Home health assessments

[PurpleDaisy🌸]

The "is anyone doing assessments" discussion over in the genral nursing forum has got me thinking...

i have often wondered how some of my coworkers can complete their HH visits so fast, even when doing a SOC. The assessment discussion got me thinking... Maybe they are not assessing as much as I am assessing?

I thought I would throw this out here: what do your HH assessments look like? Are you doing full assessments for all patients? Do you just do "the basics" on most patients, and then add in extra, PRN, depending on diagnosis? Do you do assessments with wound care, or just the dressing change?

ETA: a few ex I thought of: do you check a 1 min apical pulse on a-fib patients? Do you do full skin assessments on SOC? Do take listen to both posterior AND anterior lung sounds? Do you have all SOC ambulate for you (if this is reasonable, of course)?

[Libby1987]

I thought I had been doing thorough assessments, until I saw the 133 (or whatever number that was) assessment points. I'm not doing all of those, but definitely enough to accurately and comprehensively complete the oasis.

I could leave the house and answer any questions related to their VS, mental status, heart rhythm, edema, pedal pulses, color, temp, lung sounds, O2 sat, pain, bowel motility, urine, continence weight, appetite, nutritional and fluid intake, ht, wt, skin integrity, glucose, all things wound related, their medications including reconciliation, compliance and understanding, functional status, home environment, support, recent hx, knowledge disease mgmt, resources..

[PurpleDaisy🌸]

I thought I had been doing thorough assessments, until I saw the 133 (or whatever number that was) assessment points. I'm not doing all of those, but definitely enough to accurately and comprehensively complete the oasis.

I could leave the house and answer any questions related to their VS, mental status, heart rhythm, edema, pedal pulses, color, temp, lung sounds, O2 sat, pain, bowel motility, urine, continence weight, appetite, nutritional and fluid intake, ht, wt, skin integrity, glucose, all things wound related, their medications including reconciliation, compliance and understanding, functional status, home environment, support, recent hx, knowledge disease mgmt, resources..

Is all of the above what you would cover for revisits or just SOC?

[Libby1987]

Is all of the above what you would cover for revisits or just SOC?

That's what I would cover at SOC, then develop and follow a focused POC with a wide angled lens at revisits.

[michelleRn01]

Hi I'm new to HH and I was curious about the same. Do you do a detailed skin check on soc or ask if they have any wounds? I always check feet on DM pts

[michelleRn01]

Also how do you keep track of your patients, what you need to teach/have taught etc? It's overwhelming I go crazy worrying I'm forgetting something.

[Libby1987]

Also how do you keep track of your patients, what you need to teach/have taught etc? It's overwhelming I go crazy worrying I'm forgetting something.

While on paper we used our paper care plan and checked off instructions as they were given/achieved, on EMR I kept a single binder with a flow sheet for each patient (A-Z tabs) and penciled in the teaching plan topics and lined through as they were completed. Also wrote in frequency, MD appts, tasks such as staple removal/labs etc. I'm not sure how people who grew up in EMR keep track but that's how I did it having transitioned from years on paper to EMR.

[toomuchbaloney]

Hi I'm new to HH and I was curious about the same. Do you do a detailed skin check on soc or ask if they have any wounds? I always check feet on DM pts

I feel that it is good practice to complete a full skin assessment at SOC.