Patient Advocate Responsibilities

Question 1

What is the order that you should take vitals?

temperature, respiratory rate, heart rate, blood pressure, height, weight

Answer 1

1) weight
2) height
3) temperature
4) heart rate
5) respiratory rate
6) blood

Question 2

How long should taking vitals take (max)?

Answer 2

6 mins max

Question 3

How do you weigh a patient? 1, 2, 3, 4

Answer 3

1. ask patient to remove shoes and heavy jacket
2. move the appropriate block first. make sure the ticks are lining up
3. move the blocks slowly to make sure that the scale is balanced
4. always record total weight in lbs
   REMEMBER to 0 the scale before moving on

Question 4

How do you take the height of a patient?
5 steps

Answer 4

1. ask patient to stand up straight with their feet all the way back against the wall
2. line the lever up with the patient’s height
3. record in ft. in.
4. REMEMBER to scale back to 5 ft. (vitals outside)
5. Patient may put their shoes back on. Keep thick/heavy jackets off until after vitals are done

Question 5

How do you take a patient’s temperature?
97.6-99.6*F
8 steps

(Don’t memorize all of this, receptionist is the one in charge)

Answer 5

1. Put on Gloves (non-dominant hand)
2. Clean the mouth of the thermometer with an alcohol wipe
3. Put on a thermometer cover
4. Turn on the thermometer
5. Gently place it under the patient’s tongue
6. Record the temperature once you hear multiple “beeps”
7. Remove the slip from the thermometer and clean it again with an alcohol wipe
8. Patient should be sitting up straight and feet flat on ground from here on out

Question 6

How do you measure heart rate? 3 steps

60-100 at rest

Answer 6

1. Place your middle finger and index at the base of the thumb to find the patient’s pulse
2. Count the number of pulses for 30 secds (mult by 2)
3. Record heart rate on chart

Question 7

How do you measure respiratory rate? 20 and below
3 steps

Answer 7

1. Keep your middle finger and index at the base of the thumb as if still taking heart rate but instead discreetly take the patient’s respiratory rate by looking at shoulder, chest, or abdomen movement (1 inhale and exhale = 1 breath)
2. Count the nuber of breaths for 30 seconds (mult 2)
3. Record respiratory rate on the chart

Question 8

How do you take blood pressure
120/80
7 steps

Answer 8

1. Make sure patient rests their arm at abt heart level and keeps the palms facing up
2. Place the cuff around the patient’s arm. It is snug if you can put 2 fingers int he cuff
3. Put on stethoscope with ear
4. Inflate the cuff to 160-180 mmHg
5. Slowly release the valve and record where you hear the first (systolic) heartbeat and last heartbeat (diastolic)
6. Measure on both left and right arms
7. If you cannot read BP first time, do not try again on the same arm. Retake on the other arm first.

Question 9

Blood pressure questions:
What does the patient have to do with their feet? Can they be crossed?

Answer 9

Flat on ground. No

Question 10

BP question:
Can patient wear tight/heavy clothing?

Answer 10

No

Question 11

You think you didn’t put enough pressure in the bp cuff the first time. Can you repump it while still measuring bp?

Answer 11

NOOOOO

Question 12

???? Ask office hours // how well should we know how to take vitals – if we need to know a lot, go back and add more flashcards to slide 33

Question 13

A patient will only need to be seen in-room if their health concerns needs a ? and ? by a MS and MD.

Answer 13

full body checkup and history intake

Question 14

Out-Room Services
If a patient’s chart is red, which health Co-D do you check with?

Answer 14

PAP

Question 15

Out-Room Services
If a patient’s chart has a yellow sticker, which Co-D do you check with?

Answer 15

Diabetes

Question 16

Out-Room Services
If a patient has a green monitoring sheet or hepatitis labs, which Co-D do you check with?

Answer 16

Hepatitis Co-D

Question 17

Doctor Consultation
1st step?

Answer 17

Verify identity

Question 18

Doctor Consultation
2nd step? What do you hold onto?

Answer 18

Perform Vitals outside // Patient’s chart

Question 19

Doctor Consultation
3rd step?

Answer 19

Find table space to conduct consultation

Question 20

Doctor Consultation
4th step?

Answer 20

Look for a Preceptor to do the Consultation

Question 21

Doctor Consultation
5th step?

Answer 21

Make sure MS/MD signs the Problem Sheet before returning reorganized chart to Receptionist. Name shoudl be recorded for AD Vitals/Translations

Question 22

During a doctor’s consultation, is a medical student required?

Answer 22

No

Question 23

During a doctor’s condultation, do you give the patient’s chart to the UG Co-D or do you hold onto it?

Answer 23

Hold onto it

Question 24

Diabetes: Nutrition Consults

Answer 24

Check if a nutritionist or registered dietician is scheduled to come in for a specific clinic date - look out during morning meeting intros to identify who you should go to

Question 25

When a patient comes in for a prescription, what should you ask them?

Answer 25

Have you seen a doctor in our clinic within the past year?

Question 26

When a patient comes in for a prescription and has not see a doctor in our clinic in the past year, should you still perform their vitals?

Answer 26

Yes but note that they must consult with a Preceptor before receiving prescription

Question 27

When a patient comes in for a prescription and HAS see a doctor in our clinic in the past year, what are the 4-11 steps you should do?

Answer 27

4. Perform vitals 5. Grab prescription form(s) and fill out patient info 6. Find a MD to review chart and write prescription 7. Photocopy prescription forms, retrieve side effects sheet(s) from PAP Co-D, and update IMI card 8. Hand the prescription, side effects sheet, and IMI card to the patient 9. Return UPDATED IMI card - patient go home - Update Masters Med Sheet 10. Insert photocopies of prescriptions into patient chart underneath problem sheet. Have preceptor sign the bottom fo the problem sheet. 11. Return reorganized chart to Receptionist saying "Done done with med refill"

Question 28

When you finish a med refill, who do you tell and what do you say?

Answer 28

Receptionist / Done done with med refill

Question 29

If a patient has questions about their medication refill, what should you (the AD) do? a) read the prescription and give them medical advice b) tell them that you are not able to help them c) go to a MD - they will go over how to take the prescription, side effects, etc

Answer 29

c) go to a MD - they will go over how to take the prescription, side effects, etc

Question 30

What does PAP stand for?

Answer 30

Patient Assistance Program

Question 31

Eligibility of PAP? (6)

Answer 31

US resident or permanent resident Low-income Uninsured or underinsured patient sees a doctor and gets a blow draw every 6 months to monitor the patient's status on the med patient must reapply every year patient must give an active phone number

Question 32

What 4 documents are required for PAP? Along with Social Security Number

Answer 32

Proof of Residency Copy of patinet's most recent tax return or Social Security benefits statement if uninsured: Insurance Denial Letter if underinsured: Insurance Cards (must indicate no rescription coverage)

Question 33

PAP Protocol A patient has insurance. What do you do next?

Answer 33

Check with PAP Co-D to determine if patient is eligible for PAP programs

Question 34

PAP Protocol PAP Co-D confirms that a patient is eligible for PAP programs. What do you ask them?

Answer 34

Ask them to provide you the necessary documents

Question 35

PAP Protocol If a patient was denied from Medi-Cal, what do you need?

Answer 35

Proof of denial letter from Medi Cal along with addition forms

Question 36

PAP Protocols If a patient has not applied for insurance, what should you do?

Answer 36

Refer the patient to Covered CA Committee

Question 37

What is the last step of PAP Protocol? Or what is the end goal of PAP?

Answer 37

Patient gets free/reduced-cost medications

Question 38

PAP Refill Potocol What do you ask a patient after verifying their identity?

Answer 38

Have you seen a doctor in our clinic within the past 6 months?

Question 39

PAP Refill Protocol What do you do after asking a patient if they have seen a doctor in the clinic within the past 6 months?

Answer 39

Check with PAP Co-D that we have the patient's meds.

Question 40

PAP Refill Protocol PAP Co-D says that we do have the patient's meds. What do you proceed with?

Answer 40

Vitals Patient goes back to waiting room complete PAP questionnaire, have PAP Co-D review and sign it, retrive meds and side effects sheet from PAP Co-D, and update IMI card find MS/MD to dispense med to patient, go over side effects, and you and the patient sign PAP questionnaire reutrn the updated imi card to patient and patient goes home. update masters med sheet submit pap questionnair to pap co-d and return reorganized chart to receptionist saying, "Done done with PAP refill"

Question 41

PAP Refill Protocol What is the medication is?

Answer 41

a brown paper bag

Question 42

PAP Refill Protocol What do you say to the receptionist after finishing a PAP refill?

Answer 42

Done done with PAP Refill

Question 43

PAP Refill Protocol PAP Co-D says that we do NOT have the patient's meds. What do you proceed with?

Answer 43

Nothing. Patient goes home, return IMI card to them and chart to receptionist saying, "Done done with no meds/labs"

Question 44

A patient is taking medication that was not received from PAP. Should you list it on the PAP Questionnair?

Answer 44

Yes, list out all medications even if not from PAP

Question 45

You must have 4 signatures on the PAP Questionnaire. Whose signatures are those?

Answer 45

1. AD Name (you) 2. PAP Co-D 3. Patient 4. MS/MD

Question 46

What color are PAP patient charts?

Answer 46

red

Question 47

What documents do Covered California require? 5 documents

Answer 47

Proof of SSN Proof of Citizenship/Immigration Proof of Identity Proof of Income Proof of CA residency

Question 48

What referral programs (services offered outside of clinic) are available through Covered California?

Answer 48

SPIRIT and Diagnostic Radiological Imaging Sac (DRI)

Question 49

Diabetes Committee Paperwork

Answer 49

ADDD MORE TO THISSSS!!!!!!!!!! SLIDE 46/47

Question 50

Where is the AD8 Dementia Screening form found by?

Answer 50

by the wall near the vitals station

Question 51

For patients that are over 65 years old, how often do they have to fil the AD8 Dementia Screening?

Answer 51

yearly

Question 52

Who do you bring the original AD8 Dementia Screening Form to review? Make sure to keep a photocopy in the patient chart

Answer 52

Neurology Co-D