Monday, October 21, 2024

Medication Reconciliation in Home Health: A Guide for New Clinicians

Medication Reconciliation is a critical part of every Home Health visit. It involves reviewing and comparing the patient’s medication list to ensure it is accurate and up to date. This step is vital for preventing medication errors and ensuring that patients are taking the right medications in the correct dosages. 

In the Home Health setting, clinicians often encounter patients who are taking high-risk medications. So how can you know what to look out for? While many high-alert medications come with labels, these labels may sometimes be missing or unclear. Recognizing these medications is key to maintaining patient safety. 

Common High-Alert Medications: 

  • Antibiotics (all categories) 

  • Anticoagulants (e.g., Heparin, Warfarin, Xarelto, Eliquis) 

  • Antiplatelets (e.g., Aspirin, Plavix) 

  • Antipsychotics (all categories) 

  • Hypoglycemics (e.g., Metformin, Humalog, Lantus, Levemir) 

  • Opioids/Narcotics (e.g., OxyContin, Vicodin, Dolophine, Opana) 

Please note: This is not an exhaustive list but highlights common examples. 

During each session, it’s important to ask patients if they have been prescribed any new medications recently. For instance, as an Occupational Therapist, I often inquire about their medication routines and how they integrate them into daily activities. For example, do they take their medications during mealtimes? Do they use a pill organizer? Perhaps they take pain medication before exercising. Understanding their routines helps ensure that medications are taken correctly and safely. 

By conducting thorough medication reconciliation, Home Health clinicians and therapists can significantly reduce the risk of medication-related issues, ultimately improving patient outcomes and safety in the home care environment. 

Friday, August 30, 2024

Lack of Transportation & Its Effect on Patient Health

With home healthcare, there are times when a patient's case is closed or they are discharged due to a lack of follow-up with their PCP after hospitalization. Home health services are covered by insurance or Medicare, which often require a PCP to oversee the care plan. Various factors can impact a patient's access to healthcare. One is the lack of reliable transportation.  The lack of access to transportation can cause harm. But how do the two relate? 

1. Missed Appointments and Delayed Care

Patients who struggle with transportation might miss or delay their medical appointments. For those with chronic conditions like diabetes or high blood pressure, regular check-ups are essential. Missing these can worsen their health and lead to more serious problems. As healthcare providers, it's crucial to recognize this and help find solutions, like coordinating rides, offering telehealth options, or being flexible with scheduling.

2. Increased Emergency Room Visits

When patients can’t get to regular appointments due to transportation issues, they often end up in the emergency room for problems that could have been handled earlier. This increases healthcare costs and puts extra pressure on emergency services. For patients, it can mean longer waits and less personalized care. As healthcare providers, recognizing this can help you advocate for better support systems so patients receive timely and appropriate care.

3. Mental Health Impacts and Social Isolation

Lack of transportation can lead to mental health issues and isolation, especially for elderly or disabled patients. Regular medical visits provide essential social interaction, and without them, patients may become depressed or anxious, worsening their health. Home health therapists can help by spotting isolation and connecting patients with community support.



Below are some resources that my colleagues and I have previously used to help patients access free or low-cost transportation options.


New York, NY:

https://angelcareny.com/non-emergency-medical-transportation-services-in-new-york/

https://home.nyc.gov/site/dfta/services/transportation.page


Central Florida:

https://wecarecentralflorida.org/project-ride-to-health-2/


https://www.sunshinehealth.com/members/LongTermCare/BenefitsAndServices/transportation-services.html


Baltimore, Maryland:


https://www.baltimorecountymd.gov/departments/health/health-services/transportation#:~:text=SCHEDULE%20TRANSPORTATION%20SERVICES,45%20p.m.%2C%20except%20on%20holidays.



Photo by Vecteezy.com

Wednesday, August 14, 2024

Challenging Environments in Home Health?

Being a home health therapist can be a rewarding experience, but also comes with unique challenges. Think about possible car trouble, no parking, and bad weather. Moreover, whenever you encounter homes that aren’t clean or belong to hoarders. 

Here are four practical tips to help you stay calm and professional to handle these situations effectively.

Assess Safety First 

Safety should always be your top priority. Before even entering the home, take the time to check out the environment. If you notice anything that could be dangerous, discuss it with the patient or their caregiver. You should suggest changes to make the space safer for both of you.

Take Precautions 

Depending on the situation, wear personal protective equipment (PPE). Always use barriers when placing your bag down in a patient's home like a disposable pad or a plastic bag

Stay Calm and Professional 

Remember that a cluttered or dirty home could be a sign of deeper issues like anxiety, depression, or physical limitations. Approach the situation with empathy and avoid making judgments. Focus on your patient’s needs and the goals of your therapy session, which will help you stay calm and professional.

Problem-Solve

If the environment isn’t ideal, think outside the box. You might need to bring as few items with you as possible. Adjust your session to fit the available space, or suggest an outdoor session if the weather allows. I have done a few sessions on a patient's porch or in the backyard. 

Collaboration 

Make the effort to inform coworkers or collaborating clinicians about a patient's home that may be dirty or cluttered. You might say, "I wanted to give you a heads-up that the environment at Mr. Smith's home is challenging, as there is significant clutter and some areas are unsanitary. 


Photo Credit: Vecteezy.com