When it comes to home care people think that wounds will heal even if healing of it may not be the possible or an appropriate goal. Ideally, treatment goals can shift from primary focus on healing of the wound to patient comfort especially for those patients who have:
- A relatively short life expectancy
- Poor tissue perfusion and
- Inadequate nutrition.
In such situations, the treatment goal may shift from healing to different other aspects such as:
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- Patient comfort
- Prevention of any complications
- Reducing the pain
- Managing exudate
- Preventing odorand
- Providing optimal functional capacity.
There are different objective measures that are used to determine the type of focus to be given that will increase the probability of the wound to healin response to an aggressive local intervention. These objective measures include:
- The characteristics of the wound
- The overall health status of the patient
- Functional and nutritional status of the patient
- Family support available and provided
- Different comorbiditiesand
- Blood values.
In addition to that the identified factors that may impede the wound healing process may also be used to educate the patient as well as the family members about the fact that existence of a wound is an implication and a symptom of deteriorating health and is not the fault or due to the failure of the caregiver or the clinician.
Engaging the patients
A professional has to perform different jobs in health care and one such job, and the most important one at it, is to provide proper medication on time so that the effectiveness of the care process is retained and delivered.
In order to address these challenges to medication reconciliation there are numerous different strategies that the home care giver may implement. These strategies will ensure that the medication reconciliation is completed effectively. One such useful strategy is to engage the patients and caregivers.
Patients ideally play the most significant role in medication reconciliation. This is because they are the only one who is more knowledgeable about their own health. It is for this reason it is assumed that the medications they are taking are far better equipped to become the active participants in the medication reconciliation process.
Ideally, it is seen that the patient participation in medication reconciliation is significantly increased when:
- They are provided with reminders before a visit to have all their current medications available for inspection
- Asked to bring the updated list of their medications
- The importance of it is reinforced by the nursesand
- A list of the reconciled medication list is provided to the patients.
It is therefore necessary to engage the patients and educate them about how exactly medication reconciliation may improve the safety and quality of their care as well as the important role that they play in the healing process.
- Patients in fact should be encouraged to keep a track of themedications they take and make sure that the list is updated on a regular basis.
- They are also required to share this list with the healthcare providers. All of them if there are multiple providers.
- They must be introduced to different record-keeping tools such as PHR or online Personal Health Recordsand patient portals that are often available through theprimary care provider.
If any patient is not willing to use the electronic record keeping systems, they can be encouraged to use paper-based resources. One such useful resource is “My Medicine List” that is developed by the American Society of HealthSystem Pharmacists.
Adoption and use of EHR in home care
Over the past few years, the adoption and use of the Electronic Health Record has increased significantly in a nationwide basis. This is because the financial incentives of the meaningful use of this program. This allows more effective information sharing.
- This information sharing effectively facilitated in home healthcare sector by the use of an EHR has enhance communication between the home care providers.
- This has also provided them with an easy access to the info of the outside providers.
- The home care givers now can have a better and clearer picture of the medical conditions of the patients.
All these has facilitated the current medications greatly ensuring a more effective medication reconpractice.
In addition to that, the integration of data and infocollected by the home healthcare providers can fill the void of important information that is normally not received by any other healthcare provider.
Need for home care policy change
However, it is sad to know that only about only 44% of all of the home healthcare service providers and hospice agencies have adopted the EHR. The primary reason of such a low adoption rate may be attributed to the fact that most of the home health care providing agencies are not eligible to put this program to a meaningful use.
This signifies that there is an immediate need for a change in the policy so that it allows the home healthcare agencies and providers to participate in the federal health information technology incentive programs. It is only then that the home healthcare agencies will be able to make a meaningful use of the framework and get involved in EHR adoption more effectively and readily.
Medication, as always, has remained an important part or the health care process. This ensures safety of the patients. It also improves the quality of care across home care settings. Though there are several barriers that hinder the optimization of the medication reconciliation process, it can be made more effective in many different ways such as:
- Developing a more standardized process
- Evaluating the recon process on a regular basis and
- Forming an internal and external interprofessional relationshipand team.
However, of all, engaging the patients along with the caregivers to make them more knowledgeable about it and their healthseems to be the best way.
This will ensure that the patients take their medicines on time and as prescribed. They will even let the attending nurse of care giver know if they experience any symptom after taking any medicine. This will help further in the recon process.