Enter G H K Week 6 - Community and Home Health Nursing o Define the meaning of community.

o Identify at least four factors by which you can recognize a healthy community. o Discuss factors that create vulnerability for a population. o Compare and contrast community-based care, community health nursing, public health nursing, and community-oriented nursing. o Distinguish between primary, secondary, and tertiary interventions in regard to a community health scenario. o Discuss at least three strategies that nurses use to gather community data. � Describe the roles of nurses in the community setting. o Identify the primary goals of home care. o Describe ways in which home healthcare differs from hospital nursing. o Categorize the various agencies that deliver home healthcare according to purpose, client served, and funding source. � Describe how the nurse's emphasis differs in hospice nursing compared with home health nursing List at least four criteria clients must meet for home care costs to be reimbursed by Medicare. o Outline the steps required to prepare for a home visit, including considerations for the nurse's safety. o Explain the role of the nurse in helping clients and families manage medications and treatments in the home setting. o Describe how infection control measures differ in the home and in the hospital. o State two important safety concerns in home care that arise out of The Joint Commission 2016 home care safety goals. o Describe the nurse's role in treating caregiver strain. o Apply the nursing process to the care of patients in the home and community. o Use standardized nursing language taxonomies (NANDA-I, NOC, NIC, Omaha, and CCC) to describe care planning in community and home care. o

 

In community and public health nursing the target of care is the community, thus the community is the client receiving the care. The role of the nurse is to evaluate health concerns, and develop an aggregate plan of care to address those concerns. Aggregates or target populations in the community may include child care centers, cities, counties, senior centers, homeless shelters, minority communities, faith based organizations, work sites, schools, or other populations. Identify and discuss a few targeted populations in your community that are of interest to you, and explain your reasons for the selections identified."

Community and Home Health concepts

 Community – Explanation

 A community therefore is a group of people with some degree of similarity in terms of the character or interests or perhaps living in the same locality. It embraces the aspect of relational parents and friends as well as social networks that join persons. According to Boyer peoples from similar geographical region, having same culture, religion, professions or even facing similar situations or events can form a community.

 

 Evaluate quarterly four determinates of a healthy community

 Access to Healthcare Services: Accessibility of cheap and quality hospitals, clinics and other preventive measures are beneficial to the society.

 Clean Environment: Hygiene, including drinking water, air and water pollution, sanitation and management of wastes has a disproportionally positive impact on health status of a population.

 Social Support Networks: Cultural and social relationships as well as networking, family and friends, groups, organizations play critical role in mental and emotional health.

 Economic Stability: Availability of jobs, proper remuneration, and financial means give a community the general provisions including housing, food and health.

 The Circumstances Which Make a Co-Existing Population A Target and/or At Risk

 Economic Disparities: Some of the factors that raise vulnerability include; poverty, unemployment and circumstances that make one lack access to basic assets.

 Limited Healthcare Access: Lack of healthcare centres or being uninsured means one cannot afford medical attention to illnesses they might be suffering from.

 Education Deficits: Board education can hamper literacy and health information, which is seen in low educated adulthood.

 Social Isolation: Loneliness may result in mental complications and at the same time, restrict an individual’s social privileges.

 Community nursing has been divided into different types or categories which need to be contrasted and compared.

 Community-Based Care: Encompasses delivery of health services to the people in a community especially to families, with much concern to promotion of health.

 Community Health Nursing: Encompasses delivering interventions directly to communities in an attempt to enhance their health status or extend healthy behaviours.

 Public Health Nursing: Refers to health maintenance and enhancement activities targeted at specific population groups these activities being carried out in a planned manner to guard against disease and enhance health and length of life.

 Community-Oriented Nursing: Public health nursing: A combination of community health nursing and school nursing with limited emphasis on health and illness in the individual.

 Ultra of the types of interventions are there and what are the differences between the three categories namely; Primary, Secondary and Tertiary?

 Primary Interventions: To exclude episodes of diseases and injuries (for example, immunization, health promotion).

 Secondary Interventions: Emphasize prevention, detection at the earliest stage that is possible and possible treatment (e . g screening, early treatment).

 Tertiary Interventions: It is desirably to minimize chronic enduring sickness and/or injury (for example, physiotherapy and chronic diseases treatment).

 The Search Strategies Nurses Undertake in the Collection of Community Data

 Surveys and Questionnaires: To gather data it is recommended that information be obtained from the main source, which in this case consists of community members.

 Focus Groups: Talk to the members of the community in order to discuss certain health problem.

 Community Observations: Socio-cultural concern: It involves observing and studying people’s interactions in a community, and the physical structures and setting in which they find themselves to establish potential health issues.

 Nursing: Basic Roles for the Community Scenarios

 Educator: Educate health related knowledge to the people and groups.

 Advocate: Call for the policies and funding that would enhance the stability of any community health.

 Care Provider: Provide direct care services in clinic or homes in the communities.

 Coordinator: Oversee the ‘joining up’ of care planning and other support between different services and service providers.

 Principal Objectives of Home Care

 Promote Independence: Aid the clients in the management of their health within their homes so as to have optimum independence.

 Prevent Hospitalization: Deliver first rate care that out does hospitalization or re-hospitalization care.

 Enhance Quality of Life: Concerns include patients’ comfort; their dignity; and what is best for the patient in his or her home sphere.

 The variation between home healthcare nursing and hospital nursing

 Environment: Nursing performed at a patient’s home hence exposes the nurse to many home settings.

 Patient Independence: Home care pays much attention to the patient’s ability to manage their illness, treatments, and symptoms on their own.

 Resource Availability: Competition for medical equipment and instruments The nurses in the hospital have more access to medical instruments than the home health care providers have because the hospital has got more specialized and advanced instruments than those that the home health care providers can afford to buy for their use.

 Classification of Home Healthcare Agencies

 Purpose: They may choose to specialise in such services as hospice, rehabilitation or chronic illness management services.

 Client Served: Some agencies only dare take care of certain category of people including the elderly, disabled or those that are terminally ill.

 Funding Source: The agencies may be funded through Medicare, Medicaid, insurance or through charitable organizations.

 Organisation and Content of Home Care vs. Hospice Care

 Focus: The hospice nursing is related to terminal care for patients with terminal illness and aim at giving comfort while the home health may cover more a wider scope of services which may include physical and occupational therapy, and disease management.

 Care Goals: Whereas hospice care is directed towards improvement of quality of life of patients in their terminal stages home health care might be oriented towards better health and self sufficiency.

 Sketch of the Basis for Medicare Reimbursement to Home Care

 Medical prescription is required and the patient has to be under the care of a doctor.

 The patient has to require invasive procedures to diagnose or treat a condition or the patient has to require skilled nursing that is beyond the capacity of a home health aide.

 The patient has to be a homebound one.

 The care can only be delivered by a Medicare certified home health agency.

 Preparing for a Home Visit: Factors Affecting the Safety of the Nurse

 Assess the Environment: It is also vital to consider safety risks of the neighborhood and home.

 Plan and Communicate: Users should also inform other people about the planned visit and the place where this activity will take place.

 Emergency Preparedness: Always have a phone with charge and power and make sure you always have an emergency plan.

 Medication and Treatment Management: Responsibilities of the Nurse

 Education: Knowledge of the patients and families in terms of medication and how it should be taken.

 Monitoring: Evaluations of patients and modifications of treatment programs where necessary.

 Coordination: The relation between the healthcare providers and the patient should be effective.

 Infection Control in the Home vs. Hospital

 Home: They further found that infection control involves and depends on a strict compliance from patients and their families on aspects of hygiene.

 Hospital: Measures of infection control include distinctive measures, trained staff and specific pieces of equipment.

 Home care for patients /Getting Started: Focus on safety and infection prevention at home: Home care … (AJN, The American Journal of Nursing © 2016 The Joint Commission)

 Medication Management: Avoiding medication errors such as wrong storage, wrong handling of the product or wrong administration.

 Fall Prevention: Reducing falls in the home: Strategetic measures that may be taken.

 The current research anchored on the purpose of identifying the role of a Nurse in treating Caregiver Strain.

 Support: Provide care and counsel to the caregivers of the patients with such diseases.

 Education: Input health promotion information, which would include importance of stress fresh towels, nutrition, exercise etc.

 Resources: Of course, referral to other carers for further assistance in case of consumer difficulty.

 Using the Nursing Process in Home and Community Care

 Assessment: Acquire baseline data regarding the patient’s medical condition and his/her physical and social context.

 Diagnosis: Recognise current and potential health issues.

 Planning: It is necessary to create a care plan that will include potentially achievable goals of the patient and certain measures needed in order to achieve these goals.

 Implementation: Implement the care plan in the patient’s home of community environment.

 Evaluation: Evaluate the care plan and addend for changes.

 It is imperative, therefore to use Standardized Nursing Language Taxonomies.

 NANDA-I: Centred on the terminology related to nursing diagnosis.

 NOC (Nursing Outcomes Classification): Determines potential goals or objectives for the patients.

 NIC (Nursing Interventions Classification): Lists particular care individual actions.

 Omaha System: Cohort for community health and home care.

 CCC (Clinical Care Classification): Section 3 The implementation of CM for the purpose of standardises the terminology of home health nursing documentation.

 The Identified Targeted Populations in My Community

 Elderly Population: This group is vulnerable to chronic diseases and social exclusion because of ageing population resulting from enhanced life spans, hence needs health and other social activities.

 Homeless Individuals: More likely to live poorer quality lives than non-homeless because of lack of basic needs such as shelter for the sick and access to treatment for the rest suffering from all sorts of diseases.

 Minority Communities: Afforded unequal status in healthcare and therefore they are often required to receive sensitive and equitable treatment.

 Low-Income Families: Suffers to gain access to health care, food and proper housing, so becomes a target for community health interventions.