Chaplain/Spiritual Care Assessment Checklist
Comprehensive spiritual care assessment including spiritual needs, religious preferences, and chaplaincy intervention planning.
- Industry: Healthcare
- Frequency: Initial/As requested
- Estimated Time: 20-30 minutes
- Role: Chaplain
- Total Items: 32
- Compliance: APC Standards, Joint Commission Spiritual Care, Hospital Pastoral Care Policy
Spiritual History
Faith background
- Religious/spiritual preference documented?
- Faith community involvement assessed?
- Spiritual practices identified?
Spiritual Needs Assessment
Current spiritual needs
- Spiritual distress assessed?
- Questions of meaning/purpose explored?
- Hope and coping assessed?
- Guilt/shame/forgiveness issues explored?
Religious Needs
Specific religious needs
- Sacraments/rituals needed?
- Prayer requested?
- Religious items needed?
- Outside clergy visit requested?
Chaplaincy Intervention
Care provided
- Pastoral care provided?
- Family spiritual support offered?
- Follow-up plan established?
Pre-Assessment Information
Initial assessment documentation and patient/facility identification
- Assessor Name / Credentials
- Assessment Date
- Department / Unit
- Assessment Type (Routine/Annual/Complaint)
- Previous assessment findings reviewed?
Infection Prevention & Control
Verify infection control practices per CDC and Joint Commission standards
- Hand hygiene compliance observed?
- Appropriate PPE available and properly used?
- Isolation precautions properly implemented?
- Sharps containers available and not overfilled?
- High-touch surfaces properly disinfected?
Patient Safety & Identification
Verify patient safety protocols and identification procedures
- Two patient identifiers used before procedures?
- Fall risk assessment completed?
- Call light within patient reach?
- Bed in lowest position with brakes locked?
Medication Safety & Management
Verify medication handling and administration practices
- Medications stored securely and at proper temperature?
- Controlled substances properly secured and counted?
- No expired medications in stock?
- High-alert medications properly labeled?
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Why Use This Chaplain/Spiritual Care Assessment Checklist?
This chaplain/spiritual care assessment checklist helps healthcare teams maintain compliance and operational excellence. Designed for chaplain professionals, this checklist covers 32 critical inspection points across 8 sections. Recommended frequency: initial/as requested.
Ensures compliance with APC Standards, Joint Commission Spiritual Care, Hospital Pastoral Care Policy. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Chaplain/Spiritual Care Assessment Checklist cover?
This checklist covers 32 inspection items across 8 sections: Spiritual History, Spiritual Needs Assessment, Religious Needs, Chaplaincy Intervention, Pre-Assessment Information, Infection Prevention & Control, Patient Safety & Identification, Medication Safety & Management. It is designed for healthcare operations and compliance.
How often should this checklist be completed?
This checklist should be completed initial/as requested. Each completion takes approximately 20-30 minutes.
Who should use this Chaplain/Spiritual Care Assessment Checklist?
This checklist is designed for Chaplain professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.