Developing international scope and standards for high-quality home-based nursing practice.

The scope and standards of professional nursing practice define and guide high-quality nursing care. This article describes the collaboration between the International Home Care Nurses Organization and the American Nurses Association to develop evidence-based scope and standards of practice relevant to home-based nursing around the world.

A Clinical Nurse Specialist in Home Healthcare.

Purpose: Opportunities and challenges in home healthcare are discussed from the perspective of a gerontological clinical nurse specialist who has served as an expert clinician, administrator, and compliance director of a home health agency in the Midwest United States.

Description: Home-based nursing care requires a distinct set of knowledge and skills centered on the home environment and the way the home health patient responds emotionally and physically to become confident and self-sufficient. A Theoretical Framework for Home-Based Professional Nursing Practice is presented identifying the 6 concepts (primacy of home, patient authority, patient self-management, caregivers as collaborators, interprofessional clinical team collaboration, nurse autonomy) that are building blocks to describe the experience of patients in their homes and interactions with providers.

Home-Based Nursing Practice.

These nurses provide care in a patient's home, wherever home may be.

A Theoretical Framework of Home-Based Professional Nursing Practice.

The purpose of this article is to introduce a descriptive middle-range theoretical framework unique to professional nursing practice provided in the patient's home. The variety of care models provided in the home, ranging from nonskilled home maintenance service to hospital-at-home programs, reinforces the need to clearly define and describe home-based professional nursing practice. This framework includes six concepts (primacy of home, patient authority, patient self-management, caregivers as collaborators, interprofessional clinical team collaboration, nurse autonomy), and four relational statements of the concepts that describe the experience of patients in their homes and home-based providers.

Becoming an Expert Home Health Nurse.

The purpose of this article is to discuss the five levels of skill acquisition (novice, advanced beginner, competent, proficient, and expert) developed by Patricia Benner and colleagues, within the unique context of home health nursing. Descriptions of practice at each level are provided and can help nurses have reasonable expectations of performance. Recommendations are made for competence-based clinical support programs such as orientation, mentoring, and clinical ladders that identify, measure, and reward clinical knowledge and skill.

Incorporating Virtual Visits Into the Home Health Plan of Care.

Virtual visits, using 2-way real-time remote communication between the patient and the home health clinician, are a valuable adjunct to in-person visits to advance the prescribed plan of care. This article defines virtual visits within the larger context of telehealth and describes how to balance and integrate assessment and teaching modalities across in-person and virtual visits. Protection of patients' rights and privacy and facilitation of face-to-face visits with practitioners are also discussed.

Best-practice intervention for care of clients who self-mutilate.

Purpose: To describe the development of a best practice intervention to guide nurse practitioners (NPs) who care for individuals who self-mutilate.

Data Sources: The evidence on which the guideline was based includes six descriptive studies and expert clinical opinion articles. The framework for development of the guideline is a systematic process to obtain and analyze the best available evidence, develop a theory-driven intervention, and propose a system for ongoing evaluation of the effectiveness of the intervention.

Concept analysis of self-mutilation.

Aim: This paper is a report of a concept analysis to define and describe self-mutilation.

Background: Although there has been an increased interest in self-mutilation, as evidenced by recent publication of opinion literature, anecdotal reports and a few clinical studies, the concept has not been well developed to guide nursing research and interventions.

Method: Definitions and uses of self-mutilation were obtained in a comprehensive review of the health, psychology and education literature up to April 2007 to identify the defining attributes, antecedents and consequences.

Comparison of upper arm and forearm blood pressure.

The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest.

The meaning of time in oldest-old age.

In a phenomenological study that described the lived experience of adults older than 85 years, 19 oldest-old adults' lived time is illuminated by 5 themes: Defining Self Through Experience, Being Situated in Time, Knowing Lifetime Is Limited, Planning for the Future, and Leaving a Legacy.

Student learning with concept mapping of care plans in community-based education.

Concept mapping, a learning strategy used to understand key concepts and relationships between concepts, has been suggested as a method to plan and evaluate nursing care. The purpose of this study was to empirically test the effectiveness of concept mapping for student learning and the students' satisfaction with the strategy. A quasi-experimental pre- and posttest design was used to examine the content of concept maps of care plans constructed by junior-level baccalaureate students (n = 23) at the beginning and end of a community-based mental health course.

The lived experience of oldest-old rural adults.

The author elicited the lived experience of 19 oldest-old adults (13 women, all White, mean age 90.7 years, range 85-98 years) who lived alone in the rural Midwest to describe their everyday activities, concerns and struggles, and adaptive strategies. In-depth interviews (59 total) were audiotaped, transcribed, and analyzed in an interpretive phenomenological tradition of thematic analysis, interpretation of paradigm cases, and interpretation of exemplars.