Home Healthcare Nurses Research Articles

Home Health Care Nurse Perceptions of Geriatric Depression and Disability Care Management

Psychosocial interventions alone or combined with antidepressant medication can effectively treat mild to moderate geriatric depression. However, most home health care patients with depression and disability do not receive these interventions. Moreover, relatively little is known about home health care nurse views about depression management. Therefore, our research purpose was to provide a deeper understanding about how home health care nurses perceive and experience depression detection and evaluation within the context of caring for geriatric patients with disabilities. This qualitative descriptive study involved 2 focus groups and 16 semistructured interviews with nurses providing care to geriatric home health care patients followed by observation during 25 nurse home visits to geriatric patients who had depression and disability. Nurses demonstrated confidence in caring for elderly patients with disabilities. However, they expressed different views about the nature of depression and the integration of depression and disability care in daily practice. Evidence points to a need for advanced training that supports an enhanced role for generalist homecare nurses in providing depression care management for this vulnerable geriatric population. Policy challenges are associated with ways in which home health care is fiscally organized primarily to address patients' physical and acute skilled care needs and not depression.

Feasibility of Implementing a Web-Based Education Program in Geriatric Pain and Depression for Home Health Care Nurses

Despite a major shift in the care of older adults from acute care to home health, few home health care nurses are adequately prepared to manage the complex needs of geriatric patients. This study examined the feasibility of a web-based education program to help nurses improve their treatment of geriatric pain and depression. Nurses’ knowledge, confidence, and attitudes were assessed before and 3 months after a web-based education program. Nurses randomized to the experimental group showed significant improvement in attitudes 3 months after the intervention, however little long-term retention of knowledge. This study showed it is feasible to perform web-based geriatric training to nurses in home health care, though it needs to be accompanied by structural and procedural changes in care for long-term success.

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Home Healthcare Nurse: October 2013 - Volume 31 - Issue 9 - p 460-464 doi: 10.1097/NHH.0b013e3182a87765

Prevalence of Influenza Vaccination and Associated Factors in Chinese Nursing Home Healthcare Workers

Prevalence of Influenza Vaccination and Associated Factors in Chinese Nursing Home Healthcare Workers

Inadequate Knowledge of Pneumococcal Vaccine of Nursing Home Healthcare Workers Affects the Pneumococcal Vaccination Uptake of Older Adults in Nursing Homes

Inadequate Knowledge of Pneumococcal Vaccine of Nursing Home Healthcare Workers Affects the Pneumococcal Vaccination Uptake of Older Adults in Nursing Homes

Epidemiology and risk factors of needle stick injuries

Epidemiology and risk factors of needle stick injuries

Weekly work engagement and flourishing: The role of hindrance and challenge job demands

Two studies were conducted to examine how home healthcare nurses stay engaged in their work and maintain their psychological well-being. In Study 1, we hypothesized that nurses would perceive work pressure more as a hindrance demand than as a challenge demand, and that the reverse would be true for emotional demands. We approached 120 home healthcare nurses who filled in a survey. Results of a series of paired sample t-tests supported our hypotheses. In Study 2, we used the JD-R model to hypothesize that weekly job demands can either facilitate or undermine the positive impact of personal resources on work engagement and flourishing, depending on the nature of the job demand (hindrance vs. challenge). A sample of 63 nurses filled in a questionnaire at the end of the working week during three consecutive weeks (N=3×63=189 occasions). Results of hierarchical linear modeling showed that emotional job demands strengthened the effect of personal resources on weekly well-being, whereas work pressure undermined this effect. Taken together, the present findings challenge the idea that whether job demands act as hindrances or challenges is the same for all occupations and for all individuals.

Book review

Home Healthcare Nurse: June 2013 - Volume 31 - Issue 6 - p 343 doi: 10.1097/NHH.0b013e3182974846

Clinical Outcomes and Quality of Life of Home Health Care Patients

This study aimed to evaluate the quality of life (QOL) in home health care patients according to change in health status outcomes between the start of care and discharge or 60 days, whichever came first. This is a prospective descriptive study. The convenience sample consisted of 100 home health care patients, who started receiving home health care services from a home health care agency in the United States. The World Health Organization Quality of Life Scale-Brief (WHOQOL-BREF) was used for measuring QOL; activities of daily living (ADLs) and instrumental ADLs were collected from the Outcome and Assessment Information Set data via Centers for Medicare and Medicaid Services-required home health agencies. Descriptive statistics, paired t tests, and multiple linear regressions were used for data analysis. ADLs and instrumental ADLs of participants significantly improved between start of care and discharge or 60 days. Overall QOL, general health, and three of four QOL domains (physical, psychological, and environmental, but not social domain) were significantly improved at discharge or 60 days. Home health care nurses should maintain and improve the functional ability of patients, as this could improve the QOL of these patients.

방문건강관리 간호사의 직무스트레스, 직무만족도와 조직애착도

본 연구는 건강취약계층의 건강관리를 위하여 실시되고 있는 방문건강관리을 담당하고 있는 간호사를 대상으로 직무스트레스 및 직무만족도가 조직애착도에 미치는 영향을 파악하기 위해 실시하였다. 조사대상자는 일개 도의 방문건강관리 간호사로 130명의 조사결과를 최종적으로 활용하였다. 단순분석결과에서 직무 스트레스 영역 중 직무 불안정에 해당하는 점수가 69.7점으로 가장 높았으며 다음으로 직무 요구가 64.9점으로 높았다. 직무만족도 및 조직애착도는 각각 2.6점과 2.3점이었다. 직무만족도를 매개변수로 하여 조직애착도에 미치는 직무 스트레스의 관련성을 분석한 결과 직무요구와 직무 불안정은 직무 만족도가 부분 매개하였으며 나머지 스트레스 영역은 직무 만족도가 직무스트레스와 조직애착도간의 관련성을 완전매개하고 있었다. 이상의 결과로 보아, 방문건강관리 간호사들의 조직애착도를 높이기 위해서는 직무 요구도 파악과 직무에 대한 불안정감을 해소하는 것이 우선 실시되어야 할 것이다. Objectives: This research was done to identify relationships among job stress, fatigue, job satisfaction, and commitment to organization in customized home health care nurses. Methods: Research participants were 130 nurses who worked in the customized home health care of 20 county in Gyeongnam province. Data collection for this descriptive correlational study was done at August 2010 using self report questionnaires, and analyzed using descriptive statistics, t-test, ANOVA, and we analyzed a four step approach in which several regression analyses were conducted and significance of the coefficients is examined at each step. Results: The results from step 1 showed that, the effect of each job stress was significantly related to job satisfaction. In step 2, the direct effect of commitment to organization on job satisfactions were all significant too. Step 3 analysis showed that the total effect of each job stress on commitment to organization symptoms was significant. Step 4 showed the results of controlling for mediating factor (job satisfaction): job demand and insecurity were significantly associated with commitment to organization(p<0.001), the finding supports that others were fully mediated by each job satisfaction, and, the job demand and insecurity were partially mediated by job satisfaction. Conclusion: Results of this research indicated that job stress in customized home health care nurses was the principal variable affecting job satisfaction and commitment to organization. Appropriate stress management strategies based on assessment of job demand and job security for these nurses lead to development of improved commitment to organization.

Toward Increased Patient Safety? Electronic Communication of Medication Information Between Nurses in Home Health Care and General Practitioners

This study investigates how the use of an electronic messaging system influences patient safety in the medication information process between home health care nurses and general practitioners. Focus group interviews and semistructured interviews with 34 nurses and general practitioners were applied, and the results show that using a messaging system in the clinical communication and collaboration led to nurses in home health care and general practitioners more easily connecting, medication information being more accessible and medication information having a higher quality. The results also revealed that the use of a messaging system caused errors in the medication information. However, according to the nurses in home health care and general practitioners, the overall conclusion was that medication information improved and thereby patient safety increased.

Relations of Job Satisfaction with Emotional Labor, Job Stress, and Personal Resources in Home Healthcare Nurses

Relations of Job Satisfaction with Emotional Labor, Job Stress, and Personal Resources in Home Healthcare Nurses

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Home Healthcare Nurse: January 2013 - Volume 31 - Issue 1 - p 8-9 doi: 10.1097/NHH.0b013e3182778e51

The Home Healthcare Nurse as a Patient

When it is our turn as a home healthcare nurse to be a patient, it is gratifying to know that home healthcare is as wonderful as we say it is.

World of Home Healthcare Nursing(Lecture)

World of Home Healthcare Nursing(Lecture)

Alcoholism and Depression

One out of 2 Americans report drinking on a routine basis, making the excessive consumption of alcohol the third leading cause of preventable death in America (). Alcoholism and depression are common comorbidities that home healthcare professionals frequently encounter. To achieve the best patient outcomes, alcoholism should be addressed initially. Although all age groups are at risk, alcoholism and depression occur in more than 8 percent of older adults. Prevention through identifying alcohol use early in adolescence is vital to reduce the likelihood of alcohol dependence. This article provides an overview of the long-term effects of alcohol abuse, including alcoholic cirrhosis and hepatic encephalopathy. The diagnostic criteria for substance dependence and ideas for nonthreatening screening questions to use with patients who are adolescent or older are discussed. While providing patient care, home healthcare nurses share the patient's intimate home environment. This environment is perceived as a safe haven by the patient and home care nurses can take advantage of counseling and treatment opportunities in this nonthreatening environment.

Perceptions of Health Information Exchange in Home Healthcare

The aim of this study was to understand home healthcare nurses' current experiences in obtaining outside clinical information at the point of care and the type of clinical information they most desire in their patients' health information exchange profile. A Web-based survey was deployed to home health workers in New York to learn about their experiences retrieving outside clinical data prior to having access to health information exchange, preferred data elements and sources in their patients' health information exchange profiles, and how availability of outside clinical data may affect emergency department referrals. Of the 2383 participants, 566 responded for a 23.8% overall response rate, and 469 of these respondents were RNs. Most RNs, 96.7%, agreed that easier and quicker access to outside information would benefit delivery of care, and 72.6% said the number of emergency department referrals would decrease. When asked about pre-health information exchange access to patient data, 96.3% said it was problematic. Inpatient discharge summaries were chosen most often by the RNs as a top five desired data element 81.5% of the time. Obtaining outside clinical information has been a challenge without health information exchange, but improved access to this information may lead to improved care. Further study is required to assess experiences with the use of health information exchange.

Knowledge and perspectives of Dutch home healthcare nurses regarding medication frequently used by older people

Home healthcare nurses in their roles as caregivers, educators and administrators of medications are particularly well positioned to act on a preventive way to be alert of adverse drug reactions. However, knowledge about medication and a professional attitude is required. To describe medication-related knowledge and perspectives of Dutch home healthcare nurses regarding frequent used medication by older people. A cross-sectional study was conducted among home healthcare nurses (n=146) in the Netherlands based on the ten most frequently used drugs by older people. The mean score for total medication knowledge was 76.2% of the maximum score. Most home healthcare nurses (80.3%) felt responsible for improving older patients' medication use. Three-quarters of the home healthcare nurses agreed with the statement: "By taking appropriate action at the right time, I am able to prevent a medication-related hospital admission". Although most home healthcare nurses felt responsible for their older patients' proper medication use and agreed with the statement that they played a role in preventing older patients' medication-related hospital admissions, their knowledge regarding medications could be improved. Home healthcare nurses should profit as a professional from gaining more knowledge of medication frequently used by older people.

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Home Healthcare Nurse: June 2012 - Volume 30 - Issue 6 - p 328-330 doi: 10.1097/NHH.0b013e3182575465

Emergency Preparedness for Home Healthcare Providers

Unfortunately, disasters occur. We cannot always know the effects ahead of time, but we do know that lives can be lost, property damaged, and public health and home care agencies may not be able to provide the normal standard of care. Studies have shown that disaster preparedness content is limited in U.S. nursing programs (). Given the magnitude of recent natural disasters, such as the Japanese earthquake and tsunami in 2011, these findings are alarming. The increasing demands on healthcare providers in response to emergencies force home healthcare clinicians to identify their roles and responsibilities in emergency preparedness. This article discusses 1 model of disaster response and the role of the home healthcare provider at each stage. It further guides home healthcare nurses in creating a personal and professional plan, enabling them to understand how to minimize the impact of disasters and address the needs of their patients and those close to them.