scholarly journals An Outbreak Preparedness and Mitigation Approach in Home Health and Personal Home Care During the COVID-19 Pandemic

2020 ◽  
Vol 32 (4) ◽  
pp. 229-233 ◽  
Author(s):  
William R. Mills ◽  
Susan Sender ◽  
Karen Reynolds ◽  
Joseph Lichtefeld ◽  
Nicholas Romano ◽  
...  

The acute respiratory disease COVID-19, caused by the novel Coronavirus SARS-CoV-2, is a worldwide pandemic affecting millions of people. The methodology that organizations who provide home health and personal home care services are using to respond to this pandemic has not yet been characterized. In this report, we describe our approach to comprehensive outbreak suppression and report an initial case series of COVID-19 positive patients receiving home-based services. We implemented enhanced infection control procedures across our affiliates, and we communicated these protocols to our offices using multi-faceted methods. Using custom built software applications enabling us to track patient and employee cases and exposures, we leveraged current public health recommendations to identify cases and to suppress transmission. In the 100-day period between January 20, 2020 and April 30, 2020, our affiliates provided services to 67 COVID-19 positive patients (<0.3% of census). Twenty patients were referred to home health post hospitalization for COVID-19 related illness, whereas 47 were found to have COVID-19 while living in community settings. Of those who were found to have COVID-19 in the community, 17 (39%) required subsequent hospitalization. Hospitalized patients had an average age of 74.5 ± 18, and 53% were male. There were 13 deaths (76%) among those hospitalized from the community with COVID-19 related illness. A highly coordinated and frequently communicated approach to infection control, case identification and employee screening can be performed by home health and personal home care organizations. Studies that further assess risks and predictors of illness severity in home-based COVID-19 patients are needed.

2020 ◽  
Author(s):  
Sunniva Grønoset Grasmo ◽  
Ingeborg Frostad Liaset ◽  
Skender Elez Redzovic

Abstract Objective: The need for home care services is rapidly growing due to an increasing elderly population, earlier discharge from hospital and clients’ preference of being treated at home. While this need increases, there is high sickness absence among home health aides, and research show that home health aides have one of the highest probabilities of being granted a disability pension. A high prevalence of musculoskeletal disorders has been reported in occupations with physically demanding work, and this aspect is a major health problem among home health aides. Studies have shown that home health aides find their work stressful, physically demanding and exhausting. The objectives of this study were to summarise peer-reviewed literature on how home health aides experience their occupational health and conduct an ethnographic meta-synthesis with the aim of identifying and describing key concepts across studies. Methods: A qualitative ethnographic meta-synthesis was used to develop new insights into home health aides’ occupational experiences. By using this method, we directed attention to the interpretation of studies, development of concepts and expansion and specification of theories that concern these concepts. The first author conducted searches in the electronic databases CINAHL, MEDLINE and PsycINFO. Results: This meta-synthesis includes 27 articles. The review of these sources identified four key concepts as important to gain an understanding of occupational health among home health aides: exposure to physical demands , physical environmental factors , organisational conditions of employment and psychosocial working environment . Conclusion: The findings in this synthesis are consistent with previous research showing that occupational health among home health aides is a complex phenomenon. Specifically, physical, psychosocial and psychological exposure aspects have potential negative and positive effects on home health aides’ occupational health. In order to increase employee’s well-being, create a healthier workplace that provides well-functioning and high-quality home care services and cope with future health challenges, more investigations into the organisation of home care are needed.


2015 ◽  
Vol 29 (4) ◽  
pp. 306-324
Author(s):  
Pınar Duru ◽  
Özlem Örsal ◽  
Engin Karadağ

The aim of this study was to evaluate the attitudes about home care services and to develop a reliable and valid measurement tool. This methodological study was carried out on 290 students studying at a school of health. Mary Albrecht’s nursing model for home health care, Jean Watson’s theory of human caring, and Leslie Jean Neal’s theory of home health nursing practice constituted the theoretical framework of the study. According to the results of the confirmatory factor analysis, obtained fit indices (x2/df = 1.91, root mean square error of approximation [RMSEA] = .057, normed fit index [NFI] = .80, comparative fit index [CFI] = .89, goodness-of-fit index [GFI] = .85) showed that the proposed model is appropriate for the scale. The Attitude Scale for Home Care (ASHC) consists of 3 subdimensions and 29 items. Cronbach’s alpha of the questionnaire was .93. Therefore, ASHC is a valid and reliable instrument for measuring attitudes about home care and can be used in selecting personnel to work in home care services.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 242s-242s
Author(s):  
O. Shamieh ◽  
A. Mansour ◽  
R. Harding ◽  
M. Tarawneh ◽  
S. Payne

Background and context: The home healthcare market in Jordan is nascent with little service offered. It suffers from a highly fragmented and underregulated landscape. The limited access to qualified trustworthy home care services, lack of professional home care training, and lack of home health care insurance coverage have added to the heavy in-patient bed demand and delayed hospital discharges especially for disabled or terminally ill patients. Aim: To establish a comprehensive national home care program to improve the delivery of palliative and home care services in Jordan, and to conduct a situational analysis and generate policy recommendations. Strategy/Tactics: We used multiple strategies to reach our objectives. 1. Expansion of home care services at King Hussein Cancer Center (KHCC) to create a local demonstration project. 2. Building health care professional capacity by offering variety of educational programs. 3. Improving quality of service delivery by generating clinical practice guidelines, such as standards operating procedures and patient and family educational materials. 4. Use the pilot operational and financial data to generate an economic model to inform the development of similar home health care units in hospitals across Jordan. 5. National advocacy and building effective partnership with all related stakeholders to advance national policy. Program/Policy process: Between May 2016 and May 2017, 7818 home care visits were conducted by KHCC. For capacity building; 678 health care professionals were trained in palliative and home care, out of which 366 participants were females (54%). Palliative care was successfully recognized as a specialty by the Jordan Nursing Council and recognized as a subspecialty by the Jordan Medical Council. The palliative and home care standards of practice were included in the health care accreditation council. The analysis of economic evaluation data suggested that home care services decreased in-patient utilization and costs which is advantageous to a country with limited resources. As a result of the advocacy stream and a collaborative network, the national palliative and home care strategic framework was generated, and endorsed by the Ministry of Health. Outcomes: The NHCI resulted in a very successful pilot project and achieved specialty and subspecialty recognition. Furthermore, we were able to build the capacity of health care professionals and policy makers in the palliative and home care sector from public, private and academic institutions. In the advocacy and policy dimension, the Minister of Health officially approved and adapted the palliative and home care strategic framework that was developed by this initiative. What was learned: Cross-sector collaboration and effective partnership resulted in system change and policy advancement. Developing effective economic systems is essential in low resourced countries. The initiative was supported by a joint grant from the USAID and KHCC.


2003 ◽  
Vol 29 (2) ◽  
pp. 273-282 ◽  
Author(s):  
Cynthia F. Corbett

PURPOSE the purpose of this study was to test the effectiveness of an educational intervention to improve patients' foot care knowledge, self-efficacy, and self-care practices. METHODS A prospective, randomized, single center, 2-group design was used with a convenience sample of 40 home care patients from a Medicare-certified home health agency. Baseline measures of foot care knowledge, self-efficacy, and reported self-care practices were obtained at study entry and 6 weeks later to control for foot care interventions provided during routine home care services. After obtaining the 6-week baseline measures, patients who were randomized to the intervention group received individualized education about proper foot care. All patients were interviewed a third time 3 months after study entry to determine the effectiveness of the intervention. RESULTS The educational intervention improved patients' knowledge, confidence, and reported foot care behaviors. CONCLUSIONS A brief, individualized educational intervention about standard foot care topics improved patients' foot care knowledge and self-efficacy as well as reported self-care practices. Incorporating such interventions into routine home care services may enhance the quality of care and decrease the incidence of lower-extremity complications.


2021 ◽  
Vol 10 (1) ◽  
pp. 41
Author(s):  
Yi-Luo Wang ◽  
Ying Duan ◽  
Ying Zhang

With the increase of the aging of the population in china, the demand of the elderly continues to increase, which has brought great challenges to the elderly care service industry. As a new type of elderly care service, home-based care services directly affect the quality of the elderly&rsquo;s health and daily life in their later years. Therefore, improving the product and quality of elderly care services has become the goal and purpose of the development of home-based care service for aged. This article uses Cite Space software to perform visual analysis of keyword clustering on existing literature, and concludes that scholars focus on the integration of medical care, social elderly care service system, service quality, and influencing factors, but the impact of service quality models and indicator systems is low. Then through the integration and induction of scholars&rsquo; research progress on home care services, existing problems in service quality, and service quality evaluation index systems, in order to continue to innovate on the basis of existing knowledge, improve the service quality index system, and focus on combing process indicators with outcome indicators effectively, thereby improving the quality of community home care services.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 48-48
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang (Aaron) Yao

Abstract Home-based medical care (HBMC) is emerging in China, but research understanding the efficiency and effectiveness of this new care model is rare. In this study, researchers interviewed 17 Chinese homebound adults aged 45 and older (53% females, mean age=76) who have received HBMC, and collected detailed information regarding their experiences and attitudes toward HBMC. Participants were recruited from healthcare institutions in Shanghai, Jinan, and Zhangqiu of China. The evaluation of patients’ experiences with HBMC yielded both positive and negative aspects. Positive experiences included 1) the delivery method was convenient for homebound patients; 2) health problems could be detected timely because doctors visited patients regularly; 3) home care providers had better bedside manners and professional skills than hospital-based providers; 4) the medical insurance covered the cost of home care services. Negative experiences related to the supply and quality of care, including 1) the scope of current HBMC services was too limited to meet the needs of homebound patients; 2) the visit time was too short; 3) healthcare providers’ professional skills varied greatly. Findings from this study suggest that the HBMC model benefited Chinese older adults, primarily homebound adults, in terms of convenience and affordability. There are opportunities to expand the scope of home care services and improve the quality of care. Policymakers may consider providing more resources and incentives to enhance HBMC in China. Educational programs may be created to train more HBMC providers and improve their professional skills.


1987 ◽  
Vol 7 (3) ◽  
pp. 181-191 ◽  
Author(s):  
Harriett S. Bynum ◽  
Joan C. Rogers

The use and effectiveness of 54 selected assistive devices were studied in 30 recipients of home care services. Of these 54 devices, 82% were used and 69% were used routinely for the intended purpose. Twenty patients had bedside commodes and nine had bathtub benches or shower chairs. Only a few patients had long-handled shoe horns, reachers, raised toilet seats, sock aids, elastic shoelaces, commode armrests, or long-handled scrub sponges. No patient had a rocker knife, even though stroke was the most common medical condition. Device training, done inconsistently, generally took 30 minutes or less, spanned 1 to 2 sessions, occurred within 6 months of impairment or 1 year after onset, was carried out by a home health agency, and was judged adequate by the patient. Family members were as apt as not to be included in the training. No association was discerned between training and usage or timing of training in relation to length of impairment and usage. A substantive amount of human help was needed to complete the tasks involving the device. Device disuse was attributed to functional improvement, misprescription, and ineffectiveness.


2021 ◽  
Vol 27 ◽  
pp. 197-203
Author(s):  
Vidya Viswanath ◽  
Leela Digumarti ◽  
Nadimpalli Satyanarayana Raju ◽  
Usha Rani Venkata Lokanandi ◽  
Mohana Rao Dasu ◽  
...  

Objectives: The key component of a comprehensive palliative care (PC) unit is provision of a regular and sustainable home-based PC (HBPC) service. This quality improvement project aimed to plan, organise and sustain a regular HBPC service in a government cancer centre in Southeast India. The aim was to regularise and increase the number of home care visits among the patients identified for HBPC services through sustainable interventions. Materials and Methods: The A3 methodology with its team-based, structured problem-solving approach was the tool used. The situational process map at baseline was followed up with a sequential cause and effect analysis and team discussions to create sustainable and reliable interventions. These included creating the electronic data system for data collection in PC, allocation of resources and implementation of systems to coordinate HBPC services. The roles and ownership to maintain improvement were established by designation and this requirement has been included in the job description to ensure reliability and sustainability. Results: The regularisation of home care services with a consistent increase in the number of home visits from 2/week to over 6/week helped achieve the Specific, Measurable, Achievable, Relevant and Time bound goal. Better documentation, coordination and accountability were also positive outcomes. Working with different departments and teams along the project helped build trust and understanding along with a sound base for collaborative research. Conclusion: The A3 way of problem solving through dialogue and consensus helped to organise HBPC services and this methodology can be extended to other areas in future.


1990 ◽  
Vol 3 (1) ◽  
pp. 4-10
Author(s):  
Kate O'Neil ◽  
Leslie LaBelle ◽  
Caryn M. Bing

Home-care services have expanded greatly over the past several decades. Many pharmacy practitioners have little or no exposure to the vast majority of home-care programs. This article provides an overview of home health care services, traces the evolution of these programs and the public policy that has directed that change, and outlines the regulation governing the home-care industry. A synopsis of traditional and nontraditional home-care services precedes a brief review of other specialty services. A summary of the impact of quality management programs and some future trends for home care are presented.


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