RN Continuity in Home Health: Does It Make a Difference?

Abstract

Continuity of care in home health is valued but poorly understood. This article is about the delivery of nursing care to elderly home health patients and to determine if visits provided by the same RN improve selected “Outcome and Assessment Information Set” outcomes. Functional status, psychological status, and use of emergent care were examined. Cases selected represented individuals aged 65 years and older, with at least one chronic illness and a good prognosis. Patients received four or more visits from the same RN.The clinical and administrative billing records from an initial 60-day period yielded a convenience sample of 887 discharged cases from a suburban, U.S. hospital-based home health agency. Higher levels of RN continuity were associated with a decreased likelihood of neuro/emotional/behavioral issues for patients at discharge. The findings showed no relationship of RN continuity of care to functional status and use of emergent care for the period examined.

‘The same care providers over time who make individual adjustments and have competence’ Older South Sami People in Sweden's expectations of home nursing care

“…who state that continuity in care is beneficial and important when older people receive care and according to Russel et al. who state that continuity in care is connected to improvement in care receivers’ functional level and psychosocial well‐being . The present study specifically highlighted expectations of the same care providers over time, meaning continuity regarding personnel and information from future care providers.…”

“…The category 'Expecting the same care providers over time' could be understood as the interpersonal level of continuity of care that concerns encounters between care providers and care receivers (30). This is in line with Worral et al (31) who state that continuity in care is beneficial and important when older people receive care and according to Russel et al (32) who state that continuity in care is connected to improvement in care receivers' functional level and psychosocial well-being (33). The present study specifically highlighted expectations of the same care providers over time, meaning continuity regarding personnel and information from future care providers.…”

Measuring interpersonal continuity in high‐frequency home healthcare services

“…The Norwegian setting of high‐frequency home healthcare services (the mean number of visits was 51 in a maximum of 30 days) differs from the low‐frequency services described in the two studies on continuity in US home health care previously referred to (D'Errico & Lewis , Russell et al . ).…”

“…Interpersonal continuity may also have a direct impact on the quality of care; over time, carers learn to know their patients, their patients' health condition and care needs (Potter & Peden‐McAlpine ). Interpersonal continuity improves patients' psychosocial well‐being (D'Errico & Lewis ) and activities of daily living (ADLs) (Russell et al . ), facilitates early recognition of symptoms (Dick & Frazier ), reduces the need for emergency care (Russell et al .…”

“…Two recent studies measured interpersonal continuity of care by taking into account the number of carers and the number of visits made by these carers to individual patients (D'Errico & Lewis , Russell et al . ).…”