Home healthcare nurse最新文献

This longitudinal study describes the heart failure (HF) patient's perceived benefits and barriers to self-care during hospitalization, 1 week, and 1 month after hospitalization. Seventy-eight patients with acute HF completed the Health Belief Scales to determine the greatest benefits and barriers to self-care at each time point. Findings suggest that early benefits to performing self-care include reducing symptoms and improving quality of life. Later benefits focus more on promoting health. Barriers to self-care include forgetfulness and knowledge deficits about self-care behaviors. At 1 month, 15.1% to 48.5% patients reported that monitoring increases worry about HF. Home care clinicians can promote self-care through education and skills training.

This study investigated the effectiveness of training geriatric home-based primary care (HBPC) nursing staff in motivational interviewing (MI) techniques, with the goal of increasing patient medication adherence. Nursing staff received 4 hours of training in MI techniques from a licensed psychologist. Results indicated that the MI training increased medication adherence in the HBPC veteran sample by a small, but statistically significant, margin both 1 month and 6 months after the intervention. Although the effect size may be considered small, the clinical and cost ramifications of even a small gain in adherence are extremely important for the patient, clinician, and the medical facility. MI techniques may provide a cost-effective and impactful means of enhancing patient adherence to medications.

This article examines the role of care coordination, when fulfilled by a professional board-certified case manager, in successful long-term home- and community-based care (HCBC). A facet of care coordination, as also discussed, is a robust assessment of the individual by the professional case manager, who devises and implements a comprehensive care plan to address the clinical, psychosocial, and environmental needs of the individual as part of a person-centered, evidenced-based approach. To be successful, long-term HCBC starts with a robust assessment of the individual by a professional board-certified case manager. The case manager uses specific tools that incorporate qualitative measurements to address factors such as medical/clinical needs, (e.g., diagnoses, chronic conditions, and/or health risks); mental/behavioral health (e.g., geriatric depression screening); medication/pharmacology (e.g., review and reconciliation of prescribed and over the counter medications and supplements) and the individual's ability to self-administer; home safety; and presence of a family/support system and their ability and willingness to provide care. Based on these findings, the case manager puts in place a comprehensive care plan, working with a well-coordinated multidisciplinary team, including informal supports, physicians, registered nurses, occupational therapists, pharmacists, social workers, nutritionists, and other allied health professionals. From the beginning, the rigor of care coordination is essential to the how successfully individuals and their families/support systems realize their goal of long-term HCBC.

The patient-centered medical home (PCMH) is a team approach used to provide comprehensive care for patients in primary care settings that uses partnerships between patients and families, physicians, and other members of the healthcare team including home healthcare nurses. The goal of the PCMH model is to provide safe, high-quality, affordable, and accessible patient-centered care by promoting stronger relationships with patients, addressing care needs more comprehensively, and providing time to coordinate care across all sectors of the healthcare system. Home healthcare clinicians who have a deep understanding of the impact of community and family system interplay will have an important role in linking the home environment with the primary care based PCMH to assist patients to achieve optimal outcomes.