PRACTICE IN THE DOMIMCILARY HEALTH CARE ENVIRONMENT - Carers Australia , College Of Nursing - Asignment

1159 words - 5 pages

Diploma of Nursing
Impact of Health Problems on Domiciliary Client Care
As for all nurses, Domiciliary Nurses are entrusted with:
• Client and family information enabling them to
• Recognise and respond to
- Condition changes
- Care needs
- Coping abilities
• Family involvement is encouraged – however should be:
- Co-ordinated as per the care plan
- Timely and responsive
- And incorporate the philosophy and aims of Domiciliary Care
Case Management
Case management is a system of care provision
• commonly used in the domiciliary health care environment.
• That provides cost effective
• client assessment,
• care planning,
• implementation and
• evaluation of provided care,
• ensuring appropriate care
• An EN plays integral role in facilitating the care management process
Case Management
Working with a case manager
e.g. RN, Allied Health Professional ensuring that the care includes:
• Assessment and evaluation
• Client goal directed care planning
• Education for client and family
• Knowledge of available services
• Co-ordination and appropriate referrals
• Accurate documentation (Video 11 minutes) to ensure timely care plan
and goal revision
• Appropriate goal oriented discharge planning
Funnel et al 2009 p80-81
EN: desired qualities and awareness
To provide effective domiciliary health nursing care a nurse must:
• Adapt to different home environments and
• Adapt to client/family responses and perceptions of support and
• Be aware of
• client history and life experiences,
• immediate environment and
• cultural and religious beliefs.
Domiciliary health care environment EN role
Enrolled nurse role in domiciliary care: ‘Job description’
• Work ethically and professionally within scope of practice
• Independently under indirect S/V but seek guidance
• Recognise, respond to clinical manifestations of client health problems
• Communicate effectively with clients/families and allied health team
• Strong organisational and time management skills - self-motivation
• Client and family advocate; Non-judgmental approach
• Adapt care based on client and family needs
• Maintain safety: own and client; adhere to infection control
• Current driver’s license – no restrictions
Confidentiality, Privacy and Trust
Confidentiality and privacy of client information in all situations
• An ethical, professional and legal obligation in domiciliary health
care environment
• Mandatory reporting obligations challenging but essential
Therapeutic relationship:
• open and honest approach to gain and maintain mutual trust
Patient education:
• Explain to client how information is gathered, documented and
• Used in line with service policies and protocols encompassing
• The need to share information with other health professionals such
as the case manager
Recognising impact of Health Problem
Initial assessment involves:
• Initial phone call – establishing initial nurse, client, caregiver
therapeutic relationship
• Assessment data collecting interview re client’s health and
• Historic database including
• the socio-environmental and family assessment
• The nursing health history:
• feelings about previous health care and expectations
• Past health-illness patterns
• Risk factors and resources available
Clinical Manifestations of Health Problems
Clinical manifestations of health problems in domiciliary environment
• Medical Status
• Neglecting to eat: weight loss or gain; constipation and / or
dehydration; incontinence
• Mobility, personal hygiene; loss of muscle or bone strength; transfers
• Home environment safety: potential for harmful interactions
• Family coping? Social interactions including the lack of them
• Behaviour: emotional responses and attitudes to care – client and self
• Finances; resources use and needed
• Adverse drug reactions
• Chronic wounds
Stayles & Flanagan 2002, P 11 & 45
Discuss assessments with RN/allied health
Discuss information gained from assessments
• with RN appropriate members of the health care team for
- care planning
- problem solving and
- evaluation.
• Evaluate care and outcomes for both physical and psychological
impact for the client and family.
Assessment of client requiring domiciliary health care includes
• Health status and care needs
• Identification of actual or potential problems
• Socio-economic and cultural factors impact related to care provision
• A problem solving approach to assess health problem impact on
• Activities of Daily Living and
• The care and outcomes of physical and psychological impact on
client and family
Client consent to discuss client information to
• enable family and allied health contribution to care planning, problem
solving and evaluation
Element 2.2 Discuss assessments with RN/allied health
Element 2.3 Holistic assessment of Impact on ADLs
Gaining Consent to Discuss Issues
Client and family more active role in domiciliary health care setting
• Referral and permission for home care based on informed consent
• Client consent to discuss care with family
• Then family involvement in decision making and care
• Encouraging client /family care plan and intervention
• Acknowledgment of client’s home as the care setting
• Recognition of the multiple needs of the client
• Client self-care decision making strategies encouraged throughout
Gaining Consent to Discuss Issues
Client and family more active role in domiciliary health care setting
• In homecare the EN must be holistically client and family focused.
• As care is provided through home visits, client and family more involved
• Consent given by client for open communication with families so that:
•Family education and problem solving strategies can be incorporated
into client’s care plans.
•In turn, families, along with the client, can contribute to planning,
implementing and evaluation of care
Communicating client assessment
Discuss with RN and allied health, client assessment of:
• Actual or potential client problems.
• Impact of socio-economic / cultural factors related to care provision
• Impact of health problems on client and family
• With client consent discuss the with the client or family:
• Physical, psychological and social impacts of a health problem on
client activities of daily living
• Enabling their contribution to care planning and problem solving.
Problem Solving Approach
Critical thinking and a Problem Solving Approach essential
• In homecare EN must be holistically client and family focused.
• Care provided through home visits, client and family more involved
• Client care plans: more detailed teaching/problem solving strategies
‪Video: Nursing Process Overview: ADPIE
(Assessment, Diagnosis, Planning,
Implementation and Evaluation)‪ 9 minutes 20 seconds
Reflective Questioning
The process of Reflective questioning leads to continuous improvement
• What care would you like if you were being cared for by yourself!?
• What are you doing now?
• What can we do better?
• What differences do we need to make to our care to do it better?
• How can we make that happen?
Video Reflective Practice 4 minutes
Activity: Patient Safety in Home Care
• Explain your EN role in ensuring patient safety and quality care in
the home care environment:
• Medication Management
• Falls prevention
• Unplanned hospital admission
• Nurse work environment
• Functional outcomes and quality of life
• Wound and pressure ulcer management
Patient Safety and Quality: An Evidence-Based Handbook
for Nurses. Carol Hall Ellenbecker; Linda Samia; Margaret J. Cushman; Kristine Alster.

More like PRACTICE IN THE DOMIMCILARY HEALTH CARE ENVIRONMENT - Carers Australia , College Of Nursing - Asignment

The Study Of Falling In Health Care Facilities - Nbcc Nursing - Essay

791 words - 4 pages ... there was a curb beside the car. This accident resulted in the swelling of my ankle for months. Falls is the most common factor that negatively affects our daily living, especially in the healthcare facility falling and falls related injures are one of the main concerns of a patient’s safety, especially in among those 65 years and older. Patient’s safety, efficient patient care and quality patient care are top priority of healthcare organization ...

Palliative Care Nursing Practice - Case Study

3557 words - 15 pages ... nursing. New York: Oxford University Press.Faull, C., Carter, Y., & Daniels, L. (2nd Ed.). (2005). Handbook of palliative care. Oxford: Blackwell Publishing.Harris, P., Nagy, S. And Vardaxis, N. (2006). Mosby's dictionary of medicine, nursing and health professions. Australia: Elsevier.Heath, H. B. M. Eds.). (1995). Potter and Perry's foundations in nursing theory and practice. London: Mosby Ltd.Kemp, C. (1995). Terminal Illness. A Guide to ...

Community Health Nursing In The Communtiy - Nursing - Essay

3487 words - 14 pages ... schedule of completion, etc. I learned after speaking with my mentor the first time that while you can technically take the courses in any order you'd like there is a "typical" way of doing things and in the end I went along with this. No need to make waves if this was a good way of completing what I needed to do. Most mentors will suggest that you take Health Assessment and Care of the Older Adult first along with possibly Community and Population ...

Essay On Nursing Within The Health

831 words - 4 pages ... paper includes your data search and the relationship between the health care team member and the R. N. Topics to include are: roles, characteristics/skills used in practice, educational requirements, licensure &/or certification requirements, continuing education requirements, professional standards of practice, ethical standards of the profession, and collaborative practice with nursing professionals. The paper is to be a minimum of 5 ...

Infection Prevention And Control In Nursing Practice - Year 1 Adult Nursing Practice - Essay

1302 words - 6 pages ... and health workers.’ (Worlds health organization, 2018). This report will also evaluate the role of patient care and public involvement (PCPI’s) in infection prevention and control. Evidence-based practice plays a large role in understanding infection prevention and control in health care settings. Teaching method: 2 Nursing students are thought infection prevention and control through lectures, seminars and workshops. Lectures are one of the ...

Describe The Main Inequalities Found In Health Care And Health Status

446 words - 2 pages ... . Operations can be delayed or canceled as private patients or more urgent cases are placed ahead of the list (Walters: 1980). Pre-eminent medication with increased effectiveness and less side effects is predominantly offered only to private patients due to cost issues.The accumulation of inequalities in access to health care and quality results in variations of health status, with those particularly disadvantaged in Social class V. ...

Assignment On How Math Can Be Used In The Occupation Of Nursing - College Algebra - Research Paper

603 words - 3 pages ... Algebra in Nursing Math, although it maybe unliked by many students, is essentially to daily life. Math is apart of just about everything we do. It is used to create the cars we come to school in and the toothpaste we use to brush our teeth. It is just as essential to nursing as it is to everyday life. One of the skills required to be a nurse is solving basic linear equations for dimensional analysis. Dimensional analysis is the process of ...


5540 words - 23 pages ... Guidance: Learners must carefully read the guidance below which is linked to the components above MERIT: GD1: Understanding of the subject · Your responses to the tasks will demonstrate that you have a sound and broad understanding of ethical principles and perspectives in that you can identify these in situations that occur in health care practice. You should draw on a range of sources. · Your work will display a general understanding of how ...

Racial Barriers Of Accessing Health Care

1896 words - 8 pages Free ... The present health crisis for racial minorities in the United States can be traced back to 400 years ago when racial discrimination rooted in this continent. For this long period of time, minorities were exclusive from the so called "mainstream" health system. The most popular health care system in U.S. - managed care, has actually built in incentives which may encourage discrimination. Research shows that "the total family premiums have risen ...

Whose Wishes Should Be Followed? - North Central State College/ Health Care Ethics - Health Care Ethics

1615 words - 7 pages ... further harm to Alexander by letting him struggle with this horrible pain just to fulfill his wishes. The doctor is also aware of the emotional harm he may put Alexander’s son Michael through by not following his wishes. Beneficence is when health care officials act in the best interests of their patients. The doctor must make the decision that results in the best interest of his patient. In this instance, the doctor must weigh if it is in the ...

Health And Safety Practice In The Salon - City And Guilds Vrq - Vrq Module

1348 words - 6 pages ... Sarah Hughes 202 14.11.18 Task 1a HEALTH AND SAFETY Health and Safety at Work Act It is the EMPLOYERS responsibility to maintain the workplace and make sure I is safe to work in, they must give employees appropriate training and supervision. Access and exit points must be kept clear and free of hazards at all times. Employers must make sure the salons h/s systems are reviewed and updated regularly and that a suitable working environment and ...

Parenting Children In A Digital Society - University Of Western Sydney-child And Family Health Nursing - Essay

2777 words - 12 pages ... :10.1111/j.1532-7078.2009.00013.x Fowler, C., Rossiter, C., Bigsby, M., Hopwood, N., Lee, A., & Dunston, R. (2012). Working in partnership with parents: The experience and challenge of practice innovation in child and family health nursing. Journal of Clinical Nursing, 21(21-22), 3306-3314. doi:10.1111/j.1365-2702.2012.04270.x Heider, K. L., & Renck Jalongo, M. (2014). Young children and families in the information age: Applications of technology in ...

Evaluate The Effectiveness Of Health And Social Care - Langly Park School - Assignment

1349 words - 6 pages Free ... affecting them. Another benefit for the patients is that not only will they get good service but it will also continue when they get home. This is because health care workers will be coming to visit these individuals within their own homes. Whilst these health professionals work together they still have to follow the code of conduct and legislations put in place to protect themselves and also the patients as well. As individuals who suffer from ...

Unit 8 - Promote And Implement Health And Safety In Health And Social Care - Health And Social Care - QCF Unit

1945 words - 8 pages ... Unit 8: Promote and Implement Health and Safety in Health and Social Care 1.1 Identify legislation relating to health and safety in a health or social-care setting. • Health & Safety at Work Act 1974 • The Management of Health and Safety at Work Regulations 1999 • The Manual Handling Operations Regulations 1992 • Control Of Substances Hazardous to Health (COSHH) - 2002 • Reporting of Injuries, Diseases and Dangerous Occurrences Regulations ...

The Practice Of Safety In The Workplace - Essay

1632 words - 7 pages ... The topic for this essay is the practice of safety in the workplace. Explaining possible outcomes of a severe safety concern may get readers' attention. Food contamination is something you don't want to mess with. Contamination of food that a person consumes can result in that person becoming ill or even being very deadly. Always think that when you leave work, you should leave the same way you came to work, with no injuries. Why would anyone ...