VA PANEL What s it Like to Work at the VA? We Honor Veterans Conference March 29, 2018 VA OUTPATIENT PROGRAMS We Honor Veterans Conference March 29, 2018 Heather Rood, RN 1
Objectives Become familiar with services provided by the SCVAHCS that could benefit Veterans nearing the end of life. Become familiar with clinical practice provided by the hospice program in the SCVA Community Living Center (CLC). Long Term Services and Supports Include a wide range of services that can help Veterans remain as independent as possible when facing challenges with everyday tasks Usually provided in the home, but may also be provided at community sites, in residential settings, assisted living homes, or nursing homes. Are provided based on the clinical need for services. 2
Paying for Services Based on need for ongoing treatment, personal care and assistance, as well as availability of the service Other factors may apply: financial eligibility, service connection status, insurance coverage or ability to pay May be able to pay for long term care services and supports using: VA Benefits Medicare Medicaid Personal funds Insurance Home & Community Based Care Skilled Nursing Home Health Aide/Homemaker Respite Adult Day Health Care (Contracted) Palliative Care (*) Community Hospice Contact: Primary Care Provider/PACT Nurse 3
Home Based Primary Care Multidisciplinary healthcare program to provide eligible Veterans with medical services within the Veteran s home. Located within 40 miles of VA or CBOC Family member/caregiver willing/able to share responsibilities of home care Suitable home environment Contact: Primary Care Provider/PACT Nurse R Residential Settings Supervised living situations that provide meals and assistance with activities of daily living Adult Family Homes Medical Foster Homes Assisted Living Facilities VA does not pay rent, however may pay for some health care services in the residence such as nurse visits. 4
Questions? NURSING HOMES We Honor Veterans Conference March 29, 2018 Cate Anderson, RN 5
Nursing Homes Community Nursing Homes (CNH) VA contracts with some CNH so Veteran can receive care closer to home/family VA does not pay room/board (*) Contact: CNH Coordinator State Veterans Homes Owned, operated and managed by state governments States determine eligibility rules VA does not pay rent Community Living Center (CLC) VA facility that provides NH level of care 24/7 Services may be provided for a short time or for the rest of Veteran s life May be a cost St. Cloud VA CLC Comprised of 6 units 225 beds 6
CLC Services Respite Rehabilitation Restorative Care Continuing Care Skilled Nursing Care Dementia Care Palliative Care (*) Hospice Care Respiratory Dependent Unit Behavioral Recovery Unit Community Living Center Units Building 49 Building 50 Building 51 Hospice Focus (20) General Care (3) Memory Care/BRU (4) General Care (2) Rehab/RDU (1) MH Recovery (1) 7
CLC Hospice Census CLC Hospice Census 8
Questions? Clinical Nurse Leader Hospice Care in the CLC We Honor Veterans Conference March 29, 2018 Margaret McCue MSN, RN, CNL 9
What is a Clinical Nurse Leader (CNL)? A Clinical Nurse Leader is: A new role in nursing Master s educated nurse prepared for practice across the continuum of care within any healthcare setting Certified as a CNL by the CNC Point of Care clinical leader focused on the delivery of quality, safe, efficient, Veteran centered care Focuses on Veteran outcomes in assigned microsystem Clinical Nurse Leader at St. Cloud VA The CNL role was designed to deliver clinical leadership to Veterans and families As of December over 70 VA Health Care System are participating in the CNL initiative National VA Initiative was by the year 2016 there will be a CNL in very VA! St. Cloud had three CNLs, one in each Service Line EC&R, SSC/Primary Care, Mental Health 10
Clinical Nurse Leader in CLCs CNL is a clinical leader at the point of care Care coordination Outcomes Measurement Transitions of Care Interprofessional Communication & Team Leadership Risk Assessment Implementation of Best Practices Quality Improvement Hospice Palliative Care Hospice & Palliative Care in the Community Living Centers Point of Care/Interdisciplinary Team Rounding with Veteran on the CLC units Hospice IDT rounds weekly: RN, CNL, NP, SW, Chaplain, Pharmacists, Dietitian, Therapy, Risk Assessment/Implementation of Best Practice Pain and symptom management Subcutaneous administration of medication 11
Pain and symptom management Collaboration with Clinical Pharmacist and CNP Geropsychiatry's Subcutaneous Administration of Medications Point of care education nurses, Veterans, and families Medications, for pain and symptom management Hydromorphone, Haldol, Ativan Veterans and families very happy with care!! Questions? 12
Top 5 Reasons Nurses Love Working for the Veterans Health Administration #5 Providing quality care at the largest healthcare system in the country with support from a nation wide community of practice. 13
#4 Support for training, continuing education & degrees along with opportunities for career development. #3 Opportunity to practice in a variety of settings while receiving extraordinary benefits, retirement & competitive pay. 14
#2 Dedication to the mission of the VA & the ability to serve our country. To care for those who shall have borne the battle and their families... and #1 We take care of the best patients in the world Veterans! 15