Home Health Care Management & Practice RSS feed -- OnlineFirst Articles

A Risk Assessment Screening Tool for Community Health Care Workers

Lundrigan, E., Hutchings, D., Mathews, M., Lynch,, A., Goosney, J. — Fri, 06 Nov 2009 16:42:46 PST

Given the shift to community-based care, health care providers are facing an increased risk of workplace violence. The process of minimizing risk for staff providing home visits is a challenge and has not been extensively studied. The authors describe the development and implementation of a risk assessment instrument in a regional health authority in Newfoundland. The instrument aids community workers to identify and manage potential workplace violence risks. The process and risk assessment instrument may be useful to other health care organizations interested in promoting workplace safety.

The Retired Nurses Working in Neighborhoods (RN+WIN) Project: An Approach Toward Sustainability of an Academic Nurse-Managed Wellness Center

Resick,, L. K., Leonardo,, M. E. — Fri, 06 Nov 2009 16:42:46 PST

Obtaining resources for sustainability of academic nursing centers is an ongoing challenge. Academic wellness centers face challenges related to the limited availability of insurance to meet demand and resources for state and local contracts or fee for service. Traditionally, state and local contracts and fee-for-service insurance plans do not cover preventive or wellness-related health services. In addition, third party reimbursement for wellness, disease prevention and health promotion, and health education services may be limited because of Current Procedural Terminology codes. An approach toward sustainability of the Duquesne University School of Nursing Nurse-Managed Wellness Center was to build on the human resources of volunteer retired nurses residing in the neighboring communities of the university. This article describes the RN+WIN program as a creative approach toward sustainability of an academic nurse–managed wellness center.

Health Promotion in Culturally Diverse and Vulnerable Populations

Montgomery,, K. S., Schubart,, K. J. — Fri, 06 Nov 2009 16:42:45 PST

America is a diverse culture with multiple people, religions, cultural beliefs, and values. Health promotion is a basic nursing activity. Nurses working in distinct settings interact with multiples cultural groups. Many individuals that are part of diverse cultures are considered vulnerable. Individuals and populations are considered vulnerable because of disparities in health when compared with the dominant population. This article addresses some of the potential influences on health promotion for diverse and vulnerable cultures and identifies strategies to overcome identified barriers. Disparities exist in many health outcomes in the United States; a targeted effort by nurses and other health care providers is key to reducing this gap in health outcomes and improving the health of all Americans.

Regaining Quality of Life Through Urinary Continence Management

Cherry, P. L. — Fri, 06 Nov 2009 16:42:45 PST

Cardiovascular Risks in Adolescents With Diabetes From Vulnerable Populations

Faulkner,, M. S., Fritschi,, C., Quinn,, L., Hepworth,, J. T. — Fri, 06 Nov 2009 16:42:45 PST

Limited data exist on the predisposition for an early trajectory of cardiovascular (CV) disease in adolescents with diabetes. We explored the effects of types of diabetes and sociodemographic factors (i.e., race, gender, income level, family structure) on the following CV risks:glucose control (A1c), blood pressure (BP), and lipid profile. Adolescents with type 1 DM (T1DM) or type 2 DM (T2DM) participated:109 with T1DM and 42 with T2DM. The general linear model was used to examine the influence of type of DM, sociodemographic factors, and the interaction of type of DM and the sociodemographic factors on CV risks. Systolic and diastolic BP were increased in youth with T2DM versus T1DM. Non-Hispanic Blacks had a higher A1c and resting diastolic BP than non-Hispanic Whites. Lower income was also associated with higher resting diastolic BP. Males with T1DM had higher A1c, whereas females with T2DM had higher A1c. With low income, individuals with T1DM had higher A1c values than those with T2DM; those with high income and T2DM had higher A1c than those with T1DM. Adolescents with T1DM from single, divorced, or separated families had higher average A1c values. In comparison, those with T2DM from married families had higher A1c values. Triglycerides were increased for those with T2DM, with the greatest amount for Hispanics as compared with non-Hispanic Blacks. In summary, minority status, lower income, and family structure may have a greater impact on vulnerability for poor outcomes in adolescents with DM, regardless of the type of the disease.

A Brave New World: Preparing for OASIS-C

Cabin,, W. D. — Fri, 06 Nov 2009 16:42:44 PST

Caring for Patients From Different Cultures

Gingerich, B. S. — Fri, 06 Nov 2009 16:42:45 PST

Standing on One's Own Feet: New Graduate Nurses' Home Health Care Challenges and Work Experiences Study

Sneltvedt, T., Sorlie,, V., Odland, L.-H. — Fri, 09 Oct 2009 16:36:20 PDT

Interest is growing for information on recently qualified nurses’ initial meeting with working life. This study aims to shed light on recently qualified nurses’ experience working in home health care. The authors chose to design the study using a phenomenological hermeneutical approach with narrative interviews and text analysis. The respondents consist of a group of four recently qualified nurses. The results show that they are surprised by the many competence requirements and expectations, that they experience feeling alone, and that they also bear large responsibility. At the same time, they enjoy their work, in which they seek to influence the working conditions for their professional practice. They do experience the anxiety of not being able to cope with the challenge of nursing practice, but they are not marked by the shock of reality.

Successful Aging: Selected Indicators in a Southern Sample

Flood, M., Nies, M. A., Seo,, D.-C. — Tue, 06 Oct 2009 15:48:00 PDT

Given the increasing population of older adults in the United States, it is important to identify indicators of successful aging and the interrelationships among these variables to develop interventions to promote successful aging. This article reports an analysis of indicators of successful aging in a group of older adults from North and South Carolina. Risk factors that may make it harder for older adults to age successfully are identified. The relationships between chronic disease and indicators of successful aging are examined, and potential ideas for interventions to enhance successful aging are discussed.

Chemical Addiction

Thobaben, M. — Tue, 06 Oct 2009 15:47:59 PDT

Fatigue and Exercise

Dreiling, D. — Tue, 06 Oct 2009 15:48:00 PDT

Fatigue is a debilitating symptom of many chronic illnesses. Because of pain, discomfort, and chronic fatigue, people with chronic illnesses often decrease their activity levels. There is often a vicious cycle that can prevent a person from participating in a regular exercise program. A person will avoid exercise because of pain, discomfort, or fatigue. However, a review of research by this author has shown that mild to moderate exercise, for as little as 10 to 15 minutes a day, can improve a person’s activity level and reduce fatigue and some pain.

So, What Does It Mean to "Watch What I Eat"?

McGuire, M. B, — Tue, 06 Oct 2009 15:48:00 PDT

Whether trying to minimize symptoms of fatigue or eat to decrease disease risks, a basic approach using regular foods is usually going to meet needs. Media "sells" quick fix products that may accomplish the task, but the media does not teach lifestyle changes that we can live with long-term. This article provides simple steps to show patients about their diet intake and where they are in their nutritional intake. The steps on how to change to a healthier eating style and habits are introduced.

Trust: A Continuing Imperative

Rowe,, J., Kellam, C. — Wed, 16 Sep 2009 10:39:51 PDT

The issues regarding health care to the African American population have been examined from a number of angles. The authors argue that the trust between provider and patient is both critical and not well understood. This article examines reasons for resistance from African American patients and the historical, cultural, and psychological roots of the mistrust forming that resistance. Issues influencing the development of trusting attitudes needed for effective participation in their own care are examined, and the role of attachment in developing the ability to trust those with the power is seen as highly significant.

Social Media: How Home Health Care Agencies Can Join the Chorus of Empowered Voices

Orsini, M. — Tue, 01 Sep 2009 12:02:50 PDT

A new concept is revolutionizing the way companies and consumers communicate in the digital age. That concept is social media—online communication that is interactive, collaborative, and democratic. Things that you will learn from this article are the following: What is social media and what does it have to offer the health care community? More important, how can home health care agencies incorporate social media into their marketing plans to speak more directly to their clients?

Spirituality Goes Beyond Religiosity: A Much Needed Practice in Nursing

Alpert,, P. T. — Mon, 17 Aug 2009 17:42:10 PDT

Programmable Intermittent Pneumatic Compression as a Component of Therapy for Breast Cancer Treatment-Related Truncal and Arm Lymphedema

Hammond,, T. M., Mayrovitz,, H. N. — Mon, 17 Aug 2009 17:42:10 PDT

Lymphedema is a chronic condition often requiring lifelong treatment to avoid worsening of extremity and trunk swelling with concomitant complications. The physiological basis for truncal treatment, although clinically recognized, until recently, was not well documented. Herein, we expand on earlier work by reporting on clinical outcomes, therapist observations, and subjective impressions of five patients with truncal lymphedema whose in-home self-treatment includes the Flexitouch^® system (FT) pneumatic device. Patients received in-clinic complete decongestive therapy and in-home self-care including FT. Results, determined after 2 months of treatment, showed reductions in trunk and arm swelling, fibrotic tissue softening, pain reduction, and improved range of motion and flexibility. Patients reported that FT was easy and comfortable to use and enhanced in-home compliance. Results suggest that limb and trunk lymphedema can be effectively treated in the home with an advanced programmable pneumatic device with truncal coverage, such as the FT system.

Physical Matters : Introduction to Observational Gait Analysis

Wallmann, H. W. — Mon, 17 Aug 2009 17:42:10 PDT

How to Conduct a Successful Job Search: Considerations and Tips for Minority Nurse Educators and Researchers

Xu,, Y. — Mon, 17 Aug 2009 17:42:10 PDT

Firsthand Experience of the Post-Acute Care Demonstration Project

Jeffrey, K. D. — Mon, 17 Aug 2009 17:42:09 PDT

This report describes one agency’s participation in the post–acute care OASIS demonstration project. It provides demographic data on the agency and surrounding areas and a key strategy developed and implemented by the Continuity Assessment Record Evaluation team.

Technology and Education . . . What If?

Harris, M. — Mon, 17 Aug 2009 17:42:09 PDT

Whether we like it or not, we now live in a "knowledge-based" economy where workers span several generations and change is the norm. Information is being created at a staggering pace, and corporations have to be ready to adapt in a moment’s notice. If you take a high-growth industry, such as home care and hospice, you see an industry that must continually train workers and create and maintain information storage and distribution. How can home care agencies deal with the challenges of increasing knowledge, high growth, and high turnover?

Chronic Fatigue: Tired of Being Tired

Lasseter,, J. A. — Mon, 17 Aug 2009 17:42:10 PDT

Because of the widespread nature of chronic fatigue, health care providers need a common understanding of chronic fatigue to enable effective communication. To aid this understanding a concept analysis was undertaken using a modified version of Rodger’s evolutionary method of concept analysis. The literature review yielded many resources focused on defining fatigue and relating it to many diverse chronic conditions. This article also discusses the differences between chronic fatigue and acute episodes of fatigue. Chronic fatigue is a subjective, unpleasant, changeable, and exhausting experience that adversely affects quality of life. Whereas rest or sleep often relieves acute fatigue, chronic fatigue is unrelenting. Chronic fatigue has multiple antecedents and is a component of a diverse array of chronic diseases.

Heart Healthy Eating: What's New?

Alpert,, P. T. — Fri, 10 Jul 2009 17:30:35 PDT

Introducing Brenda Scruggs, MSN, RN, CDE

Gingerich, B. S. — Wed, 27 May 2009 15:54:17 PDT

Understanding Agency Culture and External and Internal Mitigating Factors in the Development of Compliance Plans

Rowe,, J., DeDomenico, M. — Fri, 22 May 2009 10:10:10 PDT

This article addresses the issues of organizational culture and the mitigating forces that affect and drive the development of compliance plans. It also offers insight into the potential benefits of developing a healthy compliance culture in an organization. The article discusses the major topics of understanding the culture that exists in an agency, core values for compliance, external mitigating factors, internal mitigating factors, and the benefits an agency can accrue by creating a healthy compliance culture.

Coping With Recovery Audit Contractor Audits

Cabin,, W. D. — Thu, 14 May 2009 11:41:18 PDT

Hispanic Women and Physical Activity: A Community Approach

Kohlbry, P., Nies,, M. A — Mon, 23 Mar 2009 16:32:56 PDT

Older Hispanic women are at higher risk for chronic debilitating health problems related to higher rates of inactivity and obesity when compared to other ethnic groups. The purpose of this article was to review the literature on the factors which effect levels of physical activity in older Hispanic women. A literature search was conducted using the terms Hispanic or Latina, physical activity, barriers and benefits, self-efficacy, stages of exercise change, and health promotion behaviors. Forty-two studies between 1988 and mid 2007 were selected. Research methods included qualitative, quantitative, interventional, experimental, and cross sectional. There is some research available to guide nurses in assessment of unique factors that may impact the development of culturally appropriate nursing interventions that increase a women’s level of physical activity and promote health and well-being. Practical take home points are presented. Areas for future nursing research are identified.

Improving the Quality of Life of African Americans Receiving Palliative Care

Motyka,, C. L., Nies, M. A., Walker,, D., Schim., S. M. — Mon, 02 Mar 2009 10:09:29 PST

The purpose of this pilot study was to examine the effects of personal characteristics on quality of life (QOL) among African Americans receiving palliative care. Although an important goal of palliative care is to improve the client’s QOL, no studies were found examining the QOL of African Americans receiving palliative care. The study sample included African Americans receiving palliative care in inpatient settings or through enrollment in a hospice program. Data were collected using a structured interview guided by five questionnaires to measure QOL, physical performance, spirituality, social support, and family support/satisfaction. Data were analyzed using descriptive statistics, Pearson r correlation coefficients, and multiple regression analysis. The total sample (N = 16) was predominately single, female, and 50 to 59 years old. There was a significant relationship between QOL and religious and spiritual coping and between QOL and social support. Participant recruitment was a significant issue in this study.

An Interdisciplinary Team for the Design and Integration of Assistive Robots in Health Care Applications

Nejat,, G., Nies,, M., Sexton,, Thomas. R — Fri, 27 Feb 2009 11:23:17 PST

The integration of assistive robots into the health sector requires an interdisciplinary team of researchers capable of studying and addressing issues that arise in human–robot interaction scenarios. In particular, current and future advancements in technologies demand a unique partnership between engineering and the health sciences to develop clinically relevant assistive robots. In this article, the authors discuss an interdisciplinary team approach for integration of assistive robots in health care applications. In particular, the objective of their interdisciplinary team is to design, integrate, and study socially assistive robots in the resident care practice in long-term care nursing facilities. The authors envision that the model they propose can be easily duplicated in other institutions around the world.

Technology Topics: Lets Talk Tech: Technological Competency

Nelson, J. A. — Thu, 21 Feb 2008 09:11:26 PST

Caring for the Patient and the Family in the Last Hours of Life

Kehl, K. A. — Thu, 21 Feb 2008 09:11:27 PST

Recognition of the signs and symptoms that are common in the final hours of life and a basic understanding of how to manage these signs and symptoms are important to helping the patient and family experience a good death in the home setting. The most common signs and symptoms, including pain, dyspnea, and terminal restlessness or delirium, and their management are discussed. Also addressed are other signs and symptoms, such as cardiovascular signs and symptoms including cold extremities, mottling, and changes in vital signs; respiratory signs and symptoms such as changes in breathing pattern, noisy breathing, and mandibular breathing; and neurological signs and symptoms such as disorientation, sensory changes, and semicomatose state. Changes in metabolism such as fatigue, surge of energy, and increased temperature are presented, along with decreased intake, excretion, and communication changes.