User:Alliacev/sandbox

Senior Sem Group Sandbox: Home Health Nursing

The article that we have chosen to work with is Home Health Nursing.

I think that the article could use more information on the scope of practice of a nurse in home health. Also the history section should be expanded to discuss home health more directly. Alliacev (talk) 15:04, 15 September 2017 (UTC)

I believe the article can expand more on home health care practices and what limitations are involved with home health care, also what the requirements are for approval of home health care ALAlmond7288 (talk) 04:30, 16 September 2017 (UTC)

Senior Sem: Home Health Nursing Source List

I have found an academic article about using home health care as a means to get patients out of the hospital sooner and have cost-effective benefits without sacraficing quality of care or going without much needed resources for the patient. Alliacev (talk) 13:36, 22 September 2017 (UTC)

Patient education on role of home health nurses and skills performed. Regaining more independence with home health care assistance. ALAlmond7288 (talk) 04:31, 23 September 2017 (UTC) Types of home care and what Medicare will cover. ALAlmond7288 (talk) 04:31, 23 September 2017 (UTC)

This article that Ashley found discusses the challenges of home health care, especially in the aspect of patient safety. There are many obsticles that nurses face when trying to maintain a safe environment for patients in their home. It is not a controlled environment like the hospital and presents very unique barriers in patient care. Alliacev (talk) 17:48, 24 September 2017 (UTC)

Within our community nursing textbook, there is a chapter that discusses the basics of home health. This includes the history, scope and standards of practice, evidence-based practice, and legal and ethical issues concerning it. Alliacev (talk) 18:18, 24 September 2017 (UTC)

The Foundations of Nursing text book provides an overview of nursing as a whole. The book gives a concise view of home health nursing that would improve the Home Health Nursing Wikipedia article. Pauliana Landreth (talk) 15:15, 27 September 2017 (UTC)

Senior Sem: Article Improvement Ideas

• A more in depth history
• Remove the citation used in the original Home health nursing article on Lillian Wald. It is not a proper citation and our own community nursing text book could be used in it's place. Alliacev (talk) 15:33, 27 September 2017 (UTC)

Lillian Wald is recognized as the creator of the title "public health nurse." Public health nurses of the late 1800s would provide preventative education and care to families and patients.

• Definition of home health nursing- I don't feel we need to add this section as home health is explained in the opening paragraph. Alliacev (talk) 22:23, 5 October 2017 (UTC)
• Education and Certification
• Roles and Responsibilities section should be expanded upon and organized in a more clear manner. Alliacev (talk) 15:42, 27 September 2017 (UTC)

Home health nurses provide resources and assistance to their patient(s) and family for their daily needs. These nurses provide care for all ages. Most of the roles performed by home health nurses and health care assistants are uniform. The most frequent activities performed by home health nurses include self-care facilitation, nutrition support, drug and perfusion management, skin and wound care, diabetes care, psychosocial care, and other care such as patient education. Community health nurses help promote physical and emotional well being, as well as provide guidance through weight management, emotional support, bereavement, and many other health aspects.

• Scope of Practice
• Hospice as a subcategory of home health
• Telenursing as a subcategory
• Limitations to home health nursing
• Most of the citation on the Home health nursing page need to be updated. There are more relevant and current resources that could be utilized. Alliacev (talk) 15:33, 27 September 2017 (UTC)

Article Evaluation

• Senior Sem citations: 1-4 in the reference section are the only ones found and "approved" by our group. The rest are citations that were copied over from the Home health nursing article. These citations will most likely be replaced with better quality sources.
• Check citations- including their reliability once clicked and the age of them.

Home health nursing----- First Draft

Home health nursing is a nursing specialty in which nurses provide multidimensional home care to patients of all ages. Home health care is a cost efficient way to deliver quality care in the convenience of the client's home. Home health nurses create care plans to achieve goals based on the client's diagnosis. These plans can include preventative, therapeutic, and rehabilitative actions. Home health nurses also supervise certified nursing assistants. The professional nursing organization for home health nurses is the Home Healthcare Nurses Association (HHNA). Home health care is intended for clients that are well enough to be discharged home, but still require skilled nursing personnel to assess, initiate and oversee nursing interventions.

History

Lillian Wald is recognized as the pioneer of public health nursing. She established the Henry Street Settlement which served underprivileged individuals and families. Nurses and social workers that worked at the Henry Street Settlement visited patients in their homes, assessed their health needs, and provided support with hygiene, nutrition, immunizations and more. Wald was able to convince Metropolitan Life Insurance Company to cover home care services. This allowed public health nursing to shift from charitable work to profitable work.

Education and certification

Home health nurses can have a nursing diploma, be a licensed practical nurse, have an associate of science in nursing, or a bachelor of science in nursing. They can then sit for a test through the American Nurses Credentialing Center that will allow them to become a certified home health care nurse.

Roles and responsibilities

There is a wide range of services that are preformed by many different professionals, services include wound care, disease management, medical equipment, therapy, medical social services, and patient education. Home health nurses have a wide range of duties and services provided, and in addition to services provided nurses also consult with doctors on the status of the patient and provide feedback on any potential changes that need to be made to the care plan.

Some responsibilities that home health nurses take on include promoting health and disease prevention, medication administration, educating patients on their current diagnosis, providing emotional support, and providing basic care such as personal hygiene.

Nurses also step into the role of case managers, meaning that they coordinate services from different disciplines for the patient. This can include rehabilitation, pharmacy, community resources and more.

Providing the most up-to-date and effective care for a patient is also a very important part of a home health nurse's job. They do this by continually keeping up to date on the latest research and Evidence-Based Practice.

Scope and standards of practice

The scope of home health nursing is directly related to the nursing process. This includes assessment, diagnosis, planning, implementation, and evaluation. The standards of home health nursing integrate research, education, proper use of resources, the quality of care provided, team collaboration, and ethical principles.

Barriers in home health nursing

Home health nursing is a unique field considering the obstacles faced by the healthcare professionals. When out visiting clients, the nurse is alone and is not able to rely on others most of the time. Nurses in home health care must learn to be autonomous.

The variety of home condition that a nurse will step into can also present problems. Cleanliness and safety play large roles in client care. Not all homes are equipped to provide a clean environment for the client. Environmental issues in the home include unsanitary conditions that allow for bacterial growth and conditions that may increase the risk of falling for the client, such as poor lighting and area rugs. Education regarding this is important for the nurse to share with the client.

Medication adherence is also more complicated at home. Unlike in a hospital setting, the medication is scheduled around the clock and readily available. It is really dependent on the client's resources and financial situation. Also, client compliance, or client adherence to the plan of care, factors into client health outcomes.

Eligibility

Home health care is generally less expensive and more convenient then in the hospital. When possible home health care helps regain independence, become more self sufficient, and maintain current level of function. The primary payer for home health care is Medicare dependent on meeting certain eligibility criteria.

Home health services are covered when all of the following criteria are met:

1. Patient is under the care of a doctor, and getting services under a plan of care established.
2. A doctor certifies that the patient needs, one or more of the following: intermittent skilled nursing care, physical therapy, speech-language pathology, and continued occupational therapy
3. Home health agency caring for patient is approved by Medicare
4. Doctor certifies that patient is homebound
5. As part of eligibility, a doctor or health care professional must document that they have had a face to face encounter within required timeframe and the reason was related to need for home health care

Eligibility for home health care is determined by intermittent skilled nursing care that is needed fewer than 7 days each week and daily less than 8 hours each day for up to 21 days. If skilled nursing care is needed more than this over extended period of time it would not qualify for home health benefits under Medicare guidelines.