HH teaching

danursern · Aug 6, 2005

Just wondering what the protocol was at your agency re: documentation of teaching? Do you all just write out narratively what the teaching was? Do you attach copies of teaching sheets that you have used to your nurses note? Also, are you asked to spend ridiculously long periods of time "teaching" something so that it appears (on paper) that your patient still has knowledge deficits so recert is necessary ( now I know that's sorta a whole other topice, but a fairly prevalent issue from what I've seen). Thanks in advance.
Kathryn

This HH agency seems to be one that does not do any teaching so I've learned. They do not have a protocol to follow on what the nurse on duty should teach the orientee in 2 hours (all they will pay) at $18.00 hr. This is private duty HH. Yesterday, I went to be oriented with a client. In two hours I learned nothing. I have and had to ask about everything where this modality is concerned. I am still unsure how to chart, because the charting is so haphazard. This nurse said home health was not the hospital and way different. However, most of nurses here act like they do things right, so whats wrong with this picture. Another thing I need this job now. I have no money left so I have to take this client. I guess I will have to rough it. The only part that scares me is the Vent and charting on the vent care. Any thoughts?

CardioTrans, BSN, RN · Aug 7, 2005

We basically spell out everything that we teach. If we use teaching sheets, we make 2 copies, leave one in the home and then place one on the chart as a hard copy, (we chart on computers). As far as keep on teaching the same thing....... we have checkboxes, one is verbalized understanding, needs further education, adequate return demonstration or needs to perform return demonstration. As far as meds......... on our med profile, when we teach a medication, we place a check mark in the box, and it shows that it is taught. (And of course on our note... verb understanding... or other checkboxes) That way if someone else goes in behind another nurse, they know what has been taught.

If we do have to repeat teaching (for a new caregiver) then we also document that a new cg is in place.

Also, a hint I learned many yrs ago. If you mark inst to s/s CHF and leave it at that....... you set yourself up if you ever get called into court. I saw a nurse who documented that one time then wound up in court 4 yrs later. She was asked what s/s she taught, and couldnt remember exactly. Spell it out exactly what was taught each visit.

Hope this helps.

katwoman7755 · Aug 8, 2005

Also, a hint I learned many yrs ago. If you mark inst to s/s CHF and leave it at that....... you set yourself up if you ever get called into court. I saw a nurse who documented that one time then wound up in court 4 yrs later. She was asked what s/s she taught, and couldnt remember exactly. Spell it out exactly what was taught each visit.
Hope this helps.

That's a very good point...one I'm sure I have been deliquent in many times. I think that is the reason that they are now wanting us to staple a teaching sheet to the original note and say we taught point # what ever...b/c often times we do just say on the note we taught s/s of such and such to report.

Thanks for you response,

Kathryn