Communication

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Trace DC25-6

DiraChart Clinical Reference
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1. Purpose and clinical relevance

DiraChart Clinical Reference

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4. Normal findings

The reference range below is the yardstick for “normal/at-baseline.” Normal findings are documented in Mode A with the skilled rationale that follows in Section 6 — never as “WNL” alone.

  • Clear speech and intact expressive and receptive language.
  • Communicates needs effectively.
  • Functional hearing adequate for care, with aids used as needed.
  • Functional vision adequate to read materials, with corrective lenses as needed.
  • Adequate health literacy and demonstrated comprehension of the plan.
  • No unmet interpreter or augmentative-communication need.
  • Understands the plan and can participate in care and consent.
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