Reference no: EM133846981
Assignment : Case Study - Home Health Care
Mr. Tan, a 70-year-old widowed Asian male, has an occlusive peripheral arterial disease with resultant unhealed right leg anterior tibial area ulcer of 3 cm by 4 cm. He is diagnosed with hypertension and failing eyesight, placing him at further risk for potential foot injury with ulceration. Mr. Tan is physically inactive since his wife died two years ago. He depends on a neighbor to shop, cook meals, clean the house, and take care of him at home. He recently underwent surgical debridement of the ulcerative area and has been discharged to home health care.
The home health nurse determines that Mr. Tan's Medicare will pay 100% for skilled nursing care to perform wound care and dressing changes and to monitor his medications 2-3 times per week. A physical therapist will visit 2 times per week to address Mr. Tan's deconditioned state. A home health aide will visit 3 times per week to help with activities of daily living. A social worker will visit to evaluate his living situation, need for other services, and/or assistance to obtain medications.
Homecare nurses provide intermittent care and rely heavily on clients' ability to self-manage their health problems. As such, the nurse is in a unique position to apply frameworks for practice that helps the nurse work with clients to promote independence and health. Mid-range theories, applied in homecare settings to help promote clients' self-management of chronic health problems, conceptualize nursing care as based on relationships, and provide guidelines for collaborative decision making. Apply the mid-range theory of relationship-based care to your home health nursing care for Mr. Tan and his caregiver. What steps would you, as the home health nurse, and other team members take to establish relationship-based care that recognizes the complexity of Mr. Tan's chronic illness experience? What challenges might you encounter? How will you meet those challenges?
Homecare nurses and agencies are in an excellent position to incorporate the role of care coordinator into the role of the nurse because homecare nurses often treat individuals who are at high risk for complications of chronic disease. How would you, as the home health nurse, enact the role of care coordinator for Mr. Tan and his caregiver? What does effective care coordination involve? What are the goals of the care coordination process?
Employing relationship-based care with clients involves engaging with clients to accomplish care goals rather than focusing solely on the tasks of care. What can the nurse do to further these goals? Upon what five nursing capacities should the nurse base his or her nursing action?
The desired outcomes for home health care in the management of the client with chronic illness seem initially to be quite apparent. The positive effects of the health care delivered in the home to the client, as well as the positive effects of the caregiver support mechanisms that keep the client at home and do not necessitate institutionalization, are clearly important outcomes. However, establishing outcome criteria that are stable and dependable so as to measure outcome attainment is essential for determining whether positive effects are occurring to the advantage of the client and caregiver or simply because there is no alternative to providing care. What outcome measures will you include in your evaluation of the outcome attainment with Mr. Tan?
Assignment adapted from the Publisher Resources for Lubkin's 10th edition Chronic Illness: Impact and Intervention by Pamela Larsen, Copyright 2019. Jones & Bartlett, all rights reserved.