As a veteran home health nurse and nursing educator, I am constantly looking for best-practice protocols and guidelines. I purchased the 2nd edition of "Teaching IOM-Implications of the Institute of Medicine Reports for Nursing Education" authored by Anita Finkelman and Carole Kenner. This started my thinking about the concepts of core competencies and how they relate to home health practice.
The core competencies identified are:
* Provide patient-centered care
* Work on interdisciplinary teams
* Employ evidenced-based practice (EBP)
* Apply quality improvement
* Use informatics
The October issue of Home Healthcare Nurse contains articles relating to and fostering these competencies. Patient-centered care is what home healthcare is all about as we are one-on-one with patients during home visits. The ability of home health clinicians to quickly assess the patient and their family unit in order to develop individualized care plans is one of our greatest strengths.
For many years, nursing has been studying of quality of life and using best practice/EBP. Mellisa Hall's article "Chronic Pancreatitis: An Update for Home Care and Hospice Clinicians" and Sibel Ergun, Esma Sulu, and Zumrut Basbakkal's piece entitled "Difficulties Experienced in Home Care by Mothers of children with Hemophilia" are both directed toward best-practice knowledge in the clinical setting. The Visiting Nurse Associations of America column entitled "Evidence-Based Care, Best Practices and OASIS-C" by Mary Narayan weaves EBP and Outcome and Assessment Information Set (OASIS)-C together in a positive way to explain our ability to use this knowledge to raise the level of our practice. Interdisciplinary teams can consist of transition team members, as well as members of the various disciplines in home healthcare and hospice. Donna Berry and her colleagues describe best practice throughout the transitions of home care in "Preventing Avoidable Hospitalizations-Implementing the Transitional Care Model in Home Care Utilizing Evidenced-Based Practice."
The concept of applying quality improvement in wound care is well illustrated in the articles Programs That Work-"Reduction of Pressure Ulcer Incidence in the Home Healthcare Setting" by Stephanie Hill-Brown and the CEU article "Assessment of Surgical Wounds in the Home Health Patient: Definitions and Accuracy With OASIS-C" by Rhonda Trexler.
In home healthcare, we are continuously performing and overseeing our success at measuring and achieving quality through OASIS-C, a topic that affects agencies fiscally and comparatively. Many home health staff who are using laptops for their documentation and electronic medical record can relate to the use and growth of informatics in our industry.
The five core competencies are the future direction to assure quality staff in the health professions and the October issue of Home Healthcare Nurse ties these core concepts to best practice and clinical practice.
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