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Corporate

Use of Ranges in Physician's Orders

The frequency of visits may be stated as a specific range to ensure the most appropriate level of care is provided. When a range of visits is ordered, the upper limit of the range is considered the specific frequency.   Orders for services as needed (PRN) must be accompanied by a description of the patient’s medical signs and symptoms that would initiate a visit and a specific limit on the number of those visits to be made before an additional physician order would need to be obtained.

Example 1: "Skilled nurse 1-3x/week for 4 weeks to assess open wound and provide wound care per ordered protocol."

This order is complete, and will cover up to three visits by the nurse each week.

Example 2: "Skilled nurse 5-7x/week for 9 weeks to provide wound care per ordered protocol."

This order is for daily skilled nursing, due to the upper limit on the range of "7" per week. There would have to be a reasonable endpoint to consider this order appropriate for intermittent skilled nursing.

Example 3:  “Skilled nurse 1-2x/week for 2 weeks PRN for pain rated greater than 8 on the 0 to 10 pain scale.”

This order is for as needed visits 1 to 2 times per week for 2 weeks for a specific symptom with a specific period of time.  If the signs and symptoms indicate a need for more visits, a new physician order would need to be obtained.

Updated: 07.29.15


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