Home Healthc Nurse
· 2013 Oct · PMID 24081135
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The BUILD model was created to provide a systematic framework for hospice clinicians to have important conversations with patients and families as well as facilitating useful conversations with interdisciplinary teammate...The BUILD model was created to provide a systematic framework for hospice clinicians to have important conversations with patients and families as well as facilitating useful conversations with interdisciplinary teammates. Although this article focuses on medication appropriateness and discontinuation of medications, this model can also be used when discussing prognosis, code status, goals of care, drug diversion, and when collaborating to develop a plan of care. When provided with a communication tool that is versatile, logical, and effective, hospice clinicians may use it, supporting improved patient care outcomes.
Home Healthc Nurse
· 2013 Oct · PMID 24081133
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Situation-Background-Assessment-Recommendation (SBAR) communication has become the standard for communicating across disciplines. It has demonstrated its effectiveness at improving patient outcomes, enhancing patient and...Situation-Background-Assessment-Recommendation (SBAR) communication has become the standard for communicating across disciplines. It has demonstrated its effectiveness at improving patient outcomes, enhancing patient and clinician satisfaction, and helping to control healthcare costs. It can help home healthcare clinicians with efforts to prevent avoidable hospitalizations. But how often and how well do home health clinicians use this method of shared communications with physicians? This article explores why communication between physicians and home health clinicians can be so problematic. It introduces the SBAR communication method, its origins, its features, and some of the published evidence that it provides effective and efficient communication, thereby promoting better patient outcomes.
Westra BL, Paitich N, Ekstrom D
… +4 more, Mehle SC, Kaeding M, Abdo S, Monsen K
Home Healthc Nurse
· 2013 Oct · PMID 24081131
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Providers in all settings are increasingly aware of the need to focus on transitional care needs and services across healthcare settings to improve quality of life, maintain optimal health, and prevent unnecessary hospit...Providers in all settings are increasingly aware of the need to focus on transitional care needs and services across healthcare settings to improve quality of life, maintain optimal health, and prevent unnecessary hospitalizations. Home care is an essential piece of the transitional care puzzle, especially in providing services to support older adults with chronic comorbid conditions to remain at home safely with optimal health and psychosocial well-being. Home care is essential in bridging the gap from acute hospital care to home; however, little is known about the needs of older adults after discharge from home care. Our study investigated the perceptions of older adults with chronic health conditions after discharge from home care regarding their daily activities and healthcare needs and identified how these needs were met.
Home Healthc Nurse
· 2013 Oct · PMID 24081130
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Home healthcare (HHC) agencies and schools of nursing (SONs) share the mutual goal of using evidence-based knowledge to deliver care while fostering a professionally stimulating environment. As HHC agencies strive to del...Home healthcare (HHC) agencies and schools of nursing (SONs) share the mutual goal of using evidence-based knowledge to deliver care while fostering a professionally stimulating environment. As HHC agencies strive to deliver clinically effective, cost-efficient, patient-centered nursing care, SONs use scholarly methods to develop sound practitioners with investigative skills. Collaborations have long existed between these two entities, but few studies describe how theory and practice meld in the ever-growing HHC arena. The purpose of this article is to highlight the need for such future collaborations and to summarize some of the successful collaborative methods used by schools and agencies. Additionally, the collaboration between one nonprofit HHC agency and a university-based SON is described along with the challenges and benefits to both partners.
Home Healthc Nurse
· 2013 Oct · PMID 24081129
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The purpose of this study was to explore the perceptions of senior undergraduate nursing students and perceptions of home care clients regarding the use of a new electronic health record and its impact on client care and...The purpose of this study was to explore the perceptions of senior undergraduate nursing students and perceptions of home care clients regarding the use of a new electronic health record and its impact on client care and communication. Findings indicate that providing students with the opportunity and time to become familiar with the use of computers during client care in the educational environment allows them to move more comfortably from a computer-focused visit to client-focused nursing care.
Wilde MH, Zhang F, Fairbanks E
… +3 more, Shah S, McDonald MV, Brasch J
Home Healthc Nurse
· 2013 Oct · PMID 24081128
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A long-term indwelling urinary catheter intervention was tested in a randomized trial that is described in this article. The perceived value of the intervention to the catheter users, one of the study's specific aims, wa...A long-term indwelling urinary catheter intervention was tested in a randomized trial that is described in this article. The perceived value of the intervention to the catheter users, one of the study's specific aims, was assessed at the end of their 12-month participation and is reported here. Study participants' responses, our findings, and implications for home healthcare are discussed.
The Timed Up and Go (TUG) is a popular, effective, and valid test of functional mobility and fall risk that is often completed by registered nurses (RNs) and physical therapists (PTs) throughout the course of a home care...The Timed Up and Go (TUG) is a popular, effective, and valid test of functional mobility and fall risk that is often completed by registered nurses (RNs) and physical therapists (PTs) throughout the course of a home care episode. As reimbursement becomes tied to outcomes, it is essential that all disciplines are consistent in their methods when administering the TUG. Results of this study confirm the hypothesis that test-specific training will significantly improve reliability of the TUG when completed by 2 different disciplines. The purpose of this article is to describe an initiative that provided tool-specific training to all clinical staff at our home care agency. The inter-rater reliability between PTs and RNs improved significantly from 0.77 to 0.86 (p = 0.001) after standardized training on administration of the TUG.
This is Part 2 of a 2-part series for treating urinary incontinence in the home care setting. Part 1 addresses the assessment, diagnosis, and strategies in the treatment of urinary incontinence; including a case study.This is Part 2 of a 2-part series for treating urinary incontinence in the home care setting. Part 1 addresses the assessment, diagnosis, and strategies in the treatment of urinary incontinence; including a case study.
Providing spiritual care is an important foundation of nursing and is a requirement mandated by accreditation organizations. Spiritual care is essential in all clinical areas but particularly in home care and hospice. Cl...Providing spiritual care is an important foundation of nursing and is a requirement mandated by accreditation organizations. Spiritual care is essential in all clinical areas but particularly in home care and hospice. Clinicians may be unable to respond to spiritual needs because of inadequate education or the assumption that spiritual needs should be addressed by clergy, chaplains, or other "spiritual" care providers. In reality, clinicians in the home may be in the best position to offer spiritual support when caring for patients at home at end of life. The purpose of this pilot study was to examine relationships between spirituality and nurses' providing spiritual care. Professional nurses (n = 69) working in 2 large healthcare organizations completed the Perceptions of Spiritual Care Questionnaire. Approximately, 33% of the nurses worked in home care. Significant correlations were found among those nurses whose reported nursing education programs adequately prepared them to meet spiritual needs and taught ways to incorporate spiritual care into practice and those who did not.
Home Healthc Nurse
· 2013 Jun · PMID 23736166
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This article focuses on issues and research related to informal caregivers. The first 2 profiled studies looked at caregiver burden with 1 study conducted in the United States and the other in Thailand. Caregiver burden...This article focuses on issues and research related to informal caregivers. The first 2 profiled studies looked at caregiver burden with 1 study conducted in the United States and the other in Thailand. Caregiver burden refers to the physical and emotional risks facing caregivers who are taking care of a relative or friend. Both found that the level of caregiver burden was related more to caregiver perception and attitude than to patient disease or other patient characteristic. Other important findings can be found in the summaries in this research brief. The third article profiles an investigation that was part of the Resources for Enhancing Alzheimer's Caregiver Health (REACH II) initiative. Amanda Elliott and colleagues provide evidence of an intervention that was successful in improving caregiver health. The fourth write-up summarizes an important meta-analysis recently published on evaluating the effectiveness of family caregiver interventions on reducing behavioral and psychological symptoms in people with dementia and reducing caregiver negative reactions to these symptoms. Interested readers are encouraged to read the original articles for more details.
Home Healthc Nurse
· 2013 Jun · PMID 23736164
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Although the overall incidence of head, neck, and oral cancer has been decreasing, oral and neck cancer caused by the human papillomavirus (HPV) has risen. This article discusses statistics, risk factors, causes, pathoph...Although the overall incidence of head, neck, and oral cancer has been decreasing, oral and neck cancer caused by the human papillomavirus (HPV) has risen. This article discusses statistics, risk factors, causes, pathophysiology, treatments, and the home healthcare and hospice nursing implications for these patients. A real-life patient's journey through neck cancer caused by HPV is presented.
Home Healthc Nurse
· 2013 Jun · PMID 23736162
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Much emphasis has been placed on the impact of falls among older adults, and the relationship between polypharmacy and falls in community-dwelling elders. As home healthcare agencies' critical role in the continuum of ca...Much emphasis has been placed on the impact of falls among older adults, and the relationship between polypharmacy and falls in community-dwelling elders. As home healthcare agencies' critical role in the continuum of care is recognized, so is the responsibility for ensuring that quality patient outcomes are achieved resulting in reduced hospitalizations. As we examined the factors involved in falls and hospitalizations with our home care population, it became evident that the pharmacist plays a critical role in helping to ensure that risk factors associated with falls are minimized through a thorough medication therapy review, completed in collaboration with the case manager and the physician. This project was initiated to positively impact patient outcomes by identifying potential medication issues in those patients who were also identified as high fall risk.