Integrating Home Care: An Innovative Approach for Simulation Learning.

BACKGROUND: The nature of a nurse's job is changing dramatically. Nurses are assuming expanded roles for a broad range of patients in community-based care. Nurse educators have a responsibility to teach nursing students about the needs of patients and families in the home care setting. METHOD: To describe how the creation of a home care video series and a medication reconciliation simulation scenario were used as a teaching strategy in a simulation center. RESULTS: The teaching strategy supported senior-level nursing students' understanding of the complexity of home care nursing and the nurse's role and responsibilities in care coordination, care transitions, and interprofessional practice. CONCLUSION: The home care video scenario was received favorably by nursing students. Additional simulation video scenarios are needed that address the health disparities among underrepresented and vulnerable groups. There is potential to offer the simulation in a virtual-online format during the COVID-19 pandemic and social distancing mandates. [J Nurs Educ. 2021;60(3):172-176.].

Opening the Door to an Alternative Teaching Strategy for Home Health Clinical.

BACKGROUND: Health care is increasingly shifting from inpatient to home settings. The limited availability of home health clinical experiences creates challenges for educators seeking to prepare students for providing nursing care in the home environment. The purpose of this project was to evaluate the implementation of a simulation to increase nursing students' experience in home health care. METHOD: A home health simulation was implemented with second-semester students. Effectiveness of the simulation in meeting student learning needs was measured using the Simulation Effectiveness Tool-Modified and student performance was evaluated using the Quint leveled clinical competency tool. RESULTS: The home health simulation was an effective teaching strategy to introduce second-semester students to the care of a patient in the home environment. CONCLUSION: Nurse educators can use simulation to equip students with clinical judgment skills to meet the needs of an increasing home health care population. [J Nurs Educ. 2020;59(2):97-100.].

Tecnologia educativa para cuidadores de crianças e adolescentes dependentes de cuidados especiais no domicílio / Educational technology for caregivers of children and teenagers dependent on special care in the home

Materiais educativos podem promover resultados expressivos na promoção da saúde. No entanto, a contribuição desses materiais depende do processo de elaboração e das formas de comunicação utilizadas para transmitir as informações. O estudo teve como objetivo desenvolver uma tecnologia educativa para cuidadores de crianças e adolescentes dependentes de cuidados especiais no domicílio. Estudo metodológico realizado em cinco fases: sistematização de conteúdo, escolha das ilustrações, composição da cartilha, validação da cartilha por juízes e pelos cuidadores. A cartilha foi elaborada com base em revisão integrativa da literatura e por entrevistas com 19 cuidadores. O índice de validade de conteúdo entre os juízes foi de 0,99, indicando ótimo grau de concordância. A validação semântica pelos cuidadores obteve-se um percentual de concordância de 100%. Diante dos resultados conclui-se que a tecnologia educativa teve excelente aceitação, podendo contribuir para o cuidado de crianças e adolescentes acamados em domicílio.

Educational material can promote significant results in health promotion. However, the contribution of these materials depends on the preparation process and the forms of communication used to transmit the information. This study aimed to develop educational technology for the caregivers of children and teenagers dependent on special care in the home. This is a methodological study carried out in five phases: content systematization, choice of illustrations, composition of the booklet, validation of the booklet by judges, and caregiver validation. The booklet was prepared based on an integrative review of the literature and through interviews with 19 caregivers. The content validity rating among the judges was 0.99, indicating an excellent degree of agreement. The semantic validation by the caregivers obtained an agreement percentage of 100%. Given the results, it can be concluded that the educational technology had an excellent level of acceptance, being able to contribute to the care of bedridden children and teenagers.

Nursing students contribution to rehabilitation for home-dwelling patients.

Home-dwelling rehabilitation has expanded in the last years in Norway. The goal is to strengthen self-care for those who have suffered acute impairment or has due to chronic diseases. The purpose of this study was to explore whether nursing students in home-based nursing care (HBNC) can contribute to patients' rehabilitation and mastery work during clinical placement. The study considered 121 undergraduate nursing students' HBNC clinical placements where they, in collaboration with patients, have designed and applied a rehabilitation plan. The duration of the clinical placements were 8 weeks and took place in the municipality of Oslo. Prior to the clinic placement, the students have followed an introductory course rehabilitation plan development. During the initial phase of the placement, the students an eight-step model for mapping the patient's values: 1) home, 2) close relatives, 3) physical activities, 4) friends, 5) job, 6) leisure activities, 7) body and appearance, and 8) spiritual and philosophical values. The students scaled the intensity of each value on a scale from 1 to 10. Through their clinical training a teacher and clinical supervisors have coached the students. The clinical placements have been followed by a written exam. Based on patients' values and resources, the students coached patients in self-care activities that brought the patients closer to their targets, whether it was on an activation or a participation level. The principal finding of this study was that the students in HBNC were adequately prepared to plan and carry out rehabilitation activities with patients.

[How can employers support home care nurses' continuing education and nursing professional development at workplace? Results of a Canadian qualitative survey.] / Comment l'employeur peut-il soutenir la formation continue et le développement professionnel infirmier Résultats d'une étude qualitative canadienne auprès d'infirmières de soutien à domicile.

INTRODUCTION: this article provides a new knowledge on employer's support for home care nurses' continuing education. CONTEXT: so far, literature has sustained that providing support to nurses in continuing education is mainly a matter of money. However, only few researchers have been interested in home care, especially in continuing education. OBJECTIVE: one of the objectives of the survey was to identify factors that could influence nurses' commitment, participation and choice in the matter of continuing education activities. METHODS: a qualitative survey was conducted with eight nurses, coming from one clinical home care setting (Québec, Canada), who participated in a semi-structured individual interview. Thematic analysis was used. Results were validated by intra- and inter-rater controls. Furthermore, participants were involved in the process of validation. Results have shown that support given by the employer in the matter of continuing education can be seen into five different aspects : financial, training, affective, instrumental and normative. Despite a lack of financial and training support, most of home care nurses have a positive perception of their employer's support. DISCUSSION: nevertheless, employers should pay more attention to nurses' needs. To do so, nurses should be involved into the process of continuing education at their workplace.

Aprendizagem reflexiva de enfermeiras na atenção domiciliar: caminhos para uma práxis criadora

A realização deste estudo partiu da premissa de que existem distanciamentos entrea formação acadêmica de enfermeiros e os processos necessários para a atuaçãona atenção domiciliar. Em consequência, a invisibilidade da atenção domiciliar naformação de enfermeiros lança a necessidade de aprendizagem em seu contexto deatuação, gerando implicações em sua práxis. A tese foi construída com sustentaçãonas categorias teóricas: Aprendizagem reflexiva e Práxis, segundo os referenciais deDonald Schön e Adolfo Sánchez Vázquez, respectivamente. Objetivou-se analisar oprocesso de aprendizagem e a práxis do enfermeiro na atenção domiciliar. Foirealizado um Estudo de Caso único, de natureza qualitativa, ancorado no referencialteórico-metodológico da dialética. A produção dos dados teve como cenário osserviços de atenção domiciliar do Sistema Único de Saúde dos municípios deUberlândia e Betim, em Minas Gerais, e aconteceu em dois momentos: observaçãoparticipante da atuação de treze enfermeiras e realização de entrevistas. Os dadosforam submetidos à Análise de Discurso Crítica, na perspectiva de Fairclough,possibilitando a discussão de três categorias empíricas: Prática da enfermeira nodomicílio: fazeres e saberes mobilizados pela reflexividade; Aprendizagem reflexiva:situações, fontes e mediadores; e Práxis no trabalho da enfermeira no domicílio. Osresultados indicaram a presença de fazeres e saberes mobilizados pela práticareflexiva da enfermeira no domicílio em um movimento contínuo e cíclico deaprendizagem evidenciado pelas práticas discursivas...

The execution of this study started from the premise that there are estrangements between the academic training of nurses and the processes required for working in home care. As a consequence, the invisibility of home care in the training of nurses highlights the need for learning in its work context, thereby generating implications in its praxis. The thesis was built on the basis of the theoretical categories:Reflective learning and Praxis, according to the frameworks of Donald Schõn and Adolfo Sánchez Vázquez, respectively. This study was intended to analyze the learning process and the praxis of the nursein home care. We performed a unique Case Study, with a qualitative nature, which was anchored in the theoretical-methodological framework of dialectics. The production of datatook place in home care services of the Unified Health System in the cities of Uberlândia and Betim, in Minas Gerais, and happened in two moments: participant observation of the work of thirteen nurses and accomplishment of interviews. The data were submitted to Critical Discourse Analysis, under the Fairclough‘s perspective, which enabled the discussion of three empirical categories: Practice of the nurse at home: actions and knowledge mobilized by reflexivity; Reflective learning: situations, sources and mediators; and Praxis in the work of the nurse at home. The results signalized the presence of actions and skills mobilized by the reflective practice of the nurse at home in a continuous and cyclical movement of learning evidenced by the discursive practices...

Atenção domiciliar ao idoso com demência: uma revisão narrativa da literatura / Home care for the elderly with dementia: a narrative review of the literature / Atención domiciliaria a ancianos con demencia: una revisión narrativa de la literatura

Trata-se de uma revisão narrativa da literatura sobre os cuidados ao idoso com demência em âmbito domiciliar. Os resultados apontaram as atividades práticas, a sobrecarga e os sentimentos atribuídos pelo cuidador ao processo de cuidar do idoso com demência. A literatura nacional apresenta relevante produção sobre o tema; contudo, a literatura internacional descreve de forma bem-pormenorizada as atividades de cuidado. Conclui-se que há necessidade de incremento em estudos e pesquisas em âmbito nacional, que apresentem de forma bem mais detalhada as atividades desenvolvidas pelo cuidador.

This is a narrative review of the literature on care for the elderly with dementia in the home environment. The results showed the practical activities, overload and feelings of the caregiver. The national literature presents relevant production on the subject; however, the international literature describes in detail the care activities. One concludes that it is necessary to increase the studies and researches at the national level, showing in detail the activities developed by the caregiver.

Esta es una revisión narrativa de la literatura sobre la atención a los ancianos con demencia en el entorno del hogar. Los resultados mostraron la actividad práctica, las sobrecargas y los sentimientos del cuidador. La literatura nacional presenta la producción pertinente sobre el tema; sin embargo, la literatura internacional describe en detalle las actividades de atención. Se concluye que existe la necesidad de aumento en los estudios y investigaciones a nivel nacional, muestreando en detalle las actividades desarrolladas por el cuidador.

Exposing Baccalaureate Nursing Students to Transitional Care.

Management and facilitation of care transitions from hospital to alternative settings requires skill and attention to avoid adverse events. Several interprofessional organizations and nurse leaders have called for the expansion and redesign of undergraduate nursing curricula to include care transitions. Yet there is little evidence describing how undergraduate baccalaureate nursing students are educated on this critical topic or how successful they are in improving student knowledge about care transitions. To address this gap, an in-classroom and clinical experience was implemented to prepare students to manage and facilitate care transitions from the hospital to alternative settings-including the home. Perceptions of undergraduate nursing students and home healthcare nurse preceptors were assessed via an electronic survey that was emailed to participants. Forty-eight responses to the survey were received. Students agreed this experience contributed to their understanding of caring for adults and older adults who are experiencing a care transition and they had a good understanding of care transitions to apply to their future nursing courses. Home healthcare nurse preceptors agreed they were able to demonstrate transitional care and that students were engaged. Future work should include expanding transitional care immersion to other care settings as well as the inclusion of additional healthcare disciplines in care transition education.

Evaluating an Educational Module on Home Inotrope Therapy.

Educating home health nurses presents significant challenges for nurse educators because of the vast geographical areas served and the types of patient cared for. The integration of technology into the home health care arena offers new and innovative opportunities to address the ongoing educational needs of nurses as required by accrediting bodies. This exploratory study evaluated a Web-based educational module on home inotrope therapy in regard to nurses' perceived knowledge and confidence.

Effective nursing care of children and young people outside hospital.

AIM: To assess the preparation required to ensure a workforce of nurses who can provide high quality out-of-hospital services for children and young people. METHODS: Using mixed methods, questionnaires were sent to young people and community children's nursing teams, interviews were conducted with academic staff and clinical nurses, and focus groups were undertaken with pre-registration children's nursing students. FINDINGS: Nurses' communication skills and clinical abilities were most important to young people. There is a range of opinions about optimum out-of-hospital clinical experience. Pre- and post-qualification education and recruitment in this area, therefore, need attention. CONCLUSION: Out-of-hospital care presents problems, but is developing rapidly. Adequate, updated training, supervision and resources are needed.

A motivational interviewing education intervention for home healthcare nurses.

The ability of registered nurses to communicate well with their patients is foundational to patient-centered care, the management of chronic illness, and general healthcare. It is also vital to the nurse-patient relationship. Nurses, however, tend to identify with their patients' physical needs and rely heavily on the technical skills with which they feel more comfortable. This lack of ability to communicate well with their patients can result in poor nurse-patient understanding, can lead to poor patient outcomes, and a lack of patient engagement and involvement in their care. Motivational interviewing (MI), a patient-centered manner of communication, is a means to direct the nurse-patient interaction in a way that is patient centered. Brief education of MI has shown to be effective in increasing the self-efficacy of nurses in their ability to communicate well with their patients. In 2 geographically diverse Pennsylvania home care settings, MI education was provided to 20 nurses. The educational intervention was designed to increase the self-efficacy of nurses regarding their ability to affect the negative behaviors of chronically ill patients. A pretest and posttest was administered to the nurse participants to determine the effectiveness of the educational intervention. This evidence-based education increased the nurses' overall communication self-efficacy by 25%.

Avoiding emergency department visits for COPD, pneumonia, and heart failure: when should patients go to the emergency department?

Patients with pneumonia, chronic obstructive pulmonary disease (COPD), and heart failure make frequent visits to the emergency department. Heart failure alone is the reason for more than 1 million emergency department visits annually in the United States. This article describes strategies home care clinicians can use to prevent unnecessary emergency department visits for patients with pneumonia, COPD and heart failure.