Hospice Initial Pain Assessment

Try out this free hospice initial pain assessment to gather information about hospice patients before providing quality care services.

This hospice initial pain assessment form allows you to record initial information about a patient's current medical situation, living arrangements and pain history to develop the appropriate care plan. Hospice nurses and caregivers can record the patient's health status and any services they provided during the visit.

Try our hospice initial pain assessment for free on any mobile device with a free trial of IntouchCheck mobile form software. Sign up for a free trial today and ask your Intouch specialist to load this pre-built form into your account.

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Hospice caregivers and nurses providing palliative care services to chronically ill or terminally ill patients have to better understand the needs of their charges so they can provide the appropriate end-of-life services. By learning about their patients, hospice workers can offer medical, emotional, psychological and spiritual support so their patients are comfortable and happy during this time in their lives.

The hospice initial pain assessment form allows hospice workers to gather important medical, psychological and behavioral information during the first meeting. With this information, a care plan can be created that specifically fits into each patient's needs.

Form Details

Our mobile hospice initial pain assessment form can be used by hospice caregivers, nurses and other medical professionals when they obtain a new patient that will be under their care. They can gather information about medical conditions, mobility issues, medications, the patient's mental and behavioral state, and other related hospice care data. By obtaining this information, hospice workers can perform an initial pain assessment and document services that were provided during this first visit.

The hospice initial pain assessment form can be used on any mobile device such as a smartphone, iPhone, iPad or tablet device. We have incorporated these categories fields into our template:

  • Administrative information
  • Level of provided care
  • Date
  • Time in/out
  • Topics that will be discussed with patient during initial visit
  • Patient diagnosis
  • Spiritual need intervention
  • Living arrangements
  • Sensory status
  • Pain screening
  • Respiratory, cardiovascular, renal, gastrointestinal and integumentary status
  • Psychological, emotional, mental and behavioral status
  • Permitted activities
  • Goals and outcomes of hospice care
  • Prognosis

Customize Your Digital Hospice Initial Pain Assessment

We know that every business is unique, and your forms should reflect that. Our ready-to-use template is a comprehensive list of industry standard fields, but it is most useful when customized to reflect your own needs. The IntouchCheck platform makes it simple to quickly customize the mobile form template to meet the individual needs of your company and goals; questions, fields, or sections can be quickly removed, and new queries or fields can be added in the appropriate places to fit your project.

Create Your Own Hospice Initial Pain Assessment Template

Already have processes and procedures in place? IntouchCheck’s straightforward interface makes it fast and easy to create your own forms, where you can customize the sections, categories, questions, and types of data/image capture fields. We’re here to help you get started! Try IntouchCheck for free, and see how easy it is to streamline your business processes.