MAINTAINS INFECTION CONTROL
YES NO |
BATH
SKIN CARE
PERSONAL CARE |
EXCELLENT
GOOD
FAIR
POOR |
KNOWLEDGEABLE OF TASKS
YES NO |
ORAL CARE
INCONTINENCE CARE |
AIDE COMMENTS:
|
DME USED
YES NO
|
NUTRITION
BED CARE
EXERCISE |
PATIENT/SIGNIFICANT OTHER COMMENTS:
|
FOLLOWING POC
YES NO
IDENTIFICATION BADGE
YES NO
|
BLOOD PRESSURE
PULSE RESP
TEMPERATURE
WEIGHT |
Medication reconciliation done: Yes No
No changes See changes |