Some of the homebound patients may be recovering from surgery or have a newly diagnosed disease or an exacerbation of a chronic condition. Some home health care clients may be extremely debilitated by age or illness; others may be dying. Care is individualized for each client, and teaching caregivers who are family members and friends is an important part of the care plan (Lois, 2012). Another of the community based nursing example is case management. Case management can be a long-term relationship between a patient and case manager, sometimes lasting several years.
Facility administrators need to establish a balance between providing a safe environment, while at the same time providing each resident with opportunities for choice, control, and individuality (Kane & Kane, 2001). The staffing levels of professional nurses in a nursing home are not as high as that of a hospital; however, nursing homes have registered nurses on duty that perform assessments, administer medications, perform treatments, and interact with families and physicians, to name some of their many responsibilities. Nursing home residents often become ill. In 1997, there were 1,465,000 nursing home residents and 2.1 million elderly nursing home discharges due to hospitalization and death in the United States (Gabrel, 2000). When a resident is observed to have a condition change, the nurse performs an assessment and makes a decision whether or not to notify the physician and the resident’s family or guardian.
Hospice care provides medical services, emotional support, and spiritual resources for people who are in the last stages of a serious illness, such as cancer or heart failure. Hospice care also helps family members manage the practical details and emotional challenges of caring for a dying loved one. The goal is to keep you comfortable and improve your quality of life. Hospice services usually include: Basic medical care with a focus on pain and symptom control. Access to a member of your hospice team 24 hours a day, 7 days a week.
They are the families’ contact with the medical world, in the hospital and at the patients’ home. A nurse regularly evaluates patients and check vital signs to make sure everything is going as planned. Nurses perform procedures such as IV placement, phlebotomy and administering medications. (1988) Working hours for a nurse are different almost all the time because no one can predict when an emergency is going to happen. They must be available twelve hours a day, nights, weekend, and be able to handle any rotations or changes in their shifts.
Palliative care is defined as “a medical specialty that focuses on relief of the pain, symptoms and stress of a life-threatening illness and improving quality of life. It is appropriate at any time in an illness and can be provided at the same time as curative treatment” (www.cancer.org/hospice). During this time patients are surrounded by their love ones, and are still getting treated 24/7. They are still viewed as people not as death or burdens. The average patient is in hospice 59 days.
Another reason why living at home can benefit an individual is that they may have more time spent with loved ones and are more likely to get visits from friends and family. This is important as it keeps that sense of ‘normality’. If the individual was in a care/residential home, they may not get as many visitors as the family/friends may feel uncomfortable in that environment or the family/ friends may be busy during the visiting hours. Another factor is that the individual is able to maintain a little more control over daily routine, which is important as this leaves the individual feeling cared for and listened to. Also the individuals are surrounded by their own possessions with fond memories which make them feel more secure.
Eye surgeries, colonoscopies, and other less invasive surgeries can be done in a hour or two and the patient can go home after recovery instead of staying in the hospital. This frees up hospital beds for the more critical patients. Quality health care also means quality staff; from the clerk who admitts you for your hospital stay or doctor’s appointments to janitor that cleans your room. Each individual is important to the treatment of a patient. A patient coming into a clinic to see the doctor for the first time expects the person at the desk to understand that they are there for a reason, their needs are addresssed in a professional manner.
The program would use case managers and a database tracking system to enhance patient access to regular healthcare services, connect patients to regular healthcare services and help combat logistical interference in getting the right care. Solution: Identification of potential clients: If the patient indicates a basic need (for food, shelter, etc.) during a visit to the emergency department the attending nurse or physician can initiate a referral to the case management program by giving the patient information about the program and placing an order in the chart. The case managers and program director receive weekly reports of these
Also if they are able to become more independent, they are more likely to become more confident, which means they may be able to do more things for themselves, therefore making them more independent, which therefore benefits the individual as they are in a positive atmosphere. Another reason why living at home can benefit an individual is that they may have more time spent with loved ones and are more likely to get visits from friends and family. This is important as it keeps that sense of ‘normality’. If the individual was in a care/residential home, they may not get as many visitors as the family/friends may feel uncomfortable in that environment or the family/ friends may be busy during the visiting hours. Another factor is that the individual is able to maintain a little more control over daily routine, which is important as this leaves the individual feeling cared for and listened to.
After assuring the support of my clinical coordinator and my senior leader, I spoke at a staff meeting about the benefits of couplet care. I spoke about the more efficient nursing practice we could provide and the benefits to patients as well to nursing. Many of the staff were surprisingly supportive of the approach. I brought another nurse from a local hospital to the meeting to speak about their change, barriers, and positive rewards brought about from couplet care. This speaker answered many of their questions and solved many of the obstacles the staff