CLINICAL MANAGERS



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DATE: __________________ Status: Full Time Part Time per Visit

Employee Name: __________________________________ Employee #: __________________________ Position: _________________________

(Please Print)

Manager:________________________________________________ Preceptor:______________________________________________________

| | |Date & InitialS|

|GOALS |COMMENTS | |

|1. Personal Safety & team flow | | |

|Tour of the office | | |

|Location of office Fire Extinguishers and Fire Alarms | | |

|Time cards (completes them | | |

|timely and correctly) | | |

|Calling in Sick (is able to reassign and redirect patients for the day) | | |

|Demonstrates knowledge of Agency Inclement Weather/Emergency Plan and how it| | |

|impacts our leveling and assigning visits | | |

|Requesting time off (usually 2 weeks ahead of time) | | |

|HIPAA (keeps patient information confidential) | | |

|Aware of setting limits with patients and the option of patient contracts – | | |

|Boundary Crossings. Is wary about giving out personal information and does | | |

|NOT give out cell phone #. | | |

|Street Smarts | | |

|EAP resource phone number | | |

|Other | | |

| | | |

|2. INTRODUCTIONS | | |

| Each team member | | |

| Team coordinator | | |

| Community Resource Specialist for the team | | |

| HHA Placement Coordinator | | |

| Receptionist | | |

| Director | | |

| Utilization Review Team | | |

| Social Worker | | |

| Telehealth | | |

| Psychiatric Nurse Specialist | | |

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|3. Communication | | |

| Accesses voicemail on a regular basis- both shore tel and cell phone | | |

| Accesses email at least daily | | |

| Checks mailbox regularly and keeps up to date | | |

| Use of the 6501 and 7501 lines to find colleagues without interfering | | |

|with the receptionist | | |

| | | |

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|4. CLINICALNURSING SKILLS | | |

|VITAL SIGNS | | |

|Assess all 5 vital signs each visit. Assesses pain using the 0-10 | | |

|scale and documents accordingly | | |

|Assesses temperature using clean technique | | |

|Assesses cardiac rhythm and rate (apical and radial) | | |

|Takes BP on various sized arms | | |

|Takes orthostatic vital sounds ( both AP + BP) | | |

|Teaches patient coping mechanisms for orthostatic changes and evaluates and | | |

|documents patients’ response to that teaching | | |

|Assesses respiration rate | | |

|Assesses lung sounds and describes + documents findings accurately | | |

|Assess pain using the 0-10 scale every visit and documents accordingly | | |

|Determines pain intensifiers and nullifiers and documents accordingly | | |

|Follows up with PCP for pain 7 or greater and documents plan to mitigate and | | |

|patient response | | |

|Assess dyspnea using VNAB dyspnea scale and documents correctly. | | |

|Implements dyspnea practice expectations if dyspnea rated at 1 or above | | |

|Demonstrates understanding of VNAB DNR policy | | |

|Demonstrates knowledge of signs and symptoms of elder abuse/abuse of disabled | | |

|person and mandated reporter expectations | | |

| | | |

|SYSTEM ASSESSMENT | | |

|Mental Status assessment and documentation: to determine patient’s orientation| | |

|to person, place and time as well as patient’s safety at home | | |

|Documents s/sx depression and interventions to mitigate | | |

|GI system assessment: bowel sounds, last BM, frequency of BMs, medication for| | |

|bowel care | | |

|Pulmonary - cardiac assessment including: diet, stress, medications, apical / | | |

|BP orthostatic assessment, dyspnea assessment, etc. | | |

|Assesses LE edema using objective findings pitting vs. non-pitting and | | |

|measures and documents edema per agency policy | | |

| | | |

|GENERIC NURSING SKILLS | | |

|Able to use the PT / INR machine correctly | | |

|Performs phlebotomy safely | | |

|Performs female catheterization | | |

|Performs male catheterization | | |

|Performs suprapubic tube insertion and care | | |

|Correctly uses the pulse oximeter (has MD orders, describes the range of | | |

|normal and treatment for abnormal results.) | | |

|Demonstrates pleurex cath drainage and care per P+P | | |

|Demonstrates wound vac per P+P | | |

|DIABETES | | |

|Consults with MD to establish target ranges and alarm values | | |

|Teaches patient and / or family the target and alarm values and how to respond| | |

|to those findings. | | |

|Performs blood glucose check with a glucometer and teaches patient how to log | | |

|results and / or use the memory component of the glucometer | | |

|Teaches patient the implications of the glucometer responses, what they | | |

|indicate, how to treat them and documents patient’s response to that teaching.| | |

|Performs monofilament testing correctly and documents and refers according to | | |

|patient’s eligibility for resources | | |

|Demonstrates knowledge of sick day management | | |

|Able to teach foot care to patients and documents the response to the teaching| | |

|Demonstrates knowledge of the Rule of 15: When and how to use it. Documents | | |

|patient’s response to the teaching. | | |

|Demonstrates knowledge of signs and symptoms of hyper / hypo – glycemia while | | |

|teaching patients what actions to take if symptoms are present | | |

|Teaches and documents logging and pattern recognition | | |

|MEDICATIONS | | |

|Prepares and administers injections: | | |

|IM | | |

|SQ | | |

|Administration of eye drops. | | |

|Application of trans-dermal patches. (Pain nullifiers must be placed on | | |

|muscle / fatty areas). | | |

|Medication boxes | | |

|Able to prefill correctly | | |

|Reorders or has patient do so to allow for uninterrupted prefill schedule | | |

|Knowledgeable re pharmacy prefill programs and qualifications for such | | |

|Insulin Syringes | | |

|Prefills correctly( NO PREFILLING OF LANTUS, HUMALOG OR NOVOLOG PER POLICY DO | | |

|NOT MIX LANTUS OR LEVEMIR WITH ANOTHER INSULIN) | | |

|Reorders insulin, syringes and any other DM equipment or has patient do so to | | |

|allow for uninterrupted prefill schedule | | |

|Performs medication review, reconciliation and medication teaching as | | |

|indicated: | | |

|Making sure that patient is taking the right dose, | | |

|The right medication, | | |

|At the right frequency AND | | |

|Has an MD order for each and every prescription, OTC and herbal medication. | | |

|Communicates with primary nurse about new or changed medications so med list | | |

|is current | | |

|Teaches about new and/or changed medications as indicated | | |

|Has patient verbalize understanding of the medication teaching | | |

|Demonstrates correct use of inhalers and is able to teach patient proper | | |

|technique. Documents patients’ response to that teaching. | | |

|Demonstrates correct use of nebulizers and is able to teach patient proper | | |

|technique. Documents patients’ response to that teaching. | | |

|Teaches safe use of oxygen. (Patient is not to adjust settings, smoke in the | | |

|presence of the oxygen or use petroleum based lubricants near tubing.) | | |

| | | |

|WOUNDS | | |

|Demonstrates ability to identify | | |

| Surgical wound and the healing phases | | |

| Pressure wounds by correctly determining risk or stage and status | | |

|(discussed during classroom orientation) in the field | | |

| Venous stasis ulcers and the healing phases | | |

| Diabetic ulcers | | |

| Arterial Ulcers | | |

|Able to describe wounds using: measurements, edges, wound base, drainage, | | |

|odor, healing phase, color of drainage, etc. Follows VNAB policy for when and| | |

|how to measure wounds | | |

|Demonstrates ability to use Braden Scale | | |

|WOUND CARE | | |

|Application of Una Boot Dressing | | |

|Application of 4-ply compression dressing | | |

|Performs Moist Wound Healing Dressing | | |

|Performs Wound Packing | | |

|Performs Wound VAC application | | |

| | | |

|5. DOCUMENTATION | | |

|a. Revisits | | |

|Reviews 485 goals, problems / Care plans, interventions, targets / Alarm | | |

|parameters before each revisit. | | |

|Documents objective assessment findings | | |

|Documents missed visits appropriately using the OM note section and alerting | | |

|MD. (A missed visit is when a visit was planned but the patient changed the | | |

|plan causing the clinician’s visits to fall short out of the range indicated | | |

|in the orders) | | |

|Describes which treatments and procedures were completed: dressing changes, | | |

|catheter insertions, etc. | | |

|Has documentation indicating what was taught and the patients’ response to the| | |

|teaching. Describes how the patient’s response was evaluated: (by a return | | |

|demonstration, a return teaching, etc.) | | |

|Evaluates the patient’s progress towards goals | | |

|Plan for next visit that is clear and realistic letting the next clinician | | |

|know how to carry on in the case. | | |

|Has a goal and an expectation for each visit | | |

|Maintains patient visits schedules as ordered | | |

|Prepares patient and family for discharge | | |

|Orders supplies for patients | | |

|Clinical summary includes all pertinent findings | | |

| | | |

|b. Discharges | | |

|Notifies patients and primary nurse of pending discharge at least two visit | | |

|ahead of time and fills out appropriate HBAN | | |

|Does discharge documentation in a timely manner | | |

|6. HHA Department(lpnS nOT rESPONSIBLE FOR THIS CONTENT) | | |

|Describes the role of the HHA | | |

|Demonstrates knowledge of how HHA is integrated into treatment plan. | | |

|Submits request for HHA service, or verbalizes how to do so | | |

|Completes/updates HHA Assignment sheet | | |

|Supervises HHA as per agency policy | | |

|7. RESOURCES and AFFILIATED COMPANIES | | |

|Demonstrates knowledge of Hospice Program and Private care | | |

|Demonstrates how to make an intra-agency referral to MSW, CRS, Psych CNS, PT, | | |

|OT, etc. | | |

|8. Quality Improvement | | |

|Demonstrates knowledge of Incident Report Completion (when + how) (patient + | | |

|personal) | | |

|Demonstrated knowledge of Corporate Compliance Officer and obligation to | | |

|report any wrong-doings | | |

|Demonstrates knowledge of regulatory agencies including CMS, DPH | | |

| Reports any patient falls immediately to primary nurse and completes a fall | | |

|assessment when patient falls and incident report when indicated | | |

| | | |

|9. ADMISSION PROCESS | | |

|(LPNs not responsible admissions) | | |

|Demonstrates knowledge of how to receive assignment | | |

|Demonstrates knowledge of AACE and Skill with OASIS walk/assessment | | |

|Demonstrates skill with medication review and reconcilliation | | |

|Demonstrates skill in developing initial plan of care | | |

|Demonstrates OASIS accuracy | | |

|Demonstrates ability to call when in need of help | | |

|Demonstrates ability to maintain productivity | | |

|Demonstrates use SBAR when calling MD | | |

|Demonstrates when and what to report to UM | | |

|Demonstrates when and how to obtain Prior Authorization | | |

|Demonstrates what to do if patient refuses care, is not found, is receiving | | |

|care from another HHA | | |

|Demonstrates what and when to report off to the Primary Nurse | | |

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RN/LPN ORIENTATION CHECKLIST

LPN Not Responsible for OASIS/HHA Content

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