[The role of the nurse coordinator within in-home nursing care services]. / Le rôle de l'infirmier coordonnateur en service de soins infirmiers à domicile.

Enabling a dependent person to continue to live at home requires all those involved in their care to coordinate their actions to ensure that patients' needs are respected as closely as possible. This coordination must maintain the fine balance between the patient's privacy within their home and the intrusion of the caregiving professionals.

The place of standardisation in home care practice: an ethnographic study.

AIMS AND OBJECTIVES: To explore the benefits and shortcomings of using standardised work methods in home care nursing. BACKGROUND: Health care is increasingly shaped by the use of standardised work methods. This trend is reflected in the use of management tools aimed at monitoring service quality and efficiency, as well as in the evidence-based movement that has led to a shift in focus from the practitioner to the knowledge found in guidelines and clinical protocols. This study addressed the impact of this development on home care services. DESIGN: This is an ethnographic study involving fieldwork in home care nursing in Iceland. METHODS: The study took place in one neighbourhood in an urban area in Iceland in 2010. Members of five of six home care nursing teams agreed to participate. Team leaders were observed during visits to older person's homes and at team and interdisciplinary meetings. Semi-structured interviews were conducted with the team leaders and 15 older persons. RESULTS: The results were presented as three themes: For it all to hang together, which referred to attempts on behalf of the team leaders to coordinate complex services and assistance for the benefit of each patient; Working with more advanced cases, which reflected the uptake of standardised methods to address health matters locally; and Being heard, which reflects the politics of using standardised methods. CONCLUSIONS: Standardised work methods can be helpful and are welcomed by home care nurses as long as they can also use their own discretion and draw on other forms of knowledge when needed. RELEVANCE TO CLINICAL PRACTICE: This study brought out the importance of flexibility in home care practice. Standardised work methods are welcomed and seen as helpful as long as they can be used based on the discretion of the practitioner.

Analysis of Services and Cost in CVA Patients by Severity in Hospital-based Home Health Care / 간호학회지

PURPOSE: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. METHOD: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). CONCLUSION: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.