Home Care Nursing: Using an Accreditation Approach
Author: Patsy Anderson
Home Care Nursing: Using an Accreditation Approach, is an overview of home care, from the time a client enters the home care system to the time the client is discharged. You can be confident that Home Care Nursing offers you the solid foundation you need, as the entire book is based on the categories of The Joint Commission (formerly JCAHO), which sets forth accreditation standards for all home care organizations. This comprehensive resource is organized into two parts. Part I, Clinical Operations and Client Care, covers the history of home care and hospice, outlines the home care visit, and includes such topics as safety, infection control, and client and family education. Part II, Administrative Operations, addresses the essential topics of a successful home care organization. This section begins with leadership and progresses to topics related to legal and ethical issues, quality improvement, and technology.
Table of Contents:
Foreword xvPreface xix
Acknowledgements xxi
Contributors xxii
Reviewers xxiii
About the Authors xxiv
Clinical Operations & Client Care 1
Home Care: A Long and Proud History 3
Main Factors Underlying the Growth of Home Care 4
Home Care: A Proud History 6
Definitions of Home Care 9
Governmental and Accreditation Organizations 10
Home Care Today 11
Hospice 12
Medicare and Hospice 13
The Newest Home Care Services 14
Summary 17
Care and Services 19
Disciplines and Roles 20
Physicians 20
Registered Nurses 20
Licensed Practical or Vocational Nurses 21
Therapists 21
Physical Therapists 21
Occupational Therapists 22
Speech/Language Therapists 22
Social Workers 22
Home Care Aides 22
Durable Medical Equipment Companies 23
Plan of Care and Physician's Orders 23
Coordination of Services 26
Outcomes and Assessment Information Set (OASIS) 28
The Home Care Nurse Visit 30
Conducting the Home Care Nurse Visit 30
Organizing the Visit 30
Safety 30
Assessment 31
Implementation of Procedures/Treatments 32
Monitoring Medication Therapy 33
Teaching 33
Documentation 34
Medications and the Elderly 34
Medication Use and Misuse 35
Guidelines for Enhancing Compliance 36
Working with Clients' Caregivers 36
Identify High-Risk Areas 37
Psychological and Emotional Strain 37
Physical Strain 38
Set Priorities 38
Educate the Caregiver 38
Discharge Planning 39
Continuity of Care 39
Use of the Nursing Process in Discharge Planning 40
Assessment 40
Nursing Diagnosis 40
Planning 40
Implementation 40
Evaluation 41
Summary 41
Client Education 43
The Home Care Nurse-Educator 43
Theories of Learning/Teaching 45
Adult Learning Theory 45
Teaching/Learning Needs Assessment 46
Mental Status 47
Physical Status 47
Vision 47
Hearing 49
Motor Function 50
Literacy 50
Literacy Level 51
Determining Literacy Level 51
Cultural Background 51
Teaching 55
Development of a Teaching/Learning Plan 55
Assessing Learning Needs and Readiness to Learn 56
Identifying Goals and Developing Learning Objectives 56
Implementing the Plan 57
Evaluation of the Teaching/Learning Plan 57
Documentation of the Teaching/Learning Plan 60
Technology and Teaching 60
Summary 61
Infection Control 64
Chain of Infection 65
Infection-Control Program 66
Focused or Targeted Infection Surveillance 66
Employee Health 66
Infectious Organisms in Home Care 67
Pulmonary Tuberculosis 67
Pertussis 72
Influenza and Avian Influenza 72
HIV/AIDS and Hepatitis 73
Severe Acute Respiratory Syndrome (SARS) 73
Multidrug-Resistant Organisms 73
Methicillin-Resistant Staphylococcus Aureus (MRSA) 73
Community-Acquired Methicillin-Resistant Staphylococcus Aureus 74
Vancomycin-Resistant Enterococcus 74
Pediculosis and Scabies 75
Tools for Infection Control in Home Care 75
Hand Hygiene 76
Gloves 76
Transmission-Based Precautions 77
General Precautionary Guidelines 77
Contact Precautions 77
Droplet Precautions 78
Airborne Precautions 79
Airborne NIOSH-Approved Respirator/Mask 79
Immunocompromised Precautions 79
Home Care Bag Technique 80
Hazardous Waste and Contaminated Items 83
Equipment Cleaning and Biomedical Spills 84
Employee Evaluations 84
Client Care Procedures 85
Infection Reporting 85
Client Teaching 87
Summary 90
Safety and Environment 93
Conceptualizing Safety in Home Care 94
Who Makes Home Visits 95
Perception of Safety 95
Contributors to Safety 95
Phases of the Home Visit 97
Antecedent Phase 97
Getting to the Client's Home 99
Environmental Assessment 99
Client Assessment 101
Risky Diagnoses 102
Supplies and Equipment 102
Ergonomics 102
Medications 103
Pets 105
Nurse Self-Assessment 105
Agency Assessment 107
Making the Home Visit 108
Activities of Daily Living 109
Home Conditions 110
Leaving the Home and Returning to the Agency 111
The Threat of Violence 111
Summary 113
Infusion Therapy: High-Tech Home Care Concerns and Issues 116
Clinician Safeguards 117
Setting Priorities 118
Client Assessment for Home Infusion Therapy 118
Condition of the Client and the Environment 118
Therapy Administration 119
Health Care Provider 120
Infusion Access Devices 120
Subcutaneous Infusion Devices 122
Peripheral Intravenous Access Devices 122
Complications 122
Central Venous Access Devices 122
Peripherally Inserted Central Catheter 123
Non-Tunneled CVAD 123
Tunneled CVAD 123
Implanted CVAD (Implanted Port) 124
Pumps and Infusion-Delivery Systems 125
Intravenous Push (IV Push) Medications 125
Medication Delivery via Gravity or Dial-a-Flow Pumps 126
Stationary (Pole-Mounted) Pumps 126
Elastomeric Pumps 127
Ambulatory Pumps 127
Intraspinal Infusions 127
Infusion Adapters and Caps 128
Client and Caregiver Education 128
Summary 129
Administrative Operations 131
Leadership 133
Governance 134
Advisory Group 134
The Leadership Team 135
Home Care Administrator 135
Director of Nurses 135
Financial Services Leader 136
Information Management Leader 136
Performance Improvement and Quality Manager 136
Specialty Leadership Positions 136
Organizational Structure 138
Organizational Charts 138
Policies and Procedures 139
Policies Related to Client Safety 139
Planning, Designing, and Providing Services 140
Providing Services 140
Provision of Resources 140
Staffing Plans and the Provision of Care 141
Information Management Planning 141
Emergency Management Planning 142
Strategic Planning 142
Annual Program Evaluation 143
Evaluation of Scope of Care 143
Evaluation of Client Care 144
Financial Planning and Management 144
Prospective Payment System 144
Development of the Financial Plan 144
Budget Formats 145
Contracts 145
Contracts with Other Entities 145
Contract to Provide Services 146
Quality Management and Performance Improvement 146
Performance Improvement Plan 146
Compliance Plan 147
Summary 147
Legal Issues 149
Nursing Practice and Licensure 150
A Brief History of Licensure 150
Nurse Practice Acts 151
Standards of Practice 151
Regulatory Agents 152
Client Rights 153
Client Bill of Rights 153
Health Insurance Portability and Accountability Act (HIPAA) 154
Confidentiality 155
Client 155
Records 155
Informed Consent 155
Written Consent 155
Implied Consent 156
Informed Refusal 156
Client Self-Determination Act 156
Advance Directives 156
Living Will 157
Durable Power of Attorney for Health Care 157
Issues of Concern 157
Negligence and Neglect 157
Malpractice 158
Abuse 158
Abandonment 159
Tele-Health 160
Impact of the Legislative Process 161
Summary 162
Ethics in Home Care and Hospice 164
Overview of Ethics and Morality 165
Virtue and Communitarian Ethics 166
Communitarian Ethics 166
Virtue Ethics 166
Truthfulness 168
Compassion 168
Moral Courage 169
Equanimity 170
Just Generosity 170
Moral Agency 171
Autonomy 171
Vulnerability and Dependability 172
Competence 172
Dignity and Dementia 173
End of Life 174
Death Anxiety 174
Withholding and Withdrawing Life Support 175
Voluntary Stopping Eating and Drinking 175
Rule of Double Effect 176
Terminal Sedation 176
Physician-Assisted Suicide 177
Rational Suicide 177
Summary 178
Quality Improvement 181
Quality 182
Perspectives on Quality 182
Quality Improvement 183
Quality Experts 183
W. Edwards Deming 183
Joseph Juran 183
Philip Cosby 184
Health Care's History of Quality 186
Performance Improvement 186
Performance-Improvement Methods 187
Plan-Do-Check-Act 187
Focus 187
Joint Commission Model 187
Six Sigma 188
Performance Improvement Tools 189
Control Charts 190
Histograms 191
Run Charts 191
Line Graphs 192
Scatter Diagrams 193
Cause and Effect, Fishbone, or Ishikawa Diagrams 194
Flowcharts 195
Outcome-Based Quality Improvement Systems 196
Home Health Compare 197
Summary 206
Management of Human Resources 208
Recruitment of Staff 209
Orientation, Training, and Education 210
Organization Mission Statement 210
General Organization Policies 211
Competencies 211
Preceptorship 212
Retention of Staff 212
Exit Interview 213
Employment Satisfaction Survey 214
Management Visibility 215
Personnel Records 216
Summary 216
Informatics and Technology 218
History of Informatics in Health Care 219
Assessment of Client Needs 219
Types of Tnformatics/Technology in Home Care 220
Noncomputer Technologies 220
Tele-Home Care 220
Telemonitors and Videophones 220
Messaging Devices 220
Digital Cameras 221
Point-of-Care Documentation 221
Personal Digital Assistants 223
Advantages of Information Technology in Home Care 224
Clients 224
Caregivers 225
Home Care Professionals 226
Disadvantages of Information Technology in Home Care 226
Looking to the Future 227
Governmental Influences 227
Nongovernmental Influences 227
Summary 228
Glossary 231
Index 235
Restaurant Planning Guide
Author: Peter Rainsford
This book gives authoritative advice on how to parley a strong business plan into a food service success story.
The Restaurant Planning Guide helps you with the business side of the house. Its clear, direct style and many useful checklists, question sets, and forms will make financing, managing and controlling your restaurant much easier. Topics covered include description of business, product/service, the market, location of business, the competition, and management.
Library Journal
Those contemplating becoming a restaurant owner will need information sources to help make the dream a reality, and one such source is this highly practical guide. Authors Rainsford, a professor at the Cornell School of Hotel Administration and the owner of a restaurant, and Bangs, a writer of small-business management books, describe the necessary steps to plan and manage the enterprise through the use of a case study for the fictional Stefanie's Restaurant. The authors cover such topics as evaluating the competition, buying equipment and supplies, hiring personnel, and finding the right location. Included are a sample business plan, the financing proposal, a glossary of restaurant terms, a list of resources, and worksheets for cash-flow projecting, credit inquiry, etc. This source should serve as a useful starting point for those wishing to be restaurant owners and a reference for those already in the business. Recommended to public libraries.-- Lucy Heckman, St. John's Univ. Lib., Jamaica, N.Y.
No comments:
Post a Comment