Home Health Care Management & Practice

Patients are at a higher risk of falling in the hospital than at home because of their acute illness, medications, other treatments, or unfamiliarity with the hospital environment. Despite numerous efforts, inpatient falls remain a leading adverse event in hospitals and other inpatient settings, resulting in loss of function, death, and higher health costs. This article explores the factors in hospital settings that can reduce and prevent inpatient falls.

Home care service is providing health care to the patient in his or her dwelling when care in the hospital is no longer required. Home care services provide not only medical services but also the social services that the human needs. Studies concerning home care services bear great importance. In this review, the authors aim to guide new studies by stating the legal and scientific point reached at the moment in Turkey.

The objective of this article is to characterize inpatient-related outcomes and measures of efficiency for hospitalized assisted living residents managed by an assisted living-based primary care (ALPC) team. Between 2010 and 2012, 1594 assisted living residents received ALPC. An ALPC team member served as hospital attending physician to 377 assisted living residents at three community hospitals. Several inpatient metrics were compared between the hospitalized ALPC cohort and those reported in the National Hospital Discharge Survey. Hospitalized assisted living residents who received inpatient hospital care by an ALPC team member had lower inpatient mortality, 30-day readmission rates, and shorter length of stay compared to published averages. The authors determined that an ALPC team who follows its patients in the hospital may achieve improved inpatient outcomes.

Febrile neutropenia is a potentially life-threatening oncologic emergency characterized by a dangerously low neutrophil count that places the patient at great risk. In these patients, fever may be the only sign of infection, which requires prompt treatment. With the increasing focus in shifting health care from inpatient centers to outpatient arenas, home health care clinicians will likely have an increased role in the care of neutropenic fever patients in the future. The article describes both the pharmacologic treatment and nonpharmacologic support required of these patients with particular attention to treatment that may be required in the patient’s home.

Fiber has more health benefits than treating or preventing constipation or hemorrhoids. But most individuals do not include foods with adequate amounts of fiber to their diet. Perhaps low consumption of fiber is due to poor food choices or because one is not aware of the food high in fiber content. In this issue the facts about fiber are discussed including a list of commonly consumed foods and their fiber content.

Home health nurses/staff can inform parents of the healing qualities of inexpensive and simple therapeutic art and literacy activities. They can instruct them of the variety of art, literature, storytelling, and writing activities that can be used and encourage parents to provide such opportunities for their children during their healing processes. These activities can give children some of the emotional support they need to help them heal and provide an opportunity for children to maintain healthy cognitive and emotional developmental growth even while they are homebound.

An implanted cardiac defibrillator (ICD) is a unique indwelling device for the treatment of cardiac dysrhythmia and the prevention of sudden cardiac death. On February 4, 1980, the first ICD was implanted into a human subject. Thousands of Americans have been saved as a result of this device. Near the end of life, an active ICD may no longer be consistent with a patient’s needs and/or current health status. The very benefit of the device becomes the risk. Research has shown a deficit in recipient understanding of the role and function of the ICD. Likewise, there is a deficit in physician-led discussions and education of ICD deactivation in end-of-life care.