Term Paper on "Home Health Report"

Term Paper 5 pages (1243 words) Sources: 0 Style: APA

[EXCERPT] . . . .

Internship Report -- Home Health Agency

Background of the Organization

The organization is a privately owned and operated home healthcare agency. It maintains two facilities serving different parts of large metropolitan area. The organization provides home health services to patients discharged from acute care clinics and hospitals with continuing needs for medical care at home beyond the capabilities of patients and their families to maintain. Agency personnel consist of approximately 40 certified nurse assistants (CAN), twelve registered nurses (RN), two physicians (MD), four office managers, and various administrative assistants and support office staff. Eight of the RNs employed by the organization actually deliver patient services; the other four work exclusively as field supervisors.

One-third of the agency's clients require acute nursing care for long-term management of medical conditions and two-thirds of the agency's clients receive less intensive general health support furnished primarily by CNAs. Approximately eighty percent of agency clientele receive services that are eligible for federal reimbursement by Medicare and Medicaid. Ordinarily, the office managers schedule all appointments and distribute work assignments to the available staff on a continuing basis. Certified nurse assistants deliver most home health services unless they require more advanced services. Those services are furnished by the RNs on staff.

The supervisory RNs do not usually deliver services directly but are sometimes assigned to furnish medically necessary acute services in a back-up and emergency capacity. Otherwise, they maintain an up-to-date copy of CAN and RN staff schedules and responsibilities and make field visits to patients' homes to make periodic inspections and assessments of the quality of care being furnished by agency personnel. The supervisory RNs also make arrangements to conduct occasional site visits in between scheduled care delivery appointments to have the opportunity to interview clients about the quality of the care they receive from agency personnel without the care deliverer present. The RN supervisors file daily field reports and weekly status reports detailing their findings from the field.

Research Method and Process

This research project consisted of direct observation and involvement of the researcher in the internship capacity and on face-to-face interviews with agency supervisors and office managers. Throughout the internship, the researcher took regular notes detailing a wide range of agency-related matters of a non-confidential nature. The researcher also conducted informal interviews with two office managers (one of whom was also the facility's HIPAA Information Security Officer (ISO) and three supervisory RNs. The researcher then consulted the notes taken throughout the internship, identified the five specific major problems encountered by the agency that came to light during the internship period and incorporated all recorded information into this report detailing them and proposing solutions. In most cases, the solutions described are those that the agency implemented to resolve the problems described.

Identification and Synopsis of Problems Affecting the Organization

Last year, the agency encountered the following problems:

1. Nosocomial Infections -- Numerous patients contracted chronic infections of the same types as those considered "hospital-acquired infections" when they occur in clinical settings. In most instances, the infections involved the urinary tract and were attributable to urinary catheters. Several patients contracted wound infections at surgical sites and two patients contracted an infection at fixed intravenous sites. The RN supervisors who investigated the problem determined that some of the CNAs delivering services had become lackadaisical about hand washing and about observing basic antiseptic protocols in connection with wound dressing and catheter insertion techniques.

2. Bedsores -- Several patients contracted decubitus ulcers requiring acute care to resolve. The RN supervisors who investigated the problem determined that some of the CNAs delivering services had become careless about standard procedures for preventing bedsores. The supervisor determined that while the CNAs performed the techniques required of them during their visits, they had failed… READ MORE

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