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. However, 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. At times that he is mobile he should have staff within 5 ft (roughly arms length).
*In the community, or in the home if hes deciding to run off; staff can place their arm in his and with an open palm, use it to help guide/slow Alex down.*
When erroring out a mistake on legal documents like DSLs, what are the 3 things you need to add?
A straight line through the mistake (use an arrow to show where the error is)
the word “error”, legibly
Your initial and the date (day/month/year)
*Remember your initials must be consistent on all documentation
Chewan is getting ready for bed. Staff asks him if he is going to take his shirt off. He doesn't respond.
Staff says, “Chewan, let me help you 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 Rick from his chair to his bed using his Hoyer. He is upright and has his seatbelt on still.
After asking for Rick's permission to transfer him, What is the first thing you do before starting?
Tip his chair back! Gravity is your friend!
Unbuckle him once he is secured to the Hoyer.
Who do you call Monday through Friday 8a-4p for concerns? *Non-life threatening, general questions*
Your personal supervisor and/or that specific house's supervisor.
Jasper is cycling through many behaviors. He has found several items and has been redirected from throwing them over the fence. He is also showing signs of frustration, by yelling and slapping his forehead.
What 3 things would you do as staff to help him?
Keep him safe and try to keep him away from any triggers (while maintaining your own safety as well).
Offer an option from his calming list like a walk (to distance himself from the trigger), offering a snack (maybe Jasper is hungry) or inviting him to calm down under his weighted blanket and watch his favorite show.
Assist Jasper with his anxiety prn if necessary. Call On Call/ask Jasper Notifications thread for advice if you are unsure.
How do you sign for a PRN in the MARS?
Initial PRN, (sign the bottom if you haven't) and 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 for dinner.
He then turns to leave the kitchen and says "Come get me when its done."
You reply, "Ray, can you help me gather the ingredients and preheat the stove?"
Ray gathers the ingredients and you walk him through the steps of cooking his meal.
What prompt was Ray's meal program ran at?
*The program involves encouraging Ray to stay in the kitchen while meals are cooking, not that he cooks his own meal*
Indirect Verbal
You are moving Tom in his sit to stand from his wheelchair to the recliner.
He is positioned properly in the sling and is standing upright with the strap on his calves as well. You push him over to his recliner.
After asking for Tom's permission to lower him, what do you do next?
Put on his brakes! The sit to stand could move the wrong way if not secured, causing injury.
What if 1st On Call doesn't 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.
Sometimes 1st On Call is working the floor and may not be able to immediately assist.
Dylan is upset. He is clearly wet and needing to be changed, but he does not want to stop watching his music on 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, or however more frequent is necessary.
It is documented in the tracking log section of their binders, and found in THERAP under Intake/Elimination
Staff is assisting Rick with his meds. 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? *Rick's program involves him identifying this specific medication*
Independent
What are the different colored loops on full body slings for?
*Visual example*
Creating a seated or laying position.
*Each participant has their own preference/needs that require different positioning using the loops*
In an emergency situation (especially if you called 911) who else do you have to call?
Contact 4th On Call (after addressing the emergency first/appropriately) and they will contact Administrator.
Matthew is very agitated after dinner. He is irritable at most things you say and doesn’t seem like he feels very well. You check his Dexcom and see it is still reading high, even though 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 throughout the behavior.
*Check/report if you think he is getting sick*
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).
Chewan is about to be transferred from his wheelchair to his shower chair. He is wearing just his underwear and his half-sling.
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, unless they have a preference*
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, if you feel comfortable. Then, if the issue is reoccurring, you should report via SCOMM to the house supervisor, and your supervisor. You can also report to the house notifications thread as well.
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 any redirection from these subjects. How would you support Doris?
Validate her emotions but limit discussion as much as possible on the topic. Remain positive with answers.
Remind her to be safe and to take deep breaths.
See if Doris needs her PRN by reading her protocol in her book. *Call On Call/message CV Notification thread if unsure)
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 should you do?
Report to thread and help assist with constipation PRN, like milk of magnesia (Check the MARs for which PRN to give)
*Don't forget to check both the paper tracking in the books AND Therap!*
What does the abbreviation SODAS stand for?
S - Situation
O - Options
D - Disadvantages
A - Advantages *Try to lead with these*
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, with the top aligned with their shoulders.
This 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, offering more security.