Legislative and regulatory considerations for home health nurses

"Government's influence on professional practice, quality healthcare, and agency administration increases with each passing year. Federal, state, and local laws and regulations impact the day-to-day operations...." Therefore, it is important for professional nurses to understand both legislative and regulatory processes, identify resources, and take action when necessary (, p. 675).     

Collaborative model for continuing education for home health nurses

Nursing is at the heart of home care; therefore, the profession of nursing must ensure the availability of qualified nurses to provide and manage care in the growing and increasingly complex home care market. In response to this need, the College of Nursing, Arizona State University, developed a CE program for nurse clinicians and managers in home care. This article describes the development, implementation, and outcomes of a project that linked service agencies with education in this collaborative endeavor.     

Strategies to recruit difficult-to-reach home health care nurses for research

Strategies to access a stratified random sample of New England home health care agencies and nurses are described. The combined strategies resulted in a sample of 123 home health care agencies and 2,459 home healthcare nurses from the six New England states. The results will inform researchers aiming to achieve data representativeness and clinicians critiquing the rigor of evidence.     

Developing a preceptorship/mentorship model for home health care nurses

Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship/mentorship that meets the unique needs of home health care nurses. The methods utilized included focus groups, key informant interviews, and a workflow analysis. Factors that influence preceptorship such as nursing workload, preceptor training and remuneration were examined to develop a new model that offers career enhancement and leadership opportunities for preceptors and mentors, and promotes a welcoming environment for preceptees. Reward and recognition programs were created for preceptors to acknowledge their leadership contribution at the front line. This study demonstrates how evidence and innovation were used to create a preceptorship/mentorship model to develop community nursing leaders of the future.     

How do home health nurses spend their time?

Of critical importance to the financial viability of any home health agency are its productivity standards for staff. The authors discuss the results of a study that analyzed staff time spent in direct patient care, documentation of that care, travel, and other activities, and how the resulting data influenced agency operations.     

Perception of risk by home health care nurses in Taiwan

A study of cross-sectional design was used to understand the level of risk perceived by home health care nurses in Taiwan and its correlators. A total of 413 self-administrated structured questionnaires were sent by mail. 300 responses were received, with 258 valid ones. The response rate was 72.6%. The 90 occupational hazards fell into six risk factors: "professional", "traffic", "geographical", "clients' condition and interaction among clients and families", "law" and "organization". The highest scores among the six factors were associated with "law", "clients' condition and interaction among clients and families", and "organization". Marital status and home health care training were significant variables related to the level of risk perceived. Respondents who were married or had home health care training had higher level of risk perceived in the six risk factors than those who were not married or without any training. The variable of years of experience in home health care had a significantly negative correlation with both level of risk perceived for the factors "professional" and "clients' condition and interaction among clients and families". There was a significant positive correlation between the number of visits made by respondents and level of risk perceived for the traffic and geographical factors. There was no statistically significant correlation between the demographics of respondents and level of risk perceived in law. The variables educational level, whether received home health care training, and whether obtained training certificate showed no significant difference in six levels of risk perceived by respondents. The study proposed several suggestions for practice, education, policy and future study.     

Integrating experienced and novice nurses into graduate home health education.

Preparing master's-level professionals in home health nursing presents challenges because nurses come to graduate programs with varying degrees of home health experience. The purpose of this study was to examine how nurses with varying experience in home health nursing are integrated into graduate clinical practicum courses. Representations of 10 home health graduate programs were surveyed regarding how they adapt their clinical practicums to meet the special needs of their novice and experienced nurses. Respondents revealed that individualization was used to meet the individual needs of students. Individualization allows for creativity in developing learning experiences that are both challenging and satisfying for the student. However, lack of consistency in the advanced practice skills of graduates, and lack of time efficiency for faculty and agency personnel can also occur. Faculty members need to share creative ways of teaching students, to identify unique opportunities for clinical experiences, and to collaborate on research.     

Empowering nurses. Patient satisfaction with primary nursing in home health

Responsibility, accountability, and authority are the tools of primary nursing that enable nurses to impact patient care. It is important to determine if nurses empowered by a primary nursing care delivery system can positively influence patient outcomes. The authors describe an outcome audit conducted to study patient satisfaction with nursing care, one indicator of quality patient care.     

Advanced care planning: a study on home health nurses.

The purpose of this research was to assess home health nurses' (HHNs) knowledge, comfort levels, barriers, and personal participation in advanced care planning (ACP), a practice that recognizes patient preferences for health care treatment. Licensed nurses who identified home care as their primary area of practice (N = 519) were surveyed about their knowledge of laws governing ACP and their perceptions of patients' preferences for ACP. Most respondents were women (97%), and the average age of the respondents was 54 years. Most nurses felt knowledgeable and capable of educating patients on advance directives (ADs), although the nurses' knowledge of laws governing ACP was limited and often inaccurate. Generally, nurses felt comfortable during ACP discussions with patients and families. HHNs perceived patient or family reluctance as the greatest barrier hindering discussions of ACP. No association was found between level of education and whether a nurse had a personal AD. Twenty percent of the nurses had their valid personal AD. A greater knowledge base concerning ACP would facilitate HHN discussions with patients and families. Recognition of patient preferences can be enhanced by understanding and overcoming barriers that hinder discussions of ACP. Educational opportunities focusing on ACP are encouraged for all health care providers.     

The experience of home nurses with an electronic nursing health record

DE VLIEGHER K., PAQUAY L., VERNIEUWE S. & VAN GANSBEKE H. (2010) The experience of home nurses with an electronic nursing health record. International Nursing Review Background: Electronic records are currently being introduced in both the hospital and the home care setting. However, there are few studies focusing on the evaluation of an electronic nursing record (ENR) from applicability to technicality and soft‐ and hardware, and from the perspective of home nurses. Aim: The study aims to evaluate home nurses' experiences with an ENR. Methods: A qualitative, explorative study was used by means of 13 in‐depth interviews with home nurses, head nurses and Administrators, and four focus groups with a total of 24 home nurses. All participants were employees of the Wit‐Gele Kruis, an organization for home nursing in Flanders, Belgium. Findings: This study revealed three levels that feature the implementation and integration of an ENR in home nursing: the preparation, the technicality of the ENR and the ‘user’ as an individual. Despite technical difficulties, the home nurses are willing to give the ENR a chance, because they believe in its value. But, at the same time, they are trying to find a balance between this belief and their capacity to learn to work with an IT device. This involves the need to integrate the ENR in their daily work, to meet their responsibility towards the patient and their belief that his care comes first, the impact of technical difficulties on their workload and the integration of the ENR in their personal lives. Conclusion: This study provided insights in the necessity for a multilevel approach when implementing an ENR in home nursing.