Patient Refusing Repositioning or Heel Offloading Algorithm

1. Patient Refusing Repositioning or Heel Offloading Algorithm • Does the patient have the capacity for decision making? • Demonstrates a general awareness of his/her health situation & the intervention proposed. • Understands the factual information provided about the recommended intervention. • Communicates verbally and non-verbally a clear decision regarding intervention based on that information. No Yes Document refusal education barriers identified. Identify and address the reason the patient is refusing. Is patient displaying physically aggressive behavior? Does patient now agree to repositioning? No Yes Yes No Reposition patient and offload heels. Document in EHR. Educate patient on importance of intervention. Reposition patient and offload heels. Document in EHR. Staff RN informs Charge RN for Charge RN to approach patient. Update Plan of Care with new interventions as appropriate. Update Plan of Care with new interventions as appropriate. Does patient now agree to repositioning? No Yes Follow behavioral care plan and consult interdisciplinary team as needed. Staff RN: Charge RN: •  Inform provider  Inform ANS •  Document in EHR  Inform Social Worker •  Discuss in Interdisciplinary Rounds