N_Research_Project_Week11

Running Head: NURSING HOMECARE POLICY !1

Implementing Nursing Homecare Policy.

Name: Raul Rodriguez.

Institution: Florida National University.

NURSING HOMECARE POLICY ! 2

Implementing Nursing Homecare Policy

Introduction

A nursing home, also known as a care home, a convalescent home, an intermediate care

facility, a rest home or a skilled nursing facility (SNF) provides a kind of residential care. It is

a place of dwelling for persons that need, as established by a local hospital social worker

together with their nursing facility provider, routine nursing care and has considerable

difficulty performing the necessary activities of daily living (Plunkett, 2011). Nursing

assistants together with skilled nurses are present 24 hrs a day. The majority of nursing homes

are large congregate care facilities that are financed by the government. These plants are

competing or additional classes to community services-non-facility, home health, home care

and community and home-based Medicaid waiver services.

In the United States, a variety of residential nursing facilities is available (institutional

facilities and community services) that have same Medicaid government approvals and

financing via a state health department. Irrespective of whichever category a state department

belongs, such as health, intellectual disabilities, and mental health, or their mode of

operation, the government is still the financier of nursing facilities. The most important

practice in the United States is to support community Long Term Services and Supports

(LTSS) that are led by factions like the Consortium of Citizens with Disabilities, which

represent more than 200 hundred regional disability organizations.

Motives behind the implementation of the Nursing Home Care Policy

NURSING HOMECARE POLICY ! 3 The nursing home offers a cost effective approach that enables the patients that suffer from

acute illnesses, post operation care effects and injuries to recuperate outside the healthcare

facility settings. When these patients are released from the health center, the costs of

treatment and care are covered by Medicare (Beaulieu, 2012). Additionally, nursing homes

also act as the secondary care facilities that take care of patients suffering from the chronic

conditions as well as extra long-term care requirements. Also, the people with long-term

illness may probably stay in the nursing homes for a long period in their lives without

returning home and others live the remaining of their lives and even die in the hospitals.

For most of the patients with chronic conditions, they pass through a long-term process of

care that integrates the engagement of their physical and mental ability. A nursing home

basically includes the place that is developed to take care of disabilities and medical

conditions and disabilities. They also cater for of behavior issues that may be hard to manage

by any healthcare provider. There are several alternatives before deciding to take a patient to

a nursing home. However, there have been several concerns that on average, the nursing

home residents get sicker and older than they were in the past. About 91 percent of the people

in nursing homes are people that were aged above 65 years. Besides, most of the nursing

home residents use Medicare as their major form if insurance.

Taking care of patients with chronic illnesses in nursing home care facilities

Treatment of people with this condition is emphasized to be done at hospital facilities with

PCI, which is percutaneous coronary intervention or stent placement. Similarly reopening of

the blocked coronary arteries, which should be done early, will decrease the level of damage

to the heart while at the same time improve heart attack prognosis. Heart attack medical

treatment includes using anticoagulants, clot dissolving drugs and antiplatelet drugs together

NURSING HOMECARE POLICY ! 4 with angiotesin enzyme converting inhibitors. Similarly interventional treatments for these

conditions may include percutaneous transluminal, coronary angioplasty and coronary

angiography. It can also be done using coronary artery bypass and coronary artery stents.

Patients that have heart attacks are required to be hospitalized for a long period to be able to

detect and monitor heart rhythm destructions, chest pain, and short breath.

Heart attacks can be prevented through using aspirin, ACE inhibitors, and beta blockers for

those people who have the disease. It can also be prevented through stopping to smoke,

reducing weight, controlling blood pressure and diabetes, exercising regularly. It can also be

prevented through ensuring a low fat and cholesterol diet which is rich in omega 3 fatty acids,

using multivitamins as well as folic acids.

Contributions to Nursing Home Care Policy to the delivery of aged care services

The nursing home care policy has helped the elderly in some ways, which have overall

resulted in their improved quality of life. Old age apparently comes with many challenges,

and as such, facilities like home care nursing centers deserve credit for their continued

provision of health care among other services to the elderly (Cai, et al. 2011). The

contributions of the nursing home care policy are discussed below.

Essential benefits of nursing homes are around-the-clock care. The majority of nursing homes

have healthcare professional staff that work 24 hours a day. Even though doctors may be

absent in the middle of the night, nurses are highly likely to be present carefully watching

their residents throughout the evening. Compared to being at home where the greatest

challenge sons and daughters experience has the time to take care of their parents, nursing

homes do all that for them, allowing many people to attend to their commitments without

constant distractions. The majority of adults have busy plans, and depending on a person’s

NURSING HOMECARE POLICY ! 5 condition, taking care of aged relatives can end up being a full-time job. Handling such

situations on top other responsibilities is just impossible for most people. The nursing homes

relieve people of such worries in addition to ensuring the well-being of the elderly is

paramount.

Taking care of patients before and after surgery in nursing homes

Pre-surgery

Prior to surgery, some basic tests are performed, including blood tests, electrocardiogram,

carotid Doppler, pulmonary x-ray and pulmonary function. A cardiac echocardiography

evaluates its function. More specialized tests, such as a study of electrophysiology (EP), are

requested on an individual basis.

Post-surgery

After surgery, the patient is transferred to intensive care. As soon as it is stable, it is

awakened. Every effort is made to minimize pain. The length of stay in intensive care

depends on the complexity of the surgical procedure. It is typically less than 48 hours. As

soon as the patient no longer requires special supervision, it is moved to the traditional

hospital unit.

Classically, the patient can leave the hospital within ten days. He can resume his professional

activity between 2 and 3 months after the intervention (Ryan & Ingleton, 2011). It can drive

after 6 weeks. Coronary artery bypass surgery plays an important role in the treatment of

coronary artery disease, but it is not a cure. By increasing blood supply to the heart, surgery

improves symptoms and prolongs life.

NURSING HOMECARE POLICY ! 6 The patient will always need to reduce his risk factors. He can benefit from cardiac

rehabilitation. It should be seen at regular intervals by its treating physician to monitor the

risk factors, and at least annually by its cardiologist to monitor coronary artery disease.

The Institute contacts the patient awaiting surgery at home to plan a pre-admission meeting.

He may not be able to attend the meeting. In this case, most of the information in the Surgery

Preparedness Guide can be accessed.

This procedure requires the patient to be hospitalized at the surgery unit the day before or

arrives early in the morning of the operation. Required examinations include blood and

biochemical analyses, coronary angiography, pulmonary X-ray and, as appropriate, cardiac

ultrasound and cardiac scan.

How to improve the Nursing Home Care Policy

This policy faces has several challenges which include financing shortfalls, understaffing,

insurance, shortage of nursing staff, elderly abuse and costs related to compliance. Other

challenges include high turnover and lawsuits (Plunkett, 2011). Therefore, there are several

interventions which can be made to enhance the home care policy. The government should

exercise more powers in different involvement stages. For instance, it can involve the

collaboration of the federal government on the process of medical reimbursement by

applying similar regulations across the nation.

A more difficult stage of governmental control could be real State or Federal running of

nursing facilities. The government could rent nursing homes from their present owners. This

approach would make the management of all nursing homes central. Another component of

stricter government control could be the carrying out of a national nursing home insurance

NURSING HOMECARE POLICY ! 7 plan similar to Medicare Part A. The method would comprise spending limits, co-payments,

and deductibles much like Medicare (Beaulieu, 2012). These governmental interventions in

addition to other programs being drawn by the government would certainly improve the

nursing home care policy, hence ensuring improved treatment programs for the elderly.

Another method of improving the policy could be by letting the problem fix itself. Some

people can argue that the present problems are just temporary. First, the move towards

Medicare prospective payment is causing temporary dislocation of funds as facilities adapt to

care based on the new system. Eventually, as people adjust to the new regime, nursing homes

will figure out new ways of making money with Prospective Payment System without having

to sacrifice care. Second, the State Medicaid programs will carry on tweaking payment

systems and bed ratios (Intrator, Schleinitz, Grabowski, Zinn & Mor, 2008) to aid in

strengthening the nursing care industry. Additionally, the stiff labor market for nurses and

aides will ultimately correct itself. Trained employees will stay longer in their nursing care

jobs, and quality of care will get better. Consequently, abuse and neglect cases will reduce in

number.

Lastly, to improve the nursing care policy, development of a better environment with holistic

care systems is imperative. Some people in the nursing care industry have a feeling that

altering the caregiving setting is the best approach. A supportive friendlier environment

between residents and staff results in less employee turnover, healthier residents, happier

employees and overall better care. To achieve this, the hospital model of nursing home care

must be partly abandoned.

NURSING HOMECARE POLICY ! 8

References

Plunkett, S. (2011). Palliative and nursing home care policies, challenges, and quality of life.

New York: Nova Science.

Beaulieu, E. (2012). A Guide for Nursing Home Social Workers (2nd ed.). New York:

Springer Publishing Company.

Ryan, T., & Ingleton, C. (2011). Most hospices and palliative care programs in the USA serve

people with dementia; lack of awareness, need for respite care, and reimbursement

policies are the main barriers to providing this care. Evidence-Based Nursing, 14(2),

40-41.

NURSING HOMECARE POLICY ! 9 Intrator, O., Schleinitz, M., Grabowski, D., Zinn, J., & Mor, V. (2009). Maintaining

Continuity Of Care For Nursing Home Residents: Effect Of States' Medicaid Bed-

Hold Policies And Reimbursement Rates. Health Services Research, 44, 33-55.

Cai, S., Mukamel, D., Veazie, P., Katz, P., & Temkin-Greener, H. (2011). Hospitalizations in

Nursing Homes: Does Payer Source Matter? Evidence From New York State. Medical

Care Research and Review, 68(5), 559-578.