Chapter 37 Home Health Nursing
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Chapter 37 Home Health Nursing - Marcador
Chapter 37 Home Health Nursing - Detalles
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| Accreditation | A process whereby a professional association or nongovernmental agency grants recognition to a school or institution for demonstrated ability in a special area of practice or training |
| Certification | A process in which the government evaluates and recognizes an individual institution or educational program as meeting certain predetermined standards |
| Diagnosis-related groups (DRGs) | Pays a set rate according to diagnosis for the hospitalized patient's care rather than the "cost" |
| Telehealth services | Allows for patient and care provider interaction and monitoring through the use of telephones, computers, televisions, and two-way monitors |
| Home health care | Services enable individuals of all ages to remain in the comfort and security of their home while receiving health care |
| Medicaid | Program pays for home care services to indigent and low-income people of all ages |
| Medicare | A federal program that requires agencies to be certified as meeting the federal conditions of participation which set forth specific requirements for organization, staffing, training, types of services covered, and agency evaluation |
| 4 different perspectives of home health care | Official Patient Family Provider |
| Official | A component of comprehensive health care in which individuals and their families receive services in their place of residence for the purpose of promoting, maintaining, or restoring health, or of minimizing the effects of illness and disability |
| Patient | Skilled and compassionate care provided on a one to one basis in the comforting and familiar surroundings of the home |
| Family | A means to keep the family together as a functioning, integrated unit |
| Provider | Challenges all disciplines involved to provide excellent care in often less-than-excellent conditions and surroundings |
| How did Medicare revolutionize home care? | Changing it to a medical rather than nursing model of practice Defining and limiting the services it reimbursed Changing the payment source and even changing the reason for providing homecare |
| What does licensure by the state allow? | Gives LEGAL permission to operate within that state only |
| Explain "Certificate of Need" | According to rules and formulas devised by state regulators, "Certificate of Need" is granted |
| "Deemed status" allows what? | Allows for their accreditation also to serve as the required certification |
| What are agencies classified according to? | Tax status, for profit or non-profit location, freestanding or institution-based governance, public or private |
| Social workers provide what? | Assistance with a patient's emotional, financial, and household problems, thus allowing the nurse more time to perform nursing interventions |
| Primary services include? | Skilled nursing Physical therapy Speech-language therapy Occupational therapy Medical social services Homemaker-home health aide |
| The 4 major goals of skilled nursing services | Restorative Improvement Maintenance Promotion |
| Restorative/Restorative goals | Returning to previous level of functioning as appropriate and realistic -Restorative goals: patient able to feed self without signs of choking |
| Improvement | Achieving better health and higher level of functioning that admission -Improvement goals: patient verbalizes understanding of signs of impending heart attack or brain attack and when to call emergency |
| Maintenance | Preserving functional capacities and independence by maintaining current level of health -Maintenance goals: patient demonstrates compliance with daily exercise routine to maintain strength and prevent further decline |
| Promotion | Teaching healthy lifestyles that keep the effect of illness or disability to a minimum and prevent reoccurrence of illness -Promotion goals: patient demonstrates compliance in low-fat, low-cholesterol, low-sodium diet |
| Name the types of nurses who practice in the home setting | Caregivers, teachers, counselors, case managers, and advocates |
| Physical therapy treatments range from-? | Muscle strengthening, transcutaneous nerve stimulation, and ultrasound treatments These may aide in pain management |
| Speech-language therapy goals include-? | Reducing to a minimum communication disorders and their physical, emotional, and social impact |
| Speech-language therapy ranges from-? | Language relearning to working with eating or swallowing disorders or teaching lipreading to those with hearing disorders |
| Occupational therapy services include-? | Techniques to increase independence Analysis of activities as they relate to patients' skin, environment, families, and routines Expanding the disease management approach into lifestyle management approach Design, fabrication, and fitting of orthotic or self-help devices Assessment for vocational nursing |
| Occupational therapists assist with what? | They assist patients to improve in their performance of activities of daily living and their sensory-motor, cognitive, and neuromuscular functioning |
| What do medical social services focus on? | Their focus is on the emotional and social aspects of illness |
| Home health aide falls into what 3 categories? | Personal care Physical assistance Household chores |
| Personal care | Bathing, oral hygiene, eating, dressing, and toileting |
| Physical assistance | Transfers, medications, and ambulation |
| Household chores | Cooking, light housekeeping, shopping, and laundry |
| What do both Medicare and Medicaid require? | On-site supervision of the aide every 2 weeks, principally by the RN |
| Evaluation and admission generally include what? | Complete patient evaluation Environmental assessment RELATING SPECIFICALLY TO SAFETY AND ABILITY to provide services effectively in the home Identification of primary functional impairments Identification of the impact of the disease or disability on the patient and family Assessment of the support system of the family/significant other Determination of knowledge and adherence to treatments and medications Determination of desire for care/services Involvement of the patient and the family in the development of the plan of care and goals Notification of the patient of rights as a patient along with information on costs, payment resources, and billing practices Explanation of patient's right to self-determination Provision of initial nursing interventions |
| What does the treatment plan describe? | Describes current physical status of patient, medications, treatments, the disciplines needed to provide care, the frequency and the duration of services, the goals and outcomes, and the time frame for implementation |
| Explain what documentation provides | Extended periods of health information Accessible medical docs by health care team Monitor patient compliance and care needs Promote quality of care |
| When does discharge planning begin? | During admission |
| 3 major elements of quality assurance, assessment, and improvement | 1. Structural criteria 2. Process criteria 3. Outcome criteria |
| Structural criteria | Organization, philosophy, policies, procedures, bylaws, personnel practices, supervision, orientation, contracts, and physical facilities |
| Process criteria | Evaluation of care delivery |
| Outcome criteria | Measurement of change in patient behavior, results of patient care in terms of changes, health indicators, and satisfaction |
| Major principals of quality assurance, assessment, and improvement | Quality of patient care Processes are carried out Coordination and integration of processes Employees are motivated and competent to carry out processes |
| What is the standard of care for many illnesses? | Medical management and control rather than cure |
| Explain what home health care allows for | Allows individuals to maintain personal control and participate in the direction of their own care |
| What do health care workers provide? | Care, supervision, assistance, and support in attaining the care plan goals |
| What has changed the way home health care is provided? | Legislative, regulatory, and current health care trends have changed the way it is provided |
| Home care services is based on what? | A coordinated plan of care approved by a physician |
| What are home health agencies? | Organized groups that employ or contract with professionals/paraprofessionals to provide services |
| What type of nursing is the most frequently provided service? | Skilled nursing care |
| Who reimburses home health services? | Federal, state, local, group, and private services |
| Home health care nurses pay particular attention to what? | Interaction and cooperation among family members, the patient, and other members of the health care team |