Category 1
What are the components of a community?
Structure: general characteristics of a community, which includes demographic data (gender, age, ethnicity, educational and income levels. It also includes data about healthcare services (number of primary care providers or emergency care facilities in the area)
Status: biological (morbidity and mortality rates), emotional (mental health and community survey), and social (crime rates, citizenship involvement, and functional levels of community members)
Process: overall effectiveness level of the community
examples: Do the members of the community believe they are part of a group with common purpose, values, or interests?
What is Community Health Nursing and it's goal?
It is one of the three approaches to community based care!
It focuses on how the individual health affects the community
Community health nurses strive to promote, protect, preserve and maintain the health of a population by the delivery of personal health services
It's goal is to maintain health of the population
What are some advantages of home healthcare?
Enables a viewing of clients environment at home
It allows inclusion of family members in caring for the patient
Caregivers gain the ability to assist the client with ongoing health needs even outside of the hospital facility
It facilitates holistic care
The clients self-care ability and independence will improve more in their own home setting
Give some examples of primary, secondary and tertiary community nursing interventions
Primary nursing interventions: promoting health, preventing disease, educate patients about risks
EX: educating a ninth-grade student about the risk of hepatitis B and HPV, or the benefits of vaccination
Secondary nursing intervention: aims to reduce the impact of disease and to provide early detection and treatment
EX: screening an adolescent girl who is sexually active for hepatitis B or HPV and teaching the patient how to protect themselves from STI'S, hepatitis B and HIV in the future
Tertiary nursing intervention: aims to halt disease progression and restore health
EX: A student who was sexually active has an abnormal pap smear showing cells that suggest exposure to HPV, the clinical nurse in collaboration with the provider will administer medical treatment
What is the most important home intervention for a home-care nurse to prevent the transmission of infection?
HAND HYGIENE
What is the future for home healthcare?
Increased need for home healthcare (considering the growing population of older adults)
Increased use of the home for hospice care (public acceptance of the home as a place for comfort and care)
Increased technology (technological advances such as online resources or telemedicine consultation)
Continued research (research is needed in the area of strategies to improve the effectiveness of care)
What is the difference between direct care agencies and indirect service agencies?
Direct care agencies: providing direct care to a patient, helping them with daily task like bathing, dressing and eating
Indirect service agencies: providing indirect care which is performed away from the patient but on their behalf like documenting and communicating with other providers
Who pays for home healthcare?
Medicare
Medicaid
Private Insurance
Individual payments (private pay)
(Medicare and Medicaid are the largest payers for home healthcare)
How should a home-care nurse reduce the risk of patient harm resulting from falls?
Assess the client and the home for risk environmental hazard factors such as dimly lit stairs, clutter on the floor, or loose rugs
Teach the client about fall reduction measures as well
What is community-oriented nursing and it's goal?
It focuses on health promotion, illness prevention, early detection, and treatment provided within the community setting
It is a evidence based practice and it uses information from individuals to change health on the community level
It combines community and pubic health for a more comprehensive approach
How many approaches are there to community based care?
There are three approaches
1. Community Health Nursing
2. Public Health Nursing
3. Community-oriented Nursing
What should be done by the nurse during the home-care visit ?
Make proper introductions on who you are and what you are there to do
Be beyond respectful of the clients home area, believes and individual practices
Develop a trusting relationship with the client
Identify any barriers that would disrupt the goals of the patient
What are the factors contributing to vulnerable populations?
Limited economic and social resources
Age
Presence of chronic disease/obesity
History of abuse/trauma
What are the different roles of a home health nurse?
Being the direct care provider: (performing tasks that require skill)
Being the client and family educator: (promoting self-care, providing communication skills needed and educating the patient on ways to heal/promote health)
Being the client's advocate: (supporting the client's right to make decisions and advocating for their health to a provider if necessary)
Being the client coordinator: (assessing the correct resources to develop a plan of care for a patient)
What should be done before conducting a home-care visit?
Map directions to the home and determine whether there are any safety concerns
Determine and know the purpose of the visit
Gather all necessary materials and supplies
Be aware of any additional information that may be needed before caring for the client
Make an appointment with the client that will work best for the nurse and especially for the needs of the patient
Before beginning care you want to assess the clients home area for any safety considerations before getting started
What should be done after conducting a home-care visit?
Continue to maintain safety precautions
Ensure any mess from the use of supplies at the clients home is cleaned and disposed of properly
Proceed to a safe area to complete necessary documentation for the client
Who receives or is in need of home healthcare?
Those with skilled-care needs like older adults
Those recuperating from illness/injury
Those who are terminally ill
Those with chronic illnesses, to avoid hospitalization
How does home-care nursing differ from hospital nursing?
Hospital: the environment is controlled, surfaces are regularly disinfected, supplies are stocked, foods, medications and other therapies are readily available, patient information is conveniently located, other staff members are available almost immediately if assistance is needed
Home-care nursing: you are a guest in the client's home, the client and the family determine whether they are willing to let you into the home to deliver care, you are self-sufficient and function independently, there are no other team members in the home that are immediately available for support, assistance or a consultation, you must be aware and comfortable with the family observing you as you provide care
Describe what hospice care is as well as the goal of hospice care
Hospice nursing is providing compassionate care to patients with life-limited conditions. The goal of hospice care is to promote comfort and quality of life.
This end-of-life care includes provisions for expert medical care, pain management, emotional and spiritual support that are tailored to the patients needs and intentions.
What is the goal of home healthcare and what are ways the goal can be accomplished?
Goal: promoting self care
Ways to accomplish goal:
fostering client independence
educating and teaching both the client and client's family
demonstrating skill techniques to the patient
explaining all aspects of care
What are some disadvantages of home healthcare?
Uncontrolled environment within the patients home
Not readily available supplies within the home as compared to a facility or hospital
Lack of immediate peer assistance as compared to multiple coworker assistance in a facility or hospital
Potential for personal safety issues, what is within a patients own home is unpredictable and different for every situation
How is community nursing different from home health nursing?
Community health nurses provide care for individuals, families and groups (population type based care)
Home health nursing focuses on the individual and his support system
What is the most important role of a home health nurse when it comes to a patients reimbursement (medicare/medicaid)?
The home health nurse must ensure they are completing all of their documentation regarding the clients specific needs, care that was given, and any continuation of need for care. If the home health nurse does not document accordingly the patient will be at risk of losing their reimbursement (medicare/medicaid).
What is public health nursing and it's goal?
It focuses on the effects that the communities health status has on individuals
Public healths nursing goal is to prevent individual disease and disability as well as promoting and protecting the overall health of the community
What should be included in your assessment of your home-care client?
Their health history, review of all their medications (prescribed, over the counter, and any alternatives), the patients mental status, their functional ability, availability of regular assistance from family members (family involvement), the patients nutritional status, and an overall assessment of the clients home environment