Home care is round-the-clock, direct care given by a private caregiver rather than direct health care given in group homes, clinics or nursing houses. Home care is also sometimes referred to as domiciliary care, residential care or public healthcare. The person who provides home care may be a relative, friend or other family member. The most common people who provide home care include adults, teens and children.
Many factors are considered when assigning a caregiver for a patient. One of the main considerations includes the patient’s ability to take care of himself/herself and the caregiver’s work environment. Several studies have been conducted to evaluate the work environment and the patient’s ability to maintain independence while under the care of another person. Studies suggest that the most important determinant of caregiver quality is the work environment or work setting.
The results of these studies reveal that patients who maintained greater job autonomy had better patient outcomes. It has also been observed that independent, caring and confident patients improve their self-image, self-esteem and their self-management skills. Patients who received routine care from a nurse had better outcomes at post-operative time than those who received care from independent, caring but less confident caregivers. Similarly, evidence suggests that medication management plays an important role in improving outcomes for individuals receiving care from others. Self-managing medications can have a positive impact on patient outcomes when medication management is combined with a caring, independent environment.
Another factor considered when assigning responsibilities for patients is their ability to maintain a safe work environment. Studies indicate that patients who were assigned activities-based jobs had fewer accidents at work and when they did experience an accident, their injuries were not as serious as those who were assigned hands-on activities. In fact, patients assigned tasks that required them to move around had the least accidents at work as compared to those assigned indoor tasks. Achieving this balance between care giving and safe work environments is extremely important. Studies suggest that the majority of work-related deaths occurring in health care settings are the result of nurses performing tasks in a way that puts them in unnecessary risk of injury.
One of the most common areas where nurses are assigned unneeded tasks or duties is monitoring the patient’s vital signs. In a home health care setting, a nurse is typically responsible for monitoring a patient’s blood pressure, pulse, temperature and respiratory rate. Despite the importance of checking these vital signs regularly, nurses often fail to perform their basic tasks to prevent these readings from being false. Studies have identified a number of risk factors for tending to the wrong body systems. These include ignoring symptoms that signal imminent heart failure, ignoring the signs of infection in order to save a patient’s life and failing to monitor changes in vital signs consistently enough to correctly prescribe medications.
When considering the various facets of nurse safety in a Home care setting, it is important to note that many of the outcomes are driven by the behaviors of the caregivers. Nurses are asked to adhere to strict guidelines regarding the types of actions that they are permitted to take and the manner in which they are supposed to carry out these activities. Without randomization, it is difficult if not impossible to determine how these behaviors affect the effectiveness of care provided. Studies have identified a number of risk factors for providing care that can be controlled through the use of controlled trials. Using these trials can help to ensure that caregivers effectively provide personalized care to their patients and can consequently increase the overall quality of patient care received.
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