Getting your priorities in order
Unfortunately, not everyone has access to snowmobiles or four-wheel drive vehicles allowing visits to all patients during inclement weather. 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 has printed a criterion level developed by the Daughters of Charity National Health System (now part of Ascension Health) in St. Louis. Listed here 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 TPN when there is no available capable caregiver or 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 and could be coached over the phone (if phones are available); phototherapy clients with total bilirubin level less than or equal to 15 with a documented downward trend; HME clients needing servicing of apnea monitors, phototherapy 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, continuous passive motion 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 or basic pediatric nursing care.
Source: ECRI, Plymouth Meeting, PA.
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