Community & Home Health

Question 1

What is a community?

Answer 1

• Identified by a workplace, school, geographical area, medical need
• Group with a shared interest
• More than one person

Question 2

Where is community-based care found?

Answer 2

Where people are

Question 3

What is the definition of community-based nursing care?

Answer 3

Nursing care directed toward individuals of a specific group or population within the context of the community where they live

Question 4

What are two examples of community-based nursing care?

Answer 4

• Clinics in schools

- Home healthcare

Question 5

The local community health clinic identifies patients who have children in the a certain age range with asthma. This type of RN would review meds with the family, assure they know the s/s requiring medical attention, and participate in clinical case management review.

Answer 5

Community-based nurse

Question 6

This type of RN would provide follow up with the family at the home visit. They would educate parents regarding preventative methods; assess for factors that might limit access to health care (ie no insurance); would refer to other needed resources (ie referral to environmental assessment). Info from the visit from would assist the RN in developing other resources (ie support group or written material that outlines ways to decrease common household allergies).

Answer 6

Community health nurse

Question 7

This type of RN would monitor stats regarding ED visits for asthma. They would possibly identify that most children admitted to hospitals with complications secondary to asthma have little/no health insurance. A subsequent intervention would be for the public health nurse to advocate for the availability of low-cost healthcare for the at-risk children or to develop a program linking elementary schools with an asthma prevention program.

Answer 7

Public health nurse

Question 8

Name some various roles for a community health nurse

Answer 8

• State health dept
• School nurse
• Occupational health nursing
• Hospice and home health nursing
• Community health clinics

Question 9

What is hospice?

Answer 9

• Multidisciplinary team approach caring for terminally ill individuals (estimated to have less than 6 months to live). Can be home health or can be a facility.

Question 10

What is focused on in hospice?

Answer 10

Focus on support and quality of life

• Physical, emotional, and spiritual

Question 11

What does the RN focus on often?

Answer 11

Comfort. Treating pain or other undesired symptoms.

Question 12

What do home health care services aim to maintain?

Answer 12

Maintain function, promote health, maintain ADLs! It’s all about self care.

Question 13

Home health is very interdisciplinary. What are some disciplines seen in this field?

Answer 13

• Social worker
• Case manager
• PT
• OT
• Speech therapy
• Home health aide

Question 14

What is the function of a home health nurse?

Answer 14

Provides in-home assessment directs care, patient teaching and support, coordinates services, evaluates outcomes.

Question 15

What is the function of a home health aide?

Answer 15

Provides hygiene care, cooking, supervision, companionship.

Question 16

What is the function of a social worker in home health?

Answer 16

Are more prominent in community health but assists in finding and connecting with community resources or financial resources; provides counseling and support.

Question 17

What is the function of a PT in home health?

Answer 17

Assists with restoring mobility, strengthens muscle groups, teaches ambulation.

Question 18

What is the function of OT in home health?

Answer 18

Heals patients adjust to limitations by teaching new vocational skills and better ways to perform ADLs.

Question 19

What is the function of a speech therapist in home health?

Answer 19

Teaches patients to communicate better and works with patients who have swallowing problems.

Question 20

What is the function of a nutritionist in home health?

Answer 20

Teaches patients about meal planning and diet restrictions.

Question 21

What is the function of a respiratory therapist in home health?

Answer 21

Provides home follow up for patients with respiratory problems including assessment, O2 administration, and home ventilator care.

Question 22

What factors into the functional ability of patients in home health?

Answer 22

• Developmental stage
• Altered elimination
• Health promotion and safety
• Altered nutrition
• Cognitive and sensory deficits
• Decreased mobility

These are all things we would think of in a hospital but in a MUCH broader sense

Question 23

What does a nurse need to function in community health?

Answer 23

Everything we are learning in Assessment class!
• Generalist background
• Knowledge of resources to connect patients with what they need

Question 24

What are the phases of a home health nurse visit?

Answer 24

• Initiation
• Pre-visit
• In-home
• Termination
• Post-visit

Question 25

What happens during the initiation phase of a home health nurse visit?

Answer 25

Find the purpose or reason you are going. Contact family. Find out if they even want you to come.

Question 26

What happens during the pre-visit phase of a home health nurse visit?

Answer 26

Set up initial visit. Communicate purpose to family.

Question 27

What happens during the in-home phase of a home health nurse visit?

Answer 27

Build rapport, set goals, nursing process.

Question 28

What happens during the termination phase of a home health nurse visit?

Answer 28

Summarize visit, plan future visit.

Question 29

What happens during the documentation phase of a home health nurse visit?

Answer 29

Documentation (go elsewhere to do this), plan for next visit.

Question 30

What kind of information are you looking to collect about the home from your visit?

Answer 30

* Is anything in disrepair? * Is there adequate food storage? * Do they have access to all utilities? * Is it clean, or is it able to be appropriately clean? * Are there any infestation concerns? * Is it safe?

Question 31

Who advocates for safety issues?

Answer 31

The social worker. If not available, the RN.

Question 32

What is it called when you compile all the info for different health care providers of your patient in on place?

Answer 32

Provider reconciliation

Question 33

There is often a ____________ of services in home health care.

Answer 33

Fragmentation

Question 34

Who often makes the appointments for the patient in home health care?

Answer 34

The RN

Question 35

What are the levels of discharge planning?

Answer 35

* Basic, universal * Simple referral * Complex referral

Question 36

What is an example of basic, universal level of discharge care planning? Who is involved?

Answer 36

Self-care and illness teaching ie teaching about how to administer insulin. People involved: Nurse, patient, caregiver

Question 37

What is an example of simple referral level of discharge care planning? Who is involved?

Answer 37

Referring to community resources (ie support group referral). People involved: Nurse, patient, caregiver

Question 38

What is an example of complex referral level of discharge care planning? Who is involved?

Answer 38

Patient needs more specialized care after leaving the hospital. People involved: Nurse, discharge planner, family

Question 39

What is case management?

Answer 39

Coordination of care for patients that focuses on all areas of need

Question 40

Who can be a case manager?

Answer 40

Nurse, social worker, Masters in Health Care Administration, respiratory therapist, other people on HC team.

Question 41

_____________ focus takes into account patient ability to afford care, whereas ____________ focus is on getting what is needed to promote optimal health. These can often make both disciplines are odds with each other.

Answer 41

Case management, home health nurse