The Use and Effectiveness of Assistive Devices Possessed by Patients Seen in Home Care

1987 ◽  
Vol 7 (3) ◽  
pp. 181-191 ◽  
Author(s):  
Harriett S. Bynum ◽  
Joan C. Rogers
Keyword(s):  
Home Care ◽  
Medical Condition ◽  
Health Agency ◽  
Home Care Services ◽  
Home Health ◽  
Assistive Devices ◽  
Functional Improvement ◽  
Home Health Agency ◽  
Care Services ◽  
Common Medical Condition

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.

scholarly journals Home health aides’ experiences of their occupational health: a qualitative meta-synthesis

2020 ◽  
Author(s):  
Sunniva Grønoset Grasmo ◽  
Ingeborg Frostad Liaset ◽  
Skender Elez Redzovic
Keyword(s):  
Occupational Health ◽  
Home Care ◽  
Home Care Services ◽  
Home Health ◽  
Working Environment ◽  
Major Health Problem ◽  
Positive Effects ◽  
Home Health Aides ◽  
Care Services ◽  
Key Concepts

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.

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 ◽  
...  
Keyword(s):  
Infection Control ◽  
Home Care ◽  
Case Series ◽  
Home Care Services ◽  
Home Health ◽  
Case Identification ◽  
Care Services ◽  
Home Based ◽  
Control Procedures ◽  
Novel Coronavirus

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.

Development of an Attitude Scale for Home Care

2015 ◽  
Vol 29 (4) ◽  
pp. 306-324
Author(s):  
Pınar Duru ◽  
Özlem Örsal ◽  
Engin Karadağ
Keyword(s):  
Home Care ◽  
Home Health Care ◽  
Goodness Of Fit ◽  
Home Care Services ◽  
Attitude Scale ◽  
Home Health ◽  
Measurement Tool ◽  
Fit Indices ◽  
Care Services ◽  
Fit Index

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.

scholarly journals National Home Care Initiative in Jordan: A Demonstration Project

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 242s-242s
Author(s):  
O. Shamieh ◽  
A. Mansour ◽  
R. Harding ◽  
M. Tarawneh ◽  
S. Payne
Keyword(s):  
Health Care ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Professionals ◽  
Home Care Services ◽  
Home Health ◽  
Demonstration Project ◽  
Strategic Framework ◽  
Care Services ◽  
Effective Partnership

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.

A Randomized Pilot Study of improving Foot Care in Home Health Patients With Diabetes

2003 ◽  
Vol 29 (2) ◽  
pp. 273-282 ◽  
Author(s):  
Cynthia F. Corbett
Keyword(s):  
Home Care ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Self Care ◽  
Home Care Services ◽  
Home Health ◽  
Study Entry ◽  
Foot Care ◽  
Care Services ◽  
Care Practices

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.

scholarly journals Hospital-territory integration: the role of the Integrated Access Point service of Udine

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M d'Angelo ◽  
A Panzera ◽  
R Favro ◽  
G Paulin ◽  
A Innocente ◽  
...  
Keyword(s):  
Home Care ◽  
Continuity Of Care ◽  
Health Agency ◽  
Access Point ◽  
Home Care Services ◽  
Local Health ◽  
Care Services ◽  
Hospital Transfer ◽  
Investigation Period ◽  
And Gender

Abstract Background The Integrated Access Point (PUI) is a service of the district of Udine, of the then University Health Agency (ASUI-Ud), which guarantees access to local health services for patients reported with a protected discharge path. The following study aims to evaluate the progress of the reports taken in charge from January to August 2019. Methods The reports were analyzed according to age (mean; standard deviation) and gender (M; F) of the patients; reporting date both 24 hours (h) from entering the ward and 72 h from discharge; hospital transfer, discharge with or without activation of home care services; transfer to intermediate care facilities (RSA) and evaluation date (UVM), nursing home (CDR) or Hospice (HO). The study also includes protected discharge with: non-dischargeable patient, no service provided and more. The data was extracted and analyzed with the Business Object XI program and Microsoft Excel. Results From January to August 2019, 24 hour reports were processed by the PUI relating to 2223 patients: 45.8% of these were M (74.8; 14.2); the remaining 54.2% instead of F (79.8; 12.8). The greater proportion of reports was also accompanied by the reporting form at 72 h 88.5%. Territorial services were activated as follows: home care services (ADI) for 42.1%, HO (2%), CDR (1.3%) and RSA (19.1%). The percentage of UVM is 22.6%; those concerning the remaining categories are respectively 10.5% (no service), 5% (other). Finally, by evaluating the monthly trend of the processings, it emerges that 27.1% of these refer to reports from the winter months (from January to February). Conclusions The higher volumes of the activities of the Integrated Access Point (PUI) were reported in the first two months of the investigation period. The service represents a strategic hub: ensuring continuity of care for most patients reported with protected discharge, allows for integration between hospital and local care. Key messages The Integrated Access Point (PUI) guarantees the continuity of care for most patients reported with protected discharge. The major volume of the activities of the Integrated Access Point (PUI) were reported during the winter months of the investigation period.

Abstract P852: “They Were Wonderful...They Helped a Great Deal”: Patient and Caregiver Reports of Home Health Care as a Transition of Care Practice After Ischemic Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ann M Leonhardt-Caprio ◽  
Craig R Sellers ◽  
Thomas Caprio
Keyword(s):  
Ischemic Stroke ◽  
Hospital Discharge ◽  
Community Integration ◽  
Health Agency ◽  
Home Health ◽  
Transitions Of Care ◽  
Functional Improvement ◽  
Care Practice ◽  
Home Health Agency ◽  
New Diagnosis

Background: Transitions of care (TOC) following ischemic stroke (IS) are complex for patients and caregivers; the post-hospital discharge period is stressful, fragmented, and often carries with it a fear of new stroke. Improvements in education, medication management, and support for community integration following discharge to home could ease TOC challenges and assist in reducing hospital readmissions. Methods: Diagnosis-driven certified home health agency (CHHA) referrals for IS patients were initiated at a Comprehensive Stroke Center as a TOC improvement with a goal of decreasing “missed” referrals for patients not previously considered but eligible for CHHA services. Patients discharged to home (50 patient/caregiver dyads) were interviewed 30 days following hospital discharge to solicit feedback regarding CHAA services. Results: Of those contacted, 27 (54%) received CHAA services. Three patients/caregivers (11.1%) responded with neutral feelings regarding the visit, 24 (88.9%) responded that the visit was helpful. Eleven respondents had no comment/opinion when asked how the visit was/was not helpful. The remainder of patients had responses that could be grouped into domains including encouragement/concern for me ( n = 4), teaching/guidance ( n = 4), therapy/exercise ( n = 6), functional improvement/independence ( n = 2), medications ( n = 3), blood pressure management ( n = 3), and home health agency staff ( n = 2). There were multiple positive comments such as one patient who reported that the home care nurse was “very good... called right away and got the outpatient therapy transition arranged.” A patient with a new diagnosis of diabetes felt that education and concern for how things were going was very important to understanding and managing this new diagnosis. Multiple patients reported the importance of medication reconciliation after discharge and specific comments regarding the CHHA staff included, “Really helpful. They were wonderful... they helped a great deal.” Conclusions: Positive experiences regarding TOC practices strongly supported referral for CHHA services. Comments regarding the services suggest that increasing CHHA referrals could meet perceived needs of IS patients and caregivers in the transition from hospital to home.

An Overview of Home Health Care Programs

1990 ◽  
Vol 3 (1) ◽  
pp. 4-10
Author(s):  
Kate O'Neil ◽  
Leslie LaBelle ◽  
Caryn M. Bing
Keyword(s):  
Health Care ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Care Services ◽  
Home Health ◽  
The Public ◽  
The Past ◽  
Care Services ◽  
The Impact

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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