Notes: This field is used to input the notes applicable with the SIL Service. Information can be specified in summary form or detail. Information can include details of the service activities and supports provided, concerns and notifications necessary for handover as well as the comments on the client.
Client: This field reflects the particulars of the client associated with the SIL Shift Note.
Service Schedule: This field reflects the particulars of the SIL service associated with the SIL Shift Note.
General Daily Case Notes: This field is used to input the notes applicable with the SIL Service. Information can be specified in summary form or detail. Information can include details of the service activities and supports provided, concerns and notifications necessary for handover as well as the comments on the client.
AM Medication Administered: This field is used to identify whether the clients morning medications where administered. Options include Yes, No and Declined.
AM Medication Administration Time: This field identifies the medication administered time.
Staff Name: This field lists the particulars of the staff member that administered the clients medications.
Midday Medication Administered: This field is used to identify whether the clients midday medications where administered. Options include Yes, No and Declined.
Midday Medication Administration Time: This field identifies the medication administered time.
Staff Name: This field lists the particulars of the staff member that administered the clients medications.
PM Medication Administered: This field is used to identify whether the clients afternoon medications where administered. Options include Yes, No and Declined.
PM Medication Administration Time: This field is used to specify the medication administered time.
Staff Name: This field lists the particulars of the staff member that administered the clients medications.
Evening Medication Administered: This field is used to identify whether the clients evening medications where administered. Options include Yes, No and Declined.
Evening Medication Administration Time: This field identifies the medication administered time
Staff Name: This field lists the particulars of the staff member that administered the clients medications.
Breakfast Menu followed: This field is used to acknowledge a standard menu was observed.
Breakfast Completion: This field is used to specify the level of assistance required or whether the meal was refused.
What was eaten for breakfast: This field is used to specify the food eaten during the meal service.
Lunch Menu followed: This field is used to acknowledge a standard menu was observed.
Lunch Completion: This field is used to specify the level of assistance required or whether the meal was refused.
What was eaten for lunch: This field is used to specify the food eaten during the meal service.
Dinner Menu followed: This field is used to acknowledge a standard menu was observed.
Dinner Completion: This field is used to specify the level of assistance required or whether the meal was refused.
What was eaten for dinner: This field is used to specify the food eaten during the meal service.
Snacks Menu followed: This field is used to acknowledge a standard menu was observed.
Snacks Completion: This field is used to specify the level of assistance required or whether the meal was refused.
Snack: This field is used to specify the food eaten as snack during the meal services.
Shower/Bath Completed AM:
Shower/Bath Completed PM:
Shower/Bath Completion:
Brushing Teeth Completed AM:
Brushing Teeth Completed PM:
Brushing Teeth Completion:
Changing clothes completed AM:
Changing clothes completed PM:
Changing clothes Completion:
Toileting Completed AM:
Toileting Completed PM:
Toileting Completion:
Personal Grooming completed AM:
Personal Grooming completed PM:
Personal grooming Completion:
Hygiene Log general comments:
Start Time:
Finish Time:
Supervised or unsupervised
Planned or unplanned
Purpose of Access
Method of transport
How much support was needed in the community?
Health or Therapy Appointment Data
Health/Therapy provider
Agency
Supervised/ unsupervised
Planned/ emergency?
Follow Up Needed?
Health or Therapy Appointment Data
Restrictive Practice Use
Were any restrictive practices used today?
What were used?
Behavioural Presentation Monitoring
Did the participant show any of the following today?
Distorted thinking Yes No
Fears and Phobias Yes No
Binging/overeating food Yes No
Purging/vomiting after eating Yes No
Declined to eat Yes No
Difficulties with communicating with participants Yes No
Lost interest/motivation preferred activities Yes No
Declined attend scheduled supports appts activities Yes No
Signs of illness Yes No
Verbal aggression Yes No
Anxiety Yes No
Unable to self-manage own emotions Yes No
Distress/crying/worrying Yes No
Obsessions or compulsions Yes No
Oppositional/defiant behaviour Yes No
Seeking attention of emergency services Yes No
Somatising/ complain of being unwell but in good health Yes No
Agitation/hyperarousal/ unusually heightened state Yes No
Fluctuating mood changes Yes No
Non-engagement/task refusal Yes No
Behaviour that places participant or others at risk of harm Yes No
Alcohol Use Yes No
Socially inappropriate sexual acts Yes No
Consensual, age appropriate sexual activity Yes No
Property damage Yes No
Absconding or wandering Yes No
Behaviour that would require a criminal justice response Yes No
Declined medication Yes No
Self-injury - thoughts or statements Yes No
Suicidal Ideation – thoughts or statements Yes No
Self-injury - acts Yes No
Suicidal planning or attempt Yes No
Illicit substance use Yes No
Use of non-prescribed over counter medication Yes No
Physical aggression Yes No
Other
Additional Comments about Behaviours of Concern
