The physician as a member of the home healthcare team

The physician is a vital member of the home healthcare team. Based on the Medicare legislation and regulations. The physician's participation is required for patient care and agency reimbursement. The home health care nurse is the important link between the patient and the physician. The compliance with, and sharing of, information related to the clinical, administrative, legislative and regulatory aspects of care benefits the patient, family, physician, nurse and the home health agency.     

The home as a framework for health care

A 6-month-old infant presenting initially with clinical signs of bronchiolitis developed acute symptoms of large airway obstruction and respiratory failure despite treatment for bronchiolitis. Endotracheal intubation and oxygen therapy resulted in immediate and dramatic improvement of respiratory failure. Plain chest radiograph, computerized tomography and surgical biopsy with subsequent histological examination established that the respiratory failure was due to a mediastinal cystic hygroma.     

The role of justice in team member satisfaction with the leader and attachment to the team.

This study examined the effects of team decision accuracy, team member decision influence, leader consideration behaviors, and justice perceptions on staff members' satisfaction with the leader and attachment to the team in hierarchical decision-making teams. The authors proposed that staff members' justice perceptions would mediate the relationship between (a) team decision accuracy, (b) the amount of influence a staff member has in the team leader's decision, and (c) the leader's consideration behaviors and staff attachment to the team and satisfaction with the leader. The results of an experiment involving 128 participants in a total of 64 teams, who made recommendations to a confederate acting as the team leader, generally support the proposed model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Internet as a resource for healthcare information

The Internet provides an additional means for healthcare providers to reach their patients. As more and more healthcare providers and patients get on-line and learn to use the Internet, the value of being on-line will increase. The Internet and other healthcare computing technologies will challenge us to look to the future for new ways to create partnerships with our patients. On-line skills and technological literacy will not replace more traditional approaches to patient care, but they most likely will change the model of how care is provided. Technology is an adjunct that will serve us well if it is incorporated as part of a multidimensional patient care environment. Above all, we will need to continue to foster good interpersonal relationships with patients to encourage ongoing dialogues about information obtained from all resources.     

Grant writing rewards the community and the home care team

We have found it well worth the time and effort expended to write grants. Results have benefited the community in lives saved, long-term disability prevented, human suffering reduced, parents empowered, and more than 30,000 St. Louis families served. The only way to learn grant writing is to just do it! Writing grants is a vehicle to community service. The potential rewards are immeasurable for both the community and yourself.     

The Diabetes Center home care nurse: an integral part of the diabetes team

The changing face of health care and the widely variable needs of families have forced practitioners to change the traditional education approaches for pediatric patients with diabetes. Initial management and education for pediatric patients with newly diagnosed type 1 diabetes is now moving to the outpatient setting. The Diabetes Center for Children (DCC) at The Children's Hospital of Philadelphia has created an innovative program using a diabetes home care nurse as its coordinator. The role of the home care nurse is to manage and coordinate all of the diabetes education done by the field nurses in the Children's Hospital home care department. This program has enabled the DCC to manage and educate families during an initial 3-day inpatient stay, providing a safe transition to home. With follow-up by trained home care nurses, the families receive advanced education and support in their homes. The evolution of this program over the last several years has shown that patient care can be moved safely from a complete inpatient format to one that includes a large outpatient component.     

Nursing practice and patient care in a changing home healthcare environment

In this study, lenses of autopsy eyeballs, anterior capsules including lens epithelium taken during operation for cortical cataract, after cataract tissue obtained at the time of operation, and Elschnig's pearles and Soemmerring's ring from autopsy eye-balls were examined for a variety of factors, such as growth factors, cytokines, bioactive substance factors, cytoskeleton proteins and extracellular matrices by immunocytohistochemistry. Preoperative lens epithelium expressed epidermal growth factor (EGF), EGF-receptor (R), fibroblast growth factor (FGF), FGF-R, interleukin (IL)-1-RII, tumor necrosis factor-alpha (TNF-alpha), plasminogen activator inhibitor type-1 (PAI-1), keratin and laminine. In addition to the above factors, opacified fibrous capsule in after cataract expressed transforming growth factor-beta (TGF-beta), insulin-like growth factor-II (IGF-II), platelet derived growth factor-AB (PDGF-AB), IL-6, prostaglandin-E2 (PG-E2), alpha smooth muscle actin, fibronectin, and I and III to VI type collagen. Elschnig's pearls expressed FGF-R, TNF-alpha, and laminin. Soemmerring's ring expressed EGF, FGF, FGF-R, IL-1-RII, keratin, tissue-PA, and PAI-1.     

The impact of the Balanced Budget Act of 1997 on home healthcare agencies and nurses

"Medicare home health agencies are facing a regulatory purgatory as measures to reduce home health spending by about $16 billion over five years take effect with little government guidance. Home health providers are grappling with new surety bond requirements, the banning of venipuncture as a qualifying procedure for other home health services, and an interim payment system to scale back reimbursement levels before a prospective payment system takes effect in fiscal year 2000" (Cassil, 1998). The challenges of surviving and conquering all of the current issues facing home healthcare nurses and agencies seem overwhelming. All of these legislative and regulatory issues with the resulting financial and clinical implications are occurring as agency staff and administrators continue to provide quality home healthcare services to patients of all ages. Please share your strategies for meeting the challenges of 1998 with the editor.     

Understanding the positive social psychological benefits of sport team identification: The team identification-social psychological health model.

This article presents a theoretical model designed to account for the positive relationship between identification with a local sport team and social psychological health. This model, labeled the Team Identification-Social Psychological Health Model, predicts that team identification facilitates well-being by increasing social connections for the fan. Two forms of social connections are developed through team identification: enduring and temporary. Although the enduring and temporary social connections are expected to result in improved well-being, it is predicted that this relationship will be moderated by threats to social identity and efforts to cope with the threats. The social connections resulting from team identification are expected to impact both state (via increases in temporary social connections) and trait well-being (via enduring connections). Finally, because research indicates that group and team identification are more closely related to social well-being than personal well-being, temporary and enduring social connections are predicted to have their greatest impact on social psychological health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hospital admission rates and the primary health team

The use of hospital beds was studied for a period of one year in a practice under the care of a closely co-ordinated team composed of the family physician, the family nurse, and a medical social worker. Admission rates and mean duration of stay in hospital are analysed and discussed in relation to selected socio-demographic variables.The results showed that the study population used only half as many hospital beds when compared with national rates in Israel. We consider that this was achieved by the provision of planned co-ordinated comprehensive medical nursing and social services for patients suffering from long-term illness. Such a team is able to provide a high quality medical care and can significanlty reduce the use of in-patient hospital services.     

Administrative issues in health team development: report of a workshop

Conventional microbiological assay procedures for cephalosporins in serum do not allow the determination of serum concentrations if more than one cephalosporin is present in a single sample. An HPLC procedure has been developed which permits the simultaneous quantitative determination of cefazolin sodium and cephalothin sodium in serum. Reverse phase chromatography using methanol in 0.2 M ammonium acetate as the mobile phase was employed to separate and quantitate the two cephalosporins in a trichloroacetic acid supernatant solution prepared from serum.