Charting for Emergency Shelters

file box

Most shelters do not have any computers or established way to chart on people. We recommend using paper "charts", organized alphabetically in a portable file box. This way when someone needs consultation, you can quickly look in the box for their chart to find out what has been done already. Sample charting forms, sign out logs, and OTC dispensing lists are linked below.

We also recommend getting a list of open pharmacies (try RxOpen) and calling local pharmacies to establish a relationship and find out if any of them will deliver to the shelter.

In California, according to the California Business and Professions Code Section 4064 (a), pharmacies can refill medications without a doctor's order during disasters.

Medical Record Intake Form - This form is the basis for your paper chart. Thank you to Contra Costa MRC for this template. Download Form

Sign Out Sheet Here is a downloadable form to help track things and people that need to be followed up on from one shift to the next. Download Form

Med Refill Forms - For use when people request refills. Cut into four. Download Form

Basic Progress Note - This Medical Progress Notes form has space for a doctor or other medical professional to record observations of condition throughout treatment. Download Form

Medication List - A simple form on which to log medications prescribed and frequency and time of taking them. Download Form

Nebulizer Treatment - This printable nebulizer treatment log tracks respiratory rate, pulse rate, oxygen saturation and more both before and after medication. Download Form

Over the Counter Meds PRN - We recommend using a blank sheet of paper where you write down the name of patient and the medicine dispensed. You may not need to make a chart for everyone you give a Tylenol to but it is good to put their name, and the time it was dispensed down.

If You Do Not Have Wifi But Do Have a Computer

You can use Excel to keep records on the most acute "patients" in the shelter. This is a very basic method of charting and communicating from shift to shift about the residents with medical needs. Download Excel Form

Various tabs within the spreadsheet can be helpful to organize residents into areas within the shelter, those with more acute medical needs or for keeping a record of residents who have been discharged. Since this document persists over time, it is important to note dates when entering information rather than "today" or "tomorrow". This is to be backed up on a flash drive and be password protected. Save a new file each night with a date listed in the file name for good record keeping over time. These lists can be printed prior to signout at the end of each shift and given to each nurse/ provider coming on shift. If printed copies exist, make sure they are shredded and do not leave the building.

If You Have Computers and Wifi

DHV and MRC registered volunteers should have access to PULSE (Patient Unified Lookup System for Emergencies) to be able to get information about evacuees' medical problems. Here is a link to a guide for how to use the PULSE system.

You may also be able to get information from people's hospital or clinic EMR if you have volunteers with login access. It can be very helpful to learn about patients' past medical history and medications. However, you may need to print or transcribe the information to get it into the paper chart.