As a home health aide, your daily instructions are ultimately derived from the instructions of a nurse. This nurse is then acting on instructions provided by a doctor or other higher ranking member of the care team. This is just a small portion of the care team chain of command – a chain of command put in place to ensure that the client recieves the best healthcare possible. The secondary goal of a strong chain of command is that it protects the HHA and their agency from liability. Liability is a legal term that means that someone or many someones can be held reponsible for hurting someone else.
Here is an example: pretend that something you have done for your client has inadverently caused harm to the client. However, what you did was also explicitly in the care plan and the actionw as conducted according to policy and followed proper procedure. In this case, you may not be responsible for causing harm to the patient. However, the flip side is that if you did something that harmed a client – and was not in the care plan – you most certainly could be held responsible, or liable. This is why it is critical that the HHA follow the instructions in their care plan carefully, and that an HHA agency maintains their chain of command.
By extension, it is important that home health aides understand what they can and cannot do in terms of both their care and their overall actions. This is important so that the HHA does not bring harm to the client who has placed their trust in the HHA and also so that the HHA and HHA agency or other employer are not opened up to lawsuits and liability. Some states have certifications that indicate an HHA is qualified to work. That said, it is important to remember that home health adies are not licensed healthcare providers. Everything the HHA does while following a health plan has been assigned by a licensed healthcare provider, but the HHA themself, are not licensed. Basically, a HHA acts under the authority of another professionals license. This is part of the reason that these professionals show such great interest in what the HHA is doing and how they do it – and another reason it is critical that the HHA responsibly reports their actions to their superiors.
| Step Of Care Chain | Action |
| RX Home Care | Physican orders home care. |
| Client’s Plan Of Care | Supervisor or Case Manager with care team creates a plan of care after assessing clients needs. |
| Physical Therapy Plan Nursing Plan Home Care Aide Pla |
From the main care plan, individual plans and assignments are developed |
| Home Care aide visit Activities of daily living checklist Vital signs record progress notes |
Home Care Aides document the care provided and record observations, report client feedback, vital signs and so on. This information is used to revise the clients care plan. |
Every state grants the right to practice various healthcare jobs through licensing. Examples of granted licenses include the licenses that nurses and physical therapists must obtain. All members of the health care team work under each members professional scope of practice. A scope of practice is a definition of what things you are allowed to do – and how you can do them correctly.
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