Home Health Care Nursing

Home health care nursing is a field accessible to registered nurses (RNs) as well as licensed vocational nurses (LVNs) and nurse supporters. Home health nursing staff is answerable for caring for patients in their homes and they have perform various tasks if patients and or their families are incapable to care for themselves.

Skills from many different specialties are necessary in the field of home health:

·         Medical-surgical Nursing care

·         Mental health Nursing care

·         Gerontology Nursing care

·         Paediatric Nursing care and

·         Community/ public health Nursing care

Home Health Care is the provision of medically connected  experts, Para- professional services and equipment’s to individuals and their families in their place of residence for the resolution of  promoting, preserving or repairing of  health or of  minimizing the effects of disease and disability.

Home Health Nursing includes

·         Home health nursing services empower the individuals of all ages to remain in the comfort and security of their homes while receiving healthiness care.

·         Family maintenance, familiar surroundings and participation in the care process contribute to spirits of worth and dignity.

·         Services may include skilled nursing, physical therapy, speech language therapy, occupation therapy, social services, intravenous therapy, nutritional support, home health aide, respiratory therapy, acquisition of medical supplies and equipment, and homemaker and companion care

Most home healthcare agencies required nurses who have a BSN and at least 2 years of experience as an RN in medical-surgical situations. Nurses who've operated in medical-surgical or critical care areas are generally succeed in home healthcare settings due to their comprehensive range of assessment skills. Although no specific certification is obtainable for home healthcare nursing, some nurses choose to maintain certification in medical-surgical nursing. Most patients in home healthcare settings are older than 65 and have numerous medical identifies and chronic health issues. Some of the more common include heart failure and other cardiac problems, diabetes, chronic obstructive pulmonary disease, pneumonia, and osteoarthritis. 

Nurses with knowledge and experience in these areas are a good fit for home healthcare:

·         Cardiac diseases

·         Pulmonary disorders

·         Orthopaedics

·         Diabetes

·         Wound care.

Different Perspectives –

·         Official - Services are provided to persons and their relations in their place of residence for the purpose of promoting, maintaining, or restoring health or of minimizing the effects of illness, disability and incapacity

·         Patient - Skilled and concerned care is provided on a one-to- one basis in the comforting and familiar backgrounds and surroundings of the home

·         Family - It is a means to keep the family together as a functioning, integrated unit.

·         Provider - All disciplines involved are challenged to provide excellent care in often less-than-excellent conditions and surroundings. 

Where do Home Health Care Nurses Work?

Home health nursing staff can work within the patients' homes. They usually have a facility in which they bang to receive their task. After receiving their assignment, they drive to patients' home to perform the particular indicated nursing care as ordered by the physician.

What does Home Health Care Nurse Can do?

Based on their identifications, home health care nursing staff performs a variety of responsibilities.

Registered Health care nurses perform the following duties:

·         Medication administration, including intravenous infusions

·         Wound care/ dressing changes

·         Taking vital signs

·         Performing head-to-toe physical assessments

·         Drawing labs

·         Assisting with activities of daily living (ADLs) such as bathing, toileting, grooming

·         Assisting with mobility

·         Developing a plan of care with the physician

Licensed Vocational Nurses perform the following duties:

·         Medication administration, excluding intravenous infusions

·         Wound care/ dressing changes

·         Taking vital signs

·         Reporting to the supervising RN any concerns the patient may have

·         Assisting with ADLs

·         Assisting with mobility

Nurse Assistants perform the following duties:

·         Taking vital signs

·         Report to the supervising RN any concerns the patient may have

·         Assisting with ADLs

·         Assisting with mobility

Roles and responsibilities for Home Health Care Nurses

The roles and duties of home health nurses are dependent upon their separate identifications.

Registered Health care nurses are responsible for:

·         Assessing the patient's needs

·         Developing a plan of care based on individual patient needs

·         Collaborate with the patient, family, physician, and additional support staff to provide individualized care

·         Direct LVNs and nurse assistants, and provide oversight to their care

·         Evaluate patient's response to treatment

·         Monitor progress of healing/ mobilization

·         Case management

·         Direct nursing care

Licensed Vocational Nurses (LVN) are responsible for:

·         Collecting data and presenting findings to the RN

·         Direct task-based nursing care

Nursing assistants are responsible for:

·         Task-based nursing care

·         Report concerns/ findings to registered nurse

Peri operative Care Nursing: CARING is the essence of NURSING

Surgery is a process implemented on the human body that uses instruments to alter tissue or organ integrity. Perioperative is a term used to designate the entire span of operation including what occurs before, during and after the actual operation.

Phases of perioperative care

       I.            Preoperative: It begins with the resolution to perform surgery and continues until the client has reached the operating area.

    II.            Intraoperative: It includes the entire duration of the surgical procedure until transmission of the client to the regaining area.

 III.            Postoperative: It begins with the admission to the retrieval area and remains the client receives a follow up evaluation at home or is discharged to a recuperation unit.

Types of Surgery

·         Diagnostic: Elimination and study of tissue to make  the tissue identification (Pathology)

·         Exploratory: It is most extensive to involve the exploration and examination of a body cavity or use of scopes inserted though small incision.

·         Curative: Replacement or elimination of defective tissue to restore function.(Joint)

·         Palliative: Release of symptoms or enhancement of function without cure. (Thyroidectomy)

·         Cosmetic: Rectification of deficiencies, development of appearance or change to a physical feature. 

Categories of Surgical Nursing Care

1.      Emergency

·         It performs immediately to preserve the function or the life of the patient.

·         Elective - It is performed when the surgical intervention is the favored handling and treatment for a condition that is not imminently life threatening or to improve the patient’s life.

·         Urgent –It is essential for patients health to prevent additional problem from developing, not necessarily a reserve.

·         Required – has to be performed at some point; can be pre-scheduled.

2.      Degree of risk

·         Major –It includes a high degree of risk.

·         Minor – In this normally involves little risk.

·         Age – It contains both very young and elder clients are greater surgical risks than children and adult.

·         General health- The surgery is least risky when the client’s general health is good.

·         Nutritional Status –It is required for normal tissue repair.

·         Medications – It contains the regular use of certain medications can increase surgical risk.

·         Mental status – disorder that affect cognitive function

3.      Diagnostic

·         It allows settling or establishes the diagnosis.

·         Corrective - It includes Excision or removal of diseased body part.

·         Reconstructive - It restore function or appearance to traumatized or malfunctioning tissues.

·         Ablative – This  means eliminates a unhealthy body parts

·         Palliative – it relieves or reduces aching or symptoms of a disease which will not be a curable.

·         Transplant – it can replace the malfunctioning of  structures

·         Cosmetic – Increased to improve personal appearance.

4.      Purpose

                               I.            Review of preoperative laboratory and diagnostic studies:

·         Complete blood count.

·         Blood type and cross match.

·         Serum electrolytes

·         Urinalysis

·         Chest X-rays

·         Electrocardiogram.

·         Other tests related to procedure or persevering person medical conditions such as: prothrombin time, partial thromboplastic time, blood urea nitrogen, creatinine, and other radiographic studies.

                            II.            Review the client’s health history and preparation for surgery

·         History of present illness and reason for surgery

·         Past medical history •Medical conditions (acute and chronic)

·         Previous hospitalization and surgeries

·         History of any past problem with anesthesia

·         Allergies

·         Present medications

·         Substance use: alcohol, tobacco, street drugs

·         Review of system

                         III.            Assess physical needs

·         Ability to communicate

·         Vital signs

·         Level of consciousness Confusion Drowsiness Unresponsiveness

·         Weight and height

·         Skin integrity

·         Ability to move/ ambulate

·         Level of exercise

·         Prostheses

·         Circulatory status

                         IV.            Assess psychological needs

·         Assess psychological needs

·         Emotional state

·         Level of understanding of surgical procedure, preoperative and postoperative instruction

·         Coping strategies

·         Support system

·         Roles and responsibilities

                            V.            Assess cultural needs

·         Language-need for an interpreter

Surgical Risk Factors:

· Age: Very young – Elderly

·         Nutritional Status: Malnourished – Low weight – Obese

·         Medical Problems:

Acute and chronic respiratory problems – Hypertension – Liver dysfunction – Renal failure – Diabetes

Nursing in Health care in preoperative assessment care can be useful in identifying and defining patients’ risk factors and vulnerabilities not just for operation but for the entire perioperative care trajectory. The assumption that communication gaps exist was supported by the research findings. Announcement of patient risk factors and vulnerabilities to the entire perioperative team is critical for a successful transition through the perioperative environment to occur. If patients’ susceptibilities or risks cannot be lessened, they need to at least be recognized so they can be managed as they shift within the complexity of the perioperative atmosphere.