Questions for the experienced: HH start up.

Specialties Home Health

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Lengthy post warning! We are "restarting" a home nursing program with the health dept -- I know these questions would generally fall under "public health" due to it being a health dept program, but the program itself is more home health in essence without the 24/7 responsibility, on-call, etc. (Kind of a simplistic home health program, for those that fall thru the cracks.)

Here are some things that came up at our last meeting:

1: revamping charts - could any of you email me chart forms so that I could compare ours with yours? Ours seem a little outdated (ok, a lot), and I would like to streamline and condense, streamline, but still include all info necessary. ALSO... along with a main chart, do you keep a more simplistic home chart? Kind of like a flow sheet of the main things that family wants to be kept informed of (i.e. current medication list, allergies, ongoing vitals flow sheet, etc)?

2: is there official word on prefilling insulin syringes? I checked some websites and couldn't find a definitive (and recent) answer. looking for if and WHICH insulins can be drawn up say, 1 week in advance?

3: do any of you use portable vein finders? such as a transilluminator, veinlite, etc? the administrator was interested in purchasing one for the program, and I've never used a portable one (only the huge, $20K ones at hospitals). I *have* searched online and found several, but would love input from people with actual experience using them.

4: promotional medisets? We would like to purchase some medisets to be able to give to patients in the program. I have found hundreds online but was wondering if any of you hand them out, and if so, have you found any that are very senior citizen user-friendly? Something that is easy to read, follow, and, easy to open with arthritic hands.

5: the bag of tricks. a few things -- for blood pressure cuffs to be used in the home, I'd like to order something that is very easy to clean -- haven't found anything despite the hundreds of med supply books I've looked through. also looking for the "perfect thermometer" -- easy to use, fast, easily applied covers, etc. aside from the usual (alcohol wipes, dressing supplies, blood draw supplies, extra chart forms, medisets, etc), what... "unique" things do you always carry with you into the home? and suggestions for anything else I mentioned?

Again, I would appreciate everyone's input -- thanks in advance!

-A

No one? No help? Please -- would love some input!

Hi, I'll offer what I can!!

1. Most home care skilled nursing notes are mainly a head to toe assessment, a check off with the typical stuff, like last BM, GU status, Pulmonary status, etc. , with a small area for a narrative to record skilled teaching. You'll also need a thorough wound care note if you'll be providing wound care. :up:

2. Filling insulin syringes is usually listed on our 485 simply as prefill insulin syringes for 1 wk

3. We carry a small cannister of clorox wipes to clean our instruments after each patient.

4. We don't use portable vein finders. If I can't get blood after a few tries, another nurse tries the next day, if no luck, we tell them sorry, you'll have to go to the lab.

5. In the home folder we have a simple flow sheet for v/s with a very small area for any narrative such as a new med etc. just enough room for the next nurse to have an idea of any possible changes.

6. We uses crappy oral thermometers but if i had my choice, i would get temporal scanners.

7. After years of home health, i can tell you that we carry the least amount of supplies possible. i use to fill my bag up with every little thingn possible, now it contains a b/p cuff, a therm, and a stethoscope, a few bandaids, hand sanitizer, and some lab supplies. Most of our nurses carry a box of gloves in their car and just put a few in their pockets before going in a patients home.

8. We supply only our illiterate or learning impaired patients with mediplanners. Only because patients get too used to us filling them which is not a skill. If a patient can take his meds from his bottle unassisted, we keep it that way. You probably won't run into this problem because medicare probably won't be your payer source.

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