Daily Record Form – Buzz R Nights Daily Record

Username:
Client Name*
Name (s) of all Support Worker on shift today*
Date of Shift*
Date Format: DD slash MM slash YYYY

If you are undertaking night shifts, please remember to enter the correct date the shift started.
Shift Start Time*

: HH

MM
Shift End Time*

: HH

MM

Save and Continue Later

Evening routine
What time did Buzz settle down to sleep?*
Did you need to change Buzz's nappy/bed throughout the night? If yes, give further details*
Did Buzz have a Bowel Movement throughout the night?*
Did you need to reposition Buzz throughout the night?*
- Yes
- No
Discuss repositioning in further detail.*
What was Buzz's sleep pattern through out the night?*
Please confirm when slept to and from, and record details of any issues or events that may have interrupted his sleep. Include steps taken to help or resolve these issues.
Has Buzz had any Dystonic movements overnight?*
- Yes
- No
Dystonic Movements are : repetitive or twisting movements
If yes, please describe how often.*

Save and Continue Later

Did you need assistance from Buzz's mum or dad during the night?*
- Yes
- No
If yes, please give further details including how many times assistance was needed and what assistance was needed.*
Any further details or interventions that need to be recorded?*
Any prescribed medications administered (as directed)*

Save and Continue Later

General
Did Buzz have any seizures or seizure activity throughout the night?*
- Yes
- No
If yes, please give further details including length, meds given, people informed*
Is there anything that you feel Libertatem Healthcare or need to be made aware of?*
- Yes
- No
If yes, then please give details
Do you have any safeguarding concerns?*
- Yes
- No
If yes, please give details
Signature Pad

Save and Continue Later

Submit a Daily Record