Graven LJ, Grant JS, Vance DE
… +3 more, Pryor ER, Grubbs L, Karioth S
Home Healthc Nurse
· 2014 Oct · PMID 25268530
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Home healthcare clinicians commonly provide care for individuals with heart failure (HF). Certain factors may influence the development of depressive symptoms in those with HF. This cross-sectional, descriptive, correlat...Home healthcare clinicians commonly provide care for individuals with heart failure (HF). Certain factors may influence the development of depressive symptoms in those with HF. This cross-sectional, descriptive, correlational pilot study (N = 50) examined interrelationships among HF symptoms, social support (actual and perceived), social problem-solving, and depressive symptoms. Findings indicated that increased HF symptoms were related to more depressive symptoms, whereas higher levels of social support were related to fewer depressive symptoms. The use of more maladaptive problem-solving strategies was also associated with more depressive symptoms. Study results have implications for home healthcare clinicians providing care for individuals with HF, indicating a need for programs that strengthen coping skills and resources (i.e., social support and problem solving) in an effort to decrease the risk of developing depressive symptomatology.
Home Healthc Nurse
· 2014 Oct · PMID 25268529
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Publisher ↗
To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational intervie...To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational interviewing through evidence-based health coaching. A closer look at this exciting new clinical skill reveals what it is, how it works, why it is so successful, and why our traditional patient approach has fallen short.
Lancaster R, Marek KD, Bub LD
… +1 more, Stetzer F
Home Healthc Nurse
· 2014 Oct · PMID 25268528
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Full text
The purpose of this study was to examine the number and types of discrepancy errors present after discharge from home healthcare in older adults at risk for medication management problems following an episode of home hea...The purpose of this study was to examine the number and types of discrepancy errors present after discharge from home healthcare in older adults at risk for medication management problems following an episode of home healthcare. More than half of the 414 participants had at least one medication discrepancy error (53.2%, n = 219) with the participant's omission of a prescribed medication (n = 118, 30.17%) occurring most frequently. The results of this study support the need for home healthcare clinicians to perform frequent assessments of medication regimens to ensure that the older adults are aware of the regimen they are prescribed, and have systems in place to support them in managing their medications.
Home Healthc Nurse
· 2014 Oct · PMID 25268527
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Electronic cigarettes have been marketed as a safer alternative to cigarettes, and their use is expanding exponentially. However, there is a severe lack of scientific data about the ingredients in the liquid used in the...Electronic cigarettes have been marketed as a safer alternative to cigarettes, and their use is expanding exponentially. However, there is a severe lack of scientific data about the ingredients in the liquid used in the device and the health consequences of using electronic cigarettes. As technology has outpaced regulations, the production and sale of electronic cigarettes are, as yet, unregulated and do not fall under the purview of the Food and Drug Administration. This article will review the mechanism of action and what is currently known about the safety of electronic cigarettes. The risk of poisoning for children will also be identified, as well as the implications for home healthcare clinicians.
Home Healthc Nurse
· 2014 Oct · PMID 25268526
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Publisher ↗
Each year, 5% to 20% of the U.S. population is infected with the influenza virus. The influenza season occurs annually between the months of October and May, with 3,000 to 49,000 influenza-related deaths each year. Since...Each year, 5% to 20% of the U.S. population is infected with the influenza virus. The influenza season occurs annually between the months of October and May, with 3,000 to 49,000 influenza-related deaths each year. Since complications delay recuperation, those in high-risk groups need to be monitored carefully. High-risk groups are more vulnerable to severe illness and complications of the disease and include: people older than 65 years of age, children under 2 years of age, pregnant women, obese patients, and patients with other serious comorbid conditions. This article provides home healthcare clinicians with important information on influenza, how it is transmitted, influenza virus types and changes in the virus, signs and symptoms of complications, and measures to prevent the occurrence and transmission of influenza.
Home Healthc Nurse
· 2014 Oct · PMID 25268524
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A patient was readmitted two days after discharge with severe hypoglycemia. The treating team discharged the patient on a new insulin regimen without realizing that the patient also had insulin 70/30 at home. The patient...A patient was readmitted two days after discharge with severe hypoglycemia. The treating team discharged the patient on a new insulin regimen without realizing that the patient also had insulin 70/30 at home. The patient continued to take her previous regimen as well as the new one, and was found unresponsive by her husband. The patient was in the ICU with the incident likely resulting in permanent neurological deficits. ()A patient was admitted to a hospital from a home health agency. The list of medications provided by the agency did not completely match the list provided by the patient's family physician (i.e., the antihypertensive agent metoprolol tartrate [Lopressor] was not listed by the agency as one of the medications that the patient was currently taking). Therefore, metoprolol tartrate was not initially ordered. The patient developed atrial fibrillation shortly after hospital admission and required a transfer to the ICU [intensive care unit]. A diltiazem (Cardizem) infusion was started and the patient's family physician became aware that the patient had not been receiving their antihypertensive medication and initiated an order for the metoprolol tartrate ().
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...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 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 comp...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.
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 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.
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 dis...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.
Dementia is a highly prevalent, progressive, life-limiting illness for which there is no cure. Palliative care is a specialized area of healthcare that focuses on improving the quality of life for individuals with life-l...Dementia is a highly prevalent, progressive, life-limiting illness for which there is no cure. Palliative care is a specialized area of healthcare that focuses on improving the quality of life for individuals with life-limiting diseases. Symptoms such as disorientation, tension, and anxiety occur in patients with dementia at moderate to severe levels as they approach the end of their lives, as well as other common symptoms found with cancer patients, yet the dementia population continues to be unrecognized for their need for palliative care. This article examines current literature with respect to palliative care for patients with dementia.
Diabetes is a common diagnosis for home care patients. Conducting an assessment of diabetes self-care management knowledge and skills can identify areas for improvement and support and pinpoint individual self-care barri...Diabetes is a common diagnosis for home care patients. Conducting an assessment of diabetes self-care management knowledge and skills can identify areas for improvement and support and pinpoint individual self-care barriers. This article will provide targeted questions that may be used by the home care nursing professional when conducting such an assessment.