Posted October 27, 2016
While families prefer to have the same nurse, recently surveyed homecare nurses prefer to look after multiple patients at any given time frame. Homecare agencies are often asked to provide a regular home nurse for their clients. We call this continuity of care, one of the quality performance indicators of a homecare agency. Nurses who manage multiple caseloads will have higher standards of practice because of their continued exposure to various clinical cases. Who benefits? The patient!
Homecare nurses in the United Arab Emirates commonly practice 12 hour shift nursing (commonly known as private duty nursing in Canada). They are committed and caring professionals that understand the importance of building a trusting therapeutic relationship with the patient and family. The bonds formed within the first 48 hours are important. The patient/family likes and routines are discovered as well as information about the patient’s life, previous occupation hobbies and interests. The nursing care plans are developed around the patient and their lifestyle within their environment. Patient centered care in its truest form.
MAINTAINING COMPETENCY NURSING SKILLS
Managing families expectations from the beginning is key as the most common request is “we don’t want a different nurse, we want the same nurse”. Caregiver burnout can happen even amongst the best of nurses. We call it fatigue of the same daily routine. Caring for the Dementia patient does require a different skill set than caring for someone with COPD or Stroke condition. The cardiorespiratory assessment and management skills are more developed in the latter and are those critical skills you want the nurse to have during period of crisis. To ensure that the nurse maintains a level of proficiency in the cardiovascular and respiratory management, exposure to those patients is ideal on a regular basis.
Health care research has proven that positive results is linked to volumes “The more you do, the better the outcome”.
Nurses in hospitals are exposed to different case mixes within the same shift and length of stay is less in hospitals than in the home. When we step away from the routine for a couple of days, we return fresh and bring a new approach or idea or sometimes we notice small subtle changes that would have gone unnoticed. I recall working on a Burn Unit which made it a policy to float the nurses to the medical wards once every 6 months so that we freshen up our skills in Diabetes and Cardiac care. It created a stronger Burn Unit that was able to respond to a wider range of thermally injured patients.
CONTINUITY OF CARE vs BURNOUT
Continuity of care no doubt is important in homecare. Communicate to the family from the onset the assignment of a team leader, and the relief nurses. Families beware of agencies that promise the same nurse every day. You don’t want a fatigued nurse caring for loved one. However do negotiate an appropriate level of care continuity.
Enayati Home Nursing tracks its continuity of care as one of its quality indicators in accordance with Canadian Homecare Accreditation Standards. Providing a variety of case mix will ensure competency of staff skills required to delivered comprehensive and responsive care. Nursing staff have the opportunity to work in Palliative Care, Wound Care, COPD, Dementia Parkinsons Disease and Stroke Care teams.
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