Medicine and Health Sciences Commons^™

Perspectives Of Home Care Nurses On Frailty And Resilience In Older Adults Living At Home, Lisa Foley

Seton Hall University Dissertations and Theses (ETDs)

The population of older adults is growing rapidly in the United States. As more people are living to an advanced age, they are often managing a multitude of chronic illnesses and disabilities while continuing to live at home. Frailty is a common condition that affects how one ages and the condition is associated with dependency and poor health outcomes. Resilience is considered to be a protective factor against health stressors that lead to frailty in older adults. Perspectives of home care nurses were obtained by semi-structured interviews which described how older adults live at home with frailty and demonstrate resilience. …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

Development Of An Experienced Quality Measure For Clients, Informal And Formal Caregivers In Home Care In The Netherlands: A Participatory Action Research, Roy Haex, Theresa Thoma-Lürken Phd, Anna J.H.M. Beurskens Phd, Sandra M.G. Zwakhalen Phd, Rn

Patient Experience Journal

To optimise home care provision and to identify potential improvements in the care process, it is important to gain insight into the care experiences that influence care quality. The aim was to develop a qualitative experienced quality measure for home care in The Netherlands, facilitating conversations between clients and caregivers in generating possible points of improvement for the primary care process. A participatory action research design to develop the measure following three iterative cycles, using various data sources in evaluating requirements related to the goal, feasibility in care setting, and usability in the care process. The final design comprises an …

Careless, Brenna Holland

Capstones

About This Project

I began working on this project six months ago, but my interest in the home care industry can be traced much further back. In the mid-aughts, my grandfather was diagnosed with Alzheimer’s. Hoping to live independently for as long as possible, he sought out the help of an in-home health aide. It was then that he learned he fell into a coverage gap; one that, even today, prevents many Americans from accessing home care services.

Faced with two options—father-son cohabitation or an institution—my grandfather moved in with my family, where he slipped into a catatonic depression prompted …

Caregiver Decision-Making Concerning Involuntary Treatment In Dementia Care At Home, Vincent Ra Moermans, Angela Mhj Mengelers, Michel Hc Bleijlevens, Hilde Verbeek, Bernadette Dierckx De Casterle, Koen Milisen, Elizabeth Capezuti, Jan Ph Hamers

Publications and Research

Background: Dementia care at home often involves decisions in which the caregiver must weigh safety concerns with respect for autonomy. These dilemmas can lead to situations where caregivers provide care against the will of persons living with dementia, referred to as involuntary treatment. To prevent this, insight is needed into how family caregivers of persons living with dementia deal with care situations that can lead to involuntary treatment.

Objective: To identify and describe family caregivers’ experiences regarding care decisions for situations that can lead to involuntary treatment use in persons living with dementia at home.

Research design: A qualitative …

Health Service Experiences And Preferences Of Frail Home Care Clients And Their Family And Friend Caregivers During The Covid-19 Pandemic, Lori E. Weeks, Sue Nesto, Bradley Hiebert, Grace Warner, Wendy Luciano, Kathleen Ledoux, Lorie Donelle

Nursing Publications

Objective: The COVID-19 pandemic has brought about a major upheaval in the lives of older adults and their family/friend caregivers, including those utilizing home care services. In this article, we focus on results from a qualitative component added to a pragmatic randomized controlled trial that focuses on the experiences of our study participants during COVID-19. A total of 29 participants responded to the COVID-19 related questions focused on their health services experiences and preferences from March-June 2020 including 10 home care clients and 19 family/friend caregivers in the provinces of Ontario and Nova Scotia, Canada. Results: Many participants were affected …

Developing A Resiliency Bundle For Home Care Nurses, Candace Unger

Nursing DNP Projects

Home care (HC) nurses are experiencing increased stress related to workload, isolation on the job, and COVID-19 restrictions. A literature review found numerous interventions effective in reducing nurse burnout through building resiliency and decreasing moral distress. The purpose of this evidence-based project was to improve resiliency and decrease the risk of burnout in HC nurses through the introduction of a resiliency bundle. Based on the evidence, the following priority interventions for a resiliency bundle were chosen: a) gratitude strategies, b) connecting with co-workers, c) storytelling, and d) resiliency training. Duffy’s Quality-Caring Model and Neal’s Theory of Home Health Nursing Practice …

Caring Near And Far By Connecting Community-Based Clients And Family Member/Friend Caregivers Using Passive Remote Monitoring: Protocol For A Pragmatic Randomized Controlled Trial, Lorie Donelle, Sandra Regan, Michael Kerr, Merrick Zwarenstein, Michael Bauer, Grace Warner, Wanrudee Isaranuwatchai, Aleksandra Zecevic, Elizabeth Borycki, Dorothy Forbes, Lori Weeks, Bev Leipert, Emily Read

Nursing Publications

Background: Significant chronic disease challenges exist among older adults. However, most older adults want to remain at home even if their health conditions challenge their ability to live independently. Yet publicly funded home care resources are scarce, private home care is expensive, and family/friend caregivers have limited capacity. Many older adults with chronic illness would require institutional care without the support from family member/friend caregivers. This role raises the risk of physical health problems, stress, burnout, and depression. Passive remote monitoring (RM), the use of sensors that do not require any action by the individual for the system to work, …

House Calls Are Reaching The Tipping Point — Now We Need The Workforce, Thomas Cornwell

Journal of Patient-Centered Research and Reviews

Home-based primary care (HBPC) improves the lives of high-cost, frail, homebound patients and their caregivers while reducing costs by keeping patients at home and reducing the use of hospitals and nursing homes. Several forces are behind the resurgence of HBPC, including the rapidly aging population, advancements in portable medical technology, evidence showing the value of HBPC, and improved payments for HBPC. There are 2 million to 4 million patients who could benefit from HBPC, but only 12% are receiving it. The number of these patients is expected to double over the next two decades. This requires a larger and better …

Registered Nurses' Intention To Use Electronic Documentation Systems: A Mixed Methods Study, Sarah Ibrahim

Electronic Thesis and Dissertation Repository

BACKGROUND: Home care in Ontario has become the fastest growing sector and cornerstone of the healthcare system. As a result of the increased shift to the home care sector in Ontario, there have been several health information technology (HIT) initiatives to improve the quality and delivery of health care services to patients. This is exemplified with the province-wide development and implementation of electronic documentation systems (EDS). Electronic documentation systems have the potential to ensure timely, up-to-date and comprehensive patient health and care-related information is available and accessible to healthcare providers such as registered nurses regardless of their physical location. Access …

Examining Eshift Through The Caregiver Policy Lens: A Content Analysis, Ashlee A. Worrall

Electronic Thesis and Dissertation Repository

Purpose: This research study intended to understand how a new model of palliative home care in Ontario, Canada called eShift aligned with the needs of caregivers who cared for a family member at the end-of-life.

Methods: A qualitative secondary analysis using a deductive content analysis of 14 caregiver interviews, three decision-maker interviews, and six home care agency documents collected in a three-year study and were analyzed using The Caregiver Policy Lens framework.

Findings: The eShift model of care met caregivers’ needs through timely access to respite, education, collaborating with the health care team, and physical and psychological support. Caregivers were …

Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven

Journal of Patient-Centered Research and Reviews

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing …

Risk Of Medication Errors In The Home: An Integrative Literature Review, Maria M. Crescenzi

Honors Undergraduate Theses

Regardless of the setting, medication errors are of great concern when associated with an individual’s health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant …

Effect Of Home Telehealth On Vterans With Chronic Heart Failure, Yolanda Major

Walden Dissertations and Doctoral Studies

More than 5 million Americans have heart failure, with approximately 5% of those affected being veterans. As the number of patients with CHF continues to rise, new treatment options are needed to improve the quality of care. Current studies show Telehealth is one treatment option. The purpose of this scholarly project was to determine if veterans diagnosed with CHF were able to maintain optimal weight and blood pressure following participation in Care Coordination Home Telehealth (CCHT) program. The CCHT program provides care to veterans, through the use of monitoring devices placed in their home. Bandura's self-efficacy theory was used as …

Developing An Optimal Model For Infant Home Visitation, Isaac Atuahene

Doctoral Dissertations

The United States, Great Britain, Denmark, Canada and many other countries have accepted home visitation (HV) as a promising strategy for interventions for infants after births and for their mothers. Prior HV studies have focused on theoretical foundations, evaluations of programs, cost/benefit analysis and cost estimation by using hospital/payer/insurance data to prove its effectiveness and high cost. As governments and private organizations continue to fund HVs, it is an opportune time to develop and formulate operations research (OR) models of HV coverage, quality and cost so they might be used in program implementation as done for adult home healthcare (HHC) …

Need Based Instructional Program On Care Competency Of Informal Care Givers For Chronic Renal Failure Patients At Home, Mukesh Kumar Mr, Rajesh Kumar Sharma Mr, Mahalingam

Manipal Journal of Nursing and Health Sciences

Introduction: Majority of patients with Chronic Renal Failure (CRF), Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) depends on their family and friends, to manage their chronic illness throughout the course of illness. Appropriate home care of CKD can help to prevent or delay the progression of illness. Methods: A pre-experimental study with quantitative approach was undertaken on 45 care givers of CKD patients with the objective to study the improvement in competency regarding home care through administration of an instructional programme and information booklet. The program and the booklet consisted information on nutritional management, rest and exercises, …

Reducing Heart Failure In An Era Of Reform, Sandra M. Kurpela

Evidence-Based Practice Project Reports

Heart failure (HF) affects an estimated 5 million Americans, with 550,000 new patients diagnosed yearly (American Heart Association, 2004). Despite advancements, readmissions for HF remain high. Management is especially important due to recent legislation that penalizes hospitals with excessive readmissions. The purpose of this evidence-based project (EBP) was to determine if a chronic disease HF management program with advance practice nurse, home care, and telehealth would affect hospital readmission 4 weeks post-discharge. Orem’s Self-Care Deficit Nursing Theory and the Iowa Model guided this system change. The project used a longitudinal experimental pre- and post-test design with convenience sample from two …

Medical Home Model Of Patient-Centered Health Care, Sandra N. Berryman, Sheri P. Palmer, James E. Kohl, Jon S. Parham

Faculty Publications

The medical home offers a patient-centered model of care. The foundation of a medical home is the organized and continuous interprofessional care of patients.

Shared Care Dyadic Intervention: Outcome Patterns For Heart Failure Care Partners, Margaret Sebern, Aimee Woda

Margaret Sebern

Up to half of heart failure (HF) patients are readmitted to hospitals within 6 months of discharge. Many readmissions are linked to inadequate self-care or family support. To improve care, practitioners may need to intervene with both the HF patient and family caregiver. Despite the recognition that family interventions improve patient outcomes, there is a lack of evidence to support dyadic interventions in HF. Thus, the purpose of this study was to test the Shared Care Dyadic Intervention (SCDI) designed to improve self-care in HF. The theoretical base of the SCDI was a construct called Shared Care. Shared Care represents …

Shared Care Dyadic Intervention: Outcome Patterns For Heart Failure Care Partners, Margaret Sebern, Aimee Woda

College of Nursing Faculty Research and Publications

Up to half of heart failure (HF) patients are readmitted to hospitals within 6 months of discharge. Many readmissions are linked to inadequate self-care or family support. To improve care, practitioners may need to intervene with both the HF patient and family caregiver. Despite the recognition that family interventions improve patient outcomes, there is a lack of evidence to support dyadic interventions in HF. Thus, the purpose of this study was to test the Shared Care Dyadic Intervention (SCDI) designed to improve self-care in HF. The theoretical base of the SCDI was a construct called Shared Care. Shared Care represents …

An Exploration Of Knowledge Translation Amongst Homecare Providers, Family Caregivers, And Clients, L. Jansen

Electronic Thesis and Dissertation Repository

The aim of this two-phased investigation was to enhance understanding of urinary incontinence (UI) knowledge translation (KT) to inform how UI management knowledge might be translated within in-home nursing practice and family caregiving. Although UI can be managed conservatively, it is a principal reason for the breakdown of family-care and care recipient admission to long-term care. Research has afforded little insight into family caregivers’ experience of KT and the process of in-home KT for UI management.

The first study used a hermeneutic phenomenological approach to explore family caregivers’ experience of UI KT. Data were collected from in-depth interviews with a …

Bring Mental Health Services Home: Meeting The Mental Health Needs Of Adolescents And Their Families In Rural Minnesota, Laura Filzen

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project was to develop a program that addressed housing and therapeutic support to adolescents experiencing mental health issues, allowed adolescents to remain in the community, and promoted reunification with their families. “An important indicator of success for children in out-of-home care is a timely transition to reunification” (Park and Ryan, 2009). Based on the literature and practice, it is believed that intensive family therapy is needed to promote reunification and reduce recidivism of placement.

Blending The Roles Of Home Care Nursing And Cardiovascular Specialties: A Model For Nursing Practice In The Community, Margaret A. Guthaus, Diane White

Peer Reviewed Articles

Changes in reimbursement and advances in technology have resulted in a decreased hospital stay for patients undergoing cardiac surgery. These patients are being discharged into the community setting earlier, resulting in an increased demand for transitional specialty home care. This article relates the experience of a Midwest home care agency charged with the development of specialty home care for these complex patients. It offers a new practice model for professional nursing staff delivering this level of care. This model challenges traditional beliefs that cardiac specialty home care can best be provided by nurses with critical care or acute care cardiology …

Protective Care: Mothering A Child Dependent On Parenteral Nutrition, Lorie H. Judson Phd, Mn, Rn

Dissertations

Home care of technology-dependent infants and children has become an accepted and expected consequence of higher survival rates among critically ill newborns and children who develop chronic illnesses. One of the high-tech modalities which foster dependence of these infants and children is parenteral nutrition. Parenteral nutrition, also called total parenteral nutrition (TPN), supplies life-sustaining nutrients through a central venous catheter and requires the use of machinery to pump this fluid directly into the bloodstream. Due to the tremendous cost of prolonged hospitalization for these children, and the deleterious effects to the child, home care is considered an obvious and viable …

Rearing The Child Who Is Technology Dependent: Perceptions Of Parents And Home Care Nurses, Maureen O'Brien, Carole B. Wegner

College of Nursing Faculty Research and Publications

ISSUES AND PURPOSE. Most children who are dependent on technology for survival live with their families at home. This study explores the perceptions of parents and home care nurses regarding rearing the technology-dependent child.

DESIGN AND METHODS. In this qualitative study, interviews were conducted with 16 parents whose child is technology dependent and 15 registered nurses who provided home care.

RESULTS. Rearing the child who is technology dependent is similar to but different from raising other children. Parental communication and negotiation of child-rearing expectations with home care nurses is essential.

PRACTICE IMPLICATIONS. Improved collaboration and communication between parents and nurses …