Inaccuracy of home sphygmomanometers is a common, neglected and often ignored problem. The aims of this review are to emphasize the advantages of self-measurement of blood pressure (BP) at home, to summarize basic features of automated home BP measurement devices, to point out the distinction between validation, calibration and accuracy ...

The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that ...

While quantitative research has provided valuable information, studies presenting patients' experiences have been lacking in the field of knowledge of home mechanical ventilation. The aim of this study was, therefore, to present patient views and suggestions about how to improve home ventilator care and treatment. Data in the present study ...

The care dependency scale (CDS) aims at determining nursing care needs in a holistic way, at providing standardized and meaningful descriptions of the type and intensity of nursing care needs and the degree of independence. Assessment results support appropriate care planning for individuals and they provide epidemiological data about care ...

Summary.  Bleeding episodes in patients with inhibitors can be challenging to treat. Clinical guidelines recognize the importance of early treatment, ideally within 2 h of the onset of bleeding. On-demand haemophilia care at home has been shown to reduce the time between recognition of the symptoms of bleeding and initiation of ...

Recruiting and retaining an adequate number of personal support workers in home care is both challenging and essential to allowing elders to age in place. A mixed-method, longitudinal study examined turnover in a sample of 261 personal support workers in Maine; 70 workers (26.8%) left their employment in the first ...

Home Health Compare rates for Emergent Care and Acute Hospitalization increased undesirably for Athens Regional Home Health. Data revealed that the increase was due to heart failure exacerbation. It was hypothesized that a chronic disease management program with telemonitoring, to include chest fluid bioimpedance, would allow for earlier intervention, thus ...

Improving patient-doctor continuity is one goal of the medical home, but achieving this goal may require physicians to reduce panel size. This article examines the impact on patient experience and utilization of Group Health Cooperative's process of reassigning patients to new physicians as part of their medical home demonstration project. ...

Home care clinicians frequently lack access to a health sciences library. Nevertheless, they require ongoing access to current evidence-based nursing literature. Learning to use PubMed efficiently will enable home care clinicians striving to provide high-quality care to identify and, in some cases, access the full text of peer-reviewed articles that ...

Parenteral and enteral nutrition (PEN) are life-sustaining therapies that can be administered in the home. They are also complex therapies, with many facets about which patients and caregivers must learn. Once home on PEN, the patient assumes much of the responsibility for day-to-day care. Although patients are trained in many ...

REACh introduces environmental release categories (ERCs) used to describe chemical emissions to the environment. These ERCs contain a number of default values that are combined with product usage data to estimate environmental exposure concentrations for use in risk assessment. The methodology presented in the present work constitutes a novel approach ...

To investigate whether the interaction between individual race/ethnicity and community racial/ethnic composition is associated with health-related home care use among elderly persons in the United States. A nationally representative sample of community-dwelling elders aged 65+ from the 2000 to 2006 Medical Expenditure Panel Survey (N=23,792) linked to block group-level racial/ethnic ...

Excessive use of antipsychotic medication by older people is an international concern, but there is limited comparative information on their use in different residential settings. This paper describes and compares antipsychotic prescribing to older people in care homes and the community in England and Wales. Analysis of a primary care ...

Introduction Home tracheostomy care for children in South Africa dates back to 1989. Objective This study aimed to describe the tracheostomy home programme at Tygerberg Children's Hospital (TCH), situated in a resource-limited setting in Cape Town, South Africa. Design Retrospective descriptive study. Setting Tracheostomy home programme at TCH. The primary ...

The aim of the article is to explore and explain some of the controversies around home uterine monitoring, using a socio-technical interaction networks (STIN) approach. A Cochrane systematic review identified 15 included studies. A critique of these studies, using the eight components of the STIN framework, illustrated very clearly the ...

To explore the characteristics of home care supporting clinics providing home care for frail elderly persons living alone (EPLA), a self-administered questionnaire was mailed to 998 home care supporting clinics in the 23 wards of Tokyo, Japan between July and August 2009. Clinics providing home care for the frail EPLA ...

We assessed the utilization of home care by the elderly in Brazil after implementation of the Family Health Strategy (FHS). Data were derived from a cross-sectional study in a southern city in Brazil. Using the χ(2) test and a logistic regression with different levels of determination, we tested the hypothesis ...

Given the high prevalence of obstructive sleep apnea (OSA) and the demand on polysomnography (PSG), there is a need for low cost accurate simple diagnostic modalities that can be easily deployed in primary care to improve access to diagnosis. The aim was to examine the utility of single-channel nasal airflow ...

to enhance identification of older nursing and residential home residents in a national sample and describe their chronic disease prevalence. cross-sectional analysis of an established primary care database (The Health Improvement Network). 326 English and Welsh general practices. 435,568 patients aged > or = 65. Care home residents were identified ...

Background and aims  Emergency admissions of frail older people in care homes, many of whom have dementia, are critical events which should be avoided if possible. To identify and influence factors related to emergency admissions and place of death. Method  Design of study: Completed audit cycle. Setting: Jenner Health Centre ...

Allergists often suspect home environmental conditions are contributors to allergic disease. Case management can be an effective tool in managing asthmatic patients. To describe the impact of home environmental assessments and case management on the medical care utilization of patients with allergic disease the following studies were conducted. This study ...

In response to a rapidly aging population that is living longer with more chronic health needs, increased recruitment and successful retention of home care aides is essential. Insight into the job experiences of Personal Support Specialists is provided through the qualitative findings from a mixed-method mail survey (n = 131). ...

According to Department of Health figures published in 2008, between 56% and 74% of people would prefer to be cared for and to die at home although at present only 18% of deaths occur in the home, and 17% take place in care homes. According to The Hospital Guide, published ...

The acuity and number of children with life-threatening, life-limiting, and chronic conditions has increased dramatically over the past decade. The pediatric home care nurse needs a special body of knowledge and repertoire of tools to accurately assess, intervene, manage, evaluate, and provide resources to this most vulnerable population. Inherent in ...

In 2008, in total there were 202 158 abortions performed in England and Wales and 13 817 in Scotland, unfortunately one of the most common gynaecological procedures. 'Care closer to home' applied to this service, as part of a holistic integrated care pathway, can improve access and choice and reduce cost whilst ...

This paper is a report of an investigation into the factors associated with laxative-taking by older people in care homes. Constipation is a common source of discomfort, pain and morbidity for care home residents, and laxative-taking is prevalent. Differences in the extent to which older people suffer from constipation may ...

Our research objective was to estimate the technical efficiency of regions in Ontario, Canada delivering home care relative to the 'best performance' frontier. Data Envelopment Analysis (DEA), an efficiency frontier technique, measured the technical efficiency of each geographically-defined Community Care Access Centre (CCAC) controlling for case-mix and service quality. Differences ...

Care homes are changing, with improved standards and expanding roles, and it is vital that their residents are not excluded or discriminated against by health and social services. Staff are keen to be educated, and investment of time and money is rewarded with improved outcomes in many areas.

BACKGROUND: The medical home model has been recommended as the best design for healthcare management for individuals with disabilities by the American Academy of Pediatrics and the American Academy of Family Physicians. As set forth by these guidelines, a medical home contains the following elements: access to health care, usual ...

Policy and regulatory efforts to reduce Clostridium difficile infection (CDI) rates now focus increasingly on the community setting, especially residential and nursing homes for the elderly. We aimed to describe how potentially infectious diarrhoea is managed in care homes, and to explore related infection control and human waste management practices. ...

Background: An increasing number of adults are resident in care-homes. Poor prognosis is often assumed; however, outcomes in this group are not well described. We hypothesised that the clinical characteristics of emergency admissions from care-homes are no different from those of age-matched, community-dwelling elders. Objectives: To determine the clinical characteristics ...

There has been growing interest in the patient-centered medical home as a way to provide coordinated, high-quality primary care. At the same time, the number of retail clinics has increased dramatically. Many are concerned that retail clinics undermine the medical home by fragmenting care. In this article we explore the ...

This article describes delirium and explains why its prevention is important. An enhanced educational package that was developed with care home staff to prevent delirium is outlined. The challenges and successes of the project are highlighted. Case studies and resources to enable healthcare workers to learn about delirium and take ...

Our objective is to present a case report of home extubation by a pediatric intensive care team in a terminally ill pediatric patient. Literature relevant to home extubation will be reviewed. The design is a case report. Home extubation of critically ill children may offer significant benefits and an alternative ...

OBJECTIVES: The Croydon care home support team (CHST) was developed in response to reports of patient abuse within long-term care. It presents a novel strategy for improving standards of care within care homes. A qualitative methodology was used to assess the perceived impact of the CHST. METHOD: In-depth interviews were ...

The patient-centered medical home concept is central to discussions about the reform of the health care delivery system. Most descriptions of the concept assume that a primary care practice would serve as the hub of the medical home. However, for people with severe and persistent mental disorders, specialty health care ...

Existing research suggests that models of enhanced primary care lead to health care systems with better performance. What the research does not show is whether such an approach is feasible or likely to be effective within the U.S. health care system. Many commentators have adopted the model of the patient-centered ...

AIM: To gain a deeper understanding of first-time parents' experiences of early discharge from hospital after delivery and home-based postnatal care. MATERIAL AND METHODS: The study was comprised of focus group interviews, interviews with couples and with fathers. Twenty-one parents participated. Inclusion criteria: healthy women who have given birth to ...

To gain insight into the use of quality systems to improve urinary incontinence (UI) care in older adults receiving home care and to assess the associations between these quality systems and UI-related process and patient outcomes. Cross-sectional survey. 19 home care agencies in the Netherlands comprising 155 home care teams. ...

The aim of the study was to investigate the level of agreement between the needs assessment made by professional on the one hand, and the older person's views on the other. A further aim was to explore if the estimations made by the professional were systematically lower or higher compared ...

Home care for horses with chronic laminitis has been discussed rarely in the veterinary literature even though, at any given time, most of us have at least 1 chronic laminitis case in our care that is being managed at home by the owner. Almost all of our knowledge on this ...

Concerns about some of our most frequently prescribed drugs.

BACKGROUND: Overseeing the quality of community-based, home-care services is a subject of concern in most jurisdictions confronted with population aging and the rise of chronic conditions. Although various quality management strategies have been used in different health care settings, continuous quality improvement (CQI) is still in the early stages of ...

In Dallas-Ft. Worth, TX, over 800 home care agencies compete for business--and employees - from seemingly every street corner. Among all those agencies, one of them, Haven Home Health, LLC, was named one of the area's small company "Best Places to Work" by the Dallas Business Journal. With the continuing ...

Engaging in meaningful social interaction is central to quality of life and this does not diminish following the move to a care home. However, social interaction in this setting can be difficult and is not always well supported by the environment or by staff. The aim of the action learning ...

An examination of the Washington State workers' compensation claims for home health care workers was conducted. Some comparisons were made with nursing homes, acute care hospitals, and all other industries in the state. Between 1998 and 2007, the average claims rate for home health care workers was 1,375 claims/10,000 full-time ...

PURPOSE: This study examines the proportion of cancer deaths occurring at home in six European countries in relation to illness and to demographic and health care factors. METHODS: Death certificate data of all cancer-related deaths in 2002 in Italy and 2003 in Belgium, the Netherlands, Norway, England, and Wales (N ...

AIM: To determine health-care-seeking behaviour for childhood illnesses in a resource-poor setting. METHOD: Cross-sectional survey was conducted in the children emergency room in a Nigerian tertiary hospital. Socio-demographic data and details of the place and type of care given to ill children before presentation in the tertiary hospital were obtained. ...

An estimated 36,000 home support workers assist older Canadians annually with daily activities, such as bathing, dressing, grooming, and light housework, yet home support workers' day-to-day experiences are not well understood. Mahmood and Martin-Matthews (2008) have developed a model that locates the home support worker, elderly client, and family member ...

Electronic health information systems (EHIS) containing standardized assessment data (e.g., RAI-Home Care, Outcome and Assessment Information Set [OASIS]) hold considerable promise, but their potential has yet to be fully realized. Literature was searched for strategies on implementing and using EHIS, including barriers and facilitators of their use in home care. ...