Why domiciliary care needs a written SOP
Outside the hospital, policies are invisible—but risk is not. A short, precise SOP aligns licence, privileges, insurance settings and day-to-day behaviour so home/hotel/yacht care is safe, discreet and repeatable.
Scope & prerequisites (one minute to verify)
Licence/Privileges list domiciliary settings (home/hotel/yacht).
Malpractice policy explicitly names those settings.
Named medical lead and receiving hospital documented.
Medication custody rules agreed in writing (ordering, storage, transport, disposal).
Privacy & boundaries (VIP choreography)
One clinical voice: all medical updates funnel via the medical lead.
Household PA/security handle logistics only—never clinical decisions.
Neutral language in semi-public areas; no names in corridors, lifts, docks or marinas.
No photos, no personal apps for clinical content, no device screens visible to third parties.
Core domiciliary bundle (copy/paste)
1) Arrival check
Confirm consent; review allergies, active meds, and escalation thresholds.
Locate emergency equipment; verify phone/network and address for ambulance.
2) Medication custody
Locked storage; temperature log for cold-chain items.
Two-person check for high-risk meds (insulin, anticoagulants, opioids, electrolytes).
No decanting or relabelling; pharmacy-issued packaging only.
3) Assessment & documentation
Vital signs, red-flag screen, device/line status.
Chart in the domiciliary note (time-stamped, legible) and update MAR if used.
Photos strictly prohibited; attach only device outputs if policy permits.
4) Communication & SBAR handover
Brief the medical lead with SBAR; record R (recommendation) and timing.
Write the escalation threshold in numbers/time (e.g., SpO₂ <92% for 5 min).
5) Exit check
Waste/disposal per policy; controlled drugs count.
Next appointment, tasks for household PA (logistics only), and who to call.
Yacht medicine specifics (add to SOP)
Stabilise → transfer mindset; pre-agree marina/helipad routes.
Equipment secured against movement; medication storage logged for temperature and vibration.
Communications tested (VHF/phone); GPS address/coordinates ready for EMS handover.
Mini-audits (5 minutes, weekly)
High-risk meds present? Double-check log complete.
Cold-chain within range; excursion forms filed.
Last two visits have a numeric escalation line written.
Privileges/insurance certificates current; domiciliary rider visible.
Red flags—and calm fixes
Home-care requested without domiciliary rider → add rider before visit.
Household demands beyond scope → restate boundaries; escalate to medical lead.
No safe storage → defer medication administration and document reason.
VIP crowding in room → pause care; request privacy via PA/security.
Ready-to-use templates
Domiciliary SBAR (note block)
S: Visit reason, time, location
B: Key diagnoses, allergies, high-risk meds
A: Vitals trend, devices/lines, findings
R: Actions today; Escalate if … (number/time); Call: …
Medication custody line (chart)
Received → Stored (temp) → Administered/Wasted (witness) → Count OK/Variance → Signatures
Short FAQs
Can I use WhatsApp for quick updates?
No—use approved clinical channels. Personal apps are not acceptable for medical content.
Who owns the clinical plan—household or clinician?
The medical lead. Household staff manage logistics only.
Is a second clinician mandatory?
For high-risk medication checks and some procedures—yes. Build it into scheduling.
Discreet contact
Please, talk to David on whatsapp: https://wa.me/34692100254