Source: CMSA Today
The home setting is a vastly different environment from the hospital setting. While each space in a hospital is organized according to the needs of the patient and the treatment they receive from physicians, nurses and other staff, the home is a patient’s personal space.
“We need nurses and care managers well versed in helping to manage successful transitions from hospital to home and in coordinating care of patients in their homes,” said Kathy Driscoll, chief nursing officer for Humana. “By focusing coursework that includes simulations and field experiences to successfully navigate care transitions and care in the home, we are helping students to prepare for that continuum and feel ready to practice in this type of environment.”
The partnership between University of Houston Andy and Barbara Gessner College of Nursing and Humana’s CenterWell Home Health, for example, focused on offering an innovative and forward-thinking elective to its nursing students. The Preventative and Restorative Nursing Care elective introduces undergraduate students to the concept, challenges and benefits of home health and care needs in the home.
“Community and home-based care as practice settings can be somewhat intimidating because the clinician may be alone in the care environment,” said Driscoll, adding that “this level of independence also means autonomy and the opportunity to see the environment where the patient lives and allow that to inform the care plan and goals for the patient, in addition to their health needs.”
During the two-week elective, students practiced care in the college’s interactive simulation lab, as well as spending time with patients in their homes. In the first week, the lab modeled three different spaces, each designed to look like a person’s home, with actors and mannequins taking on the roles of patients. In the second week, students paired up with nurses from Humana’s CenterWell Home Health to better understand the needs of patients in their homes firsthand, and coordinate and provide the care they needed. The students said the experience was profound, and within this short two-week period, they felt they had made a positive impact on the lives of these homebound patients, had a better understanding of the care continuum and the unique care needs of patients in home settings.
“We want our students to experience a wide variety of clinical settings,” said Kathryn Tart, professor and founding dean of the college, “and the home is an important clinical setting.”
The students and their preceptor’s patient visits included:
- Physical assessments
- Environmental assessments
- Skilled nursing care
- Assessment and coordination of needs for safety, family dynamics, financial insecurity, nutrition, medication reconciliation and patient education
- Care coordination plan for ongoing needs
“I don’t know of any other nursing program in the greater Houston area that’s doing this,” Tart said. “This is not a typical part of what a nursing curriculum looks like.”
But this will most likely change soon. In 2021, The American Association of Colleges of Nursing published The Essentials: Core Competencies for Professional Nursing Education and included home care as a core competency. As more patients and providers opt for care in the home, the Gessner College of Nursing wants to ensure competency around care coordination, and care in the home is a part of their curriculum.
“By meeting a patient’s care needs in the home, you can make a tremendous difference in people’s lives and help them to be their fullest and healthiest self,” said Tart. “That’s what we love doing as nurses.”
Efforts like these can be intrinsically rewarding for clinicians currently practicing in home settings, allowing them the opportunity to influence and support nursing students as they prepare to be part of the most caring profession, and, as Driscoll said, “help them to fully understand the continuum of care and care settings, how care managers can help ensure patients can achieve their best health at home, and hopefully consider choosing care in the home as their clinical practice setting.”
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