Home Health Assessment Help?!

[h_ley]

Hello! I have recently taken a PRN home health job to supplement my income. I have two years pervious nursing experience, 1 year in SNF and 1 year in corrections. I have always worked NOC shift so I have limited experience with admission assessments and such. My home health agency assigned me 1 shadow visit, which went smoothly but the entire visit was with a Spanish speaking client. My preceptor emphasized to me that it is super easy work, just basic assessment (COVID questionnaire, vital signs, listening to heart and lung sounds, feeling for bilateral pulses, checking for edema, etc and just educating the patient). Which is simple enough, my concern is I want to know what type of questions to ask the clients to make the visit worth both of our times. I requested a a second shadow visit this time with an English speaking client to get a better understanding of what I am there to do fully, but it took my agency two weeks to find another person willing to shadow me then again the client ended up being Spanish speaking only. I didn't want to waste anymore time and decided to accept to start seeing patients this coming week. I want to be better prepared before my first client, so I'm asking y'all for tips on what other things I should be asking while I am in the home with the patient so I look like I know what I'm doing! According to my preceptor, most of the client they receive are hospital discharge follow ups and very few ever have wounds or other types of skills needed. 

[DallasRN]

Haven't done HH for a while and it wasn't for me, but...Primarily Medicare HH patients?   Are you an RN or LVN? Different assessments for the two disciplines.  RN's typically complete the OASIS and recert visits while LVN's go in to provide the weekly, etc., assessments/treatments.  The OASIS is a bear!  A big bear!  If you will be doing that you need more than just a 1-2 days of shadowing.  I would suggest you do some clarifying with the manager in terms of responsibilities, pt. load, types of pt's, etc.

Now, as for general assessments...you will primarily focus on your admitting diagnosis.  Post-hospital cardiac?  All those typical things associated with heart/circulation...pulses, nailbed color, b/p, heart tones, swelling.  Abdominal post-op?  Surgical site assessment, wound care, bowel sounds...you really know the drill on all these things.  I like your this:  "Which is simple enough, my concern is I want to know what type of questions to ask the clients to make the visit worth both of our times".  You will know the nursing stuff (you will, I promise!) but I've found in my almost a million years of nursing experience that often simply asking the client what their major concern is opens all sorts of communication.  (Hi, Mr. Smith!  What are your two major concerns this week)?  Or sometimes I'd leave them with the idea of writing down their concerns for the next visit.

[Gan2017]

Did you try Home Health Patient Education website? They have readymade patient education and OASIS assessment templates.