Name:
University of Pennsylvania School of Nursing/Genesis Eldercare: Physical/Emotional
Symptom Tracking Form
Description:
Used to determine the presence of physical and emotional symptoms in conjunction
with an assessment and a treatment plan.
Category:
Clinical Care Tools - Symptom Management
Source:
University of Pennsylvania
School of Nursing
Hartford Center of Geriatrics
420 Guardian Drive
Philadelphia, PA 19104-6096
www.nursing.upenn.edu
or
www.nursing.upenn.edu/centers/hcgne/links.htm
Contact:
Neville Strumpf, PhD,RN
strumpf@nursing.upenn.edu
How the grantee used this instrument:
At baseline it is used as a chart abstraction tool; it is then used monthly
for palliative care patients.
Keywords:
nursing homes, symptom assessment, care planning, long-term care
To use this tool:
You may print and copy this tool for your own use from the website. Please credit
source.
References:
Developed by the project team for this project.
To view this tool:
Left click on the download link to view the PDF document in your Web browser.
Right-click on the download link to save the document to your computer.
PDF 58 KB / 1 page (Viewing
PDF files requires downloading and installation of the free Adobe
Acrobat Reader.)
Posted October 2004
University of Pennsylvania overview page
# UP09, type:symptom_management
Promoting Excellence in End-of-Life Care is a national program of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.
