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Clinical Practice Standards

The standards in this manual are designed to be used as ␣guidelines.␣ They are a reference for good practice for home health care professionals developing plans of care, policies and procedures. They are designed solely as guidelines and are not intended to substitute for sound clinical judgment.


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Standards of Care Emergency Preparedness in Home Care
Developed By Visiting Nurse Association of Boston Through a Grant From Boston Public Health Commission 2006


Patients are leveled on a 1–3 scale. Patients who are rated as 1 are to be checked on ASAP in the event of a disaster. Persons rated as a 2 are to be checked on within 24 – 48 hours. Persons rated as a 3 are to be checked on within 72 hours. Support staff may perform initial call to Level 3 patients. These standards are at a minimum. The clinician determines level of need on admission and re-evaluates at recertification or if needed before recertification.
Patient is level 1 if staff needs to make home visit as soon as possible. All level one patients will have updated medication sheet in the home on top of the refrigerator.
a. Is bed/chair bound and not able to get food or fluids b. Has equipment that cannot be interrupted. c. Cannot manage care of critical meds.
Patient is level 2 and needs second priority in the event of a disaster if any of the following are checked: Patient needs visit within 24-48 hours. a. Patient and/or caregiver confused. b. Needs medication/administration or medication management. c. Requires assistance with personal care due to incontinence and limited mobility.
d. Wound described as having copious drainage or a new surgical wound.
If any of these items are checked, patient is level 3 and needs to call for confirmation of safety and uninterrupted care. Patient needs visit within
three to four days.
a. Has family or significant others that are able to tend to needs. b. Wound described as having small to moderate drainage. c. Patient is alert, oriented, responsible and reliable. d. Independent self-administration of meds.
Those who are rated # 3 are counseled on what to do in an emergency and have them inform their family or caregiver of their personal disaster plan. All patients need an emergency contact with a phone number listed.
Extended Hours Needs – In the event patients call on extended hours and have the following needs, please identify what is applicable.
Balloon size
RETENTION Yes No Plan for replacement
___G-TUBE    ___ J-TUBE    _____Other Plan for replacement
Section I2: Emergency Preparedness Appendices    Page 2 of 13
DNR: Pronouncement    Yes    No
Funeral Home Name_______________________________
Telephone Number _______________________ ESSENTIAL    HHA HOURS – usually evening, night or day care preparation
plans for replacement if HHA is out. OTHER:    Special consideration if patient calls after 9 PM.

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