NR 443 Week 4 Assignment – Community Settings and Community Health Nursing Roles

NR 443 Week 4 Assignment – Community Settings and Community Health Nursing Roles

The community health setting I chose for this week’s discussion is home health nursing. Home healthcare was initially reserved for wealthy citizens that could afford to hire doctors and nurses to come into their homes and care for them or their family members. By the end of the nineteenth century, this luxury was extended to the poor to prevent the spread of contagious diseases. By the 1930s and 1940s, the increasing number of chronically ill patients was compromising the capacity of hospitals (Fulmer, 2017). Since the hospitals were assuming more and more responsibility for patient care costs, they decided it wouldn’t be unreasonable for chronically ill patients to be treated at home for a lower cost since the families would assume the caregiving responsibility.

While home health nurses use health promotion to improve the patient’s well-being, trying to prevent and protect patients from the effects of chronic disease is the main focus. “Leavell and Clark (1958) identified three levels of prevention commonly described in nursing practice: primary prevention, secondary prevention, and tertiary prevention” (Nies, 2019, p.7). Tertiary prevention is directed at patients that are already affected by a disease. A home health nurse would use tertiary prevention to focus on patients that have already been affected by an illness or disease and prevent the problem from getting worse. A home health nurse would also use tertiary prevention in patients that have chronic illnesses to reduce exacerbations. Education is an important part of tertiary prevention because if the patient fully understands the disease process, they can take precautions to aid inn their health. Nies (2019), uses the example of teaching insulin administration and diabetic education to a patient recently diagnosed with Diabetes.

NR 443 Week 4 Assignment – Community Settings and Community Health Nursing Roles

Not only is home health care a more affordable option, the convenience of bringing care to the home setting helps patients maintain their independence as much as possible. Home health nursing is not limited to chronically ill patients. Some home health nurses might perform wound care, long-term IV therapy of antibiotics, or nutrition therapy (Nies, 2019). Not surprisingly, one of the most important aspects of home healthcare nursing is education. Nurses are responsible for educating the patients on why a certain type of medication or method is used. Different home health agencies offer a variety of services depending on the patient’s needs. The home health nurse will assess the need for other referrals depending on the individual patient’s needs. This may include occupational and physical therapy or help from a social worker.

According to Nies (2019), changes in how Medicare reimburses for home health care visits have significantly changed over the past 20 years due to The Balanced Budget Act of 1997 (BBA) (Public Law 105–33). Before this law was passed, home health agencies were reimbursed based on whatever the agency said the service would cost, known as retrospective payments. In the year 2000, the reimbursement method was changed to a prospective payment system where the agency only receives a fixed amount based on the patient’s diagnosis and plan of care (Nies, 2019). In 2008 and 2012, the Centers for Medicare & Medicaid Services (CMS) expanded coverage for more diagnoses and allotted more scheduled therapy visits, if necessary.

Fulmer, H. (2017). History of visiting nurse work in America. Home Healthcare Now, 35(1), 33- Retrieved from: http://ovidsp.dc2.ovid.com.chamberlainuniversity.idm.oclc.org/sp- 4.02.1a/ovidweb.cgi? QS2=434f4e1a73d37e8c3511ef48f69b7c81ee7cacce1f59a0eed1e67b894426b96a6b22d28ab057 1447821494939889347a855d1dd20a4ea00b8393547f31bf82c0a01ea164e8c8f85441384d926eb4 271c6e30a3c30cad720d179ee52ff78073af96af64c04439a001d2b06e21ff87296766c5a11a225ca3 e002adff363a313f872a773b91c62635ba3827fcc63441ee3b126f1b4bd7a89202c36d63e4cd978c8 aa0bfe8f2d17b27b887e2ecc271a69b3bd0d35b927609f5af07bad5381331b4f6aa879983dac94266 8fd0e9020ac8e850337f1c7b7673357fc434ac978b4f79c41d6b03a33481d2756e8f5cc5b4ae1482a 7ba94689a5eb0b8bb4537ad4320c169

Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.

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NR 443 Week 4 Assignment – Community Settings and Community Health Nursing Roles

The purpose of this paper is to describe the community health nursing role of the home health nursing in the community setting of your choice. Health promotion nursing interventions and a professional nursing organization related to this role will also be examined.