Showing papers in "Home Healthcare Nurse: The Journal for The Home Care and Hospice Professional in 1999"

The Department of Health and Human Services.

Abstract: This letter is in response to your two Citizen Petitions dated November 17, 1994 and May 13, 2008, requesting that the Food and Drug Administration (FDA or the Agency) require a cancer warning on cosmetic talc products. Your 1994 Petition requests that all cosmetic talc bear labels with a warning such as \"Talcum powder causes cancer in laboratory animals. Frequent talc application in the female genital area increases the risk of ovarian cancer.\" Additionally, your 2008 Petition requests that cosmetic talcum powder products bear labels with a prominent warning such as: \"Frequent talc application in the female genital area is responsible for major risks of ovarian cancer.\" Further, both of your Petitions specifically request, pursuant to 21 CFR 1 0.30(h)(2), a hearing for you to present scientific evidence in support of this petition.

Predictors of hospital readmission among the elderly with congestive heart failure.

Abstract: This study compared elderly patients with congestive heart failure discharged from home healthcare to the home vs. those rehospitalized. The rate of rehospitalization in this sample of 117 was 27%. Significant predictors of rehospitalization included number of home healthcare days, number of previous hospitalizations, and the services of a home health aide. Implications include the timing and nature of home health visits.

Nutritional aspects of wound healing.

Abstract: Proper nutrition is essential to prevent the development of pressure ulcers and to support adequate and timely wound healing. Additionally, research and clinical observation suggest nutrients play a major role in wound healing. How the nutrients Vitamin A, Vitamin C, zinc, calories, protein, and fluids are used in wound healing and recommendations regarding use of supplements are discussed in this article.

Research-based practice implications for patients with diabetes. Part II: Diabetes self-efficacy.

Abstract: Part I of this two-part research article that describes diabetes knowledge pre- and post-home care instruction was reported in last month's issue of Home Healthcare Nurse. As indicated, foundational knowledge is a necessary prerequisite to effective diabetes management. This article reports on patients' self-efficacy for diabetes management before and after home care and demonstrates that boosting a person's judgment of his or her ability to perform specific diabetes activities is an important next step toward improving self-care.

Using self-efficacy to increase physical activity in patients with heart failure.

Abstract: Increasing self-efficacy is not a state that develops quickly. It is unrealistic to expect that the factors contributing to illness and disability will be modified easily. The home care nurse can positively influence self-efficacy expectations in the heart failure population by creating a supportive environment to perform physical activities (performance mastery), assisting with encouragement and support (verbal persuasion), providing anticipatory guidance and sharing how others perform (vicarious experience), and providing a realistic assessment of a person's abilities (physiologic state). By enhancing self-efficacy, the home care nurse can increase physical activity levels in this population, leading to decreased symptomatology and improved quality of life.

The Neal theory: implications for practice and administration.

Abstract: New research demonstrates that home health nurses proceed through a three-stage process to become successful and autonomous in their practice. It also indicates that they must be adaptable in order to function effectively and successfully in home care. This research has many implications for clinicians, managers, and administrators.

Research-based practice implications for patients with diabetes. Part I: Diabetes knowledge.

Abstract: Diabetes knowledge of adults who require insulin is examined in this two-part article. Part I reports on the study findings related to diabetes education and compares documented educational nursing interventions with post-home care knowledge outcomes. Part II, which will appear next month, reports on patients' self-efficacy for diabetes management before and after home care. Strategies for improving patient outcomes are presented.

Identifying and evaluating wound infection.

Abstract: Wound infection is a serious problem in the home care patient. Early detection of infection, prompt treatment, and continuous surveillance are pivotal to elimination of the infection and prevention of complications. This article addresses identification of wound infection in postsurgical and chronic wounds based on data obtained from the patient's history, physical examination, and diagnostic tests. Appreciating the overt and subtle signs and symptoms of wound infection and acting on them is critical to timely diagnosis and treatment.

Wound Care for Persons With Diabetes

Abstract: This article addresses local wound care in people with diabetes mellitus. An approach is proposed that uses wound depth and color to determine the goals of local wound treatment. Principles of cleansing, debridement, and the use of moisture retentive dressings are discussed. Infection, a significant problem in the patient with diabetes, is addressed as an essential part of local wound care in these patients.

Wound dressings: challenging decisions.

Abstract: Choosing the appropriate wound dressing is critical to positive patient outcomes. This article helps the nurse choose dressings based on principles of wound care management and comprehensive assessment. Tools are provided to choose the different products that can be used as the wound progresses through the stages of healing.

Spirituality and religiosity in palliative care.

Abstract: Positive spirituality preserved through religiosity' can be a useful tool in the care of people who are dying. Spirituality concerns the connectedness with self, others, environment, and the Other. Religiosity describes postures and acts done alone or in company with others that preserve practices and spiritual understandings for the good of the terminally ill. The home care and hospice nurse must understand these principles and act in concert with the care team to accomplish care goals.

Evidence-based practice and the home care nurse's bag.

Abstract: How safe is the home care nurse's bag anyway? What kind of precautions and procedures should an agency and nurses adopt to ensure that contamination does not occur? This article uses the evolving theory of evidence-based practice to suggest the best approaches to these challenging questions.

Managing breakthrough cancer pain: a new approach.

Abstract: Every day, nurses in all clinical settings work closely with patients who are experiencing various types and intensities of pain. Advances in pain management have given present patients and their families a variety of options that allow them a renewed dimension to the quality of their lives; an ability to live more productively and face the end of life in comfort. Because all nurses must keep up to date on basic principles of assessment, pain management, and current pharmacologic and nonpharmacologic approaches to pain, AJN and Home Healthcare Nurse are proud to provide our readers with important information about pain management and a new medication recently approved by the FDA: oral transmucosal fentanyl citrate (Actiq). You can apply the information in this supplement in your daily practice as you assess your patients' level of pain, plan and evaluate interventions, and collaborate with members of the interdisciplinary team. Your goal--to help patients determine the appropriate treatments and dosages for their own unique pain needs--is supported throughout the following pages. We would like to thank the Anesta Corp. and Abbott Laboratories, Hospital Products Division, for making this supplement possible through an educational grant. We know that not only our colleagues but our patients and their families will greatly benefit from the information presented.

Preventing pressure ulcers in home care patients.

Abstract: A large proportion of home care patients present with pressure ulcers, and many more patients are at risk. Home care nurses have an opportunity to manipulate favorably certain environmental factors that can prevent pressure ulcers from forming and to develop effective treatment plans for ulcers once they occur. This article discusses the current practice for pressure ulcer prevention. Next month, a companion article will explore treatment strategies for these wounds.

Integrating disease management and wound care critical pathways in home care.

Abstract: This article discusses the need for an integration of the concepts of disease management and critical pathways as a foundation of a healthcare delivery system. The steps in the process for development, implementation, and evaluation of a wound care critical pathway are reviewed and variance classifications are defined. Co-pathways and algorithms are presented as methodologies for dealing with variances. A template of a wound care critical pathway that has been developed for use in the home care setting is included.

Life on a ventilator.

Abstract: The increase of patients living at home on ventilator support has become a challenge because few nurses have had training in the care of patients. As the number of patients increases, patients and their caregivers need the support of home healthcare nurses for this to be a successful and positive experience. This personal account of life on a ventilator, written by an esteemed nursing educator and practitioner, gives nurses insight into ways they can be most helpful to these patients.

Using nurse practitioners in home care. A report of two pilot projects.

Abstract: Currently, nurse practitioners are not being employed by home care agencies due to problems related to reimbursement by third party payors, physician reluctance, and scope of practice concerns. This research describes client conditions and advanced practice services that home care nurses have identified as useful for the delivery of quality care.

Caring for vascular leg ulcers: essential knowledge for the home health nurse.

Abstract: Vascular leg ulcers are a significant clinical problem. Home health nurses play a critical role in caring for clients with vascular leg ulcers and require an understanding of the pathogenesis and treatment of these ulcers. This article differentiates the pathogenesis of venous and arterial ulcers and describes the critical aspects of their treatment. Interventions include modifying activity, promoting blood flow, applying compression therapy, providing local wound and skin care, improving nutrition, and treating infection.

How to assess and intervene in domestic violence situations.

Abstract: The increasing incidence of domestic violence in America requires home care nurses to have a broad understanding of the problem. This article outlines the extent of domestic violent and lists specific ways in which nurses can integrate screening for domestic violence into routine assessments. Specific interventions and a comprehensive resource guide are provided.

Who supports elderly African Americans in adhering to their healthcare regimen

Abstract: Knowing who supports elderly African Americans in adhering to their healthcare regimen is vital information. This study found that the majority of elderly individuals discussed their chronic illnesses and problems related to managing their illnesses with family members rather than with formal providers. Additionally, family members were also significant in coordinating transportation; assisting with managing medications, diet, and exercise regimens; and monitoring symptoms of chronic illnesses. These findings provide direction on how to develop effective care plans and affect positive outcomes for elderly African American clients.

Collaborative home practice: nursing and occupational therapy ensure appropriate medication administration.

Abstract: Interdisciplinary collaboration in home healthcare practice can help to generate successful outcomes for patients. However, effective collaboration requires that disciplines have a thorough understanding of team members' respective roles, use their team members' expertise effectively, and have a willingness to work together to solve problems and integrate interventions. In this case study, nursing and occupational therapy collaborated to maximize one patient's independence in medication administration.

One nurse's experience with technology.

Abstract: This article examines the positive and negative aspects of working with a documentation and information management system from the unique perspective of a practicing home care nurse who was also a student. Aspects of the nightingale tracker technology that are comparable with others used in home care, experiences of field testing, and the nurse's observations can help home care nurses see how this technology can benefit their practice.

Becoming aware: knowing yourself to care for others.

Abstract: This article describes the four quadrants of a whole person as a model of balanced health, then focuses on the natural emotions that volunteers and professionals encounter in hospice work. The significance of self-awareness in emotional and spiritual realms is emphasized to assist hospice workers in providing high-quality care and in nurturing themselves for the long term.

Nutrition-focused physical assessment.

Abstract: Although it may seem that the nutrition-focused physical examination adds more time to the visit, the exam can be done in less time than a complete physical assessment With practice, it can be built into your routine visit without adding significant additional visit time The benefit of this type of examination will more than pay off in determining a baseline assessment that will allow a comprehensive plan of care to be developed In the long-term, initial and continual assessment of a patient's nutritional status and progression toward appropriate outcomes will actually help your patient and you save you time and money and will result in less complications and better outcomes

Managing diabetic foot ulcers.

Abstract: This article discusses optimal care for a diabetic foot wound including use of a protocol with standards for assessment, treatment, and prevention. Patient and family education is also pivotal to the plan's success.