How home health nurses can complete the home health visit optimally

During a home health visit, be it an assessment or weekly visit, a home health nurse is required to do certain processes such as taking patient’s vital readings, making note of any medication changes, upcoming doctor visit etc. During the home health visit, nurses are expected to do an all round evaluation of the patient’s health status.

We have a list of recommendations for home health nurses which will help you do your patient visit faster without compromising patient care quality. Check out our list of things to do during the home health visit below-

Taking Vital Readings

  1. When you arrive for the visit, take the patient vitals during early part of the home health visit.
  2. If the blood pressure or blood sugar numbers are high and out of the normal parameters, this would allow you some time to take a second reading after 30 minutes during the visit.
  3. If you keep vitals to the later part of the visit and you realize the numbers are high at that point, allowing another 30 minutes for the visit to take a second reading could cut into your time for the next appointment and consequently lead to delay.
  4. If the numbers do not settle to normal limits even at the end of home health visit, check with your agency policy regarding the measures to be followed. Make sure the caregiver is aware of the situation.
  5. The patient/caregiver could give you a stated reading on their blood pressure and blood sugars. They could say that it was taken just a while ago. Do not accept these stated readings and take one for your visit. Remember, you were there on job and complete it.


Taking Weight Readings

  1. Taking a weight reading on every patient visit is a healthy practice.
  2. Do not assume that the patient would have a scale in the house. Carry your scale always with you for the visit.
  3. Weight recording is even more important for patients with heart failure and renal failure, as it is an easy parameter indicating fluid retention.
  4. Also, weight recording plays a significant role in establishing calorie intake limitations and goals for obesity & diabetic patients.
  5. Try avoiding taking a stated weight reading, as they could not be current. If you accepted a stated weight reading, mark it as stated only your assessment. Otherwise, if another weight reading were taken during the visit following week, which differs heavily with the initial weight reading, it could be difficult to explain.


Future Visits and Doctors Visits

  1. Check with the patient/caregiver upon their availability for future visits.
  2. Though you can see the patient any day between Sunday – Saturday, having a regular weekly schedule to see the patient can make your job easy.
  3. Do not break the routine established to the extent possible, more so, with patients who you fill the medication.
  4. If you fail to show up on the scheduled day, these patients could not be having medication in pillbox to take.
  5. Check with the patient on all the doctors he/she visits and when was the last visit done.
  6. Check with the patient who the PCP is. Often, when the referral comes from the hospital, it could be from the doctor that took care of the patient during the hospital stay and they most likely will not sign the plan of care.
  7. They would want the patient to visit the PCP at the earliest after the discharge from hospital and expect the PCP to sign the plan of care.
  8. The PCP, to a large extent, will not sign the plan of care, unless the patient goes in for a visit after the discharge from hospital.
  9. Also, some patients can fall back on PCP visits and could not have visited the PCP in long time. In such situations, it can get difficult to have the plan of care approved.
  10. The patient should have visited the doctor approving the plan of care in the last 90 days or should visit the doctor in the coming 30 days. So, encourage your patient to schedule a visit with the PCP at the earliest and follow through that during upcoming visits.



  1. For Alzheimer’s patients and patients who are extremely caregiver dependent, check with the caregiver availability to schedule your visits.
  2. For these patients, you mostly educate the caregiver on the path to accomplish the goals established on the plan of care.
  3. Notify or communicate the agency regarding the same, so that, any other staff scheduling visits for these patients would also be aware of the caregiver availability.


Medications Documentation

  1. Among the medications, ask your patient/caregiver to list out medications that are new or had a dose change recently.
  2.  Check with your patient/caregiver if there are any medications to be picked up from pharmacy. If the patient is just discharged from hospital, it is likely there could be some medication(s) that are not picked up yet from pharmacy.
  3. While taking down the medications, make sure all the medications are not expired and are good to take.
  4. Check if the patient/caregiver is aware of the name of medication, their intended purpose, side-effects, and precautions to be taken.
  5. If they are unaware, this is something you will educate them upon during upcoming visits.
  6. Also, one medication could be taken for more than one reason.
  7. Asking the patient/caregiver the purpose medication was prescribed in their case can provide you more information about their health history.
  8. For example, the drug metoprolol could be prescribed for hypertension. The same metoprolol could also be prescribed for tachycardia or arrhythmia.
  9. So, knowing the intended purpose can not only help you educate the patient/caregiver accordingly, but also to code appropriately.


Therapy Evaluation

  1. Patient evaluation for therapy requirement is one area often neglected, which leads to underutilization of therapy services. So, a good insight into evaluation for therapy services assumes significance.
  2. When you arrive at the patient’s house, you can make a note of the number of floors in the dwelling, along with the floors accessed by the patient.
  3. Individuals could poorly perform on tasks, such as, walking, climbing up & down the stairs, transfers, sitting on the toilet and getting up, and dressing, thus inviting a fall risk.
  4. Also, determine whether the patient is safe with using the assistive device or needs an upgrade. Ask the patient to walk around a few steps with the device.
  5. You could also have them climb up & down the stairs if they have been doing it routinely.
  6. Check for proper & safe use of the assistive device, which could necessitate therapy intervention.
  7. Proper evaluation of pain could also call for therapy intervention. Physical therapy is primary management measure for joint pains.
  8. Improper use of assistive devices and poor posture could be contributing to the poorly controlled pain. So, evaluation of use of assistive devices could highlight the need for therapy intervention.
  9. Occupational therapy could help with proper use of assistive device, improving posture, and safe performance of tasks within the limits of patient’s home environment.