Course Outline
Home health nurses focus their practice on promoting the optimal health, wellbeing, and quality of life of patients, their families, and caregivers within their homes and communities. They provide care and support of patients of all ages, from prenatal through end of life. Their practice emphasizes patient and caregiver education, counseling and coaching toward achieving independent self-management of patient’s illness, disease, and disability. These specialists provide skill that was unavailable, even unanticipated, a few years ago, and coordinate care amid the ongoing upheavals in health care. This book is an essential guide for their practice now and into the near future.
In 2013, ANA convened a workgroup of home health nurse experts, from across their practice specialty, to update and expand the 2007 edition to better reflect contemporary and frame future practice. With input from other nurses and organizations, they developed Home Health Nursing: Scope and Standards of Practice, 2nd Edition. It is a comprehensive, up-to-date delineation of the competent level of nursing practice and professional performance common to and expected from home health registered nurses whatever their practice level or setting. The publication’s scope or practice addresses what is expected of all home health nurses, specifying the who, what, where, when, why, and how of their practice. That detailed scope of practice discussion is given the context-the underlying assumptions, characteristics, environments and settings, education and training requirements, key issues and trends, and ethical and conceptual bases of home health nursing-needed to understand and use the standards.
Those 16 standards, providing a framework for evaluating practice outcomes, and goals, are those by which all home health nurses are held accountable for their practice. The set of specific competencies accompanying each standard serves as evidence of minimal compliance with that standard.
A foundational volume that is primarily for those directly involved with home health nursing practice, education, and research, other nursing and allied healthcare providers, researchers, and scholars will find value in this content. It is also a resource for others involved in home health, such as employers, insurers, lawyers, policy makers, regulators, and stakeholders.
About Authors
A special thank you to the volunteer members of the ANA workgroup for their time and excellent work in revising the 2014 edition of Home Health Nursing: Scope and Standards of Practice.
Workgroup
Marilyn D. Harris, MSN, RN, NEA-BC, FAAN, Chairperson
Lisa Gorski, MS, HHCNS-BC, CRNI, FAAN
Patricia Hanks, MS, RN, COS-C
Patricia M. Hunt, MS, RN
Karen S. Martin, MSN, RN, FAAN
Mary Narayan, MSN, RN, HHCNS-BC, CTN, COS-EC
Maria Radwanski, MSN, RN, CRRN
The work group that created this 2014 revision of Home Health Nursing: Scope and Standards of Practice gratefully acknowledges the work of the previous task forces of 2007, 1999, 1992, and 1986 that initiated the original documents on home health nursing.
Reviewers
Deborah Center, MSN, RN, CAN
Joann K. Erb, PhD, RN
Tina M. Marrelli, MA, RN, MSN, FAAN
Imelda A. Nwoga, MSc, RN, MSN, PhD
ANA Staff
Carol J. Bickford, PhD, RN-BC, CPHIMS- Content Editor
Maureen E. Cones, Esq.- Legal Counsel
Yvonne Daley Humes, MSA – Project Coordinator
Eric Wurzbacher, BA – Projector editor
About the American Nurses Association
The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 3.1 million registered nurses through its constituent/ state nurses associations and its organizational affiliates. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive realistic view of nursing, and by lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public.
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Learning Objectives
After completing this course you’ll be able to:
- Discuss the history of home health nursing in the United States.
- Discuss the role of Medicare in home health care.
- Describe the diverse patient population of the home health nurse.
- State the goal of home health nursing.
- Define home health nursing.
- List distinguishing characteristics of home health nursing.
- Describe how home health nursing differs from other nursing specialties.
- Discuss the five assessments.
- List the SMART goals.
- Describe the planning phase of the care plan,
- Discuss the role of the LPN/LVN in the implementation phase.
- List the minimum qualifications for a registered nurse practicing in home health.
- Describe the role of the advanced practice registered nurse, clinical nurse specialist, and nurse practitioner.
- Describe the role of the case manager.
- Discuss patient advocacy.
- Describe the role of the home health nurse administrator.
- Compare the role of the clinical manager and the quality and performance improvement nurse.
- Compare the role of the clinical educator and informatics liaison nurse.
- Describe the Magnet and Pathway Standards.
- List the nine provisions of the Code of Ethics for Nurses with Interpretative Statements.
- Discuss the research of Dwyer et al., 2013.
- Discuss the four research programs that reflect best practices in home health.
- Describe telemonitoring.
- Compare the electronic health record and electronic personal health record.
- List projected trends in financing and reimbursement for home health care.
- Describe the assessment phase.
- Discuss the diagnosis standard.
- List several competencies of the home health registered nurse when identifying out – comes.
- Describe the planning phase.
- List several measures the home health nurse implements in the plan of care.
- Compare the competencies of the home health registered nurse and the advanced practice nurse in coordination of care.
- Describe the role of the advanced practice nurse in health teaching and health promotion.
- Discuss the role of the advanced practice registered nurse when providing consultation.
- State the role of the home health registered nurse in the evaluation phase.
- Discuss the role of the home health nurse when practicing ethically.
- State several competencies of the home health registered nurse regarding education.
- Discuss methods of sharing research findings.
- Describe competencies of the home health registered nurse to maintain quality of practice.
- State methods the advanced practice registered uses to maintain quality of practice.
- List communication skills used by the home health registered nurse that promote behavior change in patients.
- Discuss ways a home health registered nurse demonstrates leadership with nursing students.
- State the leadership role of the advanced practice registered nurse.
- Discuss collaborative techniques used by the home health registered nurse.
- List collaborative efforts by the advanced practice registered nurse.
- State methods the home health registered nurse can use to evaluate one’s own nursing practice.
- Describe utilization resource methods the home health registered nurse can best implement.
- Describe methods by which the home health nurse can practice in an environmentally safe manner.
- List methods by which the advanced practice registered nurse can create an environmentally safe practice.
Table of Contents
- Introduction
- Scope of Practice of Home Health Nursing
- Evolution of Home Health Nursing
- Home Health Nursing’s Scope of Practice
- Definition of Home Health Nursing
- Distinguishing Characteristics of Home Health Nursing
- The Nursing Process in Home Health Nursing
- Assessment
- Diagnosis
- Outcomes Identification
- Planning
- Implementation
- Evaluation
- Educational Preparation of Home Health Nurses
- Certification in Home Health Nursing
- Practice Roles and Responsibilities
- Home Health Nurse
- Graduate-Level Prepared Home Health Nurse
- Advanced Practice Registered Nurse
- Clinical Nurse Specialist
- Nurse Practitioner
- Clinical Roles
- Care or Case Manager
- Patient Educator
- Patient Advocate
- Administrative Roles
- Administrator
- Supervisor or Clinical Manager
- Quality and Performance Improvement Nurse
- Clinical Educator
- Informatics Liaison Nurse
- Trends, Issues, and Opportunities in Home Health Nursing
- Practice Environments
- Ethics in Home Health Nursing
- Respect for the Individual
- Commitment to the Patient
- Advocacy for the Patient
- Responsibility and Accountability for Practice
- Duties to Self and Others
- Contributions to Healthcare Environments
- Promotion of the Nursing Profession
- Research in Home Health Nursing
- Informatics in Home Health Nursing
- Finances and Reimbursement
- Summary of the Scope of Home Health Nursing Practice
- Standards of Home Health Nursing Practice
- Significance of the Standards
- Standards of Practice for Home Health Nursing
- Standard 1. Assessment
- Standard 2. Diagnosis
- Standard 3. Outcome Identification
- Standard 4. Planning
- Standard 5. Implementation
- Standard 5A. Coordination of Care
- Standard 5B. Health Teaching and Health Promotion
- Standard SC. Consultation
- Standard 5D. Prescriptive Authority and Treatment
- Standard 6. Evaluation
- Standards of Professional Performance for Home Health Nursing
- Standard 7. Ethics
- Standard 8. Education
- Standard 9. Evidence-Based Practice and Research
- Standard 10. Quality of Practice
- Standard 11. Communication
- Standard 12. Leadership
- Standard 13. Collaboration
- Standard 14. Professional Practice Evaluation
- Standard 15. Resource Utilization
- Standard 16. Environmental Health
- Glossary
- References
- Appendix A. Home Health nursing: Scope and Standards of Practice (2007)