Prioritizing care: Set up a winter weather checklist
When winter weather comes, not everyone has access to snowmobiles or a four-wheel drive. For more than a few home care agencies, this becomes a critical situation in inclement weather because staff may end up risking their lives trying to complete their rounds.
Where to start
Deciding who should get care before others in the face of a blizzard or ice storm is a difficult decision to make. To make sure those who need care the most are receiving it, it’s a good idea to assign patients a treatment status upon admission, and keep that list on file and constantly updated.
If you’re unsure how to classify some of your patients, ECRI in Plymouth Meeting, PA, a nonprofit international health services research agency, has printed a criterion level developed by the Daughters of Charity National Health System in St. Louis. Of course, this criterion level doesn’t apply for cold weather only. It’s a useful guide in other emergency conditions, such as tornadoes or hurricanes.
Listed below are suggested priority levels for determining the provision of service:
• Priority 1
The life or well-being of the client may be significantly jeopardized if services are not provided that day. Examples include, but are not limited to:
— complicated wound care, insulin injections, IV medications, or total parenteral nutrition when there is no available, capable caregiver, or when the client cannot perform independently;
— new referrals already discharged home from a facility with acute needs;
— Home medical equipment (HME) clients on ventilators, or oxygen-dependent and needing STAT delivery.
• Priority 2
No significant adverse effects for the client are anticipated if services are postponed for one to two days. Examples include, but are not limited to:
— clients scheduled to receive services who are capable of self-care or have a willing and capable caregiver who could be coached over the phone (if available);
— phototherapy clients with Tbili level less than or equal to 15 with a documented downward trend;
— HME clients needing servicing of apnea monitors, photo-therapy equipment, internal feeding pumps, or oxygen.
• Priority 3
No significant adverse effects for the client are anticipated if services are postponed for two or more days. Examples include, but are not limited to: mother-baby visits, cardiopulmonary assessments on established clients with uncomplicated courses; HME clients requiring nonemergency equipment such as bedside commodes, CPM machines, or hospital beds.
• Priority 4 (skilled-shift program only)
No significant adverse effects are anticipated for the client if services are postponed for the duration of the emergency or disaster. Examples may include, but are not limited to:
— clients receiving respite care;
— clients receiving basic pediatric nursing care.
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