presented by Constantine Checa-Gerena
Part I of this course addresses psychiatric home care nursing and common disorder. Part II of this course focuses on evidence based care and interventions to provide holistic quality care for the older adult at home. The novice visiting psychiatric nurse can use strategies gleaned from motivational interviewing, goal-setting, and psychoeducation of disease processes and self-management techniques to address the patient’s self-care deficits and other biopsychosocial issues. As documentation is a major component of patient care and as is following Medicare regulations, this course also provides strategies to capture clinically important data to support appropriate reimbursement of services.
As a nurse, it has been Constantine Checa-Gerena’s passion to help people get through difficult times in their life’s journey by bringing hope and healing. As an educator at heart, she enjoys sharing her knowledge and experience not only about home care nursing, but also about overcoming the mental and emotional barriers that get in the way of achieving one’s full potential. She truly believes that everyone wants to be healthy, wants to find purpose and peace—and the primary job of being helpers and healers is to guide a patient toward that path. Her professional background includes being a psychiatric home care nurse and interdisciplinary care team manager. She is currently an RN supervisor of the Health Home at Risk Program—one of the many Delivery System Reform Incentive Payment (DSRIP) programs. Her educational background includes an Associate’s Degree in Liberal Arts and Science and Associate’s in Applied Science in Nursing from Queensborough Community College, a Bachelor’s Degree in Nursing from SUNY Downstate Medical Center, and she will complete her Master’s Degree in Nursing to become a Psychiatric Mental Health Nurse Practitioner by May of 2018 from CUNY Hunter College.
This chapter introduces and defines the Trans-Theoretical Model along with the basic tenets of Motivational Interviewing: Open ended questions, Affirmation, Reflections, Summary. Through these techniques, visiting nurses can identify where on the change continuum a patient is and guide a patient to change health behaviors from maladaptive or unhealthy to adaptive and healthy.
This chapter discusses the importance of goal-setting within the health home setting. By helping a patient to develop Specific, Measurable, Attainable, Realistic, and Time-Oriented (or SMART) goals, the psychiatric home care nurse is able to be patient centered while having a measure through which the need for more or less services can be determined.
This chapter presents psychoeducation and how it is employed as an evidence-based skilled intervention. It is especially crucial for patients and families to better understand their disease and how to manage it as independently as possible. Teaching psychosocial interventions and cognitive behavioral therapy techniques while eliciting feedback is one of many ways to help a patient and family learn how to manage the psychiatric condition.
This chapter summarizes the important aspects to include in documenting patient interaction—whether it is at start of care, visits within the certification, and at discharge or recertification time. Time management strategies are presented for completing effective and timely documentation. Being clear and concise supports effective care coordination, communication, and other tenets of recording quality home care documentation.
This chapter integrates the components learned throughout Part I and Part II with a patient case study. An example of a thorough, but concise nursing note is provided that highlights the assessment, problem, SMART goals, and follow-up plan along with the clinical plan of care.