41. Home Health, Hospice, and Palliative Care Flashcards
What is the term used by Medicare to describe the roles of the nurse in home health?
skilled nurse
What is the purpose of home health visits?
- gives a more accurate picture of the family and family dynamics
- can contribute to the family’s sense of control and participation
Advantages of home health visits
- client convenience
- client control of setting
- individualized services
- family present
Disadvantages of home health visits
- cost
- possible safety risks
- family can be detriment to care
What do home visits give an accurate assessment of?
- family structure
- natural or home environment
- behavior in the home
Home visits provide opportunities to do what?
- identify barriers
- identify supports for reaching family health promotion goals
5 steps of the home visit process
- initial phase (see the client and purpose of visit)
- pre-visit phase (scheduling first visit)
- in-home phase (8 weeks)
- termination phase (planned from beginning)
- post-visit phase
5 skills for effective home visits
- observing
- listening
- questioning
- probing
- prompting
steps to prepare for a home visit
- review data
- contact client/family
- gather supplies/equipment
- observe neighborhood for resources
- greet and obtain signatures and complete forms
- provide care/assessment
- discuss plan of care
- document visit details and discuss next visit
designed to demonstrate improved, cost-effective client outcomes; how medicare does reimbursement
outcome and assessment information set (OASIS)
What is the goal of medication management in home health?
assist client and family to become independent and reliable in management of their mediations
What do home health nurses need to assume about every client?
every client is potentially infected or colonized with an organism that can be transmitted
methods to prevent transmission of organisms in home health
- hand hygiene
- dispose of sharps properly
- wear barrier precautions
- aseptic technique
- double bag soiled items
- limit use of non-disposable items taken into home
interventions related to home safety
- medications (educate, monitor, and assist in compliance)
- medical supplies
- home safety check
conditions of participation in home health services fo medicare reimbursement
- client must be home bound
- service must be intermittent and provided by nurse, PT, or speech
- plan must be initiated and followed
- medicare forms, physical orders, and client record must be completed on timely basis
- HCP must have face to face visit w/ client before initiating orders
Goal of hospice care
humanize end-of-life experience
who meets criteria for hospice
physician can document they have 6 months or less to live (can surpass prognosis)
4 types of hospice
- routine home care w/ intermittent visits
- continuous home care
- general hospital care
- respite care in skilled nursing home
4 focuses of hospice care
- attention to mind, body, and spirit
- death is not a taboo topic
- health care technology should be used with discretion
- clients have a right to truthful discussion and participation in treatment decisions
hospice is the only Medicare benefit that includes what?
- medication
- medical equipment
- 24/7 access to care and support of the family
- bereavement services for family for 12 months after death of client
- does not need to be homebound
how to care for a dying person
- open discussion with patient and family
- prepare patient and family for death
How is palliative care different than hospice care?
- goal is comfortable quality of life
- not limited to those who are dying
- services for those w/ serious, complex illness regardless if they are expected to survive
- more of a consultative service
T/F: all home care givers are skilled nurses
False
