As the population of patients for whom English is not their primary language grows, home care and hospice clinicians are challenged to provide culturally respectful and acceptable patient-centered care for cultures and languages unfamiliar to them. This article identifies resources for understanding the culture of Middle Eastern-born patients and appropriate patient education materials in most of the languages spoken by this population. The resources have been made available for free on the Web by healthcare professionals, government agencies, and support organizations from around the world.
The Center for Healthcare Research & Transformation (CHRT) sponsors research and public information to promote evidence-based care delivery, improve population health, and expand access to care. Housed at the University of Michigan, CHRT is a nonprofit partnership between U-M and Blue Cross Blue Shield of Michigan to test the best ideas for improving the effectiveness and efficiency of the health care system.www.chrt.org
The use of algorithms for safe patient handling in the acute care setting has been established and integrated into standards of practice. This is not the case in the home care setting where the patient and caregivers are at risk for injury during patient transfers. Many factors need to be assessed before recommending a mechanical lift for home use. Some of the factors include the patient's weight-bearing status, cognitive level, upper extremity strength, and the caregiver's ability to lift more than 35 pounds. All of these factors have been included in the clinical decision-making algorithm described in this article. Two case scenarios are presented to assist the reader with the analysis and application of the algorithm.
Ensuring patient safety is essential for better heath care. Safety have gripped public attention ever since the release of the report "To Err is Human". To find strategies of promotion of patient safety has stimulated models that improve knowledge of adverse events. Adverse drug events are the most common cause of injury to hospitalized patients and are often preventable. Many tactics are available to make system changes to reduce errors and adverse events; they fall into five categories: Reduce complexity, optimise information processing, automate wisely, use constraints, and mitigate the unwanted side effects of change. These tactics can be deployed to support any of the three strategic components of error prevention, detection, and mitigation. Although progress has been slow, the pace of change is likely to accelerate, particularly in implementation of electronic health records and diffusion of safe practices.
I t could happen to anyone. A family is vacationing, and after checking into a hotel the kids and their mother go to bed. A short while later, the husband approaches the bed where his wife is sleeping; he notices something moving on the white sheet near her head. It's an insect. He catches it, places it on a tissue, and logs onto his computer to try to identify it. Soon he realizes it's a bedbug, wakes his wife and children, and calls the front desk. The hotel's pest manager comes up and confirms it: there's a bedbug infestation in the room, and the hotel moves the family to another part of the building.
Home Healthcare Nurse: April 2014 - Volume 32 - Issue 4 - p 205 doi: 10.1097/NHH.0000000000000041
Colleen Miller, BS, RN, CSBC, CHC, is the Principal and Cofounder, Miller & Hoffman Outcomes Architects, LLC, and with the National Society of Health Coaches, Winchester, Tennessee. The author declares no conflicts of interest. Address for correspondence: Colleen Miller, BS, RN, CSBC, CHC, 221 Victor Ln., Ringgold, GA 30736 ([email protected]).
As the population of patients for whom English is not their primary language grows, home care and hospice clinicians are challenged to provide culturally respectful and acceptable patient-centered care for cultures and languages unfamiliar to them. This article identifies resources for understanding the culture of Middle Eastern-born patients and appropriate patient education materials in most of the languages spoken by this population. The resources have been made available for free on the Web by healthcare professionals, government agencies, and support organizations from around the world.
Primeau, Marlena Seibert DNP, FNP-BC, BSHECS; Frith, Karen H. PhD, RN, NEA-BC, Author Information
Medication regimens can be complicated during the transition from hospital to home for a variety of reasons. The primary purpose of this retrospective study was to measure the impact of integrating a pharmacist into a model of care at a Medicare-certified home healthcare agency for clients recently discharged from the hospital. The secondary purpose was to describe the medication-related problems among clients receiving services from the model of care involving a pharmacist. Integrating a pharmacist within the model of care demonstrated a positive clinical impact on clients.
Laura R. Flateau-Lux is an RN in a surgical/trauma ICU at Massachusetts General Hospital, Boston, Mass. Tammy Gravel is an Assistant Professor and Director of Curriculum and Instruction at the School of Nursing, Massachusetts College of Pharmacy & Health Sciences, Worcester, Mass. The authors have disclosed that they have no financial relationships related to this article. This article originally appeared in the Nursing2013 2013;43(6):24–28.
PURPOSE: To assess whether there was a significant improvement and stabilization (not worse at discharge) in pressure ulcers, lower extremity venous ulcers, surgical wounds, urinary incontinence, bowel incontinence, and urinary tract infections in home health care (HHC) patients cared for by a certified WOC nurse. SUBJECTS AND SETTING: There were 449,170 episodes of care from a national convenience sample of 785 HHC agencies with 447,309 nonmaternity, adult patients between October 1, 2008, and December 31, 2009. DESIGN: Descriptive and comparative. INSTRUMENTS AND METHODS: Data from the Outcome and Assessment Information Set documented by HHC clinicians were analyzed using mixed-effects logistic regression, propensity score analysis, and appropriate parametric and nonparametric tests. An Internet survey identified whether WOC nurses provided care to patients in an HHC agency. Home health care agencies identified records of patients receiving WOC nurse visits/consults. RESULTS: An HHC patient assigned to a WOC nurse had surgical wounds, pressure ulcers, and incontinence problems that were significantly worse than HHC patients not assigned to a WOC nurse. Patients cared for by a WOC nurse showed significant improvement and stabilization of the number of pressure ulcers and surgical wounds and the frequency of urinary and bowel incontinence, despite having problems that were more severe than other patients. Home health care patients not cared for by WOC nurses, with less-severe wound and incontinence problems, also got better. CONCLUSIONS: WOC nurses are effective in achieving positive health outcomes for pressure ulcers, surgical wounds, and incontinence in HHC patients with severe health problems.
Jean Gash, PhD, APRN-BC, is an Assistant Professor, McAuley School of Nursing, University of Detroit Mercy, Detroit, Michigan. Gregory McIntosh, DO, FACOS, is an Urologist, Michigan Institute of Urology, Royal Oak, Michigan, and Clinical Associate Professor, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan. The authors declare no conflicts of interest. Address for correspondence: Jean Gash, PhD, APRN-BC, 683 Kimberly, Birmingham, MI 48009 ([email protected]).
This article describes how a provincial health authority in Canada improved patient care and staff satisfaction by transforming the role of home care (HC) liaison. The transformation focused on clearly defining the role, function and reporting structure, and identifying which healthcare providers could fill the liaison role. The transformation included adoption of transition best practices, leveraging an electronic referral system, creation of an interprofessional team, standardization of tools/orientation, and strong evaluation metrics, centralizing decision making, and developing a process for streaming referrals. The authors identify key success factors that made the transformation possible, as well as challenges and work that remains to sustain the change.
