Documentation
What do you document daily? Why is this important?
Goals are important for funding
What should you bring when taking someone to the ER or meeting them at the hospital?
Agency vehicle
Copy of Mar and Ready to Go form
Red ER Folder
Any adaptive equipment needed
How do you communicate between houses, programs, and departments?
E-Communication Log
What is the PEX Card used for?
- CFS services
- Residential Food and Household Expenses
What should you include in a progress note?
Factual information, (who, what, where, when, why). Include name and title at the end.
Do not put opinions!
What should you do when at the hospital with a person supported?
take case notes:
tell nursing about diets/ambulation
fill out red er packet
make sure you get the doctors consult.
Before leaving call On-Call to verify you have all information.
When should you check the E-log?
On every shift, (if you have time at the very beginning of your shift)
What is needed every time you use the PEX card
- a tax exempt form
- a receipt with total amount paid and proof no tax was paid.
How long do you have to document a goal? What is a good goal?
48 hours but should be done before the end of your shift. Goals should also be measurable.
What do you do when you return home from the ER or hospital?
Make sure all paperwork is filled out and signed.
Scan all paperwork to nursing.
Update Elog/progress notes/incident reports
Update nursing line/station MD
Update Admin on-call
Create Med Consult
Make sure any prescriptions are filled and you have approval to pass them and fill out pink med card.
Where do you find dining information?
All about me binder- IPOP
My25 Binder- located in all kitchens
R; Drive
What if you need more money on the PEX card?
Fill out an additional funds request form 1-2 weeks before
When would you put in a progress note?
Something medical happens, something occurs that is in a behavior plan, something is out of the ordinary, a person refuses something, medication changes
When should you utilize 911?
When there is a medical emergency.
When you need to Police
When there is a fire.
What is in the Telephone Guidelines?
On call for Supports and Services, Nursing, CSS, and Maintenance.
In the event something happens this is the guide to who to call and what to do.
What are 3 things to remember when doing CFS
* Stay within budget for your service
* Make sure you know all plans and ask questions
* Return all forms to their correct place
* Make sure you have visual contact with whomever you are dropping a person off to. (Unless truly independent).
* Be mindful of the spaces you use and leave areas better than you found them