Home Care Nursing Practice

By
Robyn Rice

Course Description

In the ever-changing field of home care nursing, you need a text that offers a practical mix of foundational content and clinical application. Only one book does- Home Care Nursing Practice: Concepts and Application, Fourth Edition. This valuable text covers conceptual information, leadership skills and current issues and trends. It provides clear and concise information about the best practices and quality improvement for the most common clinical conditions seen in-home care. It’s a text you will carry from the classroom into practice.

New to the Fourth Edition

  • Chapters on oncology home care, social services for home care patients, and innovative, holistic nursing strategies
  • Discussion of new trends in telehealth, including specific guidelines, legal standards, and telephone triage
  • HIPAA content highlighting the changes brought about by this new federal legislation
  • Community disaster planning and bioterrorism content
  • Additional safety information, such as a home evacuation plan

This remarkable resource also features

  • Practical information on infection control, case management, and documentation for Medicare reimbursement
  • An emphasis on patient/family/caregiver involvement
  • Important teaching strategies for home care clients and caregivers
  • Thorough nursing management of the most common clinical diagnoses seen in home care
  • Essential information on conditions most commonly seen in home care, including patients with congestive heart failure, ventilator-dependent patients, patients receiving IV therapy, and patients with AIDS
  • Guidelines for planning and conducting a home visit

About Authors

Robyn Rice has worked in-home care for more than 20 years. She is the author of several nursing references, including Manual of Home Health Nursing Procedures, Second Edition; Handbook of Home Health Nursing Procedures, and Handbook of Pediatric and Postpartum Home Care Procedures. In addition, Dr. Rice has presented many workshops and seminars at the state, national, and international levels; contributed chapters and articles to a number of nursing books and journals; and served as an item writer for the ANCC’s Home Health Nurse Certification examination and the NCLEX-RN Examination. Dr. Rice can be contacted by email at ricera@charter.net


Learning Objectives

  1. Summarize the historical background of home health nursing.
  2. Explain criteria for home health services as stated by Medicare regulations.
  3. Compare the cost of health care services provided in the hospital with those provided by home health services.
  4. Define the duties of the following home health professionals according to HCFA [Health Care Financing Administration]:
    1. Registered nurse
    2. Medical Social Worker
    3. Home Health Aide
    4. Physician
  5. List 4 factors which impact on the development of home health nursing practice.
  6. List 5 important points in the care plan for a patient receiving home health services.
  7. Define the following terms and discuss how each relates to nursing practice:
    1. Theory
    2. Conceptual framework
    3. Paradigm
  8. State the major contribution of each of the following nursing theorists to home care:
    1. Nightingale
    2. Orem
    3. Leininger
    4. Watson
  9. State the purpose of home care.
  10. Discuss the Rice Model of Dynamic Self-Determination.
  11. Compare the role of the nurse in the acute care setting with that of the home health field.
  12. List 5 characteristics or abilities the important for home health nurses.
  13. State 3 things the home health nurse can do to protect him/herself from liability.
  14. List 4 universal clinical factors which influence health care management within the hone setting.
  15. List 5 safety practices to follow when working in home health.
  16. List the components of the assessment phase of nursing care.
  17. Define the difference between the plan of care and the nursing care plan.
  18. State 7 conditions which must be net for coverage of home health services according to Medicare.
  19. State principles of documentation for home health visits and phone conversations.
  20. State the potential role of home health workers as carriers and sources of infection.
  21. Define Universal Precautions and state 3 applications to practice.
  22. List 7 signs/symptoms of infection.
  23. State an example of a disinfectant solution appropriate for home use.
  24. State how to dispose of blood and body fluids in the home setting.
  25. Give an illustration of incorporating infection control practices into scheduling home health core.
  26. List 5 principles of infection control to teach patients and caregivers.
  27. Define the role of patient education in home health nursing.
  28. List 3 types of learning.
  29. Discuss how Maslows theory of human motivation has served as a framework for humanistic learning theory.
  30. Discuss the relevance of Penders health promotion model to patient compliance.
  31. Discuss teaching strategies for the home health setting.
  32. Discuss teaching strategies for the following special patient groups:
    1. Older adults
    2. Noncompliant adults
    3. Illiterate
    4. Mental health patients
    5. Pediatric patients
  33. List 4 elements of malpractice
  34. List 5 things home health nurses should know when evaluating potential employers.
  35. Discuss the importance of correct documentation in-home health care.
  36. Define the concept of case management.
  37. Discuss the roles/s of the multidisciplinary team.
  38. Define care path.
  39. List 6 concepts related to Quality Improvement.
  40. Define the following terms:
    1. Indicators
    2. Threshold parameters
    3. Structure standards
    4. Process standards
    5. Outcome standards
  41. Define COPD and state the underlying pathophysiology.
  42. State the connection between cigarette smoking and COPD.
  43. Discuss the following in relationship to home oxygen therapy:
    1. Oxygen flow
    2. Documentation of need
    3. Patient teaching
    4. Types of equipment
  44. List 4 common goals for home health care for the COPD patient.
  45. State how each of the following needs must be incorporated into the plan of care for the COPD patient:
    1. Medication needs
    2. Dietary needs
    3. Psychosocial needs
    4. Sexual counseling
  46. List S important points to include inpatient education for the COPD patient.
  47. Define CHF.
  48. Differentiate between left and right-sided heart failure.
  49. List 2 signs/symptoms to assess in each of the following areas as they pertain to CHF patients.
    1. Mental status
    2. Cardiac system
    3. Pulmonary
    4. Skin
    5. Fluid and electrolytes
    6. Gastrointestinal
  50. List 4 common goals in the plan of care of the CHF patient.
  51. List one nursing consideration when giving a patient with CHF each of the following medications:
    1. Diuretics
    2. Cardiac glycosides
    3. Dobutamine/dopamine
  52. List one principle of dipt therapy for CUP patients.
  53. List 7 primary themes of patient education for the CM? patient.
  54. State 2 reasons why ventilator-dependent patients are being returned home.
  55. Define positive pressure ventilator.
  56. State 4 conditions necessary to ensure a safe return home for the ventilator-dependent patient.
  57. State one method of backup respiratory support for the home ventilator patient.
  58. State the role of the DME vendor in providing home health care of the ventilator patient.
  59. State 3 points to remember in-home care of the tracheostomy.
  60. Discuss the extent of dermal wounds in home-related care in the U.S.
  61. List 3 causes of tissue damage and alteration in skin integrity.
  62. List the 3 types of dermal wounds and give examples of each.
  63. List the 3 phases of wound healing.
  64. List 4 conditions which enhance wound repair.
  65. List 5 primary themes of patient education for the wound care patient at home.
  66. State 3 principles of positioning a patient which can assist in preventing skin breakdown.
  67. State precautions to follow with the following antiseptic/aseptic solutions:
    1. Betadine
    2. Dakins Solution
    3. Hydrogen peroxide
  68. Discuss demographic concerns related to incidence of diabetes in the U.S.
  69. Define the following terms:
    1. Type I IDDM
    2. Type II NIbDM
    3. Hyperglycemic ketoacidosis coma
    4. Hyperglycemic hyperosmolar nonketotic coma
  70. List 3 long-term complications of diabetes.
  71. List 5 primary themes of patient education for the diabetic patient.
  72. Give an example of a common regimen for home administration of insulin.
  73. List 3 precautions to follow in the use of insulin.
  74. List the most serious complication of insulin therapy.
  75. State the role of diet in the management of the diabetic.
  76. State 2 methods of glucose monitoring.
  77. Define bladder dysfunction.
  78. Define and give an example of each of the following:
    1. Uninhibited neurogenic bladder
    2. Atonic bladder
    3. Automatic bladder
  79. List the classic symptoms of UTI.
  80. Discuss the role of environmental assessment in relation to the patient with bladder dysfunction.
  81. List 5 primary themes of patient education in the care of the patient with bladder dysfunction.
  82. State 3 situations in which chronic indwelling catheterization may ‘be. needed.
  83. State 3 recommendations for bladder decompression.
  84. State current practice on catheter care and changing indwelling catheters.
  85. Describe criteria for how rehabilitation according to Medicare.
  86. List 4 primary themes of patient education for the patient receiving rehabilitation services.
  87. List 3 examples of DME which can serve as adjuncts in the rehabilitation process.
  88. List 4 factors which have contributed to the growth of home infusion therapy.
  89. Describe nursing considerations for each of the following:
    1. Peripheral IV therapy
    2. P1CC lines
    3. Central venous catheters
    4. Subcutaneous ports
  90. List 4 potential complications of IV therapy.
  91. State symptoms of air embolism and give the appropriate emergency interventions.
  92. Identify the major complications associated with long-term home IV antibiotic therapy.
  93. List 3 major precautions to follow when administering chemotherapeutic agents in the home.
  94. List S criteria for performing in-home transfusions.
  95. Define cerebrovascular accident.
  96. List the 4 types of stroke syndromes.
  97. List the 2 classifications of strokes.
  98. List 3 signs/symptoms of stroke.
  99. List 4 themes of patient education for the CVA patient and caregiver.
  100. Discuss the scope of multiple sclerosis in the U.S.
  101. Discuss acute complications of MS.
  102. Discuss symptoms of dementia: Alzheimer’s type.
  103. Discuss signs/symptoms of each stage of dementia.
  104. Discuss 4 major themes of patient/caregiver education for Alzheimers dementia.
  105. List 5 indicator diseases and/or opportunistic infections common to AIDS.
  106. State the role of home health nursing in the care of persons with AIDS.
  107. List 3 modes of transmission of HIV.
  108. State 4 goals of home care for persons with AIDS.
  109. State 5 primary themes of patient education for persons with AIDS.
  110. List 3 medications commonly used in treatment of AIDS and give a side effect of each.
  111. Describe nursing considerations specific to each body system to be included in planning care for persons with AIDS.
  112. Discuss the concept of family from a systems theory perspective.
  113. State 3 factors related to an infants ability to feed.
  114. State 4 primary themes of parent education for the failure-to-thrive child.
  115. List 4 common congenital cardiac anomalies.
  116. List 3 types of rejection which can occur with cardiac transplants.
  117. Discuss the relationship between surgery for congenital anomalies and sudden cardiac death.
  118. State when the family and home assessment should be done for the child having cardiac surgery.
  119. List the 4 most important points for assessing cardio¬vascular function.
  120. List 5 primary themes of parent education for the child with cardiac anomalies.
  121. Discuss length of stay trends for maternity patients.
  122. Discuss elements of post-partum assessment to be completed by the home health nurse.
  123. List 3 assessment categories for assessing the infant.
  124. Identify normal parameters for each of the above categories.
  125. Discuss 3 primary themes of patient/family education for the post-partum patient/caregiver.
  126. State the role of home care for acutely depressed or schizophrenic patients.
  127. List 3 medications which can potentially contribute to depression.
  128. List 5 primary themes of patient education for the depressed and schizophrenic patient.
  129. State 3 questions to ask the patient to assess for suicide potential.
  130. List 5 symptoms of schizophrenia.
  131. Identify signs of tardive dyskinesia and neuroleptic malignant syndrome.
  132. List one nursing intervention for dealing with each of the following types of patients:
    1. The detached patient
    2. The elusive patient
    3. The suspicious patient
  133. Summarize the effects of aging on each of the body systems:
    1. Cardiovascular
    2. Respiratory
    3. Integumentary
    4. Neurological
    5. Sensory
  134. Define dementia
  135. List 5 factors which effect the nutritional status of the older adult.
  136. List the 6 hazards of immobility.
  137. Describe a method for assessing patient safety in the home.
  138. Describe the best way to assess an elderly person medication use.
  139. List 2 criteria for patient admission to a home hospice program.
  140. Illustrate how hospice care reflects an interdisciplinary approach.
  141. State 3 principles to follow in pain management.
  142. List 4 common problems which develop in hospice patients and give one nursing intervention for each.
  143. List the 5 stages of death and dying.
  144. State what the nurse should teach the caregiver to do when the patient is actively dying.
  145. State the 3 phenomena that will impact on health care in the coming decades.
  146. Discuss micro and macro-level ethical issues within the context of home health care.

Course Contents

  1. Home Care Nursing Practice: Historical Perspectives and Philosophy of Care
  2. Understanding Home Care Nursing: Applying Theory to Clinical Practice
  3. The Role of the Home Care Nurse and Orientation Strategies
  4. Caring for Families in the Home
  5. Developing the Plan of Care and Documentation
  6. Infection Control in the Home
  7. Patient Education in the Home
  8. Legal and Ethical Issues in Home Care
  9. Case Management and Leadership Strategies for Home Care Nurses
  10. Quality Patient Care
  11. The Patient with Chronic Obstructive Pulmonary Disease
  12. The Patient with Congestive Heart Failure
  13. The Ventilator-Dependent Patient
  14. The Patient with Chronic Wounds
  15. The Patient with Diabetes
  16. The Patient with Bladder Dysfunction
  17. The Patient Receiving Home Care Rehabilitation Services
  18. The Patient Receiving Home Infusion Therapies
  19. The Patient with Neurological Dysfunction
  20. The Patient with AIDS
  21. Maternal-Child Nursing: Postpartum Home Care
  22. The Mental Health Patient
  23. The Elderly Patient
  24. The Hospice and Palliative Care Patient
  25. Managing Environmental Threats in the Home
  26. From Telehealth to Telecare: Implications for Clinical Practice

Customer Comments

“The information was presented in a interesting, relevant way that captured and maintained my attention.”

– P.Y., LVN, CA

“I found it to be very refreshing and informative.”

– A.P., LVN, CA