Chap 98 Home Care Nursing

Front 1

Identify the reasons for and benefits of home care

Back 1

Advantages of Home Care
•Home care is less expensive than hospital or nursing-home care.
•Nurses, support personnel, and primary caregivers can provide continuous care from hospital to home and until the client’s recovery or death.
•Many people are more comfortable receiving care in theirown home, where they are surrounded by their loved ones, friends, and pets. The surroundings are familiar and comfortable. Familiar food is available.
•Many clients prefer to die at home. Home care agencies often provide hospice care (see Chap. 99).
•Many clients and families experience less emotional strain at home because they avoid separation
REASONS:
Insurance, the alloted time for payment my run and the client is not well; hence, home care assistance by a nurse can be provided

Front 2

Describe situations in which home care might be most appropriate

Back 2

•Home visits two to three times a week for assessment or administration of special medications or treatments or to draw blood
•A home visit once a week to assist a client or family to setup medications for the next week
•A very limited number of home visits to assist a new mother
•Dressing changes once or twice a day after surgery for 1 to 2 weeks
•Administration of IV medications
•Administering and reading PPD tests (for tuberculosis) or administering immunizations (eg,
flu shots to senior citizens)
•Administering a periodic electrocardiogram (ECG)
•A periodic home visit to evaluate care being given by family caregivers

Front 3

Identify several nursing functions in home care

Back 3

•Furnish services in accordance with agency policies.
•Prepare clinical and progress notes.
•Assist physicians and RNs to perform specialized procedures.
•Prepare equipment and materials for treatments, observing aseptic technique as required.
•Assist clients in learning appropriate self-care techniques.

Front 4

(5) Discuss important safety practices for home care nurses

Back 4

•Wear a name badge that clearly identifies your name and your employer. It is often suggested to use only a firstname and last initial, for safety reasons. Your professional status should be on the name tag (LPN, LVN, RN).
•Dress professionally. Dress slacks may be worn to enable you to move easier. (Jeans, shorts, sandals, halter tops, and bare midriffs are not appropriate.)
•Telephone clients in advance, alerting them to the approx-imate time of your home care visit. Obtain directions to the residence and ask about parking, if necessary.
•If a client owns a pet known to be menacing, ask the client to properly secure the animal before you come to the home. If you are confronted with an aggressive dog or other animal, back away, but do not turn around and do not run. Do not make direct eye contact with a threatening dog. RATIONALE:
This may be misinterpreted by the dog as a threat, precipitating an attack.)
•Some home care nurses carry mace or pepper spray. It is important to be very careful

Front 5

(5) Discuss important safety practices for home care nurses

Back 5

•Be alert to your surroundings, including other people in the home and when driving.
•Carry a cell phone. Make sure it is charged at all times.
•Keep your vehicle in good working order, with plenty of gas. Always wear your seat belt.
•Lock your car at all times, with windows rolled up, both when driving and when parking. (Electric locks are an advantage.)
•Park your car in full view of the client’s residence. Avoid parking in alleys or on deserted side streets, if at all possible. Park in a well-lighted place
•When exiting the car, have the equipment you will need during the visit ready.
•Walk in a brisk, professional, business like manner directly to the client’s residence. (Escort services may beavailable.)
•When passing a group of strangers, cross to the otherside of the street, as appropriate, and keep eye contact with those in the group.
•Look before entering an elevator; in buildings, use com-mon walkways, avoiding isolated stairs.
•Always knock on the door or ring the

Front 6

(5) Discuss important safety practices for home care nurses

Back 6

Have your car keys and your cell phone in your hand when approaching your car. Look into your car before getting in to make sure it is empty. Lock the car immediately upon entering, before putting things away orstarting the car. If someone threatens you, use the panic button on your car key fob.
•Check your agency’s guidelines before giving a ride to a client or to a family member.
(RATIONALE: Your insur-ance might not be valid in this situation.)
•Take a self-defense class. Learn to protect yourself.(Remember that any attacker cannot defend against a hard blow to the side of the knee. This can be used as a last resort.)

Front 7

Describe and discuss the influences of regulatory agencies upon delivery of home healthcare

Back 7

The Centers for Medicare and Medicaid (CMS) is an agency established to promote increased use of technology as a means of improving management of chronic diseases, to ultimately reduce the incidence of avoidable hospitalizations. The CMS also promotes activities such as increased immunization of seniors for influenza and pneumonia, as well as improved communication at time of transition or “hand-off” from hospital to home care and from physician to nurse. These measures serve to prevent or identify and treat a deterioration of the client’s condition in order to avoid unnecessary rehospital-izations. The QIOs (quality improvement organizations) in each state are also contracted by CMS to work with homecare agencies.
The RN or registered physical therapist performs this task using a standardized data collection tool called the Out-come and Assessment Information Set (OASIS). The client is then assigned to a home health resource group (HHRG) for a given episode of care, which is usually a 60-day period.

Front 8

Describe recent changes in reimbursement for home care

Back 8

In some cases, the client pays for home nursing. However, in most cases, a third-party payor is involved. If this is the case, the number and length of visits will be limited and will be strictly regulated by the funding agency. The nurse will be expected to document the exact length of each visit and what procedures were performed.

Front 9

CHHA

CNO

HCA

HHA

Back 9

Certified Home Health Aide

Community Nursing Organization

Health Care Associates

Home Health Aides

Front 10

HHRG

NAHC

OASIS

PPS

Back 10

home health resource group

National Association of Home Care

Outcome and Assessment Information Set

prospective payment system