15 Questions
Who notifies the nurse that the client is ready for assessment?
Therapist
Where do the nurse and the client go to start assessments?
Triage
Where should the nurse enter medication and allergy information?
Nurse Assessment to access Rcopia
How should medications be written on medicine bottles?
Only use generic names
In what situation should AIMS Dyskinesia be assessed?
If client is experiencing psychosis
When is the admission type changed from Outpatient to URC?
When the client is discharged to inpatient
Which tab should you choose in the URC drop down to access the Client Data Center?
Admission
Where can you find the Provider Information form?
In the 2nd drawer of the nurse’s desk
What should you do if the client's admission type is not switched for a higher level of care?
Have the Life Skills Coach make the change
Where should you click to access Microsoft Teams?
On the 9 dots icon in the top left of the screen
What should you do if there is a shift change while with a client?
Provide data specialist with client packet
Where should the client's personal belongings be given to?
Guardian
What should be done with the paper form used for searching the client?
Put it in client chart
Where can you find the Admit/Discharge medication form?
In the file folder drawer at the nurse desk
What should be done if there is a shift change while with a client?
Complete a Progress Note
Study Notes
Nurse Workflow
- Nurse is notified by the Therapist that the client is ready for Nurse Assessment
- Nurse and client go to Triage to start assessments
- GoHealth Admission Order includes Physician's Medication Orders with:
- Medication name
- Dosage
- Reason for taking
Nurse Assessment
- In Intake Comments, the nurse provides a brief nursing assessment, including:
- Client's age and ability to answer questions
- Vital signs (VS) and whether they are within normal limits (WNL)
- Lung sounds and heart rate
- Skin issues (scars, cuts, etc.)
- Client's appearance and demeanor
Medication and Allergies
- Medications and allergies are entered into Rcopia (if needed)
- Nurse accesses Rcopia through the Medical tab and Nurses Assessment
- Specific details are required, including:
- Brand name or generic name written on the medicine bottle
- No abbreviations
AIMS Dyskinesia
- Only completed if the client is experiencing psychosis or has medications with side effects related to Tardive Dyskinesia
Client Admission Type
- Admission type is changed from Outpatient to URC if the client is going to be discharged to inpatient
- Clients discharged to higher level of care need to see the Provider
- Clients discharged to lower level of care may see the Provider if requested by the client or school
- Otherwise, clients discharged to lower level of care do not need to see the Provider
- The Nurse and Life Skills Coach contact the on-call Doctor/Med.Provider for assessment
- The chart is turned green if the chart has been moved from outpatient to URC (inpatient/residential)
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