Everyday Innovations

When to call the doctor

New guidelines to help nurses determine when to call a physician after hours have cut non-urgent calls in half between 5 p.m. and 8 a.m. at Baytown, TX-based Geriatric Associates of America, PA.

Mary Pat Rapp, MSN, RN, gerontological nurse practitioner, says she and her husband, Keith Rapp, MD, president and CEO of Geriatric Associates, developed the decision-making protocols in conjunction with the Texas Medical Directors Association and the Texas Nurses Association. They came up with a grid that lists 15 to 20 events that nurses at local skilled nursing facilities commonly call about, including falls, skin tears, and high blood sugars.

For instance, if a fall occurs without injury, the nurse is instructed to call during normal office hours for notification or to fax the information. A fall with hip deformity requires a phone call to the physician regardless of the time of day.

The protocols give the nurse standing orders to follow after an assessment, allowing them to initiate treatment without calling the physician in certain cases, such as pressure sores, unexpected weight loss, and hypoglycemia.

To read more about these protocols and other everyday innovations, visit the Best Practice Network’s Web site at www.best4health.org. The Best Practice Network, a new organization devoted to promoting information sharing in health care by nurses, physicians, and other health care professionals, offers creative solutions to problems large and small.

For more information, send an e-mail message to join-us@best4health.org or call (800) 899-2226. Contact Mary Pat Rapp at Geriatric Associates of America, PA, One Price Street, Suite 200B, Baytown, TX 77521. Telephone: (281) 837-2200.