harkness2e chap12 ppt

Chapter 12: Care Management, Case

Management,and Home Healthcare

Chapter Highlights

• Defining care management and case management

• Situating case management as a key component of home visiting

• Historical overview and definition of home care practice

• Description of the home care provision

of services

Chapter Highlights (cont.)• Examining types of home care agencies,

services, and reimbursement• Exploring role and scope of home care

nursing practice during a home visit• Identifying interdisciplinary roles and use of

telehealth• Describing types of chronic care conditions

found in home care patients• Review of current healthcare reform and

home healthcare delivery

Question

Is the following statement true or false?Case management is the development and coordination of care for a selected client and family.

Answer

TrueRationale: Case management—development and coordination of care for a selected client and familyCare management—coordination of a plan or process to bring health services together as a common whole in a cost-effective way

Care and Case Management• Care management—coordination of a

plan or process to bring health services together as a common whole in a cost-effective way

• Case management—development and coordination of care for a selected client and family

Home Care

• Home care is part of a continuum of care where clients have the opportunity to live and move through the experiences of subacute, chronic, and end-of-life care.

• The care given in home care settings is often managed and directed by a registered nurse.

Home Care (cont.)

• Many aspects of the care in both generic and hospice home care are part of a larger care management plan that is individualized using a case management approach.

• The care given in home care settings is interdisciplinary in nature.

Question

Is the following statement true or false?Home care is part of a continuum of care where clients have the opportunity to live through the experiences of subacute, chronic, and end-of-life care.

Answer

TrueRationale: Home care is part of a continuum of care where clients have the opportunity to live through the experiences of subacute, chronic, and end-of-life care.

• Assessment by collecting data about home care clients

• Diagnosis through the analysis of these data

• Outcome identification that helps home care nurses identify nurse-sensitive measures

Role and Scope of Home Health Practice

Role and Scope of Home Health Practice (cont.)

• Planning in the form of nurse-sensitive interventions directed to the identified outcomes

• Implementation-identified nurse-centered actions in collaboration with clients and families

• Evaluation outcome accomplishment through nurse-sensitive interventions

Interdisciplinary Care• Various members of the healthcare

team, not just nurses, contribute their expertise to client management in the home.

Types of Agencies• Private/voluntary (not-for-profit)• Hospital-based• Proprietary (for-profit)• Official

Financing and Regulation of Home Care

– Homebound– Plan of care– Skilled needs– Intermittent care needs– Necessity

Home Care Models• Assisted living• Home visits to the homeless• Parish/faith community nursing

Home Visit• Initiating the visit• Preparation– Equipment– Directions– Personal safety

Home Visit (cont.)• The actual visit– Assessing for risk of medication errors– Assessing for risk of falls– Assessing for risk of abuse and neglect

• Termination of the visit• Postvisit planning

Caregivers

• Caregivers are often family members and friends. They must be considered members of the home care team and offered appropriate support if their commitment to care for a loved one at home is to be successful.

Nurse–Family Interactions in Home Care

• Culture• Contracts• Confidentiality

Question

Is the following statement true or false?Telehealth is a form of electronic communication to deliver chronic care and specialty consultations.

Answer

FalseRationale: Telehealth is a form of electronic communication to deliver acute care, not chronic care, and specialty consultations.

Telehealth• Telehealth is a form of electronic

communication used to deliver – Acute care and specialty consultations– Home telenursing– Electronic referrals to specialists in expert health

facilities

harkness2e chap12 ppt

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