Teaching material for Care Kits?

[joyprn]

Wondering if any of you provide teaching material with the Care Kits to home hospice patients? I am looking at ways we can standardize teaching med use to families/ caregivers and providing written material to leave with the care kit.

Thoughts? Suggestions?

Thanks!

[SuesquatchRN, BSN, RN]

What's a care kit?

[joyprn]

A care kit (or Comfort Kit or E-kit) is a few medications sent to home hospice pts at admission in anticipation of sxs such as pain, shortness of breath, anxiety, etc. Ours has morphine sulfate, lorazepam, haloperidol, atropine gtts, and prochlorperazine, acetaminophen, bisacodyl suppositories. We verbally explain the use, have families keep in the fridge to use prn. We ask them to call before using so we can direct them to med based on sxs.

[SuesquatchRN, BSN, RN]

Oh, we call that the comfort kit.

[curiousauntie]

We do basic teaching when the comfort kit is placed in the home, with the first instruction to not open it unless the nurse tells them to. Once we need to open it, I do a note book, with marked sections for each med we are using for the family to write the date, time and response to the medication, with the heading of each section the directions for how to use it (morphine, 0.25ml every 2-4 hours for pain, etc.) Standard printed material would be kind of useless as the doses and frequencies are often different from patient to patient and situation to situation. The notebook helps the nurse know exactly how much medication is being used and gives the family or patient a feeling of being more in control of the situation. It has worked well so far for me, too.

[joyprn]

Thanks curiousauntie! We also do basic teaching at first, go through the meds, how to draw up a syringe, etc. I like the idea of a notebook page for each med when the med is started and we do something similar with a MAR in the home. What I am looking for is a written description of sxs and what med we might recommend so families have something in writing to reinforce verbal teaching. We are using more teaching sheets about other aspects of pt care and have had good feedback from caregivers, so thinking this might be a help in feeling confident re med administration. I appreciate your input- thanks for taking the time to reply!

[poorelinda-LPN]

Hi Joyprn, I actually typed up a form to reflect what is in the kit and the uses for the med and the instructions of each med. I typed my form in a Word document format and added a box in the middle with the above info.

Hope this helps.

[dshebest]

We have printed sheet that lists all meds in the comfort pak, uses, dose, frequency. We give to all home pts. It's simple and to the point. We've gotten good feedback on it.

[TammyG]

We stopped the care kits years ago. Someone decided they weren't consistent with regulatory authority, or something.

[curiousauntie]

tammyG. That's a scary thought. I can't count the number of times that care kit was a difference between an easy and a horrible death. As a full time on-call nurse, the meds in there; morphine, ativan. haldol and compazine are frequently needed when there is no way to get them in a timely manner. Like 2am with a pt who has just started actively dying and a family with their phone ready to call 911 if I don't get the symptoms managed NOW! That kit is often the difference between a comfortable death at home and a torturous trip to a hospital.

[NC29mom, ASN, LPN, RN]

We don't use "comfort kit boxes" either. However, we get comfort meds in the home soon after admit (pt per pt basis) and ask cg's to store until needed. Not every pt needs comfort meds so I completely understand why our company doesn't use. They are a waste to put in every home. As a nurse I know what generally to look for to indicate it's time to get meds in home. In my many years as a hospice nurse, I've rarely been caught in a predicament in which I was without meds to manage a symptom. Now, that's not saying I haven't used phenergan or some other med to manage something other than nausea.....this is hospice after all. We put o2/suction in almost every home for same reason. After yrs of experience you learn to always plan ahead and be resourceful with what you have......