Community care in Scotland

This ethnological perspective of Community Care in Scotland will focus on historical, political, and social contexts and their influences on the community care arrangements for individuals within various types of communities in Scotland today

Nurse Driven Early Mobility in the Intensive Care Unit: Mobility Protocol and a Designated Mobility Champion

Decreased mobility in hospitalized patients can lead to various health consequences, including increased morbidity and mortality. In the Intensive Care Unit (ICU), patients are not mobilized as frequently or as often as possible. Barriers to mobilization include limited resources such as time and staffing, perceived risk, and insufficient training in safe patient handling. This quality improvement initiative aimed to increase out-of-bed mobility in ICU patients, address activity orders at interdisciplinary rounds, and trial a designated mobility champion. The America Association of Critical-Care Nurses (AACN) Early Progressive Mobility (EPM) protocol and Bedside Mobility Assessment Tool (BMAT) were adopted and used to discuss patients’ mobility during interdisciplinary rounds. During these rounds, a mobility champion who received additional training from physical therapy in safe patient handling attended these rounds. The mobility champion then coordinated with nursing staff and other care team members throughout the day to mobilize patients. Increased numbers of patients with COVID-19 did not fit the eligibility criteria during the implementation period, and increased mobility was not seen. However, the ICU team members felt the interventions, especially the use of a mobility champion, were beneficial and decided to extend the new practice for continuing review. The mobility champion is now utilized on all inpatient units. All inpatient units have seen an increase in patients mobilized. Nurse-driven early mobility tools are safe and feasible and give nurses greater autonomy in planning mobility interventions. The use of a dedicated mobility champion compliments these tools and helps reduce barriers to early mobilization.https://scholar.rochesterregional.org/nursingresearchday/1019/thumbnail.jp

The LaGuardia - Red Hook Caregiver

Vol. II, No. 3; This document was produced as a result of a training and development project for staff in the social services system through a contractual agreement between the New York State Department of Social Services and the Research Foundation of the City University of New York on behalf of La Guardia Community College. No date, library receipt, 13 September 1979

Role of community pharmacists in patients' self-care and self-medication

This review highlights the growing prominence of self-care and explores the contribution of community pharmacy. Firstly, background to self-care is discussed, followed by placing self-care in context with regard to the general public and accessing community pharmacy. From this perspective the contribution community pharmacy currently makes is assessed, paying particular attention to the factors that negatively impact on the ability of community pharmacy to facilitate self-care

Negotiating: Experiences of community nurses when contracting with clients

A community nurse is required to have excellent interpersonal, teaching, collaborative and clinical skills in order to develop effective individualised client care contracts. Using a descriptive qualitative design data was collected from two focus groups of fourteen community nurses to explore the issues surrounding negotiating and contracting client care contracts from the perspective of community nurses. Thematic analysis revealed three themes: ‘assessment of needs’, ‘education towards enablement’, and ‘negotiation’. ‘Assessment of needs’ identified that community nurses assess both the client’s requirements for health care as well as the ability of the nurse to provide that care. ‘Education towards enablement’ described that education of the client is a common strategy used by community nurses to establish realistic goals of health care as part of developing an ongoing care plan. The final theme, ‘negotiation’, involved an informed agreement between the client and the community nurse which forms the origin of the care contract that will direct the partnership between the client and the nurse. Of importance for community nurses is that development of successful person-centred care contracts requires skillful negotiation of care that strikes the balance between the needs of the client and the ability of the nurse to meet those needs

The Business Case for Community Paramedicine: Lessons from Commonwealth Care Alliance's Pilot Program

Mobile integrated health care and community paramedicine (MIH-CP) programs expand the role of traditional emergency medical services personnel to address non-emergency needs and bring outpatient primary and urgent care into patients' homes. These programs offer potential for reducing health care costs, eliminating unecessary emergency department use, and shifting service back to community-based and home settings. Between 2014 and 2015, the Massachusetts-based Commonwealth Care Alliance (CCA) piloted a community paramedicine prgoram, Acute Community Care (ACC), to serve its members in the Greater Boston area.This brief summarizes ACC's business case assessment, which showed that increasing patient volume after the pilot period would reuslt in net savings given the progam's success in averting unnecessary emergency care. By illustrating cost considerations for an expansion of MIH-CP services, this brief may inform the design and sustainability planning of other MIH-CP programs. The business case assessment was conducted by Mathematica Policy Research through support from the Center for Health Care Strategies' Complex Care Innovation Lab, a Kaiser Permanente Community Benefit-funded initiative

Palliative care in the community

Primary care has a vital role in delivering palliative care. In most developed countries more people die in hospital than at home, although substantially more people would prefer to die at home. Primary care professionals play a central role in optimising available care, but they often lack the processes and resources to do this effectively

Study on day care : report and recommendations

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Moving Care to the Community: An International Perspective

Medical treatments that were once provided in hospital are being increasingly administered in the community. Within health systems, there is a renewed focus on delivering general health care in the community, freeing hospitals to provide more complex, specialised and emergency care. As the drive to shift specialised and non-specialised care out of hospital gathers momentum, there is a greater demand for a skilled and competent community nursing workforce to facilitate this shift at a local level. Nurses are essential in the delivery of continuous care as they often serve as an interface between acute and community care, focusing on prevention, self- management and providing support to transition patients smoothly across the health and social care services.Moving care to the community has been a UK-wide health and social care policy priority for more than a decade. However, progress has been slow and in some cases fragmented. In order to address the issue, it is important to first review where this shift has been implemented and which lessons can be learned from international experiences. The RCN is committed to working closely with its equivalent nursing organisations overseas to learn from international best practices and incorporate some of this learning to shape health and social care policy in the UK, and more specifically promote good nursing practice. This report will focus on system-wide or sector specific reforms in Australia, Canada, Sweden, Norway and Denmark as these countries have at one point or another addressed the need todeliver care outside of hospitals, either in patients' homes, GP clinics, community-basedcentres or care home settings