Home Health Nurses Research Articles

Germs: Prevent the Spread of Infectious Diseases

Germs cannot be avoided. They live everywhere. Most germs do not harm people. The 2009 H1N1 influenza virus brought the concept of germs as infectious agents to the public’s attention, which generated fear of germs in some people. Home health nurses can reduce clients’ fear of germs by educating them about the differences between bacteria and viruses, two of the more common types of germs or infectious agents, and can teach them how to reduce their risk of getting diseases caused by these germs.

Improving Outcomes for Older Adults With Heart Failure

Newly discharged older adults with heart failure continue to experience frequent hospital readmissions, lower quality of life, and decreased satisfaction with health services. A theory-guided intervention delivered by home health nurses via the telephone was studied using a randomized controlled trial to assess its feasibility and inform further studies. Findings generated a profile of older adults with heart failure, utilization by patients and nurses, operational issues, and preliminary data on intended outcomes. Implications for further study are presented.

Characteristics of Home Health Nursing by Public Health Nurses for Patients with Disabilities or Spinocerebellar Degeneration

Characteristics of Home Health Nursing by Public Health Nurses for Patients with Disabilities or Spinocerebellar Degeneration

Commentary: Who Should Follow Our Patients?

Commentary: Who Should Follow Our Patients?

Moralische Probleme in der ambulanten Pflege – Eine deskriptive pflegeethische Untersuchung

In Germany there is an increasing importance of home health care and nurses that are employed in the home care sector often have to face ethical issues. The purpose of this ethnographic study was to explore moral problems in the daily practice of these nurses. The method used was qualitative interviews with 20 nurses which have been analysed by content analysis. The results showed that the ethical principle of beneficence was the core concept for the participants. Moral problems arise when nurses cannot act in accordance to this principle or when they cannot determine the good in a situation. In particular, there were four types of moral problems: "beneficence vs. autonomy", "beneficence vs. justice", "beneficence vs. loyalty" and "The good cannot be determined". The way nurses in home health care address moral problems should be improved. Some participants lack ethical competencies. Furthermore, appropriate support services for dealing with moral problems have to be designed.

Research 101

As home health nurses begin to more fully embrace evidence-based practice, we need to be reading research articles in addition to those being published in Home Healthcare Nurse. Many of us have been out of school for several years or have never studied nursing research, and the terminology can be daunting. Evidence-based practice strengthens our ability to provide nursing care based upon the best scientific and researched information. The evidence gleaned from research demonstrates best practice methods rather than those we have traditionally used with little or no scientific basis. The purpose of this article is to provide new knowledge or dust the cobwebs from our past studies of nursing research. A review of the types of research, as well as its language, can help home health nurses be consumers of research with greater understanding. Use of the Internet and ways to access nursing research will be discussed. This article is a brief overview only and more in-depth principles can be accessed by one of the many nursing research resources.

Keeping It Real

Evidence-based practice (EBP) is a vital element of home health nursing. As healthcare becomes more costly, and more complex care is rendered in the home, the need for systematic inquiry to address the needs of clients and families is imperative. This essential systematic inquiry into nursing interventions and evaluation of clients' responses to those interventions may well transform the home health industry.The ultimate goal of nursing care is to optimize quality outcomes for patients, families, and populations, as well as healthcare providers and systems. Using a clinical case study, the authors discuss a step-by-step EBP process incorporating the nursing process from assessment of current practice to formulating a well-defined clinical question that addresses an identified problem through evaluation of the selected interventions effectiveness and efficacy.

When Professional Kindness Is Misunderstood

There is the potential for home health nurses and other home care clinicians to be subjected to intrusive and possibly stalking behavior by current and former clients. Most healthcare clinicians do not receive training on the risk of intrusive interactions or stalking, nor on strategies to manage this objectionable client behavior. This article informs nurses and other home health clinicians about the potential risk of stalking. Included is a true case vignette, the legal definition of stalking, incidence occurrence among clinicians, the basic profile and behaviors of a stalker, the victimology and psychological consequences, and implications for policy and procedures and prevention techniques.

Perspectives and expectations for telemedicine opportunities from families of nursing home residents and caregivers in nursing homes

Background This study assessed current perspectives and expectations for telemedicine by nursing home caregivers and families of nursing home patients in Taipei, Taiwan. Methods A total of 116 interviews were conducted with family members ( n = 37) and caregivers ( n = 79) using an original, four-part questionnaire devised to assess the expectations and concerns related to prospective telemedicine opportunities, including consumer attitude, knowledge of and interest in medicine, concerns and worries about telemedicine, and anticipated benefits of telemedicine. Results Statistical significance between the two groups was observed in sex, age, and educational level (all p < 0.001). Most respondents had heard about telemedicine before participation and showed some interest in telemedicine implementation. More than 70.0% of subjects in both groups had perceptions of telemonitoring of patients, notifications of health abnormalities, teleconferencing between physicians and family members, obtaining test/exam results and face-to-face consultation through telenetworks. Both groups hoped for information and education through telemedicine. More caregivers were concerned about increased costs ( p = 0.020), poor hardware quality ( p < 0.001), poor security, confidentiality, and reliability ( p = 0.036), inconvenience to patients ( p = 0.006), associated moral and ethical issues ( p = 0.006), and uncertainty about responsibility ( p = 0.022). The two groups did not differ in expectations concerning benefits of telemedicine. More than 60% of family members or caregivers expected improved efficiency and quality of hospital and nursing home health care, greater rapport between nursing homes and either staff or patients, reduced overall medical costs of caregiving, and reduced staff/caregiver working hours. The acceptable cost was anything up to $15.30 USD per month. Conclusions Nursing home caregivers and families of nursing home patients are highly interested in telemedicine; however, they are only willing to pay a slightly higher cost of nursing care for this service. The challenge for the future in this industry is to balance peoples’ demands and telemedicine's associated costs. Results of this study suggest that caregivers and families of nursing home residents favour telemedicine implementation to provide enhanced care coordination in nursing homes when economic circumstances are favourable.

Preventing Rehospitalization through Effective Home Health Nursing Care

To identify strategies to improve patient outcomes and prevent rehospitalizations in home healthcare. PRIMARY PRACTICE SETTINGS(S): Primarily for home healthcare but can also be a tool for all other fields in nursing. Through team collaboration and the proper resources, patient outcomes can improve and be cost-effective for home healthcare agencies despite the changes implemented after the Medicare change in payment for services, the prospective payment system. The main goal for home healthcare is to improve patient outcomes. Nurses experienced in case management can devise creative strategies to ensure patient outcomes are met in a cost-effective manner. With continuous changes in reimbursement and payment incentives, case managers in every level of care must know about, and be responsible for, fiscal initiatives.

Roles and functions of community mental health nurses caring for people with schizophrenia in Taiwan

The study aimed to understand the nursing roles and functions of public health nurses and home health nurses in Taiwan and the factors that affect nursing roles and functions of nurses that provide community mental health home visiting services. Although community nurses provide more psychiatric home visiting services than other psychiatric professionals, little research on their roles and functions has been conducted. Nursing roles and functions were developed through use of grounded theory method of Strauss and Corbin. Data were collected using semi-structured face-to-face in-depth interviews and unstructured non-participant observations. The constant comparative analysis continued during the open, axial and selective coding process until data saturation occurred. Participants were selected using theoretical sampling. Final sample size in this study comprised a total of 29 community nurses (18 public health nurses and 11 home health nurses) who provided community mental health home visiting. Public health nurses conducted a total of 16 (eight carers and eight clients) services and home health nurses conducted 16 (eight carers and eight clients) services. Fourteen nursing roles were identified. These roles included assessor, supporter, educator, consultant, counselor, negotiator, harmoniser, collaborator, advocate, placement coordinator, resource provider, care provider, case manager and case finder. Moreover, several factors that affect nursing roles and functions in the community mental health home visiting service in Taiwan were also identified. This is the first study to identify the role of public health and home health nurses caring for people with schizophrenia in the community in Taiwan. The recommendations based on the findings of this research can be used as a guide to improve the delivery of psychiatric home visiting services to community-dwelling clients with schizophrenia and their carers.

Nursing Studentsʼ Attitudes About Home Health Nursing

In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

Hospital Discharge Education for Patients With Heart Failure: What Really Works and What Is the Evidence?

Hospital Discharge Education for Patients With Heart Failure: What Really Works and What Is the Evidence?

Caseload Management Skills for Improved Efficiency

This article provides information about caseload management, which was one of a group of six competencies identified by nurse administrators as needed by new baccalaureate graduates. Caseload management is an important skill for nurses who work with caseloads of patients or clients (e.g., home health nurses, public health nurses, case managers, ambulatory care nurses). Because inadequate information about caseload management is contained in community health nursing textbooks, continuing education and staff development programs need to include caseload management skills to improve the efficiency and quality of nursing care.

Extent of Implementation of Evidence‐Based Fall Prevention Practices for Older Patients in Home Health Care

This study determined the extent to which fall risk assessment and management practices for older patients were implemented in Medicare-certified home health agencies (HHAs) in a defined geographic area in southern New England that had participated in evidence-based fall prevention training between October 2001 and September 2004. The standardized in-service training sessions taught home health nurses and rehabilitation therapists how to conduct assessments for five evidence-based risk factors for falls in older adults--mobility impairments, balance disturbances, multiple medications, postural hypotension, and home environmental hazards--using techniques shown to be efficacious in clinical trials. Twenty-six HHAs participated in these in-service training sessions; 19 of these participated in a survey of nurses and rehabilitation therapists between October 2004 and September 2005. Self-reported assessment and management practices implemented with older patients during home healthcare visits were measured in this survey, and HHA-level measures for each fall risk factor were constructed based on proportions of clinicians reporting assessment and management practices that were recommended in the fall prevention training sessions. For all fall risk factors except postural hypotension, 80% or more of clinicians in all HHAs reported implementing recommended fall risk management practices. Greater variation was found regarding fall risk assessment practices, with fewer than 70% of clinicians in one or more HHAs reporting recommended assessment practices for all risk factors. Results suggest that evidence-based training for home healthcare clinicians can stimulate fall risk assessment and management practices during home health visits. HHA-level comparisons hold the potential to illustrate the extent of diffusion of evidence-based fall prevention practices within and between agencies.

Preventing Rehospitalization Through Effective Home Health Nursing Care

Purpose/objectives To identify strategies to improve patient outcomes and prevent rehospitalizations in home healthcare. PRIMARY PRACTICE SETTINGS(S): Primarily for home healthcare but can also be a tool for all other fields in nursing. Findings/conclusions Through team collaboration and the proper resources, patient outcomes can improve and be cost-effective for home healthcare agencies despite the changes implemented after the Medicare change in payment for services, the prospective payment system. Implications for case management practice The main goal for home healthcare is to improve patient outcomes. Nurses experienced in case management can devise creative strategies to ensure patient outcomes are met in a cost-effective manner. With continuous changes in reimbursement and payment incentives, case managers in every level of care must know about, and be responsible for, fiscal initiatives.

Experience of Home Health Nursing Personnel in Actual and Simulated Case Finding of Wife Abuse in Korea

The purpose of this study was to examine the experience of home health nursing personnel (HHNP) in identifying wife abuse and intervening with victims during home health visits, and to analyze responses to a what-if scenario involving visiting a woman who implies her husband is abusive. A cross-sectional, descriptive design with a questionnaire survey was used and included the public health nurse's practice response to women who are abused (PHNR). From 243 public health centers nationwide, 373 HHNPs participated. Over the past year, 31.6% had identified abused women (average of 2.2 victims per HHNP) and 12.3% had intervened. The mean score for the PHNR was 55.76 (out of a possible 80), indicating higher value on thoughts, feelings, and actions to support abused women. Significant differences were found in the mean scores for age and position (nurse or nurse aide). The mean percentage of correct PHNR responses was 70.4%. The results showed a low level of competency and difficulty in initiating the topic of abuse, and a higher level of understanding methods to approach abused women. Time limit was not a hindrance to intervention. The findings indicate the need for education programs to increase self-efficacy and promote effective recognition and interventions for these women.

What Does Isolation Mean in Home Healthcare?

In the event of an infectious disease outbreak, home health nurses are called upon to care for patients who have been placed on isolation precautions. To protect themselves, patients, and caregivers, nurses must be knowledgeable about infectious diseases and infection control procedures. A checklist is provided to assist the nurse and caregiver with guidance in performing the patient's care.

Noncompliance: A Challenge for Home Health Nurses

Noncompliance: A Challenge for Home Health Nurses

A Correlational Pilot Study of Home Health Nurse Management of Heart Failure Patients and Hospital Readmissions

Heart failure is the leading cause of hospital admissions in patients more than 65 years old. The failure to provide carefully planned care to heart failure patients in the home setting predisposes patients to frequent hospital readmissions due to poor medication compliance, diet, and education of symptom management (Li, Marrow-Howell, &amp; Proctor, 2004). The objective of this pilot study is to show the importance of the home health nurse to follow heart failure patients post hospital discharge. This study uses Lydia Hall's Care, Cure, and Core Theory to show the importance of home health nurse interventions to heart failure patients (Touhy &amp; Birnbach, 2001). According to Stewart and Horowitz (2002), home health multidisciplinary team follow-up may assist patients and caregivers in recognizing the symptoms of the recurring onset of heart failure. The home health team can intervene and assist in management of the symptoms and possibly prevent hospital readmissions.