A role-playing inservice
Total Home Health Care of Lubbock, TX, created eight different case scenarios in which managers portrayed patients, and the field nurses documented their care.
This is one of the patient roles devised by the agency’s staff:
Imso Sickley
The patient is an 89-year-old female with a diagnosis of Coumadin therapy, rheumatoid arthritis, fractured humerus, hypertension, and osteoarthritis. She is alert and oriented but occasionally forgetful. The patient is able to transfer from the bed to the chair using a walker or cane but has limited range of motion (ROM) to the upper extremities and is fall prone. Gait is weak and unsteady. Patient is not following the prescribed diet and eating too many foods high in vitamin K. The patient is incontinent and the peri area is red and irritated. The patient’s home is cluttered with throw rugs all over the floors. Nurse is notified by the aide that patient’s blood pressure is elevated.
Information for patient to volunteer to nurse:
1. Fall prone.
2. Occasionally forgetful.
3. House cluttered with throw rugs.
Information for patient to give out only if asked:
1. Transfers using walker or cane.
2. Weak, unsteady gait.
3. Not following prescribed diet of low vitamin K.
4. Limited ROM to upper extremities.
5. Incontinent with red, irritated peri area.
6. Diet includes frequent foods high in vitamin K.
Acting tips:
1. Arm in cast or sling.
2. Act overwhelmed with your diagnoses, especially hypertension, and all attempts to instruct.
3. You don’t have a headache, blurry vision, or nausea.
4. You are having more trouble making it to the bathroom on time.
5. You are willing to have a bedside commode delivered, if the nurse asks and the doctor orders it.
Expected documentation:
1. Communication from aide to nurse reporting HTN.
2. Nurse’s note covering visit.
3. Communication note showing notification to doctor of change in patient’s condition.
4. Orders covering PRN visit and any instructions received from doctor. (i.e. med changes, increase in SNV, increase in HCA visits, BSC, venipuncture for PT).
5. New aide assignment showing increase in visit frequency, if applicable.
6. Communication note showing any other conversations.
Starting with January’s issue, Homecare Education Management will provide you with a regular monthly listing of days, weeks, and months to come that have been designated for disease awareness or to honor health care professionals. For instance, January 1998 is National Glaucoma Awareness Month.
It is our intent to help you plan special events at your agency, including inservices, or update your newsletter and bulletin board.
These recognition days might help you with planning special events, newsletters, inservices, and bulletin boards.
The calendar listing is provided courtesy of the Society for Healthcare Strategy and Market Development of the American Hospital Associa-tion. The organization, located at 1 North Franklin, 31st Floor, Chicago, IL 60606, sells an 89-page "Health Observances & Recognition Days" calendar (Catalog No. C-166858) for $15 for AHA members and $20 for nonmembers. Call (800) 242-2626 for more information.
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