TERM 3- MY NOTES FOUNDATIONS OF NURSING CH.37 "Home Health Nursing " Flashcards Preview

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Flashcards in TERM 3- MY NOTES FOUNDATIONS OF NURSING CH.37 "Home Health Nursing " Deck (241)
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Home Health Nursing

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1

Home health care services enable individuals of all ages to remain in the comfort and security of their homes while receiving health care. Family support, familiar surroundings, and participation in the care process contribute to feelings of worth and dignity. Possible services include skilled nursing, physical therapy, psychiatric therapy, pain education and management, speech language therapy, occupational therapy, social services, intravenous therapy, nutritional support, respiratory therapy, acquisition of medical supplies and equipment, and home health aide, homemaker, pet-care assistance, and companion care.
A)true
B)false

A

2

Patients most often receive referrals for home health services upon discharge from the hospital; however, it is also possible for the patient, the family, or the health care provider to request home health care at other times.
A)true
B)false

A

3

To qualify for coverage by Medicare, a health maintenance organization (HMO), or various types of insurance, it is necessary for the patient to be "homebound," meaning unable to leave the home or requiring a great deal of effort to travel for appointments to see the health care provider. The patient also has to be in need of intermittent skilled nursing care.
A)true
B)false

A

4

Patients older than 65 years account for half of all home health patients. Patients of all ages with various diagnoses account for the other half.
A)true
B)false

A

5

Hospitals are most likely to discharge those patients to home health care with a stroke, chronic obstructive pulmonary disease, fractured hips needing surgical interventions, and joint replacement procedures.
A)true
B)false

A

6

Home health care includes services ranging from wound care to ostomy assistance, setting up oral medications, prefilling insulin syringes or administering injections of vitamin B12, assisting patients postoperatively after undergoing total hip and total knee replacements, and monitoring patients with heart failure, diabetes, and hypertension.
A)true
B)false

A

7

The visits occur sometimes as often as twice daily and as seldom as monthly.
A)true
B)false

A

8

Home health care is needed because Americans are living longer and thus have more disease conditions that require care. Also, hospital stays are, on the average, much shorter than in the past, so many patients still require nursing interventions on discharge from the hospital.
A)true
B)false

A

9

Home health care is also essential because an increasing number of women work outside the home. Women who traditionally provided health care for their families are no longer available to provide this service. There is an increased mobility in our society and an increase in single-parent families with female heads of households.
A)true
B)false

A

10

HOME HEALTH CARE DEFINED

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11

Home health care preserves individual independence and integrity and keeps families together.
A)true
B)false

A

12

The following are definitions of home health care as viewed from four different perspectives:

• Official: A component of comprehensive health care in which individuals and their families receive services in their place of residence for the purpose of promoting, maintaining, or restoring health, or of minimizing the effects of illness and disability.

• Patient: Skilled and compassionate care provided on a one-to-one basis in the comforting and familiar surroundings of the home. Providers base care on individual needs and personalized schedules and do so over a given period to enable adjustment, change, and learning to take place effectively.

• Family: A means to keep the family together as a functioning, integrated unit. The goals are learning to adapt to change, preventing dysfunctional patterns from setting in, and attaining family wellness within the scope of an individual member's illness or disability. It provides needed emotional support and linkage with the larger community support systems.

• Provider: Challenges all disciplines involved to provide excellent care in often less-than-excellent conditions and surroundings. Independence, creativity, communication, and excellent clinical skills are integral aspects of daily practice. It is an opportunity for nurses to demonstrate the best of their profession and themselves in cooperation with the health care team to patients and families with physical and psychological needs.
A)true
B)false

A

13

HISTORICAL OVERVIEW

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14

The former definition of home care was simply providing physical care to the sick in their homes, but the scope and the complexity of the concept and practice have grown.
A)true
B)false

A

15

Roots of the concept go back to the New Testament of the Bible, which describes visiting the sick as a form of charity.
A)home care
B)false

A

16

Sixth-century monks practiced home care as an important aspect of their work in the community.
A)true
B)false

A

17

One of the earliest organized systems for home care was developed in 1617 by St. Vincent de Paul, who organized the Sisterhood of the Dames de Charite to meet social welfare and visiting nursing needs.
A)true
B)false

A

18

In the 1700s, families were the primary caregivers.
A)true
B)false

A

19

The poor were hospitalized, whereas those with financial means were cared for in their homes by visiting physicians
A)true
B)false

A

20

The first home care program in the United States came into being in 1796 as the Boston Dispensary
A)true
B)false

A

21

In 1859, William Rathbone of Liverpool, England, established the Metropolitan Nursing Association, the first organized district nursing service, because of the outstanding home care his dying wife received. He believed that many people with long-term illnesses had a better chance to receive the kind of care they desired in their own homes than in a hospital-a belief central to home care today
A)true
B)false

A

22

The Metropolitan Life Insurance Company had a major effect on the growth and nature of home serrvices when, in 1909, it began offering nursing services to its millions of industrial policy holders. This initiiated third-party payment for services. Payment until then had been primarily a matter of charity or the responsibility of the patient.
A)true
B)false

A

23

The Social Security Act of 1935 first provided governmental rather than local charitable funding for selected services such as maternal health, treatment for communicable diseases, and the training of public health professionals. The Act subsidized assistance for the poor and aged. Amendments to the Act in 1950 further defined services and opened the door to direct payment for providers
A)true
B)false

A

24

A revolution, however, occurred in 1965 with the enactment of Title XVIII (known as Medicare) and Title XIX (known as Medicaid) amendments to the Social Security Act.
A)true
B)false

A

25

Medicare provided direct federal monies for the health care of all citizens 65 and older (or disabled), regardless of socioeconomic status.
A)true
B)false

A

26

The companion Medicaid bill covered the care needs of the poor and indigent of all ages.
A)true
B)false

A

27

When Medicare became effective in 1966, it revolutionized home care by:
(1) changing it to a medical rather than nursing model of practice,
(2) defining and limiting the services it reimbursed,
(3) changing the payment source and even changing the reason for providing home care

True

28

The next major influence on home care came in 1983. Congress enacted the prospective payment system (PPS) as a part of the Tax Equity and Fiscal Responsibility Act for hospitals receiving Medicare reimbursement. This system, based on major diagnostic categories and diagnosis-related groups (DRGs), pays a set rate (according to diagnosis) for the hospitalized patient's care rather than the "cost," or charges an institution traditionally bills according to its own schedule of fees. The net effect of the change was a major shift of patients out of hospitals and into their homes, extended-care facilities, or skilled nursing facilities.
A)true
B)false

A

29

Discharge for such patients occurred earlier in their convalescence, and thus the patient required more nursing care. This created a challenge to home care in terms of volume of patients seen, of the need to provide more skilled nursing care over more intensive periods, and the evolution of highly technical procedures in the home.
A)true
B)false

A