Exploring Community Nursing: A Detailed Look at Hospital in the Home

This essay provides a comprehensive analysis of the 'Hospital in the Home' model within community nursing, focusing on the @home service developed by the NHS Foundation Trust. It summarizes the key points of an article discussing this model, highlighting its cost-effectiveness, clinical effectiveness, and improved patient satisfaction compared to traditional hospital admissions. The essay details the implementation of @home services in London, the types of patients who benefit most (those with long-term conditions), and the training required for nurses to deliver high-quality care in home settings. It further discusses the importance of collaboration, continuous innovation, and the integration of various healthcare services to provide holistic patient care. A case study of a patient with COPD illustrates the practical application and benefits of the Hospital in the Home model. The essay concludes by emphasizing the future role of nurses in this evolving healthcare landscape, stressing the need for advanced training and specialization to ensure optimal patient outcomes. Desklib provides access to this assignment, offering students a valuable resource for their studies, alongside a wealth of other solved assignments and study materials.

ESSAY

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Summary of the chosen article.....................................................................................................1
Future role as a nurse...................................................................................................................4
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
In recent times many patients are opting for home hospital services where they are
provided with professional healthcare services at their homes. All the required treatments, test,
GP referral etc. are provided to the patients at their homes. This essay will lay emphasis on the
article “The future of community nursing: Hospital in the Home” in which @home service
developed by NHS Foundation Trust given to the patients has been discussed (Lee and et.al.,
2017). Here module 'hospitals in the home' has been discussed that focuses on providing patients
with quality service.
MAIN BODY
Summary of the chosen article
Here, summary of the articles named “The future of community nursing: Hospital in the
Home” will be explained. This article was written by Gerry Lee, Nicola Pickstone, Karen
Titchener and Jose Facultad. In this article hospital as a home model to treat patient has been
discussed. Traditionally, in order to treat patients they were admitted to the hospitals but today a
new model of treatment is used which is called hospital in the home model where all the hospital
settings are done in individual's home. This model is nowadays used more as it is cost effective
financially as well as clinically effective. This model has helped in developing various ways of
managing and treating patients without worrying about admission or discharge from the
hospitals. It also helps the hospital doctors or nurses to maintain the quality of service that they
provide to their patients. Hospital in the home has been proved as one of the best way to treat
patients. It has been observed that satisfaction level of patients was much more as compared to
the patients treated with the traditional way as it is cost efficient and much more effective as they
are provided with better service quality at homes.
@home services were developed in London by St Thomas' and Guy's NHS trust
foundation trust. This service was available in Southwark and Lambeth areas so that they can
treat patients who were above 18 years of age or would be at risk when admitted to the hospital
to give assistance, support and care to the patients who have opted this service. This service was
started in 2013 and is still going on. From 2013 onwards they have treated more than 8000
patients and on an average more than 350 patients are refereed every month. This hospital at the
home facility is especially provided to all those patients who are suffering from any kind of long
term diseases such as diabetes mellitus, heart diseases such as stroke, COPD (Chronic
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obstructive pulmonary disease) etc. Such type of patients need continuous medical interventions
and treatment so that their suffering can be reduced and can be treated in an effective manner as
they need acute care. Such type of patients with long term diseases require special attention and
treatment, good quality service and a good recovery plan which is needed to be maintained
throughout their treatment and recovery time period.
According to the chief nurse of @home service, more financial investment is required to
be spend while giving treatment at home. So as per the chief nurse All the money that is spend
by the patients in hospital admission or other building expenses can be spend treating the patients
and taking care of them by providing good quality of service to them so that they can be treated
in a better manner and their satisfaction level can be increased. This also helps in accelerating the
patient care plan that is integrated as per their disease and the type of treatment they are provided
with. Hospitals providing these hospital at the home service to the patients are using
collaborative approach so that they can manage and maintain their integrated services efficiently
without reducing its quality. These @home services provide 365 days, 24*7 service to the
patients as per their needs and requirements. Whenever a patient needs assistance they contact
these @home service and within 2 hours they are responded for urgent medical assistance, also
in this daily visits are provided to the patients, at-lest 4 times a day. All kind of nursing care,
physiotherapy care, occupational therapy care are also provided to them as per their needs and
other than this if any other kind of service is required such as GP assistance then it is also
provided to them whenever required.
All the patients who are provided with hospital at the home are provided with highly
skilled nurses who can take care of unwell patients really well. Such nurses should have a
advance practise masters degree and are needed to complete all the modules of physical
assessment skills as well as need to have non-medical prescribers course. Their skills and in-
depth knowledge in such advance practices helps them to provide successful assistance to the
patients of home care by providing wide range of condition management so that good quality of
service can be provided to the patients. Patients with extremely sever condition and refuse to go
to the hospital are provided with 24*7 nursing care. All the nurses working in @home services
has to undergo intense training program so that they can provide services to critical patients as
well such as post operation patients, stroke patients etc. If any kind of diagnosis, test etc. are
required by the patient then nurses are trained in such a way that they can easily do all such
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diagnosis and test that are required by the patient under the guidance of the medical practitioner.
This complete hospital at the home is quite an innovative approach in which various other
innovative approaches, techniques, tools etc. are adopted by both the medical practitioner and
nurses working with the organization. NHS and other social care services are required to provide
and deliver their services to the patients on urgent basis as well as all the medical practitioners
and nurses should be provided with training so that they can increase their efficiency so that they
can efficiently provide quick and quality services to the patients. Nurses should be provided with
training and orientation program to use all the innovative equipments that will be used in
providing home services to the patients such as monitoring system, syringe drivers etc. NHS trust
is trying to improve their hospital services and processes in a better way. There is another
services that is provided to the patients is out of the house service. This service is implemented
when urgent crises arises. In such cases Complete team work together and initiate as well as
implement all the required services and treatment to the patient and not only this in such cases
daily meetings are also provided to the patients.
All the nurses working in such organizations are provided orientation, practices as well as
are registered based on the department in which they are working. As per their department and
services provided by the department all the nurses are provided training in order to provide best
service to the patient by the nurses and medical practitioners as they are only trained in that
particular department only. This will also help in increasing the efficiency of the nurses and they
can provide easy and effective service in terms of treatment, diagnosis, test etc. It has been
observed that most of the nurses in this field like emergency units, medical units as these are the
departments where they can show their skills and knowledge to the hospital as well as to the
patient. Hospitals that provide these home services continuously innovate and provide their
patients with improved treatment which might be beneficial for them and should provide
continuous training regarding the same to the nurses as well so that they can easily implement or
use them in a better way for the patients. Today many assistive devices have been invented
which helps both doctors and nurses to provide improved service at required time. This will also
lead to the success of the organizations as well as will also help them in increasing patients
satisfaction level with improved treatment provided to therm. This will help all the nurses and
medical practitioners to keep a track of all the requirement of patients health condition such as
operation, post operative care, test, detection of other problems that patient might be suffering g
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from such as dehydration, infection, increased blood pressure etc. so that it can be diagnosed and
treated in a timely manner so that patients current condition is not degraded.
Nowadays palliative care is also provided to the patients who need require as they are
suffering from serious diseases. This palliative care helps in improving the overall quality life of
such patients. Many hospitals and social care services are focusing on providing such such type
of improved palliative care so that the service that they focus on providing can be improved in a
better and enhanced way. Not only this all the nurses and medical practitioners must involve
themselves or must be given assignments to indulge themselves clinical care that is provided
within the hospitals so that they can improve their skills and knowledge in order to further
improve their service that they provide to the patients who opt hospital at the home service.
Patients can opt for any kind of services whether it is physical service, psychological service or
any other kind of social service that is required by them. All of these services are provided to the
patients so that environment, qualitative and quantitative delivery of service can be improved in
a better manner. There are many cares of patients who need all kinds of treatments at home
without any kind of support or assistant. Similar care of a 78 years old day named Mrs. T who
has been diagnosed with COPD has been discussed within this article. @home services analysed
her situation, physical assessment that was needed to be followed were done in order to build a
required framework. Complete throughout check-up was given to Mrs. T for all the issues that
she was facing such as breathlessness. They took daily reviews so that her current health
condition can be identified. Various test, X-Rays etc. were conducted by the nurse and all the
diagnosis done were correct. Within 5 days of home care treatment improvement within her
condition was shown. Within this 5 days treatment she was also provided assistance of a GP as
well as was also provided with a heart failure community nurse.
Future role as a nurse
Future role of a nurse is quite important in hospital at the home care service as they are
the one who act as a communication medium between the patient and the health and social care
services. It is important to provide high level training to the nurses so that in an emergency
situation they can know why they are required to do and can provide the patient with proper and
improved service according to the situation and their disease. All the nurses should be
compulsorily be provided with specialization courses so that they can tackle with any kind of
serious disease. They should also be given palliative care, assistive devices and other monitoring
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or healthcare instruments training in order to enhance their skills and increase their knowledge
which can be used to provide qualitative service to the patients with long term diseases.
CONCLUSION
From the above essay it has been summarized that many organizations are adopting
hospitals at the home integrated framework so that they can provide quality service to their
patients. This model has helped them in improving their overall system more flexible, responsive
as well as flexible. In the article a case study of a 78 years old that has opted from home services
has been discussed. It has also been analysed that these home services are provided to the
patients for 365 days, 24*7 hours as per their comfort level. This service also helps in increasing
the satisfaction level of patients.
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REFERENCES
Books and journals
Lee, G., and et.al., 2017. The future of community nursing: Hospital in the Home. British journal
of community nursing. 22(4). pp.174-180.
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