Tips for Hospice Nurses: Comparative charting is a good way to illustrate subtle decline

Tips for Hospice Nurses: Comparative charting is a good way to illustrate subtle decline - it is simply, “patient was (this), now they are (this).
I don’t generally use comparative charting in my routine notes, but I will always use it throughout my Recert notes.
With measures, it is very straight forward:
1. LMAC was 27.6, now LMAC is 25.2
2. PPS was 40%, now PPS is 30%
3. B/p avg was 130/80, now 80/50
For more subtle decline, comparative charting looks like:
1. Patient was able to ambulate down the hall to his bedroom; however, due to progressively worsening debility, patient unable to ambulate the short hallway, and must stop and rest halfway.
2. Patient was able to ambulate the short distance to his bedroom with frequent breaks to rest, but due to progression of terminal illness and worsening weakness, patient now must be wheeled to his bedroom.
3. Patient was consuming approx 70% of 3 meals daily, but due to decline, patient now only able to consume approx 40% of 2 meals daily.
4. Patient was mostly continent, but due to progressively worsening weakness patient too weak to get to even the bedside commode now, and requires diapers and protective pads at all times.
To make comparative charting on recertification easier and faster, I keep a “recert jot” note on all my pts, and when any decline or event occurs, I write it on the note.
If you would like a copy of the recert jot note, email me or visit my website to submit a request. (Please don’t put your request here r/t it’s difficult to capture all the comments)
Be safe out there!
I love Ya’ll …
xoxo ~ Shelley 💕
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