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201705138

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UWHC,

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Criteria for Inpatient Daily Care Level 5 Charge - Urology Surgery (Cystectomy) Patients (F66 Only) (9.16)

Criteria for Inpatient Daily Care Level 5 Charge - Urology Surgery (Cystectomy) Patients (F66 Only) (9.16) - Policies, Administrative, UWHC, Department Specific, Nursing Administrative, Patient Charges

9.16

POLICY & PROCEDURE





Effective Date:
May 1, 2017

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.16

Original
Revision

Page 1
Of 2

Title: Criteria for Inpatient Daily Care Level
5 Charge – Urology Surgery (Cystectomy)
Patients (F66 Only)


I. POLICY
A. This Daily Care Level 5 (V) Urology Surgery charge applies only to the F6/6 inpatient
unit. These patients require multiple nursing interventions as described below, and to
qualify for the higher charge must have Urology surgery and meet 4 or more of the
following criteria:
1. Epidural or Patient Care Analgesia (PCA) for pain control. Requires assessment
minimally every two hours for duration of therapy.
2. Require 2 or more electrolyte replacements and subsequent lab monitoring.
3. Telemetry monitoring.
4. Unable to transfer or reposition without assistance, requiring use of safe patient
handling and mobility equipment
5. Continuous pulse oximetry.
6. Four or more drains present (surgical drains, stents, Foley as drain, Foley catheter,
malencott).
II. PROCESS:
A. Upon Admission:
1. If patient meets the criteria section listed above then they should receive an
Inpatient Daily Care Level 5 (V) - Urology surgery charge until such time as the
charge criteria is no longer met. The admitting nurse will communicate to the
HUC and Care Team Leader the need to implement the Level 5 (V) daily care
charge. The HUC will enter the charge into Health Link. Charges must be entered
into the system before midnight on the day of admission.
2. F66 will have a unit reference binder with the criteria clearly listed.
3. The admitting Nurse on every shift is responsible for evaluating if there are any
new patients that require the Level 5 (V) charge and for communicating this
information to the HUC for entry into Health Link
B. Days following admission date:
1. The Level 5 (V) Urology surgery charge will be evaluated for appropriateness on
each Day shift following admission, and will be discontinued when the patient no
longer meets the charge criteria listed above. The Nurse assigned to the patient
will communicate with the HUC and Care Team Leader when the Level 5 (V) -
Urology surgery charge should be discontinued.
2. On a daily basis, the Care Team Leader/Senior Team Member on the Day shift is
responsible for reviewing all active charges. The Care Team Leader/Senior Team

POLICY & PROCEDURE





Effective Date:
May 1, 2017

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.16

Original
Revision

Page 2
Of 2

Title: Criteria for Inpatient Daily Care Level
5 Charge – Urology Surgery (Cystectomy)
Patients (F66 Only)


Member will consult with the nurse caring for the patient to verify the continued
necessity of the charge, and if no longer appropriate communicate with the HUC
to confirm the charge has been discontinued in Health Link.
C. Daily Patient Charge Review:
1. On a daily basis, the Manager or Manager's delegate (e.g. Care Team
Leader/Senior Team Member (STM) or Health Unit Coordinator) is responsible
for reviewing all active charges before midnight and for assuring that all patient
charges are correct for the midnight charge capture. Data pertinent to the daily
care patient charges can be found in either the home page patient list or the unit
census snapshot report in Health Link.
2. On a daily basis, the Manager or Manager's delegate (e.g. Care Team Leader/STM
or Health Unit Coordinator) must review the Daily Activity Journal report (DAJ)
which lists all charges posted for a patient the previous midnight. A comparison of
the DAJ with the unit census snapshot run for the previous 24 hours will be
conducted. Any patient charge errors discovered as a result of this review will be
corrected immediately. If the patient is not yet discharged, corrections can be
made in Health Link by the unit staff. If the patient has been discharged by the
time the error is discovered, the unit staff will notify the Admissions Department.
Admissions will then correct the charge error when feasible to do so.

IV. AUTHORED BY
Director, Nursing Finance and Staffing Effectiveness

V. REVIEWED BY
A. Director, Surgical & Psychiatric Nursing, May 2017
B. Nurse Manager, F6/6 Gyn/Urol/Plastics and Otolaryngology, May 2017
C. Nursing Administrative Policy & Procedure Committee, May 2017

SIGNED BY:
Beth Houlahan, DNP, RN, CENP
Senior Vice President
Chief Nurse Executive