Longer hospital stay for old age patients is generally risky due to chance of cross infection which is termed as nosocomial infection. This infection rates are higher even in highly maintained hospitals as well. Not all medical and surgical conditions are manageable at home but major bulk of care can be managed at home with comparatively lower cost than that of Hospitals. The recovery rates at home with their own environment and family members are shown higher by several studies. It reduces the stress of hospital stay.
List of cares that can be carried out with Nursing Care at Home
Parenteral medications – medicines through injection or IV lines in situ.
Vital Monitoring – regular vital monitoring which includes Blood pressure, Pluse, Respiration rate, Oxygen saturation, Blood glucose, Input and output. Especially urine output via catheter and urobag
Personal care – bowel, bladder care, bath, Oral care, feeding, dress change, position change, massage, walking, talk, companion etc
Perform procedures- dressing changes, catheter change, IV line establish, NG tube insertion, NG feeding, Oxygen delivery setups, Bipap
Physiotherapy exercise recommended
Report or discuss with treating physician, follow-up visits, evaluates progress, plan for further
Steps to Care provide Nursing Care at Home for Kathmandu Valley since Jan 2023. The total 136 Nursing care at home provided from Jan 2023 to Oct 2024 from Steps to Care. The average care provision period is 37 days.
Procedure to have Nursing Care at Home:
Contact to Steps to Care through Phone call, email, Whatsapp, Viber, Messenger etc.
Assessment visit by Supervisor – we visit to the residence where care is provided, detail assessment of client condition, specific care plan is developed
Introduction of duty nurse by supervisor with complete handover, provide coaching for certain skills, behaviors etc
Daily report of patient care in given template.
Weekly supervision- meet with the duty nurse, review the documents, patient, supplies. talk with nurse, family members, coach on gaps identified.
Challenges:
Nursing care at home is a costly intervention although it is cheaper than hospital stay. People fail to weigh the benefits of service. It gives family members freedom for work and earnings along with far better care.
Elders are not in priority for expenditure especially at non recovery conditions in contrast; more care is needed at that time.
Professional and skilled nurses availability; we are overcoming this issue by onsite training and coaching.
