On Call
What is the procedure for when you need shift coverage? *Office hours, and outside of office hours*
During office hours CALL your supervisor. Outside of office hours CALL 1st On Call (at least 2 hours before your shift.)
If you need help finding coverage, we can provide you a list of people to call. You are responsible for finding coverage for your own shift.
What is the proper way to assist Alex when walking?
Alex must have staff walking with him at all times due to his drop seizures. He is mobile, and should use proper handling skills with an open palm under his arm
When erroring out a mistake on legal documents like DSLs, what are the 4 things you need to add?
A line through the mistake, and the word “error”, legibly along with your initial and the date
*Remember your initials must be consistent on all documentation
Chewan is ready for bed. Staff asks him if he is going to get undressed. He does not respond. Staff says, “Chewan, let’s take your shirt off,” and staff partly pulls his shirt up, hand-over-hand. Chewan finishes the job and removes it.
Which prompt was Chewan’s shirt program ran at?
Partial Physical
You are moving Robin from her chair to her bed using her Hoyer. She is upright and has her seat belt and chest strap on. What is the first thing you do before starting the transfer?
Tell her you are going to transfer her, Tip her chair back! Gravity is your friend! Then unbuckle her.
Who do you call Monday through Friday 8a-4p for concerns?
Your personal supervisor and/or that specific house's supervisor.
Jasper is cycling through many behaviors. He has found several cups and has been redirected from throwing them over the fence. He is also showing signs of frustration, by groaning and slapping his forehead. He seems stressed and unable to relax. What 3 things would you do as staff to help him?
Keep him safe and try to keep him away from any triggers.
Offer an option from his calming list like a walk, van ride, or snack etc.
Assist Jasper with his anxiety prn, as a last resort.
How do you sign for a PRN in the MARS?
Initial PRN,(sign the bottom if you haven't) turn to the back. Add the medication name and dosage. State the reasoning for giving the PRN. Add initial, date,and time given.
Add results later in the shift (with date and time). Inform on coming staff if they need to add results if this occurs after your shift; however, results can be documented in as soon as 15 mins.
*Non-med passing staff may ONLY add the results to the MARs.*
Ray states he is hungry and wants to makes dinner. He then turns to leave the kitchen and says "Come get me when done". You reply with "Ray can you help me gather the ingredients and preheat the stove?" Ray gathers ingredients and you walk him through the steps of cooking his meal.
What prompt was Ray's meal program ran at?
Indirect Verbal
You are moving Tom in his sit to stand from his chair to the recliner. He is positioned properly in the sling and is standing solidly, with his calf strap on as well. You push him over his recliner, and he is now ready to be lowered. What is the next step?
Put on his brakes! The sit to stand could move the wrong way if not secured causing injury
What if 1st On Call isn't able to answer your call, what is the proper protocol?
Wait 5 minutes and try again. If you have made 2 phone calls escalate the call to 2nd On Call, 3rd On Call etc.
Dylan is upset. He is clearly wet and needing to be changed, but he does not want to stop watching his TV. Dylan is yelling and thrashing on the floor. How would you best support Dylan?
Keep Dylan safe. Try to keep him from hurting himself on anything jagged, by utilizing pillows/safety equipment.
Explain to Dylan that you need to change him so he is clean but allow him a minute to cool down and finish whatever he is watching.
Try again in 15 mins after he is calm.
How often do you need to check incontinent participants? Where is this documented?
Every 2 hours.
It is documented in the tracking log section of their binders
BMs are in tracking and found in THERAP under Intake/Elimination
Staff is assisting Rick with his medication. After Rick pops the bubble and helps push the meds out onto the med tray, he points at his Baclofen.
What prompt was Rick’s medication program ran at? How often should Rick's medication program be ran?
Independent
4x (EACH time he takes his meds)
What are the different colored loops on slings for?
Creating a seated or laying position.
Who do you call in regards to an emergency, after you have made the call to 911?
Contact 4th On Call after addressing the emergency and they will contact Administrator.
Matthew is very agitated after dinner. He is irritable at most comments given and doesn’t seem like he feels very well. You check his Dexcom and see it is still reading high, and he has already had his insulin. How do you support Matthew?
Try to find a way to get Matthew to do some exercise. Play some Just Dance on the Wii or start playing some fun music.
Encourage Matthew to drink water.
Be patient with Matthew, and validate his perspective/feelings.
When participants (like Megan) check out with anyone other than CIL employees or themself, what needs to be documented?
Who they went with, what time they left, the date, staff initials and participant signature.
*Don’t forget to sign them in when they come back home!*
Caleb is very upset and showing signs of anxiety while in his chair. What are the items on his comfort list?
Checking to see if he is wet, having a snack/drink, listening to country music, watching his favorite shows, laying him down for a nap, repositioning him in his chair, or offering a PRN for pain (last resort).
Eric is about to be transferred from his wheelchair to his shower chair. He is wearing just his undies.
Is he ready for a safe transfer?
No, he needs his braces and shoes on for support.
*Any participant should be wearing all adaptive equipment during transfers, no matter how quick the transfer!*
You come on shift and notice that the previous staff did not take out the trash from their shift. This has happened multiple times and you’re growing frustrated. How should this be addressed?
Address with staff first, then if reoccurring you should report via SCOMM to the house supervisor, and your supervisor.
Doris has had an emotional morning. She is constantly asking when she is able to visit her mother in heaven. She also seems obsessive about painting the house the color jade and will not take redirection. How would you support Doris?
Validate her emotions but limit discussion as much as possible. Remain positive with answers. Remind her to be safe and to take deep breaths. Safety, rules and right and wrong help deescalate Doris.
Keep some distance between yourself, her and Kathleen for safety.
See if Doris can have her PRN if she shows enough signs of anxiety.
You are the staff working on shift when you see in the tracking that this participant has NOT had a BM in 3 days. What protocol needs to be followed?
Report to thread and help assist with constipation PRN, like milk of magnesia (Check the MARs for which PRN to give)
What does the abbreviation SODAS stand for?
S - Situation
O - Options
D - Disadvantages
A - Advantages
S - Solutions
How should a participant be positioned in a full body sling?
The participant’s head should be positioned at the top of the sling, as high as comfortable to allow them to be comfortably moved.
This also allows for the majority of the sling to be used to support their lower half, with the bottom edge resting under the back of their knees.