Roles and Responsibilities of Home Healthcare Nurses

Home Healthcare Nurse

Provides essential medical care, education, and support to patients in their homes.

Advocator

Supports and explores client's response, ensures rights and desires are respected, helps navigate healthcare systems, and handles ethical dilemmas and family conflict.

Caregiver

Assesses, diagnoses, and plans care; provides direct care (IVs, catheters, nutrition); assists with daily activities; works with families for better care.

Educator

Focuses on teaching illness care, preventing health problems, and promoting optimal wellness.

Case Manager / Coordinator

Acts as the case manager or coordinator for the client's treatment plan, ensuring seamless communication and collaboration among the healthcare team.

Patient-Centered Care

Identifies and addresses potential hazards in the home environment to ensure the safety of adults and prevent falls or injuries.

Client Safety

Assesses home safety for hazards like falls, fires, and poisoning; educates families on risks and safety measures, documents findings, and monitors ongoing safety practices.

Evidence-Based Practice (EBP)

Occurs when the nurse integrates best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.

Steps in Evidence-Based Practice

Cultivate a spirit of inquiry; ask clinical questions using structured formats like PICOT (Population, Intervention, Comparison, Outcome, and Timeframe) for clarity.

Holistic Care

Considers the patient's individual needs, family dynamics, cultural background, and socioeconomic status to address physical, emotional, and spiritual well-being.

Infection Control

Involves practices to prevent the spread of infections in home healthcare settings.

Caregiver Support

Provides assistance and resources to family members who are caring for patients at home.

Teaching Chronic & Acute Illness Management

Involves educating patients and families on how to manage long-term and short-term health conditions.

Guiding Newborn Health & Development

Involves educating parents on the health and developmental milestones of newborns.

Explaining Drug Interactions

Involves educating patients about potential interactions between prescribed and over-the-counter medications.

Ongoing Education

Ensures that patients continue to learn and understand their health conditions and treatments.

Patient Independence

The goal of education is to ensure patients become as independent as possible in managing their health.

Home Hazard Appraisal

Involves assessing the home environment for safety features to prevent accidents.

Walkways and Stairways Safety

Involves ensuring that walkways and stairways are safe to prevent falls.

Floor Safety

Involves ensuring that floors are free of hazards that could lead to slips and falls.

Furniture Safety

Involves ensuring that furniture is arranged and maintained to prevent accidents.

Bathroom Safety

Involves ensuring that bathrooms are equipped with safety features to prevent falls and injuries.

Healthcare Systems Navigation

Helping patients and families understand and maneuver through the healthcare system.

Chronic Illness Education

Involves teaching patients how to manage their chronic health conditions effectively.

Acute Illness Education

Involves teaching patients how to manage their acute health conditions effectively.

Misconceptions Addressing

Involves correcting misunderstandings about illnesses, treatments, and medications.

Evidence-Based Practice (EBP)

A process that integrates the best available research evidence with clinical expertise and patient values.

Steps in Evidence-Based Practice

1. Search for the best evidence. 2. Critically appraise the evidence. 3. Integrate the evidence with clinical expertise and client/family preferences and values. 4. Implement & evaluate outcomes.

Critically appraise the evidence

Determine the validity, reliability, and applicability of the evidence.

Integrate the evidence

Customize evidence for the patient based on clinical expertise and client/family preferences.

Implement & evaluate outcomes

Make adjustments if the expected results are not achieved.

Quantitative Research

Entails the systematic collection, statistical analysis, and interpretation of numerical data.

Key Characteristics of Quantitative Research

1. Planned & fixed study process. 2. Attention to extraneous variables. 3. Objective researcher-subject relationship. 4. Uses statistical information, tables, and graphs.

Philosophical perspective of Quantitative Research

Linked to logical positivism, asserting that absolute truth can be discovered through measurement.

Reductionistic approach

Understanding phenomena by breaking them into parts.

Qualitative Research

Systematic collection and thematic analysis of narrative data (words).

Philosophical perspective of Qualitative Research

Rooted in naturalism, asserting that reality is relative, contextual, and individually constructed.

Key Characteristics of Qualitative Research

1. Flexible and evolving study processes. 2. Minimized distance between researcher and informant. 3. Subjectivity is accepted and valued. 4. Holistic perspective.

Three Main Qualitative Research Traditions in Nursing

1. Phenomenology - Focuses on lived experiences. 2. Ethnography - Examines cultural patterns. 3. Grounded Theory - Investigates social processes.

Other Qualitative Research Types

Historical Research and Case Study Research.

Application in Nursing Research

Individual qualitative studies are not designed to change nursing practice directly.

Research questions for Quantitative Research

Useful for questions like: What causes X? Which treatment is more effective? What factors are associated with a specific condition?

Research questions for Qualitative Research

Useful for questions like: What is the experience of receiving diagnosis X? What are typical behaviors of certain groups?

Quantitative Research VS. Qualitative Research

Quantitative research seeks objectivity and numerical data, while qualitative research values subjectivity and narrative data.

Research Process

A process in which decisions are made that result in a detailed plan or proposal for a study, as well as the actual implementation of the plan.

Evidence-Based Practice (EBP)

Essential for evaluating the credibility of studies for evidence-based practice.

Formulating the Research Problem

The researcher's first task is to narrow a broad area of interest into a more specific problem that indicates the issue of concern behind the study.

Sources of Research Problems

Recurrent problems encountered in practice, contradictions in existing literature, and unexplored or minimally researched areas.

Criteria for a Good Research Problem

Significant to nursing and offer the potential to improve client care, feasible considering resources, time, and skills, and must be scientifically investigable.

Purpose Statement of a Study

Characterized by an action verb that indicates whether the study will provide descriptive, explanatory, cause-and-effect information, or information that will allow prediction and control.

PICO Format

A strategy for stating the problem you wish to explore, including Patient, Intervention, Comparison, and Outcome.

PICO Variations

PICOD - Adds Design, PICOS - Adds Setting, PICOC - Adds Context, PICOT - Adds Timeframe.

Role of Literature Review

Helps the researcher understand the current state of knowledge and identifies successful and unsuccessful research strategies used in the past.

Dependent Variable

The behavior, characteristic, or outcome that the researcher wishes to explain or predict.

Independent Variable

The presumed cause of or influence on the dependent variable.

Hypothesis

A predictive statement about the relationship between two or more variables.

Research Methodology

Can be thought of as the logistics or mechanics of a study.

Key Elements of Research Methodology

Organization of the study, sources of information, and data collection details.

Quantitative Research Approach

A methodological decision made by a researcher that has implications for research design, sampling, and data collection.

Qualitative Research Approach

A methodological decision made by a researcher that has implications for research design, sampling, and data collection.

Collecting Research Data

The process of gathering information for analysis in a study.

Analyzing Research Data

The process of interpreting the data collected during research.

Communicating Research Findings

The process of sharing the results of a study with others.

Using Research Findings in Practice

The application of research results to improve practice.

Research Design

Refers to the overall structure or blueprint or general layout of a study.

Data Collection Frequency & Timing

Determines how often and when data will be collected in a study.

Relationships Between Variables

Explores how different variables interact with each other in a study.

Number of Groups Compared

Indicates how many distinct groups are being analyzed in the research.

Extraneous Variables Control

Refers to how variables that could affect the outcome of the study are managed.

Experimental Design

The researcher controls the independent variable and administers an experimental treatment to some participants while withholding it from others.

Cause-and-Effect Relationships

Determines how one variable affects another within an experimental design.

Nonexperimental Design

Involves no manipulation of the independent variables and may not have independent & dependent variables.

Descriptive Studies

Studies that provide a description of the characteristics of a population or phenomenon.

Sampling

Selecting data sources which can include people, events, behaviors, documents, or biological specimens.

Target Population Representation

Samples must represent the target population for accurate application.

Data Collection Strategies

Nurse researchers use strategies including questionnaires, interviews, observations, record reviews, and biophysical measures.

Pilot Study

A 'dress rehearsal' before the actual study begins to detect and correct potential study problems.

Implementation Phase

All methodological decisions are put into action, ensuring consistency in data collection.

Reliability

Consistency of measurements over time.

Validity

Completeness & conceptual accuracy of measures.

Pilot Test for Quality Control

Provides a preliminary estimate of reliability and validity and helps identify potential data collection issues.

Quantitative Data Analysis

Uses statistical procedures to interpret data.

Descriptive Statistics

Summarizes data using measures of central tendency and measures of variability.

Measures of Central Tendency

Includes mean, median, and mode.

Measures of Variability

Includes range and standard deviation.

Inferential Statistics

Allows researchers to test hypotheses about relationships between variables or differences between groups.

Statistical Significance

Indicates that results are not likely to have occurred only by chance.

Probability (p value)

By convention, a p value of less than .05 is considered to indicate statistical significance.

Confidence Interval (CI)

Indicates the range within which the true value lies, with a specific level of confidence.

Statistically Significant Findings

Findings are statistically significant as long as zero does not fall within the confidence interval.

Statistical Significance

Results that are statistically significant do not automatically mean that they are clinically significant.

Qualitative Data Analysis

Involves searching for themes & patterns and is often called content analysis because the content of narrative materials is being analyzed.

Theory Development

Findings from qualitative data analysis may lead to theory or conceptual framework development.

Importance of Sharing Findings

Ensures research is accessible and can guide practice decisions.

Methods of Communicating Research Findings

Includes publication in journals, presentation at conferences, newsletter articles for clinical settings, and research posters for visual representation of findings.

Applicability of Research

Even small-scale clinical research should be shared.

Evidence-Based Practice (EBP)

Utilizes research findings to guide client care decisions.

Scientific Validation

Critique of a study's conceptual and methodological integrity, assessing the overall quality of findings.

Comparative Analysis

Evaluates findings for implementation potential, considering comparison with other studies, transferability to clinical practice, and practical or feasibility considerations in real-world settings.

Cost-Benefit Analysis

Weighs risks and benefits of implementing or not implementing changes, considering both immediate and delayed potential costs and benefits to clients, nursing staff, and the organization.