Premier Home Health Care

Transitional Care

RN DIABETES CLINICAL PATHWAY - Visit 2

  • 1 Expected Outcomes
  • 2 Interventions
  • 3 Signature

Patient will verbalize use, dose, side effects of medication

select "Yes" or "No"

Patient will demonstrate ability to self-administer insulin, if applicable

select "Yes" or "No"

Patient will verbalize understanding of proper disposal of lancets/syringes in appropriate container

select "Yes" or "No"

Patient will demonstrate proper care and storage of Diabetic supplies

select "Yes" or "No"

Patient will verbalize dietary restrictions as per prescribed diet

select "Yes" or "No"

Patient will record and monitor blood glucose levels

select "Yes" or "No"

Instruct on dose, use, side effects of medications

select "Yes" or "No"

Assess/Instruct insulin preparation and self-administration, include site rotation

select "Yes" or "No"

Check and document the current finger stick. Notify NP/MD if results outside of parameters

select "Yes" or "No"

Initiate blood glucose log, instruct on parameters to report, interpretation of results

select "Yes" or "No"

Instruct on/provide proper container for sharps disposal and proper disposal of sharps container

select "Yes" or "No"

Provide written instructions and Initiate diet teaching, assist with meal planning/choices

select "Yes" or "No"

Assess knowledge of s/s hypo/hyper-glycemia

select "Yes" or "No"

If HHA present, supervise aide as per POC

select "Yes" or "No"

If PT services initiated, assess patient’s knowledge of/compliance with exercises/HEP

select "Yes" or "No"

Finished

Please sign here! Go to Visit 3