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Tips from TSE: Prepare your nurses for present-on-admission

Staff Development Weekly: Insight on Evidence-Based Practice in Education, August 6, 2008

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By not involving your nurses in recognizing present-on-admission (POA) conditions, your hospital might lose reimbursement and is likely not maximizing its opportunities to improve patient care. CMS defines POA conditions as "present at the time the order for inpatient admission occurs-conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered as present on admission."

"The nurse becomes the person that spends the most time with patients and is most likely to identify, through physical assessment and interviewing, that these conditions could be present and could be a risk," says Tricia Thomas, PhD, RN, assistant professor and coordinator of the clinical nurse leader program at the University of Detroit Mercy.

The following are tips for educating nurses on POA:

• Make your nurses aware of the financial implications of care. "They haven't been educated on these implications in the past," Thomas says. "Show them how their documentation, communication, and collaboration are going to influence reimbursement."
• Use case scenarios rather than lectures. For example, gives nurses a scenario in which a patient on their unit is at a high risk for falls.
• Train them on head-to-toe assessment. "Give them the ability to expand their assessment breadth for consistency," says Thomas.

Editor's note: This excerpt was taken from the August issue of The Staff Educator. Discover all the benefits of subscribing to The Staff Educator!

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