HOSPICE ROUTINE VISIT BRAIN SHEET

Stop trying to remember everything in your head during a hospice visit.

The Hospice Routine Visit Brain Sheet is a practical 2-page printable designed to help hospice nurses stay organized, recognize changes, anticipate needs, and keep track of the things that need follow-up—all in one place.

Page 1 helps you organize your visit, including vitals, pain and symptoms, GI/GU, nutrition and intake, functional decline, cognition, skin, medications, DME/supplies, caregiver status, weight/MUAC, and changes since the last visit.

Page 2 helps you close the loop, with space for interventions and response, education and teach-back, provider/IDT communication, orders, follow-up tasks, next-visit priorities, documentation reminders, and the Driveway Test—a quick check before you leave to make sure nothing important was missed.

Designed for new hospice nurses, experienced nurses who love a good brain sheet, and anyone who wants a little less chaos during routine visits. 🤍

Your purchase includes:

• 2-page printable PDF

• Designed for routine hospice visits

• Print as many copies as you need for your own personal use

• Instant digital download

ASSESS → COMPARE → ANTICIPATE → EDUCATE → REASSESS → COMMUNICATE → DOCUMENT

For educational and organizational purposes only. This resource does not replace clinical judgment, individualized orders, your organization’s policies/procedures, or applicable laws and scope-of-practice requirements.