name: Raise container 12 to 20 inches (30-50 cm) above level of vagina


name: Allow solution to flow while rotating nozzle


name: Withdraw nozzle and assist to sitting position, remaining on bedpan for a few minutes


name: Clean and dry perineum as indicated after medication administration


name: Cleanse all equipment including applicator, after each use


name: Instruct self-administration technique, as appropriate


name: Instruct to take all of medications as prescribed, to ensure effectiveness of treatment


name: Instruct to abstain from sexual intercourse as indicated by medication


name: Instruct to continue taking medications during menstruation


name: Instruct to avoid excessive use of vaginal medications, as leads to irritation of vaginal mucosa


name: Monitor neurological status and vital signs


name: Remove hair over reservoir as per agency protocol


name: Maintain aseptic technique, including wearing of masks to avoid droplet transmission of oropharyngeal flora


name: Prepare scalp with antiseptic scrub, using aqueous chlorhexidine solution or povidone iodine solution and allowing to dry completely before access


name: Pierce reservoir with smaller or thinner needle, in oblique fashion and then aspirate while noting color and opacity of cerebral spinal fluid


name: Evaluate cerebral spinal fluid for blood or cloudy returns before injection of medication


name: Perform independent double check with another qualified licensed health care provider prior to medication administration and when syringe or medication container, rate, or concentration changed


name: Verify safety of intraventricular route and its mixture with preservative-free 0.9% sodium chloride or solutions for chemotherapies (e.g., methotrexate sodium, cytarabine)


name: Inject medication slowly per health care provider order and according to agency protocol, using appropriate size needles with filters


name: Use only medications without preservatives for ventricular reservoirs


name: Ensure availability of naloxone to treat inadvertent overdoses


name: Ensure reservoir never allowed to be empty


name: Ensure strict attention to needle placement to avoid accidental injection into surrounding tissue


name: Consider use of ultrasound to access pump septum, if indicated


name: Observe site for signs of bleeding and CSF leakage


name: Monitor for 2 hours in supine position for any neurological deterioration


name: Maintain peripheral IV access for at least 24 hours due to potential need for naloxone administration for respiratory depression


name: Obtain complete medication history (i.e., examining medication vials or list, communicating with health care providers and pharmacy)


name: Verify medication history with person and family


name: Reconcile medication list for duplicate prescriptions


name: Document current drug name, dosage, frequency, and route on medication list


name: Determine if prescribed medication still indicated and clinically appropriate


name: Consult with other health care professionals to minimize number and frequency of medications needed for therapeutic effect


name: Evaluate risks and benefits of tapering or discontinuing any medication on list


name: Consult published guidelines on appropriateness of medication use (i.e., Beers Criteria for potentially inappropriate medication use in older adults)


name: Prioritize medications to discontinue based on clinical guidelines


name: Follow published evidence-based recommendations to guide medication discontinuation or tapering


name: Share decision-making with other health care providers, person, and family


name: Provide written instructions for medication discontinuation or taper schedule for person and family, as appropriate.


name: Monitor for potential adverse events from medication discontinuation


name: Use standardized tool to elicit all medication information, including prescribed medications, non-prescription medications, and dietary and herbal supplements


name: Determine medications needed and administer according to prescriptive authority or protocol


name: Identify types and amounts of non-prescription medications used


name: Provide information about use of non-prescription medications and how may influence existing condition


name: Determine if using culturally based home health remedies and possible effects on use of non-prescription and prescribed medications


name: Monitor therapeutic effect of medication


name: Monitor for signs and symptoms of medication toxicity or adverse effects


name: Monitor for nontherapeutic medication interactions


name: Review periodically with person and family types and amounts of medications taken


name: Discuss financial concerns related to medication regimen and ability to obtain needed medications


name: Determine ability to self-medicate or need for medication administration assistance


name: Discard old, discontinued, or contraindicated medications


name: Facilitate changes in medication with health care provider, as appropriate


name: Monitor for response to changes in medication regimen


name: Determine knowledge about medication regimen


name: Determine factors that preclude person from taking medications as prescribed


name: Develop strategies to enhance concordance with prescribed medication regimen (i.e., manage side effects of medications, use lower cost generic versions when appropriate, use medication delivery services)


name: Investigate possible financial resources for acquisition of prescribed medications, as appropriate


name: Determine effect of medication use on lifestyle


name: Provide alternatives for timing and modality of self-administered medications to minimize undesired lifestyle effects


name: Assist in making necessary lifestyle adjustments associated with medications, as appropriate


name: Communicate clearly with other health care professionals to incorporate person's priorities and preferences


name: Obtain health care provider order for self-medication, as appropriate


name: Instruct in method of medications administration, as appropriate


name: Instruct in expected action and side effects of medication


name: Provide written and visual information to enhance self-administration of medications, as appropriate


name: Establish protocol for storage, restocking, and monitoring of medications left at bedside for self-medication purposes


name: Review strategies for managing medication regimen


name: Provide list of resources to contact for further information about medication regimen


name: Contact post discharge, as appropriate, to answer questions and discuss concerns associated with medication regime


name: Encourage to have screening tests to determine medication effects, as needed


name: Determine current stage of legalization of medical and recreational cannabis use in state of practice


name: Determine principles of local medical marijuana dispensaries (e.g., how persons qualify, who can obtain cannabis from dispensary)


name: Provide certification for qualifying conditions (e.g., cachexia, chemotherapy induced nausea and vomiting, chronic pain, neuropathies)


name: Instruct on medications to be given, and answer questions appropriately


name: Document dosages and responses in record


name: Monitor for undesirable side effects or toxicities of cannabis (e.g., hallucinations, dry eye, paranoia, decreased blood pressure, impaired attention or memory)


name: Instruct to titrate own dose using principle of "start low, go slow" and monitoring efficacy and adverse effects


name: Instruct to regularly track dose, symptoms, relief, and adverse effects in journal


name: Instruct to store safely, in locked area and out of reach of children, and dispose of properly (i.e., collection receptacle located in pharmacy)


name: Communicate findings of clinical encounter with other health care providers


name: Administer cannabis only in medical marijuana approved programs as registered caregiver


name: Administer FDA-approved synthetic THC drugs (e.g., dronabinol, nabilone) as per facility formulary and policy


name: Determine understanding of medication and method of administration


name: Obtain consent or agreement for self-management


name: Collaborate with treatment team to ensure accurate communication of infusion plan


name: Determine type of pump and necessary steps for programming and use (e.g., continuous or intermittent, basal dose rate adjustment, continuous closed loop glucose monitoring, hybrid closed loop monitoring)


name: Develop medication self-administration plan of care


name: Ensure care measures in place for emergent episodes of health (e.g., hypoglycemia, hyperglycemia)


name: Instruct person, family, and caregivers on plan of care, including blood level monitoring, dose adjustments (e.g., basal, continuous, bolus), and requirements for safe medication administration


name: Review needed medication adjustments with activity changes


name: Review diet changes required with medication administration


name: Instruct person, family, and care providers related to delivery device operations


name: Ensure person, family, and care providers have competency with delivery device operations


name: Identify pump issues with untoward health episodes (e.g., kinked tubes, leaking catheter set, dislodgement of cannula, hematoma at insertion sites, incorrect programming, low battery, empty medication cartridge)


name: Ensure criteria for emergency management of device including possible discontinuation of medication infusion


name: Develop plan for labeling and storage of device when temporary cessation or discontinuation occurs


name: Monitor psychological status, self-care behavior, education, and training before and during use of device


name: Ensure basic physiologic monitoring maintained (e.g., respiratory patterns, blood sugar values, insulin infusion rate, diet, exercise), as indicated by type of medication administered


name: Examine insertion site regularly for redness, pain, signs of infection or signs of lipodystrophy, assuring rotation of site as indicated


name: Assist with adjustments to pump infusion as indicated


name: Assist with adjustments to pump location as indicated (i.e., removal for activities such as bathing, swimming, contact sports)


name: Provide ongoing motivation, education and support as indicated, particularly to school age children and adolescents


name: Ensure access to device manufacturer and contact information


name: Instruct in accessing device data (e.g., dose, infusion time, blood values)


name: Obtain supplies related to brand of pump (e.g., tubing, needles, arm band, batteries)


name: Perform pump maintenance in required time frame


name: Ensure monitoring requirements and best practice assessments consistent with institutional policies


name: Ensure documentation includes device used, medication administered, method of device management, and monitoring requirements per institutional documentation policies


name: Provide nurse contact information for post-discharge issues


name: Instruct to carry identification of device information


name: Review current medications and indications for each medication's use


name: Determine ability to administer medication


name: Identify medications indicated for current problems


name: Compare new medications with current medications to ensure compatibility, potentially inappropriate medications, drug-drug interactions, and drug-disease interactions in persons with comorbidities


name: Prescribe medications according to prescriptive authority and protocol


name: Use electronic prescribing methods, as available


name: Use standardized abbreviations, acronyms, and symbols


name: Verify that all medication orders are written accurately, completely, and with necessary discrimination for intended use


name: Follow recommendations for starting doses of medication (e.g., milligrams per kilogram body weight, body surface area, lowest effective dose)


name: Use appropriate laboratory monitoring of medication effects, as indicated


name: Seek regular input from pharmacist to reduce inappropriate prescribing


name: Consult reliable references as necessary


name: Simplify medication regimen by using once-daily dosing and generic drugs where possible


name: Initiate medications one at a time at lowest dose possible


name: Identify risks and benefits of any new medication prior to prescribing


name: Regularly review medication list to reduce inappropriate prescribing and polypharmacy


name: Instruct about method of drug administration, as appropriate


name: Instruct about rationale for use, expected action and side effects of medication


name: Consider potential adverse drug event as cause of any new symptom


name: Avoid "prescribing cascade" in which medications are started to treat adverse drug event


name: Instruct about how to fill prescription as necessary


name: Encourage to use one pharmacy and inform pharmacist of any medication changes to decrease risk of error


name: Instruct about when to seek additional assistance


name: Verify compliance with medication regime routinely


name: Revisit medication efficacy and continued use as needed for each medication


name: Discontinue medications with reported intolerable side effects, lack of therapeutic effects, or lack of compliance with regime


name: Reconcile medications with changes in condition or with medication changes


name: Use standardized tool to elicit all medication information, including prescribed medications, over-the-counter medications, and dietary and herbal supplements


name: Eliminate distractions and go slowly when reconciling medications


name: Collect list of medications when admitted to health care institution, seen in outpatient setting, or transferred between units or institutions


name: Obtain complete medication history by examining medication vials or list, verifying with person and family, and communicating with health care providers and pharmacy, as needed


name: Compare medication list to indications and medical history to ensure complete and accurate list


name: Compare medications currently taking or should be taking, with newly ordered medications, to address duplication, omissions, interactions, and need to continue current medications


name: Compare initial home medication list, current medication orders, and discharge medication orders to ensure medications appropriately continued, resumed, or discontinued upon discharge


name: Provide with written information about medications to take upon discharge, for each medication


name: Explain importance of managing medication information upon discharge


name: Instruct to maintain updated medication list and reconcile with health care provider at each appointment or hospital admission


name: Instruct to obtain all medications through one pharmacy to decrease risk of error


name: Instruct to take active role in medication management


name: Stimulate memory by repeating last expressed thought, as appropriate


name: Reminisce about past experiences, as appropriate


name: Mutually develop memory training plan (e.g., type of memory training techniques, frequency, length of sessions, length of program)


name: Implement memory techniques (e.g., visual imagery, mnemonic devices, memory games, memory cues, association techniques, making lists)


name: Provide and assist with use of memory training apps, websites, or computer programs


name: Assist in associate-learning tasks (i.e., practice learning and recalling verbal and pictorial information presented)


name: Provide for orientation training (e.g., rehearsing personal information, dates), as appropriate


name: Provide opportunity for concentration (i.e., matching pairs of cards), as appropriate


name: Provide opportunity to use memory for recent events (i.e., question about recent outing)


name: Structure teaching methods according to person's organization of information


name: Refer for neurological testing as appropriate


name: Refer for occupational and activity therapy as appropriate


name: Encourage to participate in group memory training programs, as appropriate


name: Identify and correct errors in orientation, as appropriate


name: Provide descriptions of problematic behavior in objective, non-judgmental, nonpejorative terms, avoiding stigmatizing labels


name: Review initial assessment of mood (e.g., signs, symptoms, personal history)


name: Evaluate for changes in mood on regular basis as treatment progresses


name: Administer self-report questionnaires (e.g., PHQ-9, Hamilton Depression Scale, Geriatric Depression Scale, Beck Depression Inventory, Social Functioning Questionnaire, other depression and functional status scales), as appropriate


name: Determine whether safety risk to self or others


name: Consider hospitalization if severity of mood disorder poses safety risk, person unable to meet self-care needs, or lacks sufficient social support


name: Initiate necessary precautions to safeguard those at risk for physical harm (e.g., suicide, self-harm, elopement, violence)


name: Provide or refer for substance abuse treatment, when contributing factor to mood disorder


name: Adjust or discontinue medications contributing to mood disorders, per appropriately licensed practitioner


name: Refer for evaluation or treatment for underlying medical illness that may be contributing to dysfunctional mood (e.g., thyroid disorders)


name: Monitor physical status (e.g., body weight, hydration)


name: Monitor and regulate level of activity and stimulation in environment in accord with needs


name: Assist to maintain normal cycle of sleep and wakefulness (e.g., scheduled rest times, relaxation techniques, sedating medications, limit caffeine)


name: Assist to assume increasing responsibility for self-care


name: Provide opportunity for physical activity (e.g., walking, riding exercise bike)


name: Use simple, concrete, here-and-now language during interactions if cognitively compromised


name: Use memory aides and visual cues to assist if cognitively compromised


name: Limit decision-making opportunities if cognitively compromised


name: Provide instruction on use of decision-making skills, as needed


name: Encourage to engage in increasingly more complex decision-making


name: Encourage to take active role in treatment and rehabilitation, as appropriate


name: Interact at regular intervals to convey caring and provide opportunity to talk about feelings


name: Help to consciously self-monitor mood (e.g., 1-10 rating scale, journaling)


name: Help identify thoughts and feelings underlying dysfunctional mood


name: Limit amount of time allowed to express negative feelings or accounts of past failures


name: Assist to ventilate feelings in appropriate manner (e.g., punching bag, art therapy, vigorous physical activity)


name: Help identify precipitants of dysfunctional mood (e.g., chemical imbalances, situational stressors, grief and loss, physical problems)


name: Help identify aspects of precipitants that can or cannot be changed


name: Assist in identification of available resources, personal strengths, and abilities to use in modifying precipitants of dysfunctional mood


name: Provide instruction on new coping and problem-solving skills


name: Encourage to engage in social interactions and activities with others


name: Provide social skills and assertiveness training as needed


name: Provide feedback regarding appropriateness of social behaviors


name: Use limit setting and behavioral management strategies to assist in refraining from intrusive and disruptive behavior


name: Use restrictive interventions only if necessary (e.g., area restriction, seclusion, physical restraint, chemical restraint), to manage unsafe or inappropriate behavior not responsive to less restrictive behavior management interventions


name: Prescribe, adjust, and discontinue medications used to treat dysfunctional mood, per appropriately licensed practitioner


name: Treat medication side effects or adverse drug reactions


name: Monitor serum blood levels of medications (e.g., tricyclic antidepressants, lithium, anticonvulsants), as appropriate


name: Assist with provision of electroconvulsive therapy (ECT) treatments when indicated


name: Monitor physiological and mental status immediately after ECT


name: Provide illness teaching if dysfunctional mood is illness based (e.g., depression, mania, premenstrual syndrome)


name: Assist to anticipate and cope with life changes (e.g., new job, leave of absence from work, new peer group)


name: Provide follow-up at appropriate intervals, as needed


name: Establish partnership based on trust and respect


name: Encourage expression of thought and feelings


name: Mutually establish purpose and goals for conversation


name: Elicit perspective about concerns, issues, or problems


name: Use reflective listening (e.g., mirror what person saying by repeating what was expressed)


name: Guide in connecting feelings to thoughts


name: Strive for mutual understanding of experience


name: Offer information designed to provide deeper understanding of concerns, with permission


name: Assist in developing own solutions (i.e., ask how to go about making change to have succuss)


name: Focus on resolving ambivalence about making desired changes


name: Ask to identify at least three reasons for making change


name: Collaboratively explore motivation and commitment to making change (i.e., ask how important it is to make change)


name: Recognize that true power for change rests within person


name: Help identify achievements already made toward making desired changes


name: Assist to identify barriers limiting change


name: Mutually explore strategies to overcome barriers limiting change


name: Evoke plan for change while reinforcing positive motivations for change


name: Conclude with summary of conversation and plan for change


name: Facilitate communication and collaboration among multidisciplinary team members to enassure effective and focused discussions that enable the team members to problem solve and efficiently provide for patient's needs


name: Define specific desired change in behavior and physiology (e.g., relaxation, stimulation, concentration, pain reduction)


name: Choose music selections representative of preferences


name: Make music equipment available to individual


name: Avoid turning music on and leaving on for long periods


name: Facilitate active participation (e.g., playing instrument, singing) if desired and feasible in setting


name: Monitor sleep quality, duration, and response


name: Monitor or assist with cleaning and trimming of nails according to self-care ability


name: Cut nails straight across with sharp nail scissors or clippers but round slightly at tips for maximum strength when trimming, and reduced occurrence of ingrown toenails


name: Keep nails shaped and free of snags by filing with emery board


name: File nail in same direction with emery board, as filing back and forth weakens nail


name: Leave cuticles alone as they protect nail roots from infection (i.e., avoid cutting cuticles or pushing them back)


name: Instruct not to bite fingernails or remove cuticle, as can damage nail


name: Instruct not to use nails for tools, to avoid chips and cracks


name: Trim toenails less frequently than fingernails as toenails grow more slowly


name: Trim toenails regularly when soft after taking baths to minimize risk of trauma and injury


name: Soak feet in warm salt water for 5 to 10 minutes when toenails thick and difficult to cut


name: Avoid "digging out" ingrown toenails, especially if infected and sore


name: Recommend specialist for ingrown toenail care


name: Instruct to wear shoes that fit properly and to alternate shoes worn each day


name: Instruct to wear flip flops at pools and in public showers to reduce risk of fungal infections


name: Use proper tools (e.g., nail clipper or nail scissors for fingernails, toenail clipper for toenails) and disinfect tools monthly


name: Monitor nails for changes in color, texture, or shape


name: Consult specialist for unusual nail changes to determine if signs of disease or infection (e.g., dark streaks, redness and swelling, clubbing, thick and overgrown)


name: Remove nail polish before surgery, as appropriate


name: Mix 1 teaspoon salt and ½ teaspoon baking soda with 1 pint lukewarm, potable water, adjusting salinity and temperature of solution according to institutional guidelines or patient preference, if necessary


name: Determine branch of emetic pathway involved (e.g., vestibular system, chemoreceptor trigger zone)


name: Ascertain severity and intensity of symptoms using an assessment tool or scale (e.g., Self-Care Journal, Visual Analog Scales, Duke Descriptive Scales, Rhodes Index of Nausea and Vomiting, NOC Nausea & Vomiting Control)


name: Evaluate precipitating and relieving factors (e.g., movement, food, fluids, hunger, aromas), and characteristics (e.g., duration, frequency)


name: Evaluate past experiences with nausea (e.g., pregnancy, car sickness, medication, anesthesia)


name: Obtain dietary history containing likes, dislikes, and cultural food preferences


name: Provide effective antiemetic drugs to prevent nausea when possible (i.e., avoid nausea related to pregnancy)


name: Administer medication via appropriate routes considering condition and needs (e.g., intravascular, oral, rectal, intramuscular)


name: Administer medication considering two or more antiemetics may be required to achieve adequate symptom control, depending upon cause


name: Prescribe medication specific to nausea etiology (i.e., antiemetics vary in their mechanisms of action, are dependent upon cause and receptor)


name: Reduce or eliminate personal factors that precipitate or increase nausea (e.g., anxiety, fear, fatigue, lack of knowledge)


name: Employ multimodal approach that incorporates both pharmacological and non-pharmacological management methods


name: Collaborate with person when selecting nausea control strategy


name: Encourage to be persistent with health providers in obtaining pharmacological and non-pharmacological relief


name: Instruct on use of non-pharmacological techniques (e.g., biofeedback, hypnosis, relaxation, guided imagery, music therapy, distraction, acupressure) to manage nausea


name: Encourage use of non-pharmacological techniques before, during, and after treatments; before nausea occurs or increases; and along with other nausea control measures


name: Inform other health care professionals and family members of any non-pharmacological strategies being used


name: Use frequent oral hygiene to promote comfort unless stimulates nausea


name: Encourage eating small amounts of food that are appealing, if not contraindicated


name: Provide information about nausea (e.g., causes, duration)


name: Provide anti-nausea measures preventively if indicated


name: Verify health history, including preexisting conditions, medications and treatments, to determine risk level


name: Determine baseline status of immune system via bloodwork and physical examination


name: Institute protective isolation precautions as indicated


name: Provide private room as indicated, or ensure appropriate square feet per person as required by CDC guidelines, when unable to provide private room


name: Place notice on door indicating requirements for anyone entering room (e.g., hand washing, PPE)


name: Restrict microorganisms in environment where possible, using positive pressure isolation room (i.e., clean air pumped into room continuously creating air pressure such that microbes unable to enter)


name: Use isolation rooms with high-efficiency particulate air (HEPA) filter systems where possible


name: Ensure all equipment and furniture in room disinfected


name: Use disposable and dedicated equipment where possible


name: Leave reusable equipment in room and disinfect after each use (e.g., thermometers, blood pressure machines, ECG machines, IV poles)


name: Ensure team members adhere to strict aseptic technique at all times


name: Require hand washing with soap and water or antimicrobial solutions prior to entering, as indicated


name: Require all persons entering room to wear proper PPE, as indicated


name: Restrict or deny visits with children or those with colds, flu or other illnesses, as indicated


name: Minimize room traffic by allowing only necessary personnel to enter and exit


name: Monitor body temperature, laboratory work, and vital signs closely to ensure awareness of immunocompromised status at all times


name: Obtain fever workup for temperature of 38.3° C (101° F) once, or 38.0° C (100.4° F) two times, 4 hours apart (e.g., blood cultures, urine cultures, open wound cultures)


name: Ensure empiric antimicrobial therapy started within 2 hours of fever workup


name: Ensure person follows neutropenic diet (i.e., well-cooked foods; no foods that might have bacteria, such as unwashed fruit)


name: Provide bottled or filtered water for fluid intake, as tolerated


name: Avoid scratching, cutting, or nicking person's skin


name: Avoid permanent or semipermanent venous access devices when functionally or quantitatively neutropenic


name: Change IV tubing per organization protocol unless blood, lipids, or parenteral nutrition are infused through IV lines, then change IV tubing daily


name: Avoid rectal medical procedures (e.g., enemas, suppositories)


name: Ensure performs frequent oral care including toothbrushing and gentle flossing as tolerated


name: Ensure uses antimicrobial mouth rinses when poor oral hygiene or gingivitis present


name: Ensure wears mask whenever necessary to leave room (e.g., x-ray, CT scan, surgical procedure)


name: Restrict flowers, potted plants, floral arrangements with water in vases, and dried flower arrangements


name: Ensure that regular cleaning of room, including damp dusting, performed


name: Monitor emotional status for heightened anxiety and fearful episodes related to isolation


name: Provide support as indicated for emotional needs


name: Clean environment appropriately after discharge


name: Determine current infection control practices and tailor instruction to learning needs


name: Instruct about preexisting conditions that increase infection risk


name: Instruct on condition and need for isolation, and how to follow precautions


name: Instruct on conducting isolation precautions at home if needed after discharge


name: Instruct to wash hands often, including before and after eating or using bathroom


name: Inform to shower daily, being sure to clean sweaty areas like feet, armpits, and groin


name: Encourage to ask others to wash hands often, particularly visiting friends and family


name: Educate to avoid intercourse, but if having sex, always use water-soluble lubricant


name: Instruct to avoid anyone who is ill, even if just mild cold


name: Instruct to avoid recently vaccinated persons, child or adult


name: Inform to stay away from large crowds, including public transportation, restaurants, and stores


name: Educate to avoid animals completely if possible and especially avoid touching animal waste


name: Instruct to take measures to prevent constipation as straining from constipation can irritate rectal area (i.e., eat enough fiber and drink five to six glasses of water daily)


name: Inform to avoid live plants when possible


name: Instruct to use gloves when outside in garden or lawn area


name: Inform to avoid tampons and use pads to decrease risk for toxic shock syndrome


name: Educate to practice good oral care (i.e., brush teeth after eating and before bed, using soft toothbrush and brushing gently)


name: Instruct to always wear sunscreen with high sun protection factor


name: Educate to keep IV lines clean (i.e., ensure IV always dry and clean and without redness or pain every day)


name: Instruct to avoid cuts and injuries such as scratches (i.e., avoid sharp objects, be sure to wear gloves while cleaning)


name: Instruct to delay or avoid dental work or vaccines, unless have health care provider approval


name: Instruct to practice kitchen hygiene when preparing meals (e.g., wash hands before and after preparing food and eating; use clean utensils, glasses, plates and wash after each use; wash fresh fruits and vegetables well)


name: Educate to avoid uncooked and raw foods (e.g., raw or unwashed fruits and vegetables; raw or undercooked meat, including beef, pork, chicken, fish; uncooked grains, raw nuts, honey)


name: Instruct to cook meat until safe internal temperature, using food thermometer to check


name: Educate to avoid cross-contamination when preparing foods, keeping raw meat away from cooked foods


name: Instruct not to share food or drinks with other people, and avoid self-serve stations like bulk food bins, buffets, and salad bars


name: Inform to seek health care attention immediately if any signs or symptoms of infection as infections that occur during neutropenia are life-threatening and require emergency care


name: Educate to check temperature twice daily,


name: Instruct on signs and symptoms of infection (e.g., fever, chills or sweats, persistent cough, sore throat, difficulty breathing, any new pain, vomiting, diarrhea, bloody urine, skin rash, redness or swelling at IV site)


name: Inform to attend all follow-up appointments and see health care provider if exposure to infected persons


name: Select smooth pacifier or pacifier substitute that meets standards to prevent airway obstruction


name: Use clean pacifier (e.g., sterilize daily, used with only one infant, no contact with contaminated areas)


name: Provide pacifier or gloved finger to encourage sucking during tube feeding and for 5 minutes after tube feeding


name: Provide pacifier or gloved finger to encourage sucking at least every 4 hours for infants receiving long-term hyperalimentation


name: Use pacifier or gloved finger after feedings if infant demonstrates continual need to suck


name: Rock and hold baby while sucking on pacifier or gloved finger when possible


name: Inform parents on importance of meeting sucking needs


name: Inform of alternatives to nipple sucking (e.g., thumb, finger, pacifier)


name: Administer medications before eating (e.g., pain relief, anti-emetics), if needed


name: Review information on nutritional status


name: Measure weight and height, and length as indicated for pediatric persons


name: Measure head circumference for children less than 36 months


name: Start nutritional support as soon as possible, as appropriate


name: Monitor appropriateness of prescribed diet to meet daily nutritional needs, as appropriate


name: Eliminate potential causes of malnutrition and dehydration, as soon as possible


name: Initiate prescribed number of calories and type of nutrients needed to meet requirements, as appropriate


name: Consider cultural and religious preferences


name: Consider nutrition therapy for persons who have limited food and fluid intake


name: Offer nutritional supplements, as appropriate


name: Evaluate concordance with nutritional supplement consumption routinely


name: Encourage to select semisoft food if lack of saliva hinders swallowing


name: Ensure that diet includes foods high in fiber content to prevent constipation, as appropriate


name: Offer mealtime assistance to support adequate dietary intake, as appropriate


name: Determine need for enteral tube or parenteral feedings


name: Manage enteral feeding or parenteral nutrition, as needed


name: Evaluate benefits and potential risks of enteral nutrition routinely


name: Discontinue use of tube feedings as oral intake tolerated


name: Offer herbs and spices as alternative to salt


name: Structure environment to create pleasant and relaxing atmosphere


name: Encourage to share mealtimes with others, as appropriate


name: Present food in attractive, pleasing manner, giving consideration to color, texture, and variety


name: Modify consistency of foods, such as soft foods that require little chewing, as necessary


name: Encourage adequate dental and mouth care


name: Assist to sitting position before eating or feeding


name: Measure blood glucose initially after artificial nutrition initiation and at least every 4 hours, for first 2 days, as appropriate


name: Monitor laboratory values such as electrolytes, as appropriate


name: Instruct about nutritional information and prescribed diet


name: Provide written examples of prescribed diet


name: Check medications and alter where possible to minimize adverse effects


name: Offer nutritional counseling through individual sessions, group sessions, telephone contacts, and written advice, as appropriate


name: Encourage physical activity to maintain or improve muscle mass and function


name: Establish mouth care routine, including regular oral inspections with oral health measurement tools


name: Encourage and assist to rinse mouth if able


name: Facilitate toothbrushing and flossing at regular intervals (e.g., after meals, bedtime)


name: Encourage parents to have children begin regular toothbrushing and flossing at preschool age


name: Recommend use of soft-bristled toothbrush


name: Instruct to brush teeth, gums, and tongue


name: Instruct on proper toothbrushing technique required for oral hygiene (e.g., Sulcular, Bass, Stillman Charter)


name: Instruct and assist to perform oral hygiene after eating and as often as needed


name: Perform oral hygiene including toothbrushing and flossing if person unable, twice daily minimally


name: Combine toothbrushing with oral antiseptics for at-risk persons


name: Inspect mouth as needed to ensure teeth are clean


name: Rinse mouth vigorously with water if unable to do brushing or flossing


name: Monitor for signs and symptoms of glossitis and stomatitis, or bacterial colonization


name: Consult provider or dentist about readjustment of wires and appliances and alternative methods of oral care if irritation of oral mucous membranes occurs from these devices


name: Consult provider if oral dryness, irritation, and discomfort persist, or if bacterial or yeast colonization noted


name: Recommend healthy diet with coarse, fibrous foods (e.g., fruits, vegetables) and adequate water intake with fluoridated water


name: Schedule topical applications of fluoride if fluoridated water unavailable


name: Identify any risk for development of stomatitis secondary to drug therapy


name: Arrange for dental checkups as needed (e.g., every 6 months)


name: Determine type of artificial teeth (e.g., lower plate, upper plate, bridge, full set)


name: Ensure artificial teeth are to be removed for cleansing (e.g., fixed bridge)


name: Ensure artificial teeth are well-fitted and do not cause undue discomfort


name: Determine current routine for cleaning (e.g., daily, after meals, soaking, brushing)


name: Use toothpaste or soaking materials appropriate for teeth (e.g., dentifrice, effervescent tablets) and cleaning compounds as indicated for plates


name: Follow manufacturer directions related to how long or how frequently dentures to be soaked, and how to store dentures overnight


name: Notify dentist if loose or ill-fitting dentures


name: Instruct on care and application of dentures


name: Discourage smoking, tobacco chewing, and excessive intake of foods and drinks high in sugar between meals


name: Instruct to chew sugarless gum to increase saliva and cleanse teeth between meals if indicated


name: Monitor condition of mouth (e.g., lips, tongue, mucous membranes, teeth, gums, dental appliances and their fit)


name: Provide regular oral health screening and risk assessment


name: Determine usual dental hygiene routine, identifying areas to be addressed, if necessary


name: Instruct on frequency and quality of proper oral health care (e.g., flossing, brushing, and rinsing; adequate nutrition; use of fluoride-containing water, supplement, or other preventive product; other considerations based on developmental level and self-care ability)


name: Assist in brushing teeth, gums, and tongue, rinsing, and flossing as needed


name: Assist with dentures in oral care as needed (i.e., remove, cleanse, reinsert dentures; brush gums, remaining teeth, and tongue; massage gums with brush or fingers)


name: Provide oral care using appropriate precautions (i.e., turn head to side or place in side-lying position, when possible, insert bite block or padded tongue blade, avoid putting fingers in mouth, use small amounts of liquid, use bulb syringe or other suction devices)


name: Assist in identifying and obtaining oral care products most suited to meet needs (e.g., toothbrush with easy-to-grasp handle, powered toothbrush, dental floss holder, immersion cleanser for dentures, athletic mouthguard)


name: Instruct on role of sugar in development of caries (i.e., encourage to limit natural sugar intake; suggest use of artificial sweeteners in diet, particularly xylitol; and instruct parent on appropriate use of bottles and sippy cups and their contents)


name: Discourage smoking and tobacco chewing (i.e., instruct on effects of tobacco use, implement tobacco-use prevention measures, and provide tobacco-cessation assistance)


name: Provide community-level services (i.e., assist in meeting needs for transportation and translational services, use health fairs and cultural events as opportunities for education, and develop public service announcements)


name: Monitor condition of mouth (e.g., lips, tongue, mucous membranes, teeth, gums, dental appliances and their fit), including character of abnormalities (e.g., size, color, location of internal or external lesions or inflammation, signs of infection)


name: Obtain order from health care provider to perform routine oral hygiene, if applicable


name: Encourage maintenance of identified oral health schedule


name: Instruct to use soft-bristled toothbrush or disposable mouth sponge


name: Instruct on appropriate selection of floss use and type (i.e., avoid use if at-risk for bleeding; use waxed floss to prevent tissue trauma)


name: Administer mouth rinse (e.g., anesthetic, effervescent, saline, coating, antifungal or antibacterial solution)


name: Administer medication (e.g., analgesics, anesthetics, antimicrobials, anti-inflammatory agents), if needed


name: Remove dentures, encouraging to use only for meals


name: Discourage smoking, tobacco chewing, vaping or alcohol consumption


name: Instruct on frequency and quality of proper oral health care


name: Instruct to avoid oral hygiene products containing glycerin, alcohol, or other drying agents


name: Instruct to keep toothbrushes and other oral equipment clean


name: Avoid spicy, salty, acidic, dry, rough, or hard foods


name: Avoid foods causing allergenic response (e.g., coffee, cheese, nuts, citrus fruits, gluten, potatoes) if applicable


name: Instruct on signs and symptoms of stomatitis, including when to report to health care provider


name: Determine type of ostomy (e.g., bowel, bladder, continent, incontinent)


name: Determine current level of knowledge related to ostomies, ostomy equipment, and required cares


name: Determine comfort level and usual patterns with care of ostomy


name: Explain procedure and establish level of participation


name: Assist to comfortable position either sitting or lying on bed, or sitting or standing in bathroom


name: Empty pouch of ostomy bag and remove ostomy skin barrier


name: Do not throw away reusable ostomy bag clamp


name: Note consistency, color, and amount of stool or urine, including odor to urine, if any


name: Note stoma appearance including size, (e.g., protruding, retracted)


name: Note peristomal skin condition including signs of irritation


name: Use gauze to cover stoma while cleansing and preparing peristomal skin


name: Prepare peristomal area according to ostomy bag design (i.e., cut wafer to fit or ensure pre-designed wafer is correct size and shape, ensure skin clean and dry)


name: Attach ostomy bag following directions on wafer or pre-fit bag


name: Cover stoma with dressing or bandage if not using ostomy bag


name: Instruct to empty continent urinary diversion devices (e.g., Indiana pouch) when feel sensation of fullness or at regular intervals (e.g., every 4-6 hours) using urinary catheterization equipment


name: Instruct to empty ostomy bag and urinary diversion bags when one third to one half full of urine, stool, or gas


name: Instruct to empty pouch moving feces down pouch sides with fingers and wipe end of pouch with tissue or premoistened towelette


name: Irrigate ostomy using cone on enema catheter tip, in amounts of 300 to 500 mL, as indicated


name: Instruct on ability to establish regular evacuation pattern with routine irrigation, if indicated


name: Instruct on use of ostomy equipment and care


name: Monitor for postop complications (e.g., intestinal obstruction, paralytic ileus, anastomotic leaks, mucocutaneous separation)


name: Instruct when to change ostomy bag to new bag, as appropriate


name: Encourage to express feelings and concerns about changes in body image


name: Explain what ostomy care will mean to day-to-day routine


name: Instruct how to monitor for complications (e.g., mechanical breakdown, chemical breakdown, rash, leaks, dehydration, infection)


name: Assist to identify factors that affect elimination pattern


name: Instruct in appropriate diet and expected changes in elimination function


name: Provide support and assistance as develops skill in caring for stoma and surrounding tissue


name: Instruct to chew foods thoroughly, avoid foods that caused digestive upset in past, add new foods one at a time, and drink plenty of fluids


name: Instruct in Kegel exercises if has ileoanal reservoir


name: Express confidence that can resume normal life with ostomy


name: Notify wound ostomy nurse for follow-up and continued instruction, as appropriate


name: Verify order for oxygen therapy before administering, as indicated


name: Instruct on oxygen therapy, role in delivery, and need to avoid smoking


name: Ensure pulse oximetry available to monitor response to therapy, as indicated


name: Document baseline observations including saturations, respiratory rate, blood pressure, and pulse


name: Monitor respiratory effort, skin color, and level of consciousness


name: Clear oral, nasal, and tracheal secretions to optimize airway patency


name: Position for optimum breathing efficiency (e.g., high or semifowlers)


name: Insert flow meter into outlet and attach appropriate oxygen tubing and delivery device (e.g., mask, nasal cannula, ET tube)


name: Adjust method of delivery to accommodate age (e.g., oxygen tent or isolette for small children and neonates)


name: Attach humidifying unit to the flow meter, as indicated (i.e., oxygen must be humidified to avoid mucosal drying when delivery bypasses oral cavity or when delivered at levels higher than 6 L/min)


name: Place appropriate signage around room or at home


name: Plan nursing care so tent or isolette is entered as little as possible to prevent oxygen levels from dropping


name: Provide children with favorite toy or blanket when fearful of tent


name: Instruct about importance of leaving oxygen delivery device on (i.e., oxygen will ease dyspnea or discomfort)


name: Encourage to breathe through nose if using nasal cannula


name: Instruct concerning safety precautions associated with oxygen use


name: Check oxygen delivery device routinely to ensure that prescribed concentration delivered (i.e., tubing not kinked, mask or cannula in wrong position)


name: Monitor effectiveness of oxygen therapy (e.g., pulse oximetry, ABGs)


name: Ensure replacement of oxygen mask or cannula whenever device removed


name: Monitor ability to tolerate removal of oxygen when eating


name: Change oxygen delivery device from mask to nasal cannula during meals, as tolerated


name: Observe for signs of oxygen-induced hypoventilation (e.g., anxiety, decreased level of consciousness, inability to concentrate, fatigue, dizziness, cardiac dysrhythmias, pallor, cyanosis, dyspnea)


name: Monitor oxygen equipment to ensure not interfering with attempts to breathe


name: Monitor anxiety related to need for oxygen therapy


name: Instruct to obtain supplementary oxygen prescription before air travel or trips to high altitude, as appropriate


name: Consult with other health care professionals regarding use of supplemental oxygen during activity or sleep


name: Instruct about use of oxygen at home (e.g., how to use equipment, when to have oxygen refilled, no smoking)


name: Encourage to use oxygen vendor whose services include trained personnel to instruct in use and maintenance of equipment, 24-hour emergency service, and monthly follow-up visits for equipment maintenance and instruction


name: Arrange for use of oxygen devices that facilitate mobility and instruct accordingly


name: Encourage to share fears and concerns about oxygen therapy


name: Refer to local support group that uses home oxygen, as indicated


name: Assure confirmation of pacemaker placement post-implantation in initial insertion with baseline chest x-ray


name: Provide sedation and analgesia for patients with external trans-cutaneous pacemaker, as indicated


name: Select and implement intervention options tailored to the patient's risks benefits and preferences (e.g., pharmacological, non-pharmacological, interpersonal) to facilitate pain relief, as appropriate


name: Incorporate non-pharmacological interventions to the pain etiology and patient preference, as appropriate


name: Encourage appropriate use of non-pharmacological techniques (e.g., biofeedback, TENS, hypnosis, relaxation, guided imagery, music therapy, distraction, play therapy, activity therapy, acupressure, heat and cold application, and massage) and pharmacological options as pain control measures


name: Provide scientific and factually based information on pandemic precautions


name: Avoid stigmatization and marginalization during discussions regarding pandemic precautions


name: Identify reasons for resistance to pandemic precautions, as needed


name: Discuss high-risk areas that may increase likelihood for contracting pandemic-related disease (e.g., industrial or food processing facilities, correctional facilities, healthcare facilities, service industries)


name: Determine living arrangements to identify congregate setting, multigenerational home, or homelessness status, which may contribute to disease spread


name: Identify specific behaviors that would influence increased likelihood of contracting pandemic-related disease


name: Educate on common symptoms associated with pandemic-related disease


name: Encourage frequent handwashing of at least 20 seconds with soap and water after being in public spaces, touching face, or contact with high-touch surfaces


name: Educate to use hand sanitizer with at least 60% alcohol if hands are not visibly soiled and soap and water are not available


name: Identify measures for decontaminating high touch surfaces at home and workplace


name: Demonstrate proper mechanics for covering coughs and sneezes


name: Educate on scientific rationale and proper technique for wearing face masks


name: Educate on use of vaccinations, based on availability, to help reduce transmission of pandemic-related disease


name: Instruct to maintain physical distance from others as close contact with individuals in pre-symptomatic or asymptomatic phase may lead to infection


name: Discuss benefits of stay-at-home orders and state-based mandates for masking on reducing transmission of pandemic-related disease


name: Discuss impact of poorly ventilated spaces and crowded areas on spread of disease during pandemics


name: Educate persons and family members on appropriate self-isolation and quarantine procedures if someone in person's home diagnosed with pandemic-related disease


name: Identify potential contacts with persons that were diagnosed with pandemic-related disease, including prior to diagnosis, as needed


name: Identify local, state, regional, and national resources available to provide supplies and resources to persons


name: Determine knowledge and readiness and ability to learn about infant care


name: Provide anticipatory guidance about developmental changes


name: Assist in articulating ways to integrate infant into family system


name: Encourage to practice exclusive breastfeeding until 6 months of age


name: Provide anticipatory guidance about signs of breastfeeding problems


name: Instruct on formula preparation and selection


name: Provide information about risks and necessity of using pacifiers


name: Provide guidance about introduction of solid foods after 6 months of age


name: Provide guidance about risks of infant obesity


name: Instruct on appropriate fluoride supplementation


name: Give information about developing dentition and oral hygiene


name: Provide anticipatory guidance about changing elimination patterns


name: Instruct on how to treat and prevent diaper rash


name: Provide anticipatory guidance about changing sleep patterns


name: Instruct about infant sleeping positions


name: Demonstrate ways to stimulate infant's development


name: Encourage to hold, cuddle, massage, and touch infant


name: Encourage to provide pleasurable auditory and visual stimulation


name: Give examples of safe toys or available items in home that can be used as toys


name: Provide with written materials appropriate to identified knowledge needs


name: Reinforce ability to apply teaching to childcare skills


name: Provide support when learning infant caretaking skills


name: Assist in interpreting infant cues, nonverbal cues, crying, and vocalizations


name: Demonstrate reflexes and explain their significance to infant care


name: Assist to identify behavioral characteristics of infant


name: Explain and demonstrate infant clinical condition


name: Monitor skill in recognizing infant's physiological needs


name: Provide information about making home environment safe for infant


name: Provide information about safety needs of infant when in motor vehicle


name: Instruct on how to reach health professionals


name: Place follow-up call 1 to 2 weeks after encounter


name: Provide information about importance of having infant vaccinated


name: Provide guidance about infant exposure to electronic devices


name: Encourage participation in routine consultations to monitor infant growth and development


name: Examine structure of family environment (i.e., adequate provision of inputs, safe space for child and family)


name: Assist parents with realistic expectations appropriate to developmental and ability level of child


name: Provide information according to family knowledge level


name: Instruct parents to respond to behavior cues exhibited by their infant


name: Listen to parents' problems and concerns non-judgmentally


name: Recommend administration of aspirin and nonsteroidal anti-inflammatory drugs in conjunction with narcotics, as appropriate


name: Provide with written statement of rights as recipient of care, in preferred language (e.g., American Hospital Association Patient Bill of Rights)


name: Provide interpreter if unable to understand written or verbal explanations of rights


name: Provide environment conducive for private conversations


name: Protect privacy during all care activities


name: Determine whether wishes about health care are known (e.g., living will, durable power of attorney for health care)


name: Work with health care providers to honor wishes


name: Ensure cultural and religious preferences are respected


name: Know legal status of living wills in current state


name: Honor wishes expressed in living will or durable power of attorney for health care, and "Do Not Resuscitate" orders


name: Document in health care record mental competency to make decisions, as appropriate


name: Provide appropriate pain management for acute, chronic, and terminal conditions


name: Maintain privacy and confidentiality of health information


name: Document issues related to person's rights, per agency policy


name: Instruct to tighten then relax ring of muscle around urethra and anus, as if trying to prevent urination or bowel movement


name: Instruct to avoid contracting abdomen, thighs, and buttocks, holding breath, or straining down during exercise


name: Ensure that individual can differentiate between desired drawing up-and-in muscle contraction and non-desired bearing down effort


name: Instruct female individual to identify levator ani and urogenital muscles by placing finger in vagina and squeezing


name: Instruct individual to tighten pelvic floor muscles and hold for count of 10 and relax muscles completely for count of 10; instruct to do 8 to 12 repetitions, three to five times a day (i.e., morning, afternoon, and night).


name: Inform individual that it takes 8 to 12 weeks for exercises to be effective


name: Instruct to monitor response to exercise by attempting to stop urine flow no more often than once per week


name: Incorporate biofeedback or electrical stimulation for selected individuals when assistance indicated to identify correct muscles to contract and elicit desired strength of muscle contraction


name: Encourage, as appropriate and under supervision, bridge and squat exercises


name: Review history for contraindications for pessary therapy (e.g., pelvic infections, lacerations, space-occupying lesions, noncompliance, endometriosis)


name: Discuss maintenance regimen before fitting pessary (i.e., fit is trial and error; frequent follow-up visits are required; cleaning procedures)


name: Ask to change positions (e.g., stand, squat, walk, bear down slightly)


name: Recommend semi-annual Pap examinations, as appropriate


name: Observe for presence of abnormal vaginal discharge, odor, itching, or vaginal color change


name: Recommend vaginal hygiene with water and mild soap


name: Recommend pelvic floor strengthening exercises, as appropriate


name: Provide space to express doubts and questions about use of pessary


name: Determine impact of pessary on sexual health


name: Determine if drawing blood from artery or arterial line


name: Palpate radial, brachial, or femoral artery for pulse


name: Obtain syringe with anti-clot medication


name: Cleanse skin area with appropriate solution


name: Position extremity appropriately for access (e.g., hand hyperextended over rolled cloth; extremity hyper-abducted and externally rotated)


name: Palpate artery proximal to needle entry with non-dominant hand


name: Insert needle at a 45-60 degree angle into artery with dominant hand until blood flash appears


name: Allow syringe to fill to appropriate level; avoid pulling back on plunger


name: Pull syringe back slightly and reposition needle if arterial flow lost


name: Withdraw needle and immediately apply pressure to puncture site with sterile gauze


name: Apply pressure until hemostasis achieved, per policy


name: Expel all air from syringe by holding sample upright and gently tapping


name: Place syringe in ice if delay in transport


name: Dispose of materials and all personal protective equipment appropriately


name: Adhere to agency protocol for donor screening and acceptance (e.g., drug abuse, HIV status, tattoos)


name: Obtain demographical information and written consent from donor


name: Determine risks related to venipuncture (e.g., anticoagulation therapy, bleeding disorders)


name: Ensure that donor has eaten 4 to 6 hours before donating


name: Determine hemoglobin and hematocrit levels, weight, and vital signs


name: Ensure appropriate site (i.e., avoid arm on mastectomy side or hemodialysis shunt)


name: Determine presence of allergies to tape, latex, or cleansing agents


name: Ensure skin at site of venipuncture free of lesions


name: Place donor in semi-recumbent position during donation process


name: Cleanse skin before venipuncture, according to agency protocol


name: Ensure blood products collected in bag mixed with correct additive


name: Maintain continuous flow of blood product


name: Instruct to elevate arm and apply firm pressure for 2 to 3 minutes after completion of blood or blood product donation process


name: Instruct to remain recumbent per agency policy after donation, or longer if faintness or weakness experienced


name: Encourage to remain seated after donation per agency policy


name: Instruct to eat and drink immediately after donation, with increased fluid intake for next few days


name: Instruct to keep pressure bandage on and dry for several hours after donation


name: Instruct to avoid strenuous activity or heavy lifting for several hours after donation


name: Instruct to lie down with feet up if lightheaded, until feeling passes


name: Instruct if bleeding after removing bandage to put pressure on site and raise arm until bleeding stops


name: Instruct if bruising occurs to apply cold pack to area periodically during first 24 hours


name: Recommend adding iron-rich foods to diet to replace iron lost with blood donation


name: Minimize anxiety by explaining procedure and rationale, as appropriate


name: Review previous venipuncture experiences and preferences for venipuncture site


name: Determine possible risks associated with venipuncture (e.g., anticoagulant therapy, bleeding disorders)


name: Select appropriate blood specimen tube, size, and type of needle


name: Promote vessel dilation through use of tourniquet, gravity, application of heat, milking vein, or fist clenching and relaxation


name: Cleanse area with appropriate solution, per agency protocol


name: Cleanse site with circular motion, starting at point of anticipated venipuncture and moving in outward circle


name: Insert needle in direction of venous blood return


name: Remove needle from the vein and apply pressure and dressing


name: Advise to leave dressing in place for at least 1 hour


name: Verify specimens has correct name, date, and time of collection, per agency protocol


name: Obtain provider prescription for phototherapy including frequency, distance, intensity, and duration, as appropriate


name: Instruct about treatment (e.g., indications for use, treatment procedure)


name: Assist in obtaining appropriate light source for treatment, including correct brightness, intensity, lux, and filtering of ultraviolet light (i.e., fluorescent bulbs emitting white light are preferred source)


name: Increase treatment times for lower lux light sources


name: Assist to set up prescribed light source in preparation for treatment, including correct distance and intensity


name: Monitor mood level (e.g., prolonged sadness, loss of energy, change in sleep pattern, irritability)


name: Ensure familiarity with baseline symptoms to discern whether therapy exacerbating symptoms and adverse effects


name: Terminate treatment if develops side effects


name: Modify treatment, as ordered, to decrease or eliminate side effects


name: Consider increasing dosage or adding evening does to regimen, if symptoms have not improved within 2 to 4 weeks


name: Place infant in isolette or radiant warmer


name: Monitor vital signs every 3 hours, per protocol or as needed


name: Check temperature every 3 hours or as needed


name: Change infant position every 3 hours or per protocol


name: Monitor signs of dehydration (e.g., depressed fontanels, poor skin turgor, loss of weight)


name: Determine type of condition to be treated


name: Instruct about treatment (e.g., indications for use, treatment procedure, preparation of area to be treated)


name: Test small area of skin initially with prescribed light source


name: Increase treatment times as tolerated and per protocol


name: Monitor for side effects of treatment (e.g., increased areas of irritation, signs or symptoms of infection)


name: Ensure familiarity with baseline skin condition to discern whether therapy effective


name: Ensure availability for scheduled treatments (e.g., once weekly, two or three times weekly, monthly)


name: Terminate or modify treatment if develops untoward side effects, as ordered


name: Reduce treatment in incremental stages after desired effect achieved


name: Educate related to care of treatment area between visits


name: Review each situation individually, ensuring accompaniment when necessary


name: Determine number and type of personnel and equipment required


name: Ensure adequate means of communication among all involved


name: Explain need for accompaniment and roles of involved individuals


name: Ensure safety of individuals and personnel at all times


name: Monitor equipment continuously as indicated


name: Follow agency policies regarding accompaniment


name: Document accompaniment including destination and persons attending


name: Determine need for social distancing (e.g., infected person, required excursions from home during contagious disease outbreak)


name: Determine presence of risk factors for contagion (e.g., age, disabled, low socioeconomic class, crowded housing with poor ventilation, respiratory illness) or increased mortality (e.g., comorbidities, chronic respiratory disease, elderly)


name: Instruct to find and follow guidance from local public health authorities before going out of home (e.g., restrictions on travel, leaving home, physical distancing requirements)


name: Encourage avoidance of close physical contact between non-cohabitating persons when outside home or with infected persons in home (i.e., maintain distance between people per established guidelines)


name: Minimize contact time with non-cohabitating persons or with infected persons


name: Encourage use of PPE when outside home or in contact with infected person (e.g., masks, gloves)


name: Encourage use of other everyday preventive actions (e.g., avoiding touching face with unwashed hands, frequently washing hands with soap and water for at least 20 seconds, using hand sanitizer)


name: Instruct to cover nose and mouth with tissue during coughing or sneezing, dispose of tissue and perform hand hygiene after contact with respiratory secretions


name: Encourage avoidance of unnecessary touching of items without proper hand hygiene


name: Encourage avoidance of unnecessary excursions outside home and to limit opportunities to encounter persons outside home


name: Model healthy social distancing in all interactions (e.g., per established guidelines)


name: Instruct to consider available social distancing options to travel safely when running errands or commuting to and from work (i.e., distance ability with walking, bicycling, wheelchair rolling, or using public transit, rideshares, or taxis)


name: Encourage to arrange to work from home where possible


name: Encourage to avoid unnecessary use of public transportation


name: Instruct when using public transit, maintain distance from other passengers or transit operators per established guidelines (e.g., waiting at bus station, seat selection on bus, ride share or train)


name: Instruct to avoid pooled rides when using rideshares or taxis


name: Instruct to sit in back seat in larger rideshare vehicles to keep appropriate distance from driver


name: Instruct to maintain distance when meeting others in person per established guidelines


name: Instruct to avoid crowded places and gatherings where distancing difficult


name: Allow other people appropriate space when passing by them in both indoor and outdoor settings


name: Instruct to only visit stores in person for household essentials when absolutely needed


name: Instruct to maintain appropriate distance from others while shopping and in lines


name: Instruct to follow physical guides to assist with maintaining proper distancing (e.g., use of masks, tape markings on floors, signs on walls)


name: Instruct to use drive-thru, curbside pick-up, or delivery services to limit face-to-face contact with others whenever possible


name: Instruct to wear masks and maintain physical distance between self and delivery service providers during exchanges


name: Encourage to stay home and away from other people, staying appropriate distance away from other people in home if infected


name: Restrict movements of infected person in household to single room with private bathroom, if possible


name: Avoid sharing items like towels and utensils when infected


name: Encourage to stay socially and spiritually connected via technology


name: Encourage to visit loved ones by electronic devices where possible


name: Encourage choice of safe social activities (e.g., call, video chat, social media connections)


name: Encourage to remain active while socially distanced (e.g., walk, bike ride, wheelchair roll in neighborhood where distance can be maintained)


name: Implement alternatives to restraints, such as sitting in a gerichair or close observation, as appropriate


name: Confer with the surgeon and anesthesia professional about deflating the tourniquet for 10 to 15minutes to allow tissue reperfusion when the duration of tourniquet inflation is longer than 2 hours


name: Place on appropriate therapeutic mattress or bed


name: Explain procedure of turning, as appropriate


name: Encourage involvement in position changes, as appropriate


name: Premedicate before turning, as appropriate


name: Monitor neutral alignment, without extreme lateral rotation or hyperextension, as appropriate


name: Position to facilitate ventilation or perfusion matching (i.e., "good lung down"), as appropriate


name: Encourage joint goals to reduce risk of injury or other complications of immobility


name: Identify number of professionals needed for passive positioning


name: Avoid placing in positions that increase pain


name: Avoid changing positioning right after meals


name: Minimize friction and shearing forces when positioning or turning


name: Elevate affected limb higher than level of heart to improve venous return, as appropriate


name: Instruct how to use good posture and good body mechanics when performing any activity


name: Develop written schedule for repositioning, as appropriate


name: Turn immobilized person at least every 2 hours according to specific schedule, as appropriate


name: Place call light and frequently used objects within reach


name: Document passive positioning time and procedure


name: Note nutritional status, presence of chronic illness, comorbidities, pre-existing pressure ulcers, and at-risk conditions (e.g., obesity, diabetes, anemia, advanced age, demineralizing bone conditions, pediatric patients)


name: Place in the proper surgical position for specific surgery (e.g., supine, prone, lateral chest, lithotomy, Kraske jackknife position)


name: Consider clinical criteria for positioning (e.g., ratio of partial pressure arterial oxygen and fraction of inspired oxygen less than 150 mmHg) and contraindications for positioning (e.g., spinal instability, facial or pelvic fractures, open chest or unstable chest wall, uncontrolled intracranial pressure, severe hemodynamic instability)


name: Use institutional policies and procedures to standardize prone positioning (e.g., checklist, protocol, guidelines, work instructions about nursing care)


name: Explain rationale and procedure for prone position, including risks and benefits


name: Ensure adequate number of professionals for positioning with pre-assigned roles (e.g., respiratory therapist, nurses, physical therapist)


name: Ensure stability and positioning of medical devices during positioning (e.g., orotracheal tube, chest drain, enteral feeding, bladder catheter)


name: Record baseline vitals, hemodynamic data, and anterolateral aspects of skin


name: Apply foam dressing to areas at risk for pressure injury (e.g., forehead, chin, sternum, shoulders, knees, anterior iliac crests)


name: Pause enteral feedings for 1 hour prior to proning, then resume


name: Ensure emergency intubation equipment at bedside


name: Perform eye care (i.e., apply lubricant or ointments, tape lids closed)


name: Position team members on both sides of bed (i.e., three on each side and head supported)


name: Move person up in bed so head off bed during turn and head supported by team member


name: Place arms either in swimmer's position or along sides of body


name: Evaluate vital signs and blood gas analysis in first hour after maneuver and after every 4 or 6 hours, or as indicated


name: Continuously monitor peripheral oxygen saturation and oxygen saturation values to be at levels of 92% to 96%


name: Return to supine position if hemodynamic instability occurs (e.g., unscheduled extubation, endotracheal tube obstruction, hemoptysis, SpO2 <85% or PaO2 <55 mmHg for more than five minutes, cardiac arrest, heart rate below 30 bpm, systolic blood pressure below 60 mmHg for more than 5 minutes)


name: Check position of orotracheal tube after maneuver to avoid injuries to labial commissure and accidental extubation


name: Rotate arms and head positions every 2 hours


name: Instruct patient on non-pharmacological relief of pain (e.g., sitz baths, ambulation, massage, imagery, ice packs, witch hazel pads, and distraction)


name: Establish therapeutic, trusting relationship


name: Review health history, including prenatal and obstetrical history, developmental history, and past and present health status related to confirmed or suspected genetic risk factors


name: Review environment for possible risk factors (e.g., potential teratogen and carcinogen exposures)


name: Review lifestyle for possible risk factors (e.g., tobacco, alcohol, prescription medication, drug use)


name: Develop preconception, pregnancy-oriented, health risk profile based on history, prescription medication use, ethnic background, occupational and household exposures, diet, specific genetic disorders, and lifestyle


name: Inquire about physical abuse, as indicated


name: Obtain thorough sexual history, including frequency and timing of intercourse, use of spermicidal lubricants, and postcoital habits such as douching


name: Investigate possible causes of infertility in couples who have not been able to get pregnant for more than 1 year


name: Refer women with chronic medical conditions for a pre-pregnancy management plan


name: Evaluate for hemoglobin or hematocrit levels, Rh status, urine dipstick, toxoplasmosis, sexually transmitted diseases, rubella, hepatitis, and genetic defects


name: Advise partners to test to identify risks as needed


name: Counsel about avoiding pregnancy until appropriate treatment has been given (e.g., rubella vaccine, Rho(D) immune globulin, immune serum globulin, antibiotics)


name: Evaluate need for screening mammogram based on age and desire for prolonged breastfeeding


name: Refer to teratogens information service to locate specific information about environmental agents


name: Advise use of folic acid for both partners at least 3 months before conception


name: Encourage contraception until prepared for pregnancy, as appropriate


name: Encourage participation in support groups for couples trying to get pregnant


name: Provide copy of written plan of care for both persons


name: Instruct in prospective identification of major premenstrual symptoms (e.g., bloating, cramping, irritability), use of prospective calendar check list or symptom log, and recording of timing and severity of each symptom


name: Collaborate to prioritize most problematic symptoms


name: Collaborate to select and institute stepwise approach to eliminating symptoms


name: Prescribe symptom specific medication (e.g., NSAIDs, hormone therapy) as appropriate to practice level


name: Encourage to participate in PMS support group if available


name: Encourage physical exercise, cognitive behavior therapy, and dietary changes


name: Offer information about alternative or complementary therapies (e.g., supplements of calcium, vitamin D, Vitex agnus-castus, Ginkgo biloba)


name: Explore non-pharmacological strategies to reduce pain (e.g., warm compress, hot bath, lie down ventrally and place pillows in abdominal region)


name: Promote strategies to reduce stress and anxiety


name: Instruct patient on nonroutine tests and treatments (e.g., non-stress test, biophysical profile, Rh-immune globulin, and stripping of membranes), if needed


name: Ensure readiness for explanations or descriptions


name: Describe upcoming sequence of events and environment associated with procedure or treatment


name: Describe typical sensations associated with procedure or treatment (e.g., see, feel, smell, taste, hear)


name: Present descriptions of experiences prior to experience


name: Provide person in emergent situations to explain procedures with rationales as they occur, where possible


name: Present sensations and procedural or treatment events in sequence experienced


name: Provide descriptions in specific language, using interpreter as needed


name: Use age-appropriate tools as needed for pediatric persons (e.g., puppets, colorful toys)


name: Describe sensations using descriptive words and length of time


name: Avoid evaluative adjectives that reflect degree of sensation or emotional response


name: Provide opportunity for questions and clarification of misunderstandings


name: Establish intention to convey unconditional positive regard toward person and their situation


name: Cultivate and communicate caring, empathy, compassion, and understanding


name: Be sensitive to cultural traditions, beliefs, and practices


name: Strive to know person as unique human being


name: Convey sense of knowing that allows person to feel valued and understood


name: Convey openness, authenticity, and genuineness


name: Listen intently and actively to concerns


name: Offer gentle touch judiciously to express concern, as appropriate


name: Be physically available to offer assistance when needed


name: Reassure and assist parents in their supportive role with significant others


name: Offer to contact other support persons, as appropriate


name: Describe characteristics of pressure injury at regular intervals, including size (e.g., length, width, depth), stage (I-IV), location, exudate, granulation or necrotic tissue, and epithelization


name: Monitor color, temperature, moisture, and appearance of surrounding skin


name: Apply moist heat to pressure injury, as prescribed


name: Cleanse skin with mild soap and water, as indicated


name: Cleanse with appropriate nontoxic solution


name: Apply permeable adhesive membrane to pressure injury, as prescribed


name: Apply saline soaks, ointments, and dressings, as prescribed


name: Position every 1 to 2 hours or more frequently, as appropriate


name: Use specialty beds and mattresses, as appropriate


name: Monitor nutritional status ensuring adequate dietary intake


name: Consult Wound Ostomy Continence Nurse (WOCN), as appropriate


name: Instruct about signs of skin breakdown, as appropriate


name: Instruct on wound care procedures (e.g., debridement, electrical stimulation)


name: Complete comprehensive inspection of skin


name: Identify risk factors (e.g., diabetes, depressed immune system, vascular disease, nutritional deficiencies, smoking, immobility)


name: Document any previous incidences of pressure injury


name: Document skin status on admission, daily and per agency protocol


name: Use established risk assessment tool to monitor risk factors (e.g., Braden, Norton scale)


name: Use established guidelines or agency protocol for specific preventive activities (e.g., bundles)


name: Use methods of measuring skin temperature to determine risk, per agency protocol


name: Inspect skin under medical devices regularly (e.g., face masks, nasal cannulas, feeding tubes, catheters, neck braces, tracheostomy tubes)


name: Remove excessive moisture on skin (e.g., perspiration, wound drainage, feces, urine)


name: Apply protective barriers (e.g., creams, moisture-absorbing pads), as prescribed


name: Turn every 1 to 2 hours or more frequently, as appropriate


name: Avoid friction when turning to prevent injury to fragile skin.


name: Encourage frequent shifts of body weight


name: Post turning schedule at bedside, as appropriate


name: Use positioning and protective devices, as appropriate


name: Consult Wound Ostomy Continence Nurse (WOCN) and skin champions as appropriate


name: Instruct on signs of skin breakdown, as appropriate


name: Encourage self-evaluation to include career interest, knowledge, and skills


name: Assist in creating career plan with measurable goals, objectives, and actionable strategies


name: Ensure plan includes balance of professional and personal life


name: Identify opportunities to improve knowledge and skills (e.g., communication, technology)


name: Prioritize continuing education opportunities to increase knowledge and skills


name: Offer guidance in seeking advanced education (e.g., bachelor's, master's, doctorate)


name: Recommend pursuing recognized specialty board certifications


name: Encourage participation in quality improvement, safety, or decision-making teams


name: Recommend participation in evidence-based practice initiatives


name: Pursue organizational career advancement plans (e.g., clinical ladders), as appropriate


name: Participate in peer review activities, as appropriate


name: Recommend opportunities to advance role (e.g., charge RN, preceptor, leader)


name: Assist in creating professional portfolio, curriculum vitae, or resume


name: Provide guidance to conduct periodic review of goals, objectives, and strategies


name: Identify significant health needs or problems


name: Use available resources to determine need or priority (e.g., Community Health Needs Assessment tool)


name: Convene task force to examine priority need or problem


name: Evaluate cost, resource needs, feasibility, and required activities


name: Describe methods, activities, and time frame for implementation


name: Hire personnel to implement and manage program, as appropriate


name: Procure equipment and supplies, as appropriate


name: Keep continence specification record for 3 days to establish voiding pattern and determine likelihood of success


name: Allow time to self-initiate request for toileting assistance


name: Determine awareness of continence status by asking if wet or dry


name: Use respectful communication in all requests for voiding


name: Inform of time of next toileting session


name: Instruct to consciously hold urine between toileting sessions, if not cognitively impaired


name: Instruct to self-initiate requests to toilet in response to urge to void


name: Discuss continence record with staff to provide reinforcement and encourage compliance with prompted voiding schedule on weekly basis and as needed


name: Provide regular training for staff to ensure adequate comfort level with intervention


name: Determine cause (e.g., dermatologic, systemic, medications, psychogenic)


name: Perform full body physical examination to assist in identifying cause (e.g., location, onset, duration, rash, lesions, systemic symptoms)


name: Consider laboratory and radiologic diagnostic testing, as indicated


name: Treat or remove cause (e.g., insect infestation, infections, dry skin, allergic reaction) as indicated


name: Provide comfort measures as indicated (e.g., cold applications, medications, emollients)


name: Encourage use of complete emollient therapies (e.g., dermatological bath oils, soap substitutes, moisturizers), as indicated


name: Instruct to avoid perfumed products (e.g., bubble baths, soaps, oils)


name: Instruct to avoid bath soaps and shower gels that increase dry skin areas


name: Consider complementary and alternative therapies for qualifying persons (e.g., acupressure, aromatherapy, acupuncture)


name: Instruct not to wear tight-fitting clothing and wool or synthetic fabrics


name: Instruct to keep fingernails trimmed short


name: Instruct to minimize sweating by avoiding warm or hot environments


name: Instruct to limit bathing to once or twice per week and no longer than 20 minutes in bath water, as appropriate


name: Instruct to bathe in lukewarm water, pat skin dry, and avoid vigorous rubbing of skin to dry


name: Instruct to apply emollients after bathing to seal in water absorbed from bath


name: Encourage use of non-slip bathmat if oils and emollients used in bathing


name: Instruct to use palm of hand to rub over wide area of skin or pinch skin gently between thumb and index finger to relieve itching


name: Instruct persons with casts not to insert objects in cast to scratch skin


name: Notify of need to quarantine based on recommendations from local, state, or national health institutions


name: Provide detailed information about expected length of quarantine


name: Educate to monitor for symptoms of communicable infectious disease to which they were exposed


name: Provide rationale for necessity of quarantine


name: Identify if resides alone or with others


name: Provide recommendations to quarantine away from others living in home, as applicable


name: Instruct on infection prevention practices


name: Inform individual of quarantine restrictions specific to their communicable infectious disease (e.g., do not go to grocery store, do not interact with neighbors)


name: Provide community resources, as available, to support individual while in quarantine


name: Ensure access to basic human needs including food, water, household and medical supplies, and psychological support


name: Promote physical activity based on overall health status, while in quarantine


name: Evaluate nutritional, well-being, weight, and cardiovascular effects of quarantine if required for extended period of time


name: Provide documentation to support job protection (e.g., Family and Medical Leave Act documentation)


name: Instruct to continue current medication and health regimens, as appropriate


name: Monitor for increased anxiety and depression


name: Recommend appropriate interventions to promote mental and physical wellness during quarantine


name: Provide written list of communication methods for contact with health care provider


name: Offer telehealth appointments, as appropriate, for physical and mental health needs


name: Advocate for consistency in local, state, and national quarantine and isolation laws and policies


name: Determine clinical indications for induction


name: Explain procedure and rationale if indicated


name: Determine landmarks on anatomy and absence of obstruction (e.g., foreign body, epiglottitis, edema) to facilitate endotracheal tube placement


name: Preoxygenate with mask and bag for 3 minutes minimally


name: Pre-medicate as indicated to mitigate physiological response of body to intubation (e.g., lidocaine, atropine, fentanyl)


name: Give sedative (e.g., propofol, ketamine, etomidate) and paralytic (e.g., vecuronium, rocuronium, succinylcholine) at same time or quickly after induction


name: Place in proper intubation position (e.g., towels under head, align ears with suprasternal notch) after sedation and paralysis


name: Insert endotracheal tube and inflate cuff, no more than 1 minute after sedation and paralysis


name: Mark level of insertion at teeth and secure tube


name: Obtain confirmation of proper tube placement


name: Document care, including tube type, medications used, and tolerance of procedure


name: Initiate ongoing flexible plan for discharge throughout care continuum


name: Ensure that primary provider discharge goals and person goals coincide


name: Focus discharge planning efforts at multiple points during the pre-discharge and post-discharge periods, assuring ongoing family or caregiver involvement


name: Evaluate readiness for discharge as ongoing process


name: Assist in planning for supportive environment necessary to provide posthospital care


name: Provide description of possible signs and symptoms of condition post-discharge including helpful interventions


name: Review what to do if problem arises at home


name: Determine degree of understanding of overall discharge plan, including medications, dietary orders, treatments, and outpatient care, as indicated


name: Instruct on specific areas needed to prevent readmission (e.g., medication adherence and management, dietary needs, monitoring and reporting symptoms, staying physically active)


name: Provide medication calendar that lists brand and generic medication names and when and how to take medication


name: Encourage to bring medication calendar during provider follow-up


name: Elicit beliefs as to what constitutes an emergency


name: Instruct on what to do in cases of emergency (i.e., when to dial 911 versus call private health care provider)


name: Provide written copies of all information in preferred language


name: Provide appropriate contact numbers or provider or institution contact information with discharge instructions


name: Develop action plan to know when need to alert provider about decline in health


name: Report to provider any areas of concern for discharge teaching or planning, prior to discharge


name: Ensure appropriate discharge care setting for at-risk persons


name: Involve appropriate health care team for select high-risk persons (i.e., pharmacy for persons with greater than 15 medications, social services for homeless persons)


name: Consider post-discharge visits for medication reconciliation and adherence check for at-risk persons (e.g., heart failure with high LACE scores)


name: Enroll qualifying persons in 30-day readmission prevention program or transitional care program


name: Ensure ongoing adequate information flow with primary care providers and interdisciplinary care team


name: Ensure designated discharge advocate to coordinate with interdisciplinary team and at-risk person, if indicated


name: Compile comprehensive and accurate discharge summary


name: Plan for follow-up results from lab tests or labs pending at discharge


name: Advocate for home health assistance or health coaching for persons with areas of concern


name: Provide telephone reinforcement of discharge plan within 48 hours of discharge


name: Provide positive feedback via telephone during contacts to reinforce confidence and ability


name: Coordinate with home health agencies to increase discharge information, follow-up, or after-hospital care, as indicated


name: Consider home monitoring techniques for at-risk, qualifying persons (e.g., telemanagement, wireless sensors, video visits, audio and auscultation monitoring)


name: Determine need for palliative care or hospice referral, if indicated


name: Document readmission prevention plan and updates, per institutional policy


name: Identify nature and severity of signs and symptoms, as needed


name: Determine current level of knowledge of treatment, illness, self-care, and resources available


name: Establish physical, mental, and cognitive capacity to carry out recovery process independently


name: Determine willingness to participate in treatment plan


name: Explore past lapses or relapse episodes and relapse dreams or fantasies, as needed


name: Explore perception, awareness and attitudes toward illness, and attitudes and motivation toward changing health


name: Identify ethnic and cultural background, and community support, social environment, accommodation, religion, spiritual beliefs, and lifestyle factors


name: Explore personal protectors (e.g., coping mechanisms, self-efficacy in high-risk situations), and environmental protectors and potentiators, as needed


name: Explore personal vulnerability factors, high-risk behaviors, and cognitive factors (e.g., negative thinking, self-destructive patterns, rationalization, denial, desire for immediate gratification)


name: Identify situations, stressors, and crisis events (e.g., developmental, situational, adventitious) that may lead to relapse


name: Determine unrealistic expectancies in high-risk situations (i.e., expects substance use to help cope with negative emotions)


name: Explore warning signs for relapse as needed


name: Examine extent of social network, readiness, and actual capabilities to participate in symptom recognition plan and any characteristic of network (e.g., level of expressed emotion)


name: Establish relapse prevention plan with person, family, and social network (e.g., information, early detection, collaboration, agreements, actions, monitoring, realistic objectives for short, medium and long term), as needed


name: Use specific intervention strategies to enhance coping with high-risk situations (e.g., enhance self-efficacy, relapse management, cognitive restructuring)


name: Consider recommending participation in evidence-based self-management program with service users


name: Focus specific interventions on enhancing cognitive, emotional, and behavioral self-awareness


name: Promote participation in disease prevention, health promotion, treatment, and rehabilitation programs, as appropriate


name: Perform psychoeducation to persons, families, or social network (e.g., course of disease, early signs of relapse, comorbidities, treatment, sleep, coping skills, managing relationships), as needed


name: Use interdisciplinary approach, promoting coordination between different levels of care


name: Offer crisis resolution and home-treatment teams as first-line service if severity of episode or level of risk to self or others exceeds capacity of services or other community teams


name: Provide home care and monitoring, as needed


name: Maintain contact and follow-up, as needed


name: Facilitate hope for the future, as needed


name: Encourage manifestation of feelings, perceptions, and fears, as needed


name: Facilitate expression of difficulties for adherence to treatment and therapeutic plan, as needed


name: Encourage to assume responsibility for ADLs and self-care


name: Encourage healthy lifestyle (e.g., practice of physical exercise adapted to condition, healthy diet, participation in leisure activities, sleep hygiene), as needed


name: Promote treatment concordance, as needed.


name: Discuss effects of alcohol, tobacco, prescription and non-prescription drugs, and illicit drugs and their possible interference with treatment


name: Promote sustained abstinence from substance use over time


name: Discuss any non-prescribed therapies including complementary therapies (e.g., safety and efficacy of therapies, possible interference with therapeutic effects of prescribed medication, psychological interventions)


name: Promote use of adequate coping strategies in high-risk situations (i.e., behavioral strategy such as leaving the situation; cognitive strategy such as positive self-talk or self-reassurance), as appropriate


name: Provide communication and problem-solving skills training, as needed


name: Instruct to recognize and monitor warning signals (e.g., stress, lack of lifestyle balance, strong positive expectancies)


name: Instruct family and social network regarding monitoring of early warning signals, as needed


name: Instruct and encourage in techniques for anxiety and stress management (e.g., mindfulness-based techniques, relaxation techniques, stimulus control techniques), as needed


name: Instruct and encourage in motivational techniques, as needed


name: Assist to identify and use strengths and abilities


name: Link with community resources, as needed


name: Link with self-care or support groups, as needed


name: Monitor serum, urine, and expired air levels, as needed


name: Perform pharmacological monitoring, as needed


name: Monitor occasional lapses that may precipitate relapse, as needed


name: Monitor regularly for signs and symptoms of relapse (e.g., intensifying behaviors, medications modified or discontinued), especially when early warning signs are already present


name: Create a quiet, non-disrupting environment with dim lights and comfortable temperature, when possible


name: Identify excessive dependence upon religious leaders and practice


name: Recognize cultural and background influences on religious dependence


name: Seek guidance from those knowledgeable of culture or religious background


name: Encourage behaviors that contribute to growth and faith development, consistent with culture or belief system


name: Explore various elements of religious addiction


name: Explore freedom for beneficial religious formations


name: Instruct on methods to defend from religious or other addictive processes


name: Offer to pray for healthy, life-giving relationships with self, God or Higher Power, and others, as appropriate


name: Explore process of ongoing faith development with individual


name: Educate about dangers of using religion to control other persons


name: Promote formation of self-help groups or support groups that are relevant to individual, to develop religious balance


name: Provide opportunities for discussion of various belief systems


name: Encourage participation in religious rituals or practices that are not detrimental to health or safety


name: Identify desires regarding religious expression (e.g., lighting candles, fasting, circumcision ceremonies, food practices)


name: Provide access to pastoral care or religious advisor of choice


name: Offer quiet or sacred space for person and visitors when possible


name: Provide access to relevant items of religious participation (e.g., Bible, Quran, prayer rug, rosary, chador, veil, kippah, prayer shawl)


name: Demonstrate respect when religious items are displayed or given


name: Encourage ritual planning, participation, and attendance, as appropriate


name: Coordinate or provide transportation to worship site, when practical


name: Provide video or audio access to religious services, as available


name: Encourage to reflect on significant past spiritual experiences


name: Develop sense of timing for prayer or ritual to avoid interruptions


name: Answer all questions promptly and completely


name: Present optimistic attitude by pointing out positive aspects of relocation


name: Explore context of relocation including age and gender of person, previous relocations, perception of relocation, ability to adjust


name: Include in relocation plans, as appropriate


name: Explore what most important in person's life (e.g., family, friends, personal belongings)


name: Examine thoroughly all needs and preferences and include all available options for relocating


name: Allow time to think and provide opportunities to ask questions or state concerns


name: Validate and acknowledge positive and negative feelings surrounding transition


name: Assist to grieve and work through losses associated with relocation


name: Resolve concerns promptly, where possible


name: Be aware of transfer anxiety related to loss of close monitoring, secure environment, and dedicated staff when in acute care settings