Home Health Care Management & Practice current issue

I Was Thinking

Gingerich, B. S. — 2008-09-05

A Cross-Sectional Investigation of Status Post-Lower Extremity Joint Replacement Patients

Maloney, S., Ng, D., Schneider, D. — 2008-09-05

The objective of this cross-sectional investigation is to describe a cohort of 275 status post joint replacement patients who received home health services from an orthopedic home health agency in St. Louis, Missouri. This study also aims to determine if these patients achieved statistically significant improvements in their functional mobility skills, pain, and emotional status. Demographic data were collected together with functional mobility elements from the Outcome and Assessment Information Set pertinent to the rehabilitation of status post joint replacement patients on admission and discharge from home care. Because of the limited nature of participant selection and convenience sampling, no correlations or trends were established among the data collected. However, this cross-sectional analysis validated the incidence of a patient subpopulation that is admitted directly to home care after undergoing joint replacement surgery and demonstrated that these patients achieved significant positive outcomes in functional measures.

Cultural Competence of North Carolina Nurses: A Journey From Novice to Expert

Lampley, T. M., Little, K. E., Beck-Little, R., Xu, Y. — 2008-09-05

This study reports the survey findings of self-reported cultural competence of a convenience sample of 66 registered nurses of varying ages, gender, ethnicity, educational backgrounds, and experience in North Carolina. Campinha-Bacote's model of cultural competence and Benner's model of clinical skills acquisition serve as the conceptual frameworks. The process of cultural competence among health care professionals, developed by Campinha-Bacote, is used to measure cultural competence in participants. In addition to descriptive statistics, bivariate analysis of variance was conducted to compare means of cultural competence scores of different groups. Findings indicate that level of education, nursing experience, and continuing education are factors that promote cultural competence, whereas gender and race/ethnicity have no bearing. In addition, qualitative data generated four themes: language or verbal communication barrier, religious beliefs, different health beliefs and behaviors, and culturally inappropriate nonverbal communication. Implications of these findings for nursing education, practice, and future research are elaborated.

Understanding Oropharyngeal Dysphagia: From Hospital to Home

Riquelme, L. F., Soyfer, A., Engelman, J., Palma, G. L., Stein, L., Chao, J. L. — 2008-09-05

Providing services in the home to a patient with oropharyngeal dysphagia remains a clinical challenge. All health care providers involved in the care of patients with dysphagia need to understand the complexities of swallow physiology, its impact on the patient's overall well-being, and the experience the patient has recently undergone. Namely, it is important to know if the patient is returning home after an acute care stay, if the patient is returning home after a stay at a rehabilitation center, or if simply the patient has become increasingly decompensated while at home. This will allow the clinician working in the home to understand the work-up and possible treatments the patient has thus far undergone, and possibly better understand the overall etiology. Furthermore, it is important to understand that while returning home may be one of the most exciting moments for the patient and his/her family, it may also be the most stressful, as the patient is probably returning home with a different set of needs. This article provides an in-depth approach and discussion of the subject of swallow physiology, diagnosis, and treatment, and provides a resource for all members of the patient care team. It concentrates on the experience of older adults diagnosed with oropharyngeal dysphagia who are returning home.

Actualizing "Professional Altruism": A Comparison of Home Health Care and Hospice Social Workers

Cabin, W. D. — 2008-09-05

The Medicare home health benefit and the Medicare Hospice Benefit (HMB) differ significantly in social work coverage, with social work being only 1%-2% of national Medicare home health visits compared to about 10% of national HMB visits. There has been some research on the frustrations of home care and hospice social workers. However, there is no research that compares home care and hospice social workers. The article presents results of convenience sample interviews of 34 home care social workers and 42 hospice social workers in New York City from August 2006 to October 2007. The analysis finds that, in contrast to home health social workers, hospice social workers feel more able to actualize their altruism professionally; their professional training is more relevant to actual practice; their patients and caregivers have fewer unmet psychosocial needs; and their care is less constrained, and actually enhanced to a great extent, by payer requirements.

A Key to Success in Home Health Care!

McIntyre, E. — 2008-09-05

This article presents five specific components of the certified nursing assistant's (CNA's) role in the clinical setting that are essential to patient care quality. These are hands-on skill level, communication, reliability and integrity, documentation and technology, and clinical knowledge base. The importance of education and communication by the caregiver staff for patients within long-term- and home-care settings is discussed relative to how these elements affect care and service delivery. Central to this ongoing observation and reporting is the role of the CNA within the long-term-care setting or the home health aide within the home care setting. By taking preventive actions and working as a team in the provision of patient care to individuals at risk for dehydration and renal failure, improved patient outcomes can be achieved. An education tool is also provided as a resource to direct caregivers in long-term- and home-care settings.

Back to the Future for Home Care: Roots of Social Work and Nursing in America

Byrd, M. D. — 2008-09-05

This article presents a historical look at early home care and social work in Charles Town, South Carolina. The article references specific statements and recollections of home care and social work through out the 1700s and 1800s. This history was similar to the national impetus for home care and social work through out the British Colonies during the early 1700s and the United States after the Revolutionary War. Even in the early beginnings, home care was perceived to be a less expensive care delivery option than the hospital setting and care quality within the home care setting reported to be of better quality than the hospital setting.

Another Year . . . Another Failed Outcome

Veronesi, J. F. — 2008-09-05

Wound Healing and Nutrition: An Evidence Update

DePalma, J. A. — 2008-09-05

Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) Accreditation

Gingerich, B. S. — 2008-09-05

Centers for Disease Control and Prevention's (CDC) An Ounce of Prevention--Keeps the Germs Away Campaign: A Resource for Home Health Nurses to Help Prevent the Spread of Infectious Diseases

Thobaben, M. — 2008-09-05

Advantages of Online Education

Nelson, J. A. — 2008-09-05

Mentoring and Career Development of Minority Nurses and Faculty

Xu, Y. — 2008-09-05

Resource Review: Home Health Aide Guidelines for Care: A Handbook for Caregiving at Home

Gingerich, B. S. — 2008-09-05