BSS6A Clinical practice in Municipal Home Care Services

Contents and structure

The course builds on the main curriculum elements: Nursing Discipline and its Professional Basis 8 credits, and Social Sciences 3 credits, and Medicine and Natural Science 1 credit.

The role of the nurse in home health care is based on the competence and professional understanding to adapt nursing in relation to different user situations.

The course content relates to the nursing functions:

• health promotion and preventive care
• care and treatment
• education and counseling
• professional ethical attitude and action
• development, quality assurance and research
• organization, management, policy and legislation

Nurses in home care services require advanced skills in identifying the patient¿s nursing needs, especially when the user does not recognize these needs and resists health care. Safeguarding the patient`s personal hygiene is sometimes difficult to implement to a responsible hygienic standard. Undernourishment and malnutrition are often seen among nursing service users. This places great demands on nurses' knowledge about the relationship between nutrition, appetite and social community at mealtimes. Other examples might include the facilitation of the use of a respirator in the home and the use of other equipment that can ease breathing problems, such as oxygen flasks for COPD patients. Other nursing skills in home care services may be giving injections, care of wounds, stoma, care of pyelostomy catheters, execution of CIC, and care of permanent catheters.

Patients in home care are in a heterogeneous group of people. The groups common feature is that all patients have functional status sufficient to live in their own home supplied with home care services. The Coordination Reform (White Paper 47), requests changes to home care services, as the health care services primarily should be conducted in the municipalities and patients should be discharged earlier from hospital to home care services. The purpose of home care services is to improve the functioning of patients, prevent health problems, contribute to a dignified life in the home. A clear intention (white paper 47) is that patients with far advanced diseases, and short life expectancy shall be able to stay longer time at home, and if they desire, be able to die at home. In Norway less than 15% of patients die in their own homes.

Professional nursing care in home care service requires a high degree of autonomy and collaboration with patients, their families, the general practitioner and additional inter-professional cooperation.

Knowledge:

• understands the position of home care services in relation to specialist health services
• gives an account of how nurses in home care services gives advise and collaborate with patients and caregivers.
• protects the individual patients integrity and rights in accordance with laws and regulations
• follows the home care services guidelines for medication management
• Understands the importance of inter-professional learning and inter-professional cooperation in the care of patient and the caregiver.

Skills:

• ensures professional nursing as expert in another persons¿s home with respect for the patient and family`s habits and wishes
• participates in interdisciplinary cooperation in home care services
• makes observations of deteriorating health, disease, illness or injury
• makes observations of effects and side-effects of medical treatment and report these observations
• handles medication dispensers responsibly

General competence:

• assess the service provision in view of the patient`s understanding of their own situation and the possibility of self help
• evaluates service provision decisions in view of the patient`s need for assistance
• applies professional judgment in performing assigned tasks and assess user needs for assistance and takes appropriate action
• assess the patient`s needs for assistance and takes appropriate action
• documents in accordance with current laws and regulations and reflects on the possibilities and limitations of the documentation system
• plans and manages own work and the work of others

• prepared outline of learning outcomes in for the period
• participation in two group counselings
• Prepare a reflection note.

The mandatory work requirements must be approved before the student can pass the course.

Clinical placement. The student's weekly studies consists of 30 hours in collaboration with patients and caregivers, and 10 hours individual studies.

Clinical placement is assessed with a pass/fail grade.

Absence in excess of 10% does not qualify the candidate for evaluation.

To be accepted as an exchange student for this course students must have passed their 2nd academic year.