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VNAA's Clinical Procedure Manual, 20th Edition is a staple of home-based care agencies committed to ensuring high quality care for each patient at each visit. As the backbone of clinical practice, it is imperative that clinical procedures be performed in a consistent, reliable way by each clinician each time. The expansion of the 20th edition to a searchable web-platform ensures access to these standards every place a patient needs care.
Includes one printed copy of VNAA's Clinical Procedure Manual (CPM), 20th Edition. Additional printed copies of the CPM manual can be ordered below at a discounted price.

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Table of Contents

SECTION 1: Cardiovascular
1.01 Assessment: blood pressure
1.02 Assessment: edema
1.03 Assessment: pulse
1.04 Assessment: weight *Weight chart
1.05 Cardiac monitoring
1.06 Compression stockings
1.07 External defibrillators, AED, life vest
1.08 Heart failure
1.09 Left ventricular assist device (LVAD)
1.10 Pacemaker and AICD
1.11 Sternal precautions

SECTION 2: Endocrine System
2.01 Assessment: Foot assessment with diabetes
2.02 Assessment: Patient with diabetes
2.03 Blood glucose testing
2.04 Hyperglycemia
2.05 Hypoglycemia
2.06 Insulin injection *Needle disposal do’s and don’ts
2.07 Insulin mixing
2.08 Insulin pen
2.09 Insulin pump
2.10 Insulin ketone test

SECTION 3: Gastrointestinal
3.01 Bowel program for constipation
3.02 Enemas
3.03 Fecal impaction
3.04 Ostomy: Appliance application
3.05 Ostomy: Colostomy irrigation
3.06 Ostomy: Mucous fistula care
3.07 Tubes: Biliary tube
3.08 Tubes: Care of gastrostomy, jejunostomy
3.09 Tubes: Enteral feeding
3.10 Tubes: Nasogastric

SECTION 4: Genitourinary
4.01 Assessment: Sexuality
4.02 Assessment: Post void urine volume
4.03 Bladder: Continuous irrigation
4.04 Bladder: Medication instillation
4.05 Catheter: External female
4.06 Catheter: External male
4.07 Catheter: Indwelling: Care
4:08 Catheter: Indwelling: Insertion: Female
4.09 Catheter: Indwelling: Insertion: Male
4:10 Catheter: Indwelling: Irrigation
4:11 Catheter: Indwelling: Removal
4:12 Catheter: Indwelling: Specimen collection
4:13 Catheter: Indwelling: Suprapubic cystectomy
4:14 Catheter: Intermittent self-catheterization
4:15 Catheter: Peritoneal dialysis
4:16 Catheter: Troubleshooting
4:17 Incontinence: Bladder training *Bladder diary
4:18 Incontinence: Pelvic floor muscle exercises
4:19 Incontinence: Pelvic organ prolapse – pessary
4:20 Nephrostomy care
4:21 Ostomy: Urostomy
4:22 Ostomy: Urostomy: Incontinence
4:23 Ostomy: Specimen collection sterile catheterization

SECTION 5: Hospice and Palliative Care
5.01 Defibrillator deactivation
5.02 Anorexia/dehydration
5.03 Catastrophic bleed
5.04 Constipation
5.05 Delirium
5.06 Dypsnea
5.07 Nausea and vomiting
5.08 Palliative wound care

SECTION 6: Immune System
6.01 Temperature

SECTION 7: Infection Control
7.01 Agency program
7.02 Agency program: infection surveillance
7.03 Agency program: Risk assessment
7.04 Bag technique
7.05 Blood spill
7.06 Clean, sterile, no-touch techniques
7.07 Cleaning and disinfection equipment
7.08 Hand hygiene
*Hand wash – how to
*Hand rub – how to
7.09 Infested and unsanitary homes
*Bed bug action plan
7.10 Organisms: Bedbugs
7.11 Organisms: Clostridium difficile
7.12 Organisms: Lice, body-pubic
7.13 Organisms: Lice, head
7.14 Organisms: Multi-drug resistant organisms
7.15 Organisms: Scabies
7.16 Organisms: Tuberculosis
7.17 Standard precautions
7.18 Transmission precautions- airborne, droplet, contact
*Putting on PPE
7.19 Visit-generated waste

SECTION 8 Infusion Therapy
8.01 Anaphylaxis and first dose procedure
8.02 Central line: Blood specimens
8.03 Central line: Occlusion and TPA
8.04 Central line: Repair
8.05 Central line: Implanted port
8.06 Central line: Non-tunneled
8.07 Central line: PICC
8.08 Central line: Tunneled
8.09 Epidural and intrathecal lines
8.10 Factor administration
8.11 Hemodialysis line
8.12 Infiltration and extravasation
8.13 Infusion: Medication administration
8.14 Infusion: Patient controlled analgesia
8.15 Infusion: Total Parental Nutrition
8.16 Medication: Chemotherapy
8.17 Medication: Immunoglobulin
8.18 Medication: Inotropic agents
8.19 Mid-line catheter
8.20 Peripheral line
8.21 Regional anesthesia pump
8.22 Subcutaneous infusion: Hypodermoclysis
8.23 Subcutaneous infusion: Initiation and management

SECTION 9: Labs and Specimens
9.01 Blood: Capillary specimen
9.02 Blood: Culture
9.03 Blood: Venipuncture
9.04 CLIA waived testing
9.05 Nose and throat specimens
9.06 PT/INR point of care testing
9.07 Requisitions and transportation
9.08 Sputum specimens
9.09 Stool specimens
9.10 Urine specimens
9.11 Vaginal specimens
9.12 Wound specimen

SECTION 10 Lymphatic System
10.01 Intermittent pneumatic compression
10.02 Lymphedema care

SECTION 11 Maternal-Newborn Care
11.01 Antepartum: Fetal movement counts
*Fetal movement counting
11.02 Antepartum: Fetal heart rate
11.03 Antepartum: Gestaional diabetes
11.04 Antepartum: Pregnancy induced hypertension
11.05 Antepartum: Hyperemesis gravidarum
11.06 Antepartum: Preterm labor
11.07 Antepartum: Screening for psychosocial risks
11.08 Newborn: Assessment
11.09 Newborn: Bathing and skin care
11.10 Newborn: Bottle feeding
*Bottle feeding like breast feeding
11.11 Newborn: Breast feeding
*Breastfeeding survival guide *Engorgement
11.12 Newborn: Jaundice and hyperbilirubinemia
11.13 Newborn: Safety education
*Calming a crying newborn
11.14 Postpartum: Assessment and teaching
11.15 Postpartum: Breast care and problems
11.16 Postpartum: Breast pumping

SECTION 12 Medications
12.01 Administration basics
12.02 Assessment and comprehensive medication review
12.03 Disposal
*EPA medication disposal guide
12.04 Errors
12.05 Orders and documentation
12.06 Reconciliation
12.07 Route: Ear
12.08 Route: Enteral, G-tube, J-tube
12.09 Route: Eye
12.10 Route Injections
12.11 Route: Intravenous push
12.12 Route: Oral
12.13 Route: Rectal and vaginal
12.14 Route: Topical
12.15 Assessment: Height

SECTION 13 Mental Health
13.01 Anxiety: Assessment and management
*GAD 7 tool
13.02 Dementia
*Mini-cog tool
13.03 Depression: Assessment and management
13.04 Suicide risk: Assessment and management

SECTION 14 Mobility and Transfers
14.01 Ambulation: Cane
14.02 Ambulation: Crutches
14.03 Ambulation: Walker
14.04 Bed mobility
14.05 Gait-transfer belt
14.06 Transfer: Manual lift
14.07 Transfer: Mechanical lift
14.08 Transfer: Side to side
14.09 Transfer: Stand-pivot

SECTION 15 Musculoskeletal
15.01 Amputation: Residual limb care
15.02 Assessment: Gross muscle testing
15.03 Assessment: Posture plumb line alignment
15.04 Cast care
15.05 Compression fractures: Precautions and care
15.06 Continuous passive motion machine (CPM)
15.07 Exercises: Balance
15.08 Exercises: Range of motion: Assisted active
15.09 Exercises: Range of motion: Passive
15.10 Exercises: Stretching
15.11 Exercises: Weight bearing
15.12 Joint precautions
15.13 Spinal precautions

SECTION 16 Neurological
16.01 Assessment: Neurological
16.02 Assessment: Vision
*Snellen test
16.03 Eye irrigation
16.04 Precautions: Aspiration
16.05 Precautions: Seizure

SECTION 17 Nutrition
17.01 Assessment: Hydration
17.02 Assessment: Nutrition
*Reading nutrition facts label
*Eat the My Plate way
*DETERMINE screening
17.03 Carbohydrate counting
*Carbohydrate diet handout
17.04 COPD diet
*COPD diet handout
17.05 High fiber diet
17.06 Kidney disease diet
*Kidney disease diet handout
17.07 Low fat-cholesterol diet
17.08 Low purine diet
17.09 Low sodium diet
17.10 My Plate method
*My Plate
17.11 Weight reduction diet
17.12 Wound healing diet
*Wound healing diet handout

SECTION 18 Pain Management
18.01 Assessment: Screening and comprehensive
*Numeric rating scale
*FACES pain scale
*PAINAD scale
18.02 Complimentary therapies: Breathing and relaxation
18.03 Complimentary therapies: Guided imagery and visualization
18.04 Management with medications
18.05 Management of “Total Pain”
*Memorial Symptom Assessment tool
*Symptom distress scale
18.06 Management of older adults with pain

SECTION 19 Patient Education
19.01 Assessment of learning needs
19.02 Goal setting
19.03 Health coaching
19.04 Teaching and evaluation of learning
19.05 Topic: Advanced directives
19.06 Topic: Personal health record

SECTION 20 Pediatrics
20.01 Assessment: Blood pressure
20.02 Assessment: Pain
*FACES revised tool
*FLACC scale
20.03 Assessment: Temperature
20.04 Gastrointestinal: Enteral feeding
20.05 Gastrointestinal: Gastrostomy, jejunostomy tubes
20.06 Gastrointestinal: Nasogastric tube
20.07 Medication: Calculation milligram/kilogram dosing
20.08 Medication: Diastat
20.09 Medication: Synagis
20.10 Musculoskeletal: Orthoses
20.11 Respiratory: Diaphragmatic/phrenic nerve stimulation
20.12 Respiratory: High frequency chest wal oscillation and chest est
20.13 Respiratory: Chest therapy-mechanical
20.14 Respiratory: Chest therapy- percussion and postural drainage
20.15 Respiratory: Suctioning- naso-oropharyngeal
20.16 Respiratory: Tracheostomy suctioning
20.17 Respiratory: Tracheostomy care and tie change
20.18 Respiratory: Tracheostomy tube change
20.19 Respiratory: Tracheostomy decannulaiton and ventilarot weaning

SECTION 21 Personal Care
21.01 Bathing: Bed bath
21.02 Bathing: Sink
21.03 Bathing: Shower
21.04 Comfort: Back rub
21.05 Comfort: Positioning
21.06 Comfort: Sitz bath
21.07 Comfort: Skin care
21.08 Dressing: Clothes
21.09 Dressing: Orthotic devices and prostheses
21.10 Eating: Feeding
21.11 Grooming: Hand, foot and nail care
21.12 Grooming: Oral care
21.13 Grooming: Shampoo
21.14 Grooming: Shaving
21.15 IADL: Changing an occupied bed
21.16 Toileting: Bed pan and urinal

SECTION 22 Preventive Care and Immunizations
22.01 Biometric screening clinic
22.02 Vaccination schedules: Child, adolescent and Adult
22.03 Vaccine: Influenza at home
22.04 Vaccine: Influenza clinic
22.05 Vaccine: Pneumonia
22.06 Vaccine: Shingles
22.07 Vaccine: Tetanus/Diptheria/Pertussis

SECTION 23 Respiratory System
23.01 Breathing and coughing techniques
23.02 Chest physical therapy
23.03 Chest tube: One way valve
23.04 Chest tube: Pleural catheter
23.05 Cleaning/disinfecting respiratory equipment
23.06 Device: Incentive spirometer
23.07 Device: Metered dose inhaler or spacer
23.08 Device: Nebulizer
23.09 Device: Peak flow meter
23.10 Oxygen therapy
23.11 Pulse oximeter
23.12 Tracheostomy: Routine and emergency care
23.13 Tracheostomy: Suctioning
23.14 Ventilator-dependent patient

SECTION 24 Safety
24.01 Abuse and neglect assessment
24.02 Body mechanics
24.03 Communication with physicians: Parameters
24.04 Communication with physicians: SBAR
*SBAR tool
24.05 Death (Unexpected) in the home
24.06 Falls risk assessment
*MAHC-10 tool
24.07 Fall risk management
*GEM Environmental Assessment
24.08 Fire and burn prevention
24.09 Linguistically and culturally appropriate care
24.10 Latex allergy
24.11 Oxygen safety
24.12 Pet problems
24.13 Restraint avoidance
24.14 Safe patient handling
24.15 Visit safety

SECTION 25 Skin and Wound Care
25.01 Assessment: Pressure ulcer risk and prevention
25.02 Assessment: Wound
25.03 Debridement: Autolytic and enzymatic
25.04 Debridement: Conservative sharp
25.05 Debridement: Silver nitrate
25.06 Drains: Interventional radiology
25.07 Drains: Surgical
25.08 Wound care: Cleansing and irrigation
25.09 Wound care: Dressing application
25.10 Wound care: Packing
25.11 Wound care: Solutions: Home preparation
25.12 Wound care: Transparent film
25.13 Wound closures: Staples, sutures and steri-strips
25.14 Wound device: Montgomery straps
25.15 Wound device: Negative pressure wound therapy
25.16 Wound device: Pin care and external fixators
25.17 Wound device: Pouch for drainage
25.18 Wound type: Pressure ulcer deep tissue injury
25.19 Wound type: Pressure ulcer stage I
25.20 Wound type: Pressure ulcer stage II
25.21 Wound type: Pressure ulcer stage III and IV
25.22 Wound type: Pressure ulcer unstageable
25.23 Wound type: Skin tears
25.24 Wound type: Stasis ulcers- assessment
25.25 Wound type: Stasis ulcers- multilayered compression bandage system
25.26 Wound type: Surgical wound

SECTION 26 Telehealth Technology
26.01 Assessment: Patient and home appropriateness
26.02 Equipment: Installation
26.03 Equipment: Post use cleaning
26.04 Patient visits: In home
26.05 Patient visits: Remote

Additional Information

Additional Information

Technical Details

System Requirements

Personal Computer or Mobile Device (Tablet or Smart Phone)
Modern Browser
Windows, Apple, or Android Operating System
Internet Access
Active Email Address

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