Community Health Week 4 notes - Home Health and Hospice
Community Health Week 4 notes - Home Health and Hospice NU 426
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This 4 page Class Notes was uploaded by Allison Black on Friday February 5, 2016. The Class Notes belongs to NU 426 at Jackson State University taught by in Fall 2015. Since its upload, it has received 42 views. For similar materials see Community Health Across the Lifespan in Nursing and Health Sciences at Jackson State University.
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Date Created: 02/05/16
Unit 3 Community Health Student Learning Outcomes. ▯ 1. Explain the focus of the nursing process and how public health nurses (PHNs) and other nurses working in the publicly funded sector use it to provide care in their communities. ▯ Functions of school nurses: ▯ • Health services for chronic conditions (individualized health plans [IHPs] for asthma, diabetes, seizures, food allergies; behavioral problems and learning disabilities; medication administration) • Health services to prevent illness or injury: immunizations, safety measures • Health education and health promotion: screenings • Promotion of healthful school environment: nutrition, exercise, risk behaviors (sexual activity, substance abuse), mental health, abuse • School-based health centers ▯ Functions of a corrections nurse: ▯ Restore & maintain health of inmates via a variety of skill; track & screen for communicable diseases; assist in setting up resources for continuing care after release; educate and promote healthy lifestyles; assist in assessing medical conditions; assist in medical emergencies. ▯ 2. Describe how federal, state, and local public health infrastructures influence the population’s health. • State health departments: carry forth regulations and policies determined by federal government such as Medicaid, Medicare, State Children’s Health Insurance Programs • Local health departments: carry out state laws and policies; provide the most direct, immediate care; work with state health departments ▯ List of publicly funded health organizations: ▯ • Health Resources and ServicesAdministration (HRSA) • Indian Health Services (IHS) • CDC • NIH • FDA • SAMHSA • Agency for Toxic Substances and Disease Registry (ATSDR) • Agency for Health Care Research and Quality (AHRQ) 3. Evaluate the potential benefits of school-based health centers (SBHCs) and discuss possible parental or community objections. ▯ ▯ Private Settings for Community Health Nursing – Chapter 31 ▯ 1. Identify the distinctiveness of various nurse-managed health clinic models. • Three types: wellness, comprehensive primary care, specialty care. 2. Describe funding sources for nurse-managed health clinics. • Fee for service • Sliding fees Grant support • • Third-party payments • Cost-based reimbursement available to federally qualified health centers • Comprehensive primary care centers: advanced practice nurses provide primary care usually reimbursable under Medicaid and managed care medical insurance plans 3. Describe the evolutions of faith community nursing. • Newest specialties; oldest means of health care delivery; parish nursing • Faith community: organization of families and individuals sharing common values, beliefs, religious doctrine, and faith practices • Name changed to “faith community nurse” in 2005 • Also called health ministry nurse, congregational nurse 4. Describe and differentiate among the roles of the faith community nurse. • Health educator • Health counselor • Advocate • Referral agent Developer of support groups • • Coordinator of volunteers • Integrator of faith and health 5. Identify the steps for establishing a practice as a faith community nurse. • Assessment of community needs • Identification of how faith community nurse would meet the needs Seeking of support • • Seeking of formal approval from organization’s governing body • Launching of practice; establishing community contacts and identifying resources • Education of community including faith community 6. Explain the role of the occupational and environmental health nurse and other members of the occupational health team in protecting and promoting workers’health and safety. • Ensure workforce is healthy and productive. • Traditional focus on illness and injury care • Specialty focus for identifying and assisting in the management of physical, chemical, biologic, ergonomic, and psychosocial factors in the workplace affecting workers’health and safety Participation in the organization’s goals through activities that contribute • to the productivity of the workforce • Roles: consultant, educator, role model; no supervisory responsibility 7. Recognize at least three adverse working conditions that impact health status. • Downturn of the global economy • Increasing worldwide competition • Increase in technologic hazards • Escalating health care costs 8. Discuss the opportunities for nurse entrepreneurship in community/public health practice. • Common examples of nurse entrepreneurs include the following: • Legal consultants • Forensic nurses • Owners of home health care agencies • Authors • Nurse consultants in a variety of areas ▯ Clients Receiving Home Health and Hospice Care – Chapter 32 ▯ 1. Summarize the history and contemporary circumstances of home health and hospice care. • Care in the home by family members throughout history • Latter half of 20th Century, hospitals making referrals for home care for nonacute patients • Medicare Home Health Benefit: brief visits, temporary care; no reimbursement for health promotion or long-term care • Balanced BudgetAct and Medicare Prospective Payment System: payment rates based on client characteristics and need for service: closure of many Medicare-certified agencies • Cost and number of visits declined; rates of wound healing incontinence and psychosocial problems increased • Decreased patient contact; increased documentation 2. Describe Medicare standards for home health and hospice programs. • Criteria: • Service type and frequency reasonable & necessary • Client homebound • Plan of care on Medicare forms • Client in need of skilled service (observation, assessment, teaching, performing selected procedures) • Service intermittent and part-time • Episode of care: 60 days • Admission: assessment using OASIS • Medicare documentation: OASIS, Medicare Plan of Care 3. Explain family caregiver burdens of providing home care. • Primary caregiver: daily tasks of care • Secondary caregiver: intermittent responsibilities • Caregivers assuming enormous burdens: physical, psychological, economic 4. Explain how Medicare reimburses home health and hospice care. • Medicare hospice benefit: prognosis of 6 months or less, sign up for comfort-focused hospice benefit, waive regular hospice benefit; acknowledgment of terminal prognosis; choosing comfort care instead of life-extending care • Hospice coordinating care in all settings • Four payment levels - Routine home care with intermittent visits - Continuous home care when the patient’s condition is acute and death is near - Inpatient hospital care for symptom relief - Respite care in a nursing home to relieve family members 5. Describe essential characteristics of home health and hospice nursing practice. • RN as central to hospice interdisciplinary team • Case manager; frequent visits • Collaboration with physicians • Rotation through 24-hour call 7 days/week to assure continuous availability by telephone and visits for emergent problems • Competencies similar to home health nurses with addition of added expertise in relieving physical and emotional suffering of terminally ill people and families • Sustaining oneself • Connecting, speaking truth, and encouraging choice • Collaborating • Strengthening the family Comforting (palliative care, pain management, see Display 32.6 and • Display 32.7) • Spiritual practice and letting go
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