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Clinical Procedure Manual Review Board
The MedBridge Clinical Procedure Manual Review Board ensures the development and maintenance of up-to-date and evidence-based clinical procedures. The review board is composed of leading nurse experts in the field: Danielle Pierotti, RN, PhD, CENP, and Margherita Labson, RN, BSN, MSHSA. The review board is involved in selecting the scope of procedures developed, approving subject matter experts, and reviewing all clinical procedures.
Margherita Labson
Margherita Labson, RN, BSN, MSHSA, spent most of her career of 40+ years working to advance safe, quality home care, including home-based primary medicine, home care, skilled home health/infusion, and palliative and hospice care. During her 25 years at The Joint Commission as executive director of home care, she led the development and launch of the first certification for home-based palliative care providers and the first award recognizing franchisors devoted to promoting quality home care services. She left to continue her postgraduate studies and now works with CHAP as a strategic advisor and with other providers and associations to ensure compliance and to promote the advancement of safe, high-quality palliative care, hospice care, and home health care. She is an experienced educator, is a published author, is an experienced bereavement facilitator, and is currently completing work in spiritual direction. When not empaneled on committee as subject matter expert, she can be found working with groups to facilitate effective interdisciplinary operational performance and to coach leadership development, strategic planning, and bereavement and spiritual counseling.
Danielle Pierotti
Danielle Pierotti, RN, PhD, CENP, is a nurse leader, author, researcher, speaker, advocate, and educator. She is an expert in nursing leadership and healthcare quality. She is dedicated to the continuous advancement of individual health and wellness through the ongoing evolution of the science and practice of nursing. By actively translating research into practice and researching topics in practice, she strives to weave theory and practice into everyday actions.
Dr. Pierotti has been developing her practice for more than three decades, in acute, ambulatory, and home-based settings. She has represented and advocated for nurses and patient care directly with elected officials, federal and state policy agencies, and accrediting bodies. She has contributed to and led the development of numerous standards-of-care documents, national quality measures, and economic impact studies. She has served on committees with CMS, the National Quality Forum, and the Institute for Healthcare Improvement and has served as a reviewer to the MedPAC Report to Congress on Medicare utilization.
As the director for undergraduate nursing at Idaho State University, Dr. Pierotti is focused on the dual needs of Idahoans as patients and future nurses. She translates her commitment to person-centered care into student-centered education, leading innovation in public nursing education to increase access and success for everyone who wants to be a nurse in all the ways and places nurses can serve.
Courses with Clinical Procedure Manual Review Board
Browse Course CatalogDementia Assessment (Mini-Cog)
Presented by Deborah Chartrand, MSN, RN-BC, WCC and Clinical Procedure Manual Review Board
Dementia Assessment (Mini-Cog)
This course will cover the proper procedure, as well as patient assessment, follow-up interventions, and care considerations, for administering the Mini-Cog.
Parenteral Nutrition (PN) Administration
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Parenteral Nutrition (PN) Administration
This course will cover the proper procedure, as well as patient education, documentation guidelines, and care considerations, for parenteral nutrition (PN) administration.
Subcutaneous Fluid Administration
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Subcutaneous Fluid Administration
This course will cover the proper procedure, as well as patient education, documentation guidelines, and care considerations, for subcutaneous fluid administration.
Subcutaneous Medication Administration
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Subcutaneous Medication Administration
This course will cover the proper procedure, as well as patient education, documentation guidelines, and care considerations, for subcutaneous medication administration.
Phlebotomy
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Phlebotomy
This course will cover the proper procedure, as well as patient education, documentation guidelines, and care considerations, for phlebotomy.
Peripherally Inserted Central Catheter (PICC) Removal
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Peripherally Inserted Central Catheter (PICC) Removal
This course will cover the proper procedure, as well as patient education, documentation guidelines, and care considerations, for removal of a peripherally inserted central catheter (PICC).
Constipation Management
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Constipation Management
This course will cover the proper procedure as well as risk identification, caregiver education, and other care considerations for the prevention and palliative management of constipation.
Seizures Symptom Management
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Seizures Symptom Management
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the management of seizure symptoms.
Assessment—Suicide Risk (C-SSRS)
Presented by Deborah Chartrand, MSN, RN-BC, WCC and Clinical Procedure Manual Review Board
Assessment—Suicide Risk (C-SSRS)
This course will cover the proper procedure as well as documentation guidelines, intervention considerations, and clinical decision-making for assessing suicide risk with the Columbia-Suicide Severity Rating Scale (C-SSRS).
Assessment—Depression (PHQ-9)
Presented by Deborah Chartrand, MSN, RN-BC, WCC and Clinical Procedure Manual Review Board
Assessment—Depression (PHQ-9)
This course will cover the proper procedure as well as documentation guidelines, care considerations, and clinical decision-making for assessing depression with the Patient Health Questionnaire (PHQ-9).
Assessment—Anxiety (GAD-7)
Presented by Deborah Chartrand, MSN, RN-BC, WCC and Clinical Procedure Manual Review Board
Assessment—Anxiety (GAD-7)
This course will cover the proper procedure as well as assessment, interventions, documentation guidelines, and clinical decision-making for assessing anxiety with the Generalized Anxiety Disorder Questionnaire (GAD-7).
Pleural Catheter Management
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Pleural Catheter Management
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for draining a pleural catheter and changing the dressing at the pleural catheter site.
Application of TED Hose (Antiembolism Stockings)
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Application of TED Hose (Antiembolism Stockings)
This course will cover the proper procedure for the application of antiembolism stockings, as well as patient education, documentation guidelines, and care considerations.
Diabetes Assessment and Management
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Diabetes Assessment and Management
This course will cover the proper procedures as well as patient education, documentation guidelines, and care considerations for diabetes assessment and management.
Specimen Collection—Urine
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Specimen Collection—Urine
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for nose and throat specimen collection.
Administration of Enteral Feedings
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Administration of Enteral Feedings
This course will cover the proper procedure, as well as patient education, documentation guidelines, and care considerations, for the administration of enteral feedings with gastrostomy, jejunostomy, and nasogastric (large-bore and small-bore) tubes.
Changing a Gastrostomy Tube
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Changing a Gastrostomy Tube
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for gastrostomy care and changing a gastrostomy tube.
Suprapubic Catheter Care & Maintenance and Reinsertion
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Suprapubic Catheter Care & Maintenance and Reinsertion
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations when caring for, maintaining, and reinserting a suprapubic catheter.
Administration of Oxygen in the Home
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Administration of Oxygen in the Home
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the administration of oxygen and the cleaning of oxygen equipment in the home.
Neurological Assessment
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Neurological Assessment
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for performing a neurological assessment.
Application of Hydrogel Dressing
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Application of Hydrogel Dressing
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the application of hydrogel dressing.
Specimen Collection—Stool
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Specimen Collection—Stool
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for stool specimen collection.
Specimen Collection—Sputum
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Specimen Collection—Sputum
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for sputum specimen collection.
Assessment—Weight Measurement
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Assessment—Weight Measurement
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for weight assessment.
Pulse Oximetry
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Pulse Oximetry
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for pulse oximetry.
Use of a Hoyer/Hydraulic Lift
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Use of a Hoyer/Hydraulic Lift
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the use of a Hoyer/hydraulic lift.
Pneumatic Compression Device
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Pneumatic Compression Device
This course will cover the proper procedure, as well as patient education, documentation guidelines, and care considerations, for pneumatic compression.
Wound Care—Odor Management
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Wound Care—Odor Management
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for odor management in wound care.
Assessment of Home Safety for Patient and Family
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Assessment of Home Safety for Patient and Family
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the assessment of patient and family home safety.
Home Safety for Staff
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Home Safety for Staff
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for home safety for staff.
Medical Equipment—Cleaning and Disinfecting
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Medical Equipment—Cleaning and Disinfecting
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for cleaning and disinfecting medical equipment.
Mental Status Assessment—Mental Status Exam
Presented by Clinical Procedure Manual Review Board and Deborah Chartrand, MSN, RN-BC, WCC
Mental Status Assessment—Mental Status Exam
This course will cover the proper procedure as well as patient assessment, follow-up interventions, and care considerations for administering an MSE.
Management of Terminal Hemorrhage
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Management of Terminal Hemorrhage
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the management of a terminal hemorrhage.
Determination of Death
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Determination of Death
This course will cover the proper procedure as well as caregiver education, special circumstances, and other care considerations for the determination of death for a hospice patient.
Management of Hiccups
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Management of Hiccups
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the management of hiccups.
Pain Assessment
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Pain Assessment
This course will cover the proper procedure as well as evidence-based tools and other care considerations for thorough pain assessments at end-of-life.
Spiritual Needs Assessment
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Spiritual Needs Assessment
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for spiritual needs assessments.
Pain Management
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Pain Management
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for pain management.
Insulin Pen
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Insulin Pen
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the administration of insulin using an insulin pen.
Insulin Types—Onset and Duration
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Insulin Types—Onset and Duration
This course will cover patient education, documentation, clinical decision-making, and other care considerations related to the onset, peak time, and acting duration of different types of insulin.
Insulin Syringe Preparation
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Insulin Syringe Preparation
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the mixing, drawing, and administration of insulin through a syringe.
Nasogastric Tubes—Irrigation, Maintenance, and Removal
Presented by Audra Dennis, RN, BSN, COS-C and Clinical Procedure Manual Review Board
Nasogastric Tubes—Irrigation, Maintenance, and Removal
This course will cover the proper procedures as well as patient education, documentation guidelines, and care considerations for the irrigation, maintenance, and removal of NG tubes.
Application of Hydrocolloid Dressing
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Application of Hydrocolloid Dressing
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the application of hydrocolloid dressing.
Blood and Body Fluid Spills
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Blood and Body Fluid Spills
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for blood and body fluid spills.
Medication Disposal Guide / Sharps Disposal Dos and Don’ts
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Medication Disposal Guide / Sharps Disposal Dos and Don’ts
This course will cover the proper procedure as well as regulations, patient education, and other care considerations for safe and appropriate disposal of medications and sharps.
Application of Transparent Dressing
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Application of Transparent Dressing
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the application of transparent dressing.
Management of a Patient Utilizing Peritoneal Dialysis
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Management of a Patient Utilizing Peritoneal Dialysis
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for assessing and managing patients utilizing peritoneal dialysis. It will NOT describe how to provide peritoneal dialysis.
Ear Instillations and Irrigations
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Ear Instillations and Irrigations
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for instilling ear medication and irrigating the external ear.
Eye Medications—Drops and Ointments
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Eye Medications—Drops and Ointments
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the administration of eye drops and ointment medications.
Assessment—Musculoskeletal
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Assessment—Musculoskeletal
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for performing a musculoskeletal assessment in the home.
Opioid Conversion Factors
Presented by Cathleen Armato, RN, CHC and Clinical Procedure Manual Review Board
Opioid Conversion Factors
This course looks at conversions from short-acting to long-acting, routes of administration and their bioavailability, when to rotate opioids, and rotation of opioids by calculating the morphine milligram equivalent (MME).
PPE Sequence and Selection
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
PPE Sequence and Selection
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for donning and doffing PPE.
Application of a Leg Bag
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Application of a Leg Bag
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for applying a leg bag.
Unna Boot
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Unna Boot
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the application and wrapping of an Unna boot.
Residual Limb (Stump) Shaping and Shrinkage
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Residual Limb (Stump) Shaping and Shrinkage
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for shaping and shrinkage of a residual limb by wrapping with elastic bandage or applying a stump shrinker.
Aide Skills: Eating and Feeding
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Aide Skills: Eating and Feeding
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations when providing assistance with eating and feeding.
Tracheostomy—Humidity Administration, Speaking Valve Placement and Removal, and Unplanned Tube Decannulation
Presented by Karen LaRoché, RRT-ACCS and Clinical Procedure Manual Review Board
Tracheostomy—Humidity Administration, Speaking Valve Placement and Removal, and Unplanned Tube Decannulation
This course will cover the proper procedures as well as patient education, documentation guidelines, and care considerations for these essential areas of tracheostomy care: humidity administration, speaking valve placement and removal, and response to unplanned tube decannulation.
Management of Home Ventilators—Humidity Administration and Manual Ventilation With a Handheld Resuscitator
Presented by Karen LaRoché, RRT-ACCS and Clinical Procedure Manual Review Board
Management of Home Ventilators—Humidity Administration and Manual Ventilation With a Handheld Resuscitator
This course will cover the proper home ventilator management procedures as well as patient education, documentation guidelines, and care considerations for humidity administration and manual ventilation with a handheld resuscitator.
Management Of Automatic Implantable Cardioverter Defibrillator (AICD) and Monitoring Client With Pacemaker At Home
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Management Of Automatic Implantable Cardioverter Defibrillator (AICD) and Monitoring Client With Pacemaker At Home
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the management of an automatic implantable cardioverter defibrillator (AICD) and pacemaker.
Changing Oxygen Tank Regulators
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Changing Oxygen Tank Regulators
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for changing an oxygen tank regulator.
Specimen Collection—Nose and Throat
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Specimen Collection—Nose and Throat
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for nose and throat specimen collection.
Specimen Collection—Wound Culture Collection
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Specimen Collection—Wound Culture Collection
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for wound culture collection.
Use of a Holter Monitor at Home
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Use of a Holter Monitor at Home
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the use of a Holter monitor in the home setting.
Managing Airborne Precautions at Home
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Managing Airborne Precautions at Home
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the management of airborne precautions at home.
Liquid Oxygen System
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Liquid Oxygen System
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for the operation of a liquid oxygen system, including refilling of a portable device.
Aerosol Nebulizers and Inhalers
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Aerosol Nebulizers and Inhalers
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for aerosol nebulizer and inhaler treatments.
Cleaning and Checking a Hearing Aid
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Cleaning and Checking a Hearing Aid
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for cleaning and checking a hearing aid.
Transcutaneous Electrical Nerve Stimulation Unit (TENS)
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Transcutaneous Electrical Nerve Stimulation Unit (TENS)
This course will cover the proper procedures as well as patient education, documentation guidelines, and care considerations for the use of transcutaneous electrical nerve stimulation (TENS).
Diabetic Foot Screening and Diabetic Foot Care
Presented by Kim Tate, RN, BSN and Clinical Procedure Manual Review Board
Diabetic Foot Screening and Diabetic Foot Care
This course will cover the proper procedures as well as patient education, documentation guidelines, and care considerations for diabetic foot screening and foot care.
Hand Hygiene
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Hand Hygiene
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for hand hygiene.
Managing the COVID Patient at Home
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Managing the COVID Patient at Home
This course will cover the proper procedure, patient education, documentation guidelines, and care considerations for the management of the COVID patient at home.
Continuous Positive Airway Pressure (CPAP)
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Continuous Positive Airway Pressure (CPAP)
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for CPAP assessment and management.
Prevent Transmission of Bedbugs, Lice, and Scabies
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Prevent Transmission of Bedbugs, Lice, and Scabies
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations related to the prevention of transmission of bedbugs, lice, and scabies.
Clostridium Difficile
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Clostridium Difficile
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations related to the prevention of transmission of Clostridium difficile also known as C. diff.
Blood Pressure Measurement Education—Upper and Lower Extremity
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Blood Pressure Measurement Education—Upper and Lower Extremity
This course will cover the proper procedure as well as patient education, documentation guidelines, and care considerations for blood pressure measurement of the upper and lower extremities.
Vital Signs: Respiratory Rate
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Vital Signs: Respiratory Rate
Respiratory rate is a fundamental vital sign skill that is used to monitor various conditions being addressed in home healthcare. This is an assessment of breathing status that includes observations of the rate, depth, and pattern of breathing of the patient.
In this training, we'll review the equipment and procedures for assessing a patient's respiratory rate. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures in the home
It is important to observe both inspiration, or breathing air into the body, and expiration, pushing old air out of the body. This skill applies to all home health staff, including nurses, aides, and therapists.
Vital Signs: Pulses
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Vital Signs: Pulses
Pulse rate is a fundamental vital sign that is used to monitor various conditions being addressed in home healthcare. Knowing how to measure the pulse and recognize when the pulse rate is outside acceptable parameters or does not have a regular rhythm is an important skill to master. In this training, we'll review the equipment and procedures for checking a patient's pulse. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures
The pulse measurement is an assessment of the heart rate (how fast or slow the heart is beating) and the rhythm. This skill applies to all home health staff, including nurses, aides, and therapists. Checking the patient's pulse is necessary for most home health patients, and aides will perform this assessment when it is listed on the aide's plan of care.
Vital Signs: Temperature
Presented by Amy Shortall-Cardillo, MSN, RN, COS-C, WCC and Clinical Procedure Manual Review Board
Vital Signs: Temperature
Temperature is a fundamental vital sign that is used to monitor various conditions that can be addressed in home healthcare. Failure to obtain an accurate temperature can result in improper treatment. The purpose of measuring body temperature is to obtain an average temperature of the core body tissues. In this training, we'll review the equipment and procedures for assessing patient temperature. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing this procedure
This skill applies to all home health staff, including nurses, aides, and therapists. It is necessary for most home health patients, and aides will perform this assessment when it is listed on the aide's plan of care.
Administering an Enema
Presented by Amy Rose, RN, MSN, CHPN and Clinical Procedure Manual Review Board
Administering an Enema
Though constipation can usually be avoided with the correct application of a closely monitored bowel regimen, sometimes constipation that is chronic or related to disease processes requires the administration of an enema. In this training, we'll review the equipment and procedures for administering an enema. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures
Enemas are liquids instilled into the lower bowel to assist in the evacuation of stool or gas. Enemas can also be utilized to instill medications; however, this learning module specifically addresses the utilization of enemas for the treatment of constipation or fecal impaction. Enemas can be administered by RNs, LPNs, or aides if they have had special training and their scope of practice allows. Patients or family caregivers can also be educated on how to administer enemas.
This course was reviewed by Amy Rose, RN, MSN, CHPN, and Jennifer Kennedy, EdD, MA, BSN, RN, CHC, to ensure the content meets current professional guidelines and best evidence-based practices.
Digital Disimpaction or Stimulation
Presented by Amy Rose, RN, MSN, CHPN and Clinical Procedure Manual Review Board
Digital Disimpaction or Stimulation
Digital disimpaction is the utilization of a finger to manually break up and remove hardened stool, or impaction, in the lower rectal vault. Digital stimulation can be used for patients with neurodegenerative diseases affecting the lower colon who need to stimulate the muscle responses to defecate effectively. In this training, we'll review the equipment and procedures for digital disimpaction and stimulation. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures
Though fecal impaction can usually be avoided with the correct application of a closely monitored bowel regimen, sometimes constipation that is chronic or related to disease processes requires the use of digital disimpaction to assist in the evacuation of hardened stool. Digital disimpaction or stimulation can be administered by an RN or LPN. Patients or family caregivers can also be educated on how to complete digital disimpaction or stimulation.
This course was reviewed by Amy Rose, RN, MSN, CHPN, and Jennifer Kennedy, EdD, MA, BSN, RN, CHC, to ensure the content meets current professional guidelines and best evidence-based practices.
Hospice RN Comprehensive Assessment
Presented by Amy Rose, RN, MSN, CHPN and Clinical Procedure Manual Review Board
Hospice RN Comprehensive Assessment
The comprehensive assessment is an integral competency of home-based care delivery. In this training, we'll review the equipment and procedures for administering the comprehensive assessment. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures
This assessment is conducted at the start of care and at regular intervals throughout the care and allows the care team to have a baseline of a patient's condition as the patient progresses through care. A comprehensive assessment can be completed by an RN or LPN/LVN but is most commonly completed by the RN. In this training, we'll review the equipment and procedures for administering the comprehensive assessment. We will also review the completion of a mid-arm circumference measurement--a measurement of the mid upper arm to determine weight and muscle mass gain or loss for a patient who can no longer be weighed on a scale.
This course was reviewed by Amy Rose, RN, MSN, CHPN, and Jennifer Kennedy, EdD, MA, BSN, RN, CHC, to ensure the content meets current professional guidelines and best evidence-based practices.
Functional Assessment Staging Tool (FAST) for Dementia
Presented by Amy Rose, RN, MSN, CHPN and Clinical Procedure Manual Review Board
Functional Assessment Staging Tool (FAST) for Dementia
The Functional Assessment Staging Tool, also known as FAST, is a common tool used for scoring a patient's progression in Alzheimer's disease. In this training, we'll review the equipment and procedures for using the Functional Assessment Staging Tool. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures
The FAST is an important quantitative tool the interdisciplinary team can use to review a patient's progress. Typically, the FAST is performed by a registered nurse.
This course was reviewed by Amy Rose, RN, MSN, CHPN, and Jennifer Kennedy, EdD, MA, BSN, RN, CHC, to ensure the content meets current professional guidelines and best evidence-based practices.
Nutrition and Hydration at End of Life
Presented by Amy Rose, RN, MSN, CHPN and Clinical Procedure Manual Review Board
Nutrition and Hydration at End of Life
Nutrition and hydration at the end of life can contribute to a patient's quality of life. In this training, we'll review the equipment and procedures for ensuring nutrition and hydration as well as for administration of a nutritional assessment. This course includes
o Video demonstrations of procedures
o Tips and best practices for performing these procedures
As patients progress through the death and dying process, their nutritional needs can fluctuate, requiring frequent assessment and flexible interventions to ensure high-quality care. The RN is the primary coordinator of assessments and nutritional care. There may be a need to refer the patient to a dietician for engagement in the care plan. Other members of the interdisciplinary group, such as home health aides, can often contribute valuable information to the nutritional assessment as they are most often present during patients' mealtimes.
This course was reviewed by Amy Rose, RN, MSN, CHPN, and Jennifer Kennedy, EdD, MA, BSN, RN, CHC, to ensure the content meets current professional guidelines and best evidence-based practices.
Hospice Postmortem Care
Presented by Amy Rose, RN, MSN, CHPN and Clinical Procedure Manual Review Board
Hospice Postmortem Care
Postmortem care is the care of a patient's body after death has occurred. The period after death occurs is a sacred time for many and can contribute significantly to a loved one's grieving process. In this course, we'll review the equipment and procedures for postmortem care. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures
Postmortem care can include a variety of procedures that require sensitivity and an awareness of the patient's cultural and/or religious preferences. Though declaration or assessment of death requires a medical provider or coroner, postmortem care can be provided by RNs, LPNs, or aides and often includes the spiritual care provider or social worker.
This course was reviewed by Amy Rose, RN, MSN, CHPN, and Jennifer Kennedy, EdD, MA, BSN, RN, CHC, to ensure the content meets current professional guidelines and best evidence-based practices.
Medication Reconciliation in the Home
Presented by Amy Rose, RN, MSN, CHPN and Clinical Procedure Manual Review Board
Medication Reconciliation in the Home
Medication management in the home care environment can be complicated. The healthcare professional can have a meaningful impact on the safety and effectiveness of a patient's medication regimen through a full medication reconciliation. In this training, we'll review the equipment and procedures for conducting a medication reconciliation. This course includes
o Video demonstrations of procedures
o Downloadable procedure guide PDFs
o Tips and best practices for performing these procedures
The cost of care provided to patients due to drug-related issues in the US is estimated at $14 billion annually, and approximately 30% of hospital admissions are related to medication. Older adults discharged from the hospital on five or more medications are more likely to visit the emergency department or be rehospitalized within six months after discharge. After taking this course, you should understand the impacts of and be able to conduct a comprehensive medication reconciliation in the home.
This course was reviewed by Amy Rose, RN, MSN, CHPN, and Jennifer Kennedy, EdD, MA, BSN, RN, CHC, to ensure the content meets current professional guidelines and best evidence-based practices.
Bag Technique
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Bag Technique
Proper bag technique is an essential part of providing effective care as a home health provider. In this training, we'll review the equipment and procedures for bag technique. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Every time you visit a patient's home, you should make sure you're following effective bag technique to prevent any cross contamination and keep your patients healthy.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Cardiovascular Assessment
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Cardiovascular Assessment
A cardiovascular assessment is commonly conducted to understand the patient's current status as it deviates from baseline or normal functioning. The results of this assessment are then used to develop a comprehensive clinical picture with the primary care provider, to develop a proper plan of care, and to implement interventions.
In this training, we'll review the equipment and procedures for the Cardiovascular Assessment. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Throughout the procedure, nursing staff, physical therapists, and physician assistants must consider the patient's age, past medical history, surgical interventions, thoracic trauma, and any medication use.
We will learn how to assess cardiovascular anatomy through inspection, palpation, and auscultation as well as assess cardiovascular function through a series of subjective and objective questions.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Edema Assessment and Management
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Edema Assessment and Management
Assessment of lower extremity edema is commonly conducted to understand the patient's current status as it deviates from baseline or normal functioning. In this training, we'll review the equipment and procedures for edema assessment and management. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
The results of this assessment are used to develop a comprehensive clinical picture with the primary care provider, to develop a proper plan of care, and to implement interventions. Throughout the assessment, nursing staff, physical therapists, and physician assistants must consider the patient's age and genetics, past medical history, surgical interventions, and any medication use.
In this instruction, we will review the equipment and procedures used for identifying and assessing peripheral edema through palpation.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Cardiac Pulses Assessment: Upper Body and Lower Extremity
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Cardiac Pulses Assessment: Upper Body and Lower Extremity
A pulse assessment is commonly conducted to understand the patient's current status as it deviates from baseline or normal functioning. In this training, we'll review the equipment and procedures assess cardic pulses for the upper and lower extremity. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
The results of this assessment are then used to develop a comprehensive clinical picture with the primary care provider, to develop a proper plan of care, and to implement interventions. Throughout the assessment, nursing staff, physical therapists, and physician assistants must consider the patient's age and genetics, past medical history, surgical interventions, peripheral trauma and scarring, and presence of severe edema.
In this training, we will review the equipment and procedures for identifying and assessing peripheral pulses through palpation.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Gastrointestinal Assessment
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Gastrointestinal Assessment
A gastrointestinal, or GI, assessment is commonly conducted to understand the patient's current status as it deviates from baseline or normal functioning. In this training, we'll review the equipment and procedures for how to perform an assessment of the gastrointestinal anatomy through inspection, palpation, percussion, and auscultation, and how to assess the gastrointestinal function. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
The results of this assessment are then used to develop a comprehensive clinical picture with the primary care provider, to determine proper plans of care, and to implement interventions. When conducting a GI assessment, nursing staff, physical therapists, and physician assistants must consider the patient's age, surgical interventions, medication use, and any trauma the patient has experienced.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Ostomy/Ileostomy Assessment and Pouch Change: One- and Two-Pouch System
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Ostomy/Ileostomy Assessment and Pouch Change: One- and Two-Pouch System
Assessing, pouching, and providing stoma care are necessary procedures for patients who require the use of a pouch system for treatment. It is important for nursing staff, physician assistants, physical therapists, and occupational therapists to have a thorough understanding of this procedure to assess the function of the patient's newly formed stoma. In this training, we'll review the equipment and procedures for ostomy/ileostomy assessment and pouch change for the one- and two-pouch systems. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Throughout the procedure, clinicians must be aware of skin irritation that can occur with an ill-fitting pouching device on an ileostomy, as well as any allergies to adhesives the patient may have.
In this instruction, we will learn how to perform an assessment on a stoma and determine the appropriate output for ostomy type, as well as assist nurses in understanding how to care for a patient with a colostomy or ileostomy.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Genitourinary (GU) Assessment
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Genitourinary (GU) Assessment
A genitourinary, or GU, assessment is commonly conducted to understand the patient's current status as it deviates from baseline or normal. In this training, we'll review the equipment and procedures to assess the bladder's anatomical size, location, and function through palpation and questioning as well as assess the kidneys for signs and symptoms of kidney dysfunction. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
The results of this assessment are then used to determine appropriate interventions and plans of care for the patient. When conducting a GU assessment, nursing staff, physical therapists, and physician assistants must consider the patient's age, medication use, and any transplantations.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Urinary Catheter Irrigation
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Urinary Catheter Irrigation
Irrigation of a urinary catheter is an essential procedure for patients who require catheter placement for treatment. In this training, we'll review the equipment and procedures for urinary cateter irrigation. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This procedure is an aseptic procedure that requires adequate space for sterile field and equipment. When irrigating a catheter, it is important to adhere to evidence-based procedures to prevent home care-acquired conditions such as catheter-associated urinary tract infections (CAUTIs).
In this training, we'll review the equipment and procedures for performing irrigation of a urinary catheter.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Urinary Catheterization: Intermittent and Continuous
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Urinary Catheterization: Intermittent and Continuous
A urinary catheter is commonly placed for patients who require treatment for urinary retention or urinary obstruction. In this training, we'll review the equipment and procedures for urinary catheterization. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This is an aseptic procedure that requires adequate space for sterile field and equipment. When inserting a catheter, nursing staff must adhere to evidence-based procedures to prevent home care-acquired conditions such as catheter-associated urinary tract infections (CAUTIs).
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Urostomy Stoma Care
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Urostomy Stoma Care
Assessment of a stoma for an ileal conduit is a necessary procedure for determining a plan of care for a patient requiring stoma care. In this training, we'll review the equipment and procedures for performing an assessment on a stoma for an ileal conduit, as well as how to care for a patient with a urostomy and ileal conduit stoma. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Nursing staff and physician assistants conducting the assessment must consider treatment of skin irritation from an ill-fitting pouching device, as well as any allergies the patient may have to adhesives commonly used in the procedure.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Percutaneous Nephrostomy (PCN) Site Care, Tube Care, and Irrigation
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Percutaneous Nephrostomy (PCN) Site Care, Tube Care, and Irrigation
Assessing a percutaneous nephrostomy (PCN) site is a necessary procedure for patients who require the use of a PCN for treatment. In this training, we'll review the equipment and procedures to perform an assessment of the nephrostomy insertion site, troubleshoot possible complications related to nephrostomy obstruction, and explore evidence-based care to reduce infection. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
It is important to have a thorough understanding of PCN and site assessment as understanding line maintenance is crucial when caring for patients with lines and drains at home, the assessment is a relatively common and high-risk procedure that requires knowledge of aseptic technique to prevent possible infectious processes, and clinicians need to be aware of possible sequelae and monitor the patient for signs and symptoms of dehydration, infection, and/or bleeding. Throughout this procedure, nursing staff must adhere to proper aseptic technique, utilizing sterile gloves and a sterile field.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Respiratory Assessment
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Respiratory Assessment
An assessment of a respiratory, or pulmonary, system is commonly conducted to understand the patient's current status as it deviates from baseline or normal functioning. The results of this assessment are used to develop a comprehensive clinical picture with the primary care provider, to develop a proper plan of care, and to implement interventions. In this training, we'll review the equipment and procedures for respiratory assessment. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Throughout the assessment, nursing staff, physical therapists, and physician assistants must consider the patient's age and genetics, past medical history, surgical interventions, and any medication usage.
In this instruction, we will review the equipment and procedures for performing a respiratory assessment utilizing subjective and objective techniques as well as identifying abnormal lung sounds.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Tracheostomy Care
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Tracheostomy Care
Many patients require the use of a stoma and tracheostomy for treatment to prevent airway compromise. In this training, we'll review the equipment and procedures for tracheostomy care. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
It is imperative the home health nurse be able to perform tracheostomy care for these patients. Throughout the care procedure, nursing staff must consider the patient's age and genetics, past medical history, surgical interventions, and any medication use.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Peak Flow Meter Use and Assessment
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Peak Flow Meter Use and Assessment
A peak flow meter is commonly used to determine deviations from normal lung function related to respiratory symptoms. Throughout the procedure, nursing staff and physician assistants must consider the patient's age and genetics, past medical history, and any medication use. In this training, we'll review the equipment and procedures for utilizing a peak flow meter to measure forced expiratory volume to determine lung function related to respiratory symptoms. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Spacer Use and Cleaning
Presented by Amanda Fay, MSN, RN and Clinical Procedure Manual Review Board
Spacer Use and Cleaning
A multidose inhaler (MDI) chamber, or spacer, is commonly used by patients who require inhalation of medicine for treatment. In this training, we'll review the equipment and procedures for using a spacer use and cleaning. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Nursing staff, physical therapists, and physician assistants must be able to instruct patients on the appropriate use and rationale for a chamber with multidose inhaler use. Throughout the procedure, clinicians must consider the patient's age and genetics, past medical history, surgical interventions, and any medication use.
In this instruction, we'll review the equipment and procedures for using a chamber (aka spacer) appropriately for patients prescribed a multidose inhaler for a respiratory condition, as well as cleaning a chamber appropriately to prevent cross contamination.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
General Infusion Therapy Administration: IV Push, Gravity Drip, Elastomeric Pump, Electronic Infusion Pump
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
General Infusion Therapy Administration: IV Push, Gravity Drip, Elastomeric Pump, Electronic Infusion Pump
Infusion therapy is administered via a variety of methods, depending on the prescribed medication or solution, the frequency of administration, infusion rate requirements, drug stability, patient safety and preferences, and reimbursement. This course will discuss different general infusion therapy administration techniques such as IV push, gravity drip, elastomeric pump and electronic infusion pump.
In this training, we'll review the equipment and procedures for these different infusion methods. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Central Venous Access Device (CVAD): Site Care and Dressing Change, Flushing and Locking
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Central Venous Access Device (CVAD): Site Care and Dressing Change, Flushing and Locking
A central vascular access device (CVAD) is commonly placed for patients who require weeks or months of infusion therapy. In this training, we'll review the equipment and procedures for CVAD site care, dressing changes, flushing, and locking. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course will cover the most common type of CVADs such as the peripherally inserted central catheter (PICC). Other types of CVADs include subcutaneously tunneled catheters, which are more common for very long courses of infusion therapy such as parenteral nutrition, and nontunneled CVADs, which are less often seen in home care. The implanted vascular port is another type of CVAD but is not addressed in this module.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Central Venous Access Device (CVAD): Blood Sampling for Laboratory Studies
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Central Venous Access Device (CVAD): Blood Sampling for Laboratory Studies
Blood withdrawal from central venous access devices, or CVADs, for laboratory studies is a common practice in home health. Patients generally prefer blood withdrawal from CVADs over venipuncture to avoid the brief pain and discomfort associated with venipuncture. Risks of this procedure include bloodstream infection (BSI) due to catheter manipulation at the hub, loss of catheter patency (occlusion), and erroneous laboratory values. Attention to Aseptic Non Touch Technique, or ANTT, and adequacy of flushing and locking will reduce risks of infection/occlusion.
In this training, we'll review the equipment and procedures for CVAD blood sampling for laboratory studies. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Accessing an Implanted Vascular Access Port
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Accessing an Implanted Vascular Access Port
The implanted vascular access port is a central vascular access device (CVAD) that is placed completely underneath the skin. The port consists of a catheter attached to a reservoir, or port, and is accessed through the skin using a noncoring, or Huber, needle. The port may be located in the chest and placed via the subclavian or internal jugular vein. Alternatively, the port can be placed in the arm above the antecubital area via one of the upper arm veins (e.g., basilic, cephalic, or brachial). As with any CVAD, the catheter tip should be located in the lower third of the superior vena cava at or near the cavoatrial junction. The implanted port is commonly placed for patients who require weeks or months of infusion therapy. The port requires access when needed for infusion therapy or for routine flushing and locking.
In this training, we'll review the equipment and procedures for accessing an implanted vascular access port for patients with CVADs. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Peripheral IV Catheter (PIVC) Insertion
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Peripheral IV Catheter (PIVC) Insertion
A peripheral IV catheter (PIVC) is placed for patients who require several days, but generally less than a week, of infusion therapy when the medication or solution is well tolerated by peripheral veins. Drugs that are irritating, classified as vesicants, or hyperosmolar are administered with caution via a PIVC. A PIVC may also be the vascular access device of choice for patients who require an occasional dose of a medication (e.g., furosemide) or biologic agents (e.g., infliximab) that are administered on a less frequent basis, such as once every four to eight weeks.
In this training, we'll review the equipment and procedures for insertion of a PIVC. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Discontinuing a Chemotherapy Infusion
Presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN and Clinical Procedure Manual Review Board
Discontinuing a Chemotherapy Infusion
Chemotherapy infusions are usually set up at the oncology center. Some patients undergoing chemotherapy will receive these infusions at home over several days, with orders for the home care agency nurse to discontinue the infusion. Notably, some patients may be taught to do this procedure independently by the oncology center nurses. Most patients will have an implanted vascular port in place for the infusions. There are a number of chemotherapy infusions that are home administered, 5-fluorouracil being an example of a very common home infusion chemotherapy drug. Chemotherapy drugs are hazardous drugs, based on characteristics including carcinogenicity, teratogenicity, reproductive toxicity, organ toxicity at low doses, and genotoxicity. While there is scarce literature on hazardous drug education for home care nurses, nurses who administer any level of chemotherapy should receive specific education. The Oncology Nursing Society provides excellent online education and recommendations, such as a best practice and a clinical competency for all home care nurses who perform any chemotherapy procedures. While nurses may consider this procedure a task, often referring to it as a "chemotherapy takedown," it involves much more than performing procedures.
In this training, we'll review the equipment and procedures for discontinuing a chemotherapy infusion. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Wound Care: Assessment and Measurement
Presented by Carrie Adkins, RN, BSN, CWOCN and Clinical Procedure Manual Review Board
Wound Care: Assessment and Measurement
Assessing and measuring wounds is vital for the care and treatment of patients with wounds in the home care setting. By assessing a wound and its characteristics, you can determine proper treatment and organize a plan of care for the patient. Having a proper wound assessment is important not only for the patient's care but also to enable fellow nurses to read the documentation of the previous home health visits for a clear picture of wound status. In addition, accurate wound assessment is important for the OASIS assessment that contributes to reimbursement for a home health agency.
In this training, we'll review the equipment and procedures for assessing and measuring a wound.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Wound Care: Cleansing and Packing a Wound
Presented by Carrie Adkins, RN, BSN, CWOCN and Clinical Procedure Manual Review Board
Wound Care: Cleansing and Packing a Wound
A packed wound will need to be unpacked, irrigated/cleansed, and repacked. In this training, we'll review the equipment and procedures for cleansing and packing a wound. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Debris and excess exudate need to be removed while cleaning to support healthy healing. Properly packing and dressing a wound ensures a wound has the best environment in which to heal. If one packs the wound too tightly, there is no room for new tissue to grow. If a wound is packed with too little dressing, then the packing may get lost or not absorb enough exudate.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Wound Care: Multilayer Compression Therapy
Presented by Carrie Adkins, RN, BSN, CWOCN and Clinical Procedure Manual Review Board
Wound Care: Multilayer Compression Therapy
Multilayer compression therapy, also known as multicomponent compression bandaging, is an essential component for healing venous stasis ulcers. It improves venous function for ambulatory patients with venous ulcers to the lower legs.
In this training, we'll review the equipment and procedures for Multilayer Compression Therapy. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
A light or modified compression system may be used for patients with "mixed," or venous and arterial, disease. Medicare guidelines may not consider compression wrapping a skilled need with home care patients when there is not a wound or active drainage from the lower legs. There are cases in which the entire leg is wrapped with compression wrapping, but this technique is not often utilized with home care patients.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Wound Care: Negative-Pressure Wound Therapy
Presented by Carrie Adkins, RN, BSN, CWOCN and Clinical Procedure Manual Review Board
Wound Care: Negative-Pressure Wound Therapy
Negative-pressure wound therapy (NPWT) is a type of topical wound care that promotes wound healing by reducing edema, assisting with granulation tissue formation, and increasing blood flow. It assists with fighting infection.
The goals of NPWT are to promote the growth of granulation tissue in the wound bed and to manage exudate in the wound to promote moist wound healing.
In this training, we'll review the equipment and procedures for negative-pressure wound therapy. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Wound Care: Staple and Suture Removal
Presented by Carrie Adkins, RN, BSN, CWOCN and Clinical Procedure Manual Review Board
Wound Care: Staple and Suture Removal
Staple and suture removal are essential to the recovery process for some patients in the home care setting. In this training, we'll review the equipment and procedures for removing surgical staples and sutures. This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
Prior to completing this skill, you need to have a physician's order, be aware of any bleeding precautions for the patient, and ensure the patient is premedicated for pain they are experiencing. This skill applies to both nurses and therapists.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
Wound Care: Jackson-Pratt Drain (JP Drain) Care and Removal
Presented by Carrie Adkins, RN, BSN, CWOCN and Clinical Procedure Manual Review Board
Wound Care: Jackson-Pratt Drain (JP Drain) Care and Removal
Many patients in the home health setting will have a Jackson-Pratt drain or bulb drain. These provide low-pressure suction and pull fluid or air from a surgical site. In this training, we'll review the equipment and procedures for JP drain emptying, suction reactivation, insertion site dressing, and drain removal.This course includes
- Video demonstrations of procedures
- Downloadable procedure guide PDFs
- Tips and best practices for performing these procedures in the home
It is important for nurses to be competent and confident in this skill as the goal is to teach the patient how to care for the JP drain and know when to call the physician or home care nurse with concerns. Nurses are the primary clinicians who will need to know and teach this skill.
This course was reviewed by Danielle Pierotti, RN, PhD, CENP, to ensure the content meets current professional guidelines and best evidence-based practices.
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