The Home Healthcare Nurse

Abstract

The home healthcare nurse is a concept that has grown rapidly in the past two centuries, however, the role and meaning remain ambiguous. Continuous changes in the healthcare system have sparked confusion with patients and healthcare providers as to the essence of the home healthcare nurse. With the popularity and demand for home healthcare-based care on the rise, it is necessary to differentiate the concept of the home healthcare nurse from other related terms through a concept analysis. Using Walker and Avant's methodology, a literature search using Cumulative Index to Nursing and Allied Health Literature (CINAHL) along with dictionaries, encyclopedias, and professional organizations was performed to identify all the uses, attributes, and characteristics of the concept. Five defining attributes emerged during the analysis: autonomy, adaptability, person-centered holistic care, care coordination, and self-efficacy. Antecedents, consequences and empirical referents were identified. As a first step, this concept analysis brings clarity to the meaning and role of the home healthcare nurse from which arose an operational definition and proposed conceptual model. With the number of patients admitted to home healthcare accelerating, healthcare organizations and clinicians must distinctly understand the concept of the home healthcare nurse. Future research should include testing theoretical relationships between the home healthcare nurse and patient outcome variables to enhance nursing science and promote population health.

A Theoretical Framework of Home-Based Professional Nursing Practice

“…It is a different way of being a nurse with a unique knowledge and skills set and a different approach to patient care (Narayan et al, 2017). Riekert (2021) provides a concept analysis of a home healthcare nurse with the operational definition of a licensed nursing professional demonstrating the five defining attributes of autonomy, adaptability, person-centered holistic care, care coordination, and nurse self-efficacy in critical thinking, communication, and clinical and system navigational skills. Further, the home healthcare nurse provides care to sick patients at their place of residence with outcomes of patient/caregiver engagement, patient self-efficacy in disease management, and improved patient health, well-being, and satisfaction.…”

Management of the decompensating patient receiving home health

“…Home health services have become an increasingly important aspect of healthcare delivery in recent years 1. This care model demonstrates patient-centered care in a way that simply can't be done in a hospital setting, as more people seek medical treatment in the comfort and convenience of their own homes 2. As a result, home health continues to evolve greatly in response to the growing demand 2.…”

“…This care model demonstrates patient-centered care in a way that simply can't be done in a hospital setting, as more people seek medical treatment in the comfort and convenience of their own homes 2. As a result, home health continues to evolve greatly in response to the growing demand 2. However, incorporating new technologies and innovating practices in the home health setting can be especially challenging due to its field-based delivery of care model 3.…”

“…Patients with acute medical conditions are being discharged earlier from inpatient facilities at an accelerating rate. This healthcare approach allows patients who are stable enough to receive treatment at home in a more comfortable setting 2,3…”

“…2 As a result, home health continues to evolve greatly in response to the growing demand. 2 However, incorporating new technologies and innovating practices in the home health setting can be especially challenging due to its field-based delivery of care model. 3 Patients with acute medical conditions are being discharged earlier from inpatient facilities at an accelerating rate.…”