Name of the Procedure:

Common Name: Skilled Nursing Services
Technical/Medical Term: HCPCS Procedure G0494

Summary

This procedure involves a licensed practical nurse (LPN) providing skilled services for the observation and assessment of a patient's condition in 15-minute increments. The focus is on identifying and evaluating any changes in the patient's condition that require the expertise of skilled nursing personnel.

Purpose

Medical Conditions/Problems Addressed:

• Chronic illnesses
• Post-surgical recovery
• Acute medical conditions requiring close monitoring

Goals/Expected Outcomes:

• Early identification of changes in patient condition
• Prevent further complications
• Provide timely interventions and adjustments to the care plan

Indications

Specific Symptoms/Conditions:

• Unstable vital signs
• New or worsening symptoms
• Recent surgery or medical procedures
• Chronic conditions requiring continuous monitoring

Patient Criteria:

• Patients with complex medical needs
• Patients who are at risk for rapid changes in their health status

Preparation

Pre-Procedure Instructions:

• Ensure all medical records are up to date
• Clarify any specific symptoms or changes in health to the nurse
• Follow any specific dietary or medication instructions provided by healthcare providers

Diagnostic Tests/Assessments:

• Baseline vital signs
• Recent medical history review
• Specific diagnostic tests as ordered by the primary healthcare provider

Procedure Description

Step-by-Step Explanation:

1. The LPN reviews the patient's medical history and current condition.
2. The nurse conducts a thorough assessment, including vital signs and physical examination.
3. Any changes or abnormalities are carefully documented.
4. The nurse communicates findings to the healthcare team and may suggest further interventions.
5. The process is repeated at 15-minute intervals, or as needed, based on the patient's condition.

Tools/Equipment Used:

• Blood pressure monitor
• Thermometer
• Oxygen saturation monitor
• Stethoscope
• Medical record documentation tools

Anesthesia/Sedation:

• Not applicable

Duration

The assessment is carried out in increments of 15 minutes, with the overall duration dependent on the patient's condition and care plan.

Setting

• Hospital
• Outpatient clinic
• Home healthcare settings

Personnel

• Licensed Practical Nurse (LPN)
• Potential collaboration with Registered Nurses (RNs), physicians, and other healthcare professionals

Risks and Complications

Common Risks:

• Minor discomfort during the assessment

Rare Risks:

• Overlooked symptoms due to rapid changes not recognized within the 15-minute timeframe

Possible Complications:

• Delayed interventions in rapidly deteriorating conditions

Benefits

Expected Benefits:

• Timely detection and management of health changes
• Enhanced coordination of care among healthcare professionals
• Potential prevention of hospital readmissions

Realization Timeframe:

• Immediate to short-term depending on the patient’s condition and timely intervention

Recovery

Post-Procedure Care:

• Continued monitoring as per the developed care plan
• Documentation of any changes and interventions

Expected Recovery Time:

• Varies based on the underlying condition and interventions performed

Restrictions/Follow-Up:

• Follow-up appointments as needed
• Any specified activity or dietary restrictions based on the patient’s condition

Alternatives

Other Treatment Options:

• Continuous remote patient monitoring
• Utilization of Registered Nurses for continuous assessment

Pros and Cons of Alternatives:

• Remote monitoring can reduce the need for physical presence but may not capture all nuances.
• Registered Nurses may provide a higher level of assessment but are typically more costly.

Patient Experience

What to Expect During the Procedure:

• Regular, brief assessments by the LPN
• Clear communication with the healthcare team

After the Procedure:

• Immediate feedback on any findings
• Minimal discomfort during assessments

Pain Management and Comfort Measures:

• Generally not required due to the non-invasive nature of the assessments

General Comfort:

• The LPN aims to ensure that the patient is comfortable and reassured throughout the process.