The following procedure requires approval from the Commissioner’s Office / DAIL Nurse Consultants prior to Guardian consent:
Initial surgical placement of Gastrostomy Tube for the administration of artificial nutrition
Steps for Obtaining Commission’s Office Approval:
Step 1:
When a facility contacts you to request consent for an initial gastrostomy tube placement, please get their contact information (name and telephone number) and let them know that a DAIL Nurse Consultant will be in touch with them.
Step 2:
Please email the name of the individual under guardianship, the name of the contact person, and their telephone number to BOTH DAIL Nurse Consultants.
Please be sure to include BOTH DAIL Nurse Consultants in all communications to ensure timely response as they cover for one another when one is out.
Step 3:
One of the DAIL Nurse Consultants will contact the provider and discuss what options are available for the individual to ensure the best interests of the individual.
Step 4:
The DAIL Nurse Consultant will discuss with the provider what they may need for review.
The DAIL Nurse Consultant will review the information submitted.
The DAIL Nurse Consultant may see that it is very evident what is in the best interest of the individual under guardianship and provide approval to the Guardian to give consent.
Step 5:
If it is not immediately clear whether the procedure is in the best interest of the individual, the DAIL Nurse Consultant will then forward their professional opinion to the Guardianship Director for review, who will then forward the information to the DAIL Commissioner for final review.
Step 6:
The Guardian and Guardianship Supervisor will be notified of any updates in the process as they occur.
Step 7:
If approved, the DAIL Nurse Consultant will notify the Guardian and Guardian Supervisor, who will then give consent for the procedure to be performed. The DAIL Nurse Consultant will enter an event in KYGFIS to include physician statements, medical records, and email chains if applicable.
Step 8:
The Guardian/Guardian Supervisor will document the name of the person that they give consent to.
Step 9:
If denied, the DAIL Nurse Consultant will discuss options with the Guardianship Director, request more information if necessary, and notify the Guardian and Guardian Supervisor accordingly. The DAIL Nurse Consultant will document the denial in KYGFIS along with all the information that was received.
Emergency Consent only applies to procedures that would otherwise require OLS Approval (removal of a bodily organ, amputation of a limb, sterilization, or abortion).
The physician must complete the Physician’s Affidavit of Emergency Need for Emergent Removal of a Bodily Organ, Amputation of a Limb, Sterilization, or Abortion.
By signing the form, the physician is stating that the procedure will be performed within 24 hours and is emergently necessary in order to preserve the individual’s life OR to prevent serious impairment of their physical health.
NOTE: The most up-to-date form is available on the shared guardianship drive.
Once the guardian receives the completed form back, the guardian will forward the documentation and request for Emergency Procedure to their supervisor.
The supervisor will consult with the branch manager.
If it is determined that emergency criteria is met, the supervisor will give consent, document who consent was given to, and enter an event in KYGFIS addressing all the required information.
The guardian or supervisor will attach the physicians’ affidavit as a file to the event.
The Guardian will enter an outcome once the procedure is complete.
Certain procedures carry a high risk of long-term, life-altering effects. These procedures must be authorized by the Guardianship nurse consultants, followed by approval by court processes. This lesson will focus on medical consents requiring court approval.
Hi! I am Dazia, we are now going to take a look at several SOPs related to the home and living of an individual under guardianship. This includes owning pets, traveling out of state, and moving.
You will be able to download each SOP to your desktop for future reference. Some SOPs will have a scenario to provide more context or details. These are an opportunity for you to practice what you are learning.
Several SOPs will be reviewed, and there will be an opportunity for a brain break.
Hi! I am Simon, and I am going to review some of the SOPs that you will use when working as a Guardian. The SOPs that I will be reviewing are related to the medical, health, and safety needs of an individual under guardianship. This includes reporting incidents, health care needs, and life-saving measures.
You will be able to download each SOP to your desktop for future reference. Some SOPs will have a scenario to provide more context and details about the SOP. These are an opportunity for you to practice what you are learning.
We will be reviewing several SOPs, but don’t worry; we will offer opportunities for brain breaks.
Hi! I am Ronnie, and I am going to be discussing some of the SOPs that you will use when working as a Guardian. The SOPs that I will be reviewing are related to working with an individual under guardianship. This includes things like is a person eligible, maintaining records, and use of state vehicles.
You will be able to download every SOP to your desktop for future reference, and some SOPs will have a scenario to provide more context and details about the SOP. These are great opportunities to practice what you are learning.
We will review many SOPs, but don’t worry. There will be several opportunities for brain breaks.
Use this space to continue our conversation on School Age Training Needs, so that we support each other in this work. Ask/answer questions, share successes and challenges, and respond to each other!
(If you have any trouble posting, email your questions to julie.halitzka@uky.edu, and we will post for you.)
Use this space to continue our conversation on Refresh Self (Self-Care), so that we support each other in this work. Ask/answer questions, share successes and challenges, and respond to each other!
(If you have any trouble posting, email your questions to julie.halitzka@uky.edu, and we will post for you.)
Congratulations! You have completed DAIL 114: Incident Reporting! Please note that your supervisor may have follow-up questions or need more information. Please respond to any requests promptly.
Once you click “mark complete,” a certificate of completion will be available to you. You may print or download your certificate to verify the completion of DAIL 114: Incident Reporting. This certificate will also be available at the beginning of the course anytime you log on.
Reminder from Aida
This course is part of a series of training required for all new employees All new hires are required to satisfactorily complete trainings before being assigned cases.
All courses must be completed in order and in a timely manner.
This includes DAIL:
New Employee Orientation Part 1 (completed!)
New Employee Orientation Part 2 (completed!)
Guardianship Program Overview (completed!)
Universal Precautions (completed!)
Person-Centered Planning (completed!)
Supported Decision Making (completed!)
Effective Case Work Documentation (completed!)
Guardianship the Law (completed!)
Court Process and Forms (completed!)
Guardianship SOP
Levels of Care (completed!)
Common Diagnoses Explained (completed!)
Kentucky Medicaid Home and Community-Based Services (HCBS) Waiver Overview (completed!)
Incident Reporting (completed!)
Medical Consent
DNR/EOL
Guardianship Community Partners and Collateral Contacts
Safety Awareness
Communication and Coping When a Client Passes Away
KYGFIS System Training
Click the “Mark Complete” button below to access your certificate of completion.
