Person-Centered Care at Home

Activity 2:

The article by Lee et al. (2017) mentions that increase in the elderly population who require long-term care has led the professionals to develop alternative care. This is because traditional hospital-based care model is found not to be efficient in delivering satisfactory care. In the Hospital in Home (@home service) care, integrated person-centred care is seen to be formed which is delivered directly in the home of the elderly patients without making them leave it and get admitted to the hospital. The initial benefits of @home service care is that it lowers the care cost for the patient along with reduce changes of acquired infection the hospital, emotional issue with being at the hospital and other. The Hospital in Home care was established in 2013 as mentioned in the study by Guy’s and St Thomas’ NHS Foundation Trust. It was developed with the aim to prevent re-admission and avoidable hospital admission of elderly patient to save valuable hospital bed for more complex health condition of other individuals.

Lee et al. (2017) mentions that Hospital in Home service delivery to Mrs T who is a 78-year-old individual is explained who has been referred for the service by the London Ambulance Service. The study informs that practitioner-to-practitioner referral is made in @home services so that the patient can receive care under professional assistance. In the @home service for Mrs T, the study mentions that thorough physical assessment was initially made to determine her physical health condition. She is reported to have COPD exacerbation and the physical assessment led to identify that she is suffering from the risk of heart failure. However, only after laboratory test and electrocardiogram, the @home nurse developed her specific treatment plan. The patient was provided initial medication based on her clinical symptoms but it was later changed to provide specific medication and intervention on the basis of health report. This indicates that @home nurse provides primary and effective secondary care to the service users. The study also reflected that @home care is available 365 days and 24 hours along with continuous monitoring of the patient is made each day minimum four times. The @home nurse arranged emergency practitioner when needed by Mrs T, provided her care through team-based approach and forming partnership with multi-disciplinary professional and met her spiritual needs ensuring they provided holistic care to Mrs T.

The big key message conveyed by Lee et al. (2017) is that Hospital in Home service is effective for the elderly to deliver them care similar to the hospital at home. The @home care is available 365 days and 24 hours along with continuous monitoring of the patient is made each day minimum four times. Thus, no gap in care while receiving support at the home would be faced by the patients. Moreover, this nature of care would be effective for elderly patients in making them avoid facing stress and anxiety while being in the hospital that is away from home.

Activity 3:

The article led me to develop the knowledge as a future adult nurse is that providing care to the elderly at home is effective health intervention for those patients for whom the health problem raised in avoidable hospital admission. The study also mentioned that as a future adult nurse I need to meet the physical as well as spiritual needs of the elderly to offer them holistic care. The NMC Code of Conduct mentions that the confidentiality of the patients is to be maintained (NMC, 2018). This aspect of the Act is able to be met by me as a future adult nurse as the main article continuously informed in the case study the way through the use of anonym the patient's identity can be protected. The main article mentioned that elderly and their family members feel very satisfied with @home service as their medication as well as other health intervention is appropriately met. The fact is supported by the other article of Facultad and Lee (2019) where it is mentioned that out of 1462 participants surveyed who received @home care nearly 97% reported they are very much satisfied with the care in all aspects. The main article reported that @home service is alternative care for hospital admission and readmission that could be avoidable. The fact is supported by Dilwali (2013) who mentioned that increased number of elderly release from the hospital has led many of them to develop non-adherence to medication and management of effective health out of continuous care support. However, use of @home services are effective to resolve the issue and ensure them avoid deterioration of health that leads to avoidable readmission in hospital.

Activity 4:

References

• Dilwali, P.K., 2013. From acute care to home care: The evolution of hospital responsibility and rationale for increased vertical integration. Journal of Healthcare Management, 58(4), pp.267-276.
• Facultad, J. and Lee, G.A., 2019. Patient satisfaction with a hospital-in-the-home service. British journal of community nursing, 24(4), pp.179-185.
• Lee, G., Pickstone, N., Facultad, J. and Titchener, K., 2017. The future of community nursing: Hospital in the Home. British journal of community nursing, 22(4), pp.174-180.
• NMC 2018, Professional standards of practice and behaviour for nurses, midwives and nursing associates, Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed on: 16 October 2020]

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