ScenarioPlusby Waiver Academy
‹ Skilled Care

Pocket guide · Home health

Skilled Care

Skilled hands, careful notes.

  1. Check the current ordersBefore each visit, read the patient's current orders and care plan. Orders change, and care must follow what is ordered now, not what you remember. Ask the supervising nurse or physician if anything is unclear. Episode 1: Read the Orders
  2. Check every medicineMedication reconciliation means comparing every medicine the patient actually takes, including over-the-counter and borrowed ones, against their list and orders. Report differences to the physician and record what you found and did. Episode 2: Every Pill
  3. Measure, don't guessDescribe wounds with measurements and clear findings, following your agency's wound care policy. Words like "healing" don't show change over time. Accurate records help the team spot problems early and report them to the physician. Episode 3: Measure the Wound
  4. Stop germs at the doorFollow your agency's infection control steps at every visit: keep the nursing bag on a clean barrier on a hard surface, never the floor, and clean your hands before and after patient contact. Germs travel from home to home. Episode 4: Clean Hands, Clean Bag
  5. Respect a refusalPatients have the right to refuse care. Stay calm, ask why, explain what could happen, and respect their choice. Document the refusal and the reason, and tell the physician so the plan can be adjusted. Episode 5: Not Today
  6. Act before a fallSmall changes, like grabbing furniture or new dizziness, can come before a fall. Ask about them, check what your orders and policy call for, tell the physician, and set up simple safety steps right away. Episode 6: Before He Falls
  7. Write each note freshEvery visit note must show what you actually assessed and did that day. Copying old notes forward can record things that didn't happen, hides real changes, and can't support billing for the visit. Episode 7: Copied Forward
  8. Stay in your roleAides follow their own care plan and do only the tasks they're trained and allowed to do under your state's rules. When a patient asks for something outside that role, explain kindly and call the nurse right away. Episode 8: The Aide's Visit
  9. Report changes right awayA sudden change in condition, like new confusion, needs to be reported to the physician promptly, following your agency's policy and the orders. Share clear findings and document the call, the response and what you did next. Episode 9: Something's Changed
  10. Missed means missedIf a visit wasn't made, record it as missed, never as done, and never bill for it. Tell your supervisor right away so the patient is covered and the physician is told if your policy requires it. Episode 10: Visit Not Made