IRF meal times and staffing start times

[Guest guest]

We have a 30 bed IRF facility and a 60 bed SNF facility and we struggle with the

whole morning process and start up time. Most places run a day shift of nursing

that start around 7am with breakfast starting shortly thereafter. There are a

lot of tasks that need to be completed with the patient prior to going to a

breakfast meal including meds, assessments, vitals, morning hygiene tasks and

dressing to leave the room etc. We also have therapists trying to start

treatment sessions prior to breakfast with some patients. Would you share with

me your process for the morning " pre-meal " time? Of particular interest is:

1. What time do you serve your meals to patients?

2. Do the patients eat in their rooms vs. a central dining room?

3. If they are in there room, who is responsible for safety with feeding for

patients at risk?

4. What time does your PT staff start work and what time is their first

treatment?

5. What time does your OT staff start work and what time is their first

treatment?

6. Same question for ST?

7. What time do you serve lunch and supper and do patients eat in a dining room

or in their room?

8. Do your nurses (rehab in particular) take responsibility to get patients

ready in the morning or do you use NA's?

9. What are your nurse:patient and NA:patient staffing ratios (to complete the

morning nursing and adl tasks)

10. What time does your day shift nursing start and how are the nursing tasks

broken up by shift (ie. do you have night shift passing morning meds or getting

patients up to get ready?)

11. How many beds are you operating and what is your average census?

Any additional information about making this process smooth for the patients

would be greatly appreciated. Thank you for taking the time to share on this

site. I enjoy reading the interactions and learning from what all of you are

doing.

Jodi Weigand, PT, MS

Woodlawn Therapy Services