Home Hospital and Health Education: legal documentation analysis pre COVID / Hospital a Domicilio y Educación para la Salud: análisis legislativo pre COVID

Introduction: Hospital from home (HH) is a valid and stable alternative to the conventional hospital admission. Although it has been used since early XX century only recently was implemented in Portugal, on the public sector. Health literacy is a sine qua non condition to exercise of citizenship and informed consenting.Method:document analysis based on a review process of public legal documents from the last 5 years related with the implementation of HH and the development and role that health literacy plays on the process on HH. A discourse analysis was undertaken after documents gathering.Results:a total of 27 documents were recovered from the Portuguese public legal database (Diário da República Portuguesa). From those, a total of 3 versed HH. Discourse analysis presented the lack of emphasis on health literacy on the documents and, thus, on the legal fundamentals of implementation of HH units.Conclusions:Health literacy is a key element to included individuals on their health seeking behaviors and to manage their own health balance. Thus, to accept a different kind of hospital admission (when conditions are met) individuals should be provided with fundamental tools to overcome and develop their health literacy and to have an informed decision and consenting. Health literacy and health education are the core of HH units and, therefore, should be present on the discourse that establishes the units implementation on a legal basis. (AU)

Introducción: La Hospitalización Domiciliaria es una alternativa válida y competente al internamiento clásico. No obstante, a pesar de contar con una existencia desde el siglo XX, solo recientemente fue una opción concreta para los pacientes del Serviço Nacional de Saúde. La educación para la salud y la alfabetización en salud son criterios fundamentales para un ejercicio de ciudadanía plena y acceso a cuidados de salud.Método:Estudio de análisis documental basada en una revisión de los documentos legales (leys) de los últimos cinco años (2015-2020) y relacionado con la hospitalización domiciliaria y alfabetización en salud y educación para la salud. Al final se realizó un análisis discursivo de los documentos elegidos.Resultados:Un total de 27 documentos resultaron de la búsqueda en el website del Diário da República Portuguesa Online. Dentro de este, 3 eran del Ministério da Saúde y su alcance era la Hospitalización Domiciliaria. El análisis discursivo demostró que no hay énfasis en el soporte legal para la Hospitalización Domiciliaria y sus unidades sobre la educación para la salud o alfabetización en salud.Conclusiones:La educación para la salud y la alfabetización en salud son promotores de comportamientos saludables y el conocimiento puede servir para manejar enfermedades crónicas. La Hospitalización Domiciliaria maneja, mayoritariamente, enfermos con condiciones crónicas en fase aguda. La Hospitalización Domiciliaria es un contexto importante para desarrollar procesos de educación para la salud y promoción de la alfabetización en salud. Es fundamental que la documentación que regula el funcionamiento de la Hospitalización Domiciliaria tenga suporte para intervenciones para la promoción de la alfabetización y educación para la salud. (AU)

[Home blood transfusion in France: Benefits and development terms]. / Transfusion à domicile : intérêt et conditions de développement dans le contexte français.

OBJECTIVES: Patients with cancers or malignant homeopathies can suffer from chronic anemia and be regularly transfused in hospitals. Most of the time, their performance status is low. Few local structures currently provide blood transfusion services and patients have to go under difficult and costing transportation to the hospital. The objective of this work is to evaluate benefits and development terms of home blood transfusion for patients with chronic anemia and having to get transfused regularly. METHODS: A field investigation-mixing observations and interviews and a literature review were conducted. RESULTS: Home blood transfusion represented a little part of home health care activity. When it was practiced, its organization was heterogeneous: it was sometimes performed by a doctor, sometimes by a nurse. Home blood transfusion was benefic for patients: it was more comfortable and it allowed them to avoid harmful transportation to the hospital. Few adverse events occurred during various experiments, all were mild. Before its revaluation in March 2018, home blood transfusion was not enough funded by National health insurance. Home blood transfusion also suffered from a lack of framework until the publication of recommendations in April 2018. CONCLUSIONS: Lack of a framework and sufficient funding prevented home blood transfusion development until changes that occurred in 2018. Therefore, this activity should develop in years to come. Allowing reducing unnecessary hospitalizations, home blood transfusion fit into French health national strategy.

Time pressure and regulations on hospital-in-the-home (HITH) nurses: An on-the-road study.

This study investigated both causal factors and consequences of time pressure in hospital-in-the-home (HITH) nurses. These nurses may experience additional stress from the time pressure they encounter while driving to patients' homes, which may result in greater risk taking while driving. From observation in natural settings, data related to the nurses' driving behaviours and emotions were collected and analysed statistically; semi-directed interviews with the nurses were analysed qualitatively. The results suggest that objective time constraints alone do not necessarily elicit subjective time pressure. The challenges and uncertainty associated with healthcare and the driving period contribute to the emergence of this time pressure, which has a negative impact on both the nurses' driving and their emotions. Finally, the study focuses on anticipated and in situ regulations. These findings provide guidelines for organizational and technical solutions allowing the reduction of time pressure among HITH nurses.

[Home blood transfusion]. / Transfusion en hospitalisation à domicile.

CONTEXT: The development of alternatives to hospitalization including home medical care (HAD), an aging population and a more secure transfusion raises the question of the feasibility of home blood transfusion. The legislation allows the home blood transfusion under specified conditions, but when they are met, the texts on nursing care and the transfusion gesture may hamper this progress. METHODS: We report our experience of 3 years: a protocol was established to do home blood transfusions by trained transfusion nurses from the HAD. Six patients were eligible for transfusion at home but only three of them could be treated at home. Moreover, since late 2009, the Nursing Department no longer allows this practice for legal reasons. At the same time, a questionnaire was sent to 224 HAD to find out about their practice on the subject. DISCUSSION: In the light of practices in different countries, earnings for the quality of life of the patient, lack of space in hospitals and the aging population, it seems essential to change the law to permit a rational transfusion, thoughtful, safe for the patient at home and for caregivers who are involved.

Normas de internación domiciliaria / Rules for home care

El presente artículo relata la elaboración de las Normas de Organización y Funcionamiento de Servicios de Internación Domiciliaria para la República Argentina, destacando el aporte de la representante de enfermería. A continuación se detalla el contenido de la Resolución 704/200 sobre las mencionadas Normas

Normas de internación domiciliaria / Rules for home care

El presente artículo relata la elaboración de las Normas de Organización y Funcionamiento de Servicios de Internación Domiciliaria para la República Argentina, destacando el aporte de la representante de enfermería. A continuación se detalla el contenido de la Resolución 704/200 sobre las mencionadas Normas (AU)

[Legal social status of management with portable liquid oxygen devices in Germany]. / Zur sozialrechtlichen Situation der Versorgung mit tragbaren Flüssigsauerstoffgeräten in der Bundesrepublik Deutschland.

This survey is based on three successful German sociolegal court proceedings instituted against relevant statutory medical cost bearers in respect of providing pulmonary patients with portable light-weight oxygen equipment. The sociolegally relevant indications for liquid oxygen treatment are described contrasting with conventional oxygen suppliers such as concentrators or steel flasks. Also detailed are the sociolegally appropriate prescription procedures for patients suffering from chronic respiratory insufficiency who can be mobilised by treatment with oxygen.

Public policy out of control. The home health care experience.

The home health care delivery system is facing challenges that threaten its survival as well as its very essence. Currently, the federal government provides the threat of disaster for home care patients, staff, and organizations. The dangers are palpable and very real. Although the immediate survival threat is fiscal, there are two other areas which have the potential to be equally devastating. The first is reduced, in some instances absent, patient access to care at home. The second is the flight of professional and paraprofessional personnel from home care.