41. Home Health, Hospice, and Palliative Care

Question 1

What is the term used by Medicare to describe the roles of the nurse in home health?

Answer 1

skilled nurse

Question 2

What is the purpose of home health visits?

Answer 2

• gives a more accurate picture of the family and family dynamics
• can contribute to the family’s sense of control and participation

Question 3

Advantages of home health visits

Answer 3

• client convenience
• client control of setting
• individualized services
• family present

Question 4

Disadvantages of home health visits

Answer 4

• cost
• possible safety risks
• family can be detriment to care

Question 5

What do home visits give an accurate assessment of?

Answer 5

• family structure
• natural or home environment
• behavior in the home

Question 6

Home visits provide opportunities to do what?

Answer 6

• identify barriers

- identify supports for reaching family health promotion goals

Question 7

5 steps of the home visit process

Answer 7

• 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

Question 8

5 skills for effective home visits

Answer 8

• observing
• listening
• questioning
• probing
• prompting

Question 9

steps to prepare for a home visit

Answer 9

• 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

Question 10

designed to demonstrate improved, cost-effective client outcomes; how medicare does reimbursement

Answer 10

outcome and assessment information set (OASIS)

Question 11

What is the goal of medication management in home health?

Answer 11

assist client and family to become independent and reliable in management of their mediations

Question 12

What do home health nurses need to assume about every client?

Answer 12

every client is potentially infected or colonized with an organism that can be transmitted

Question 13

methods to prevent transmission of organisms in home health

Answer 13

• hand hygiene
• dispose of sharps properly
• wear barrier precautions
• aseptic technique
• double bag soiled items
• limit use of non-disposable items taken into home

Question 14

interventions related to home safety

Answer 14

• medications (educate, monitor, and assist in compliance)
• medical supplies
• home safety check

Question 15

conditions of participation in home health services fo medicare reimbursement

Answer 15

• 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

Question 16

Goal of hospice care

Answer 16

humanize end-of-life experience

Question 17

who meets criteria for hospice

Answer 17

physician can document they have 6 months or less to live (can surpass prognosis)

Question 18

4 types of hospice

Answer 18

• routine home care w/ intermittent visits
• continuous home care
• general hospital care
• respite care in skilled nursing home

Question 19

4 focuses of hospice care

Answer 19

• 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

Question 20

hospice is the only Medicare benefit that includes what?

Answer 20

• 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

Question 21

how to care for a dying person

Answer 21

• open discussion with patient and family

- prepare patient and family for death

Question 22

How is palliative care different than hospice care?

Answer 22

• 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

Question 23

T/F: all home care givers are skilled nurses

Answer 23

False