Name of the Procedure:

Skilled Nursing Services in Home Health or Hospice Setting

Common name(s): Home Health Nursing, Hospice Nursing Technical or medical terms: Licensed Practical Nurse (LPN) or Registered Nurse (RN) Skilled Services, HCPCS Code G0164

Summary

Skilled nursing services provided by either a Licensed Practical Nurse (LPN) or Registered Nurse (RN) involve professional medical care, education, and training delivered in the patient's home. These services help patients or their family members understand and manage medical conditions, including medication administration, wound care, and disease management.

Purpose

Skilled nursing services are designed to help manage chronic conditions, aid in recovery from illness or surgery, and provide palliative care. The goals are to ensure optimal patient health, advance recovery, reduce hospital readmissions, and improve the quality of life for those with terminal illnesses.

Indications

• Chronic illness management (e.g., diabetes, heart disease)
• Post-surgical care
• Wound care and dressing changes
• Palliative care for terminal illnesses
• Medication management and administration
• Patient and family education on disease management and home care

Preparation

• No specific fasting or medication adjustments required.
• The nurse may review the patient's medical history and recent lab results.
• The patient's home environment may be assessed for safety and suitability.

Procedure Description

1. Initial Assessment: The nurse evaluates the patient's condition and reviews medical history.
2. Care Plan Development: The nurse, in consultation with the patient's healthcare provider, develops a personalized care plan.
3. Patient Education: The nurse educates the patient and family members on managing the medical condition, including medication administration and wound care techniques.
4. Skill Demonstration: The nurse demonstrates necessary skills and ensures the patient or family can replicate them.
5. Ongoing Monitoring: The nurse regularly monitors the patient's health and updates the care plan as needed.

Tools/Equipment used:

• Blood pressure monitors
• Glucose meters
• Wound care supplies
• Educational materials

Anesthesia or sedation: Not applicable.

Duration

Each session lasts approximately 15 minutes, but the total duration will vary based on the complexity of the patient's needs and the frequency of visits prescribed by the healthcare provider.

Setting

The procedure is performed in the patient's home.

Personnel

• Licensed Practical Nurse (LPN)
• Registered Nurse (RN)

Risks and Complications

Common risks:

• Minimal, usually related to specific medical interventions (e.g., wound care may lead to infection if not done properly).

Rare risks:

• Adverse reactions to medications
• Mismanagement of medical conditions due to misunderstanding of instructions

Possible complications include infections or improper use of medical equipment, which can be managed by regular nurse visits and communication with the healthcare provider.

Benefits

• Improved management of chronic and acute conditions
• Faster recovery times
• Decreased hospital admissions
• Enhanced patient and family understanding of disease management
• Improved quality of life for terminal patients

Benefits may be realized immediately through better symptom management, though overall improvement in condition can be gradual.

Recovery

Since this is an ongoing care procedure, post-session care involves following the nurse's instructions precisely. Recovery focuses on the patient’s gradual improvement and better management of health conditions with consistent nurse guidance.

Alternatives

• Inpatient hospital care: More intensive but less comfortable and more costly.
• Outpatient clinic visits: Requires travel and may not provide as personalized care.

Pros and cons of alternatives:

• Hospital care offers immediate access to a broad range of treatments but lacks the comforts of home and is more expensive.
• Clinic visits allow for professional follow-ups but lack the continuous, personalized support available with home health care.

Patient Experience

During the procedure, the patient will interact closely with the nurse, learning valuable care techniques and managing their condition. Pain should be minimal and managed through proper nursing techniques. The patient will receive continuous support and guidance to feel confident in their ability to manage their health.