role is to monitor the health of the client and act in any situation that is unusual or when the well being of the client is compromised. Staff may call: an RNor RPN at another program, the family doctor, or Tele Health, or take the client to the nearest hospital Emergency Department. In the case of an emergency, 911 will be called.

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