INTRODUCTION
Nursing is the journey a caregiver takes with a patient through to recovery. An entire patient experience journey requires high professionalism in the doctrine. The nursing profession requires one to take skill-based training at different levels with access to varied care roles. Additional skill-based training includes the undergraduate and graduate levels. Graduate-level nursing provides specialized, intensive training through more profound knowledge than the undergraduate level. Completion of graduate-level nursing opens an expanded opportunity. Nurse educators, clinical nursing officers, case managers are some of the skills equipped at the graduate level stage. A bachelor’s degree prepares a student to become a registered nurse by studying nutrition, pharmacy, management, and chemistry. On the other hand, graduate-level programs focus on specialty areas, preparing students for more advanced roles (American Academy of Ambulatory Care Nursing, 2016).
Established in the early 1880s, home care organizations encompass home health agencies, home care assistance organizations, and hospices. Home health organizations are certified and provide skilled nursing assistance. Most home care agencies employ a medical director or a physician to improve care. Physicians in the health care agencies enhance the scope of practice and physicians’ revenues. Responsibilities carried out by a home care agency physician include and are not limited to documentation completion, quality assurance, and review on utilization. A medical director uniquely connects the agency and other physicians in policy matters and patient care. Home care research, home care staff education, and education of patients and caregivers are different roles for the medical director.
Patients receiving home health Medicare services have circulatory systems, respiratory disorders, musculoskeletal and neoplasms diseases. Patients eligible for home care nursing must require skilled nursing and should also meet the homebound Medicare definition, which cannot leave their homes without massive difficulty. The patients only leave the house for office visits or attend church service. Studies show that most patients are of the age of 85 years and above and in poor health. Such patients require nurses with high skills of exceptional nursing care to administer to the patients’ particular needs. This focuses on clinical, administrative roles, responsibilities, and features and a discussion on how the parts affect effective home care delivery.
BODY
Graduate-level nursing equips learners with nurse executives, case managers, and chief nurse administrators. Nurse executives have several competencies, as highlighted. Demonstrate ability to implement nursing intervention independently in both population-based and individual-based. Prioritize interventions based on individual conditions and needs during health care. Plan implementation, utilization of competence, and evidence-based nursing interventions during care coordination. Interprofessional health team collaboration across health care settings to implement population and individual care effectively. Provision of age and population appropriateness across healthcare settings. Nursing executives should acquire skills actively with information technology to acquire documentation skills and care processes. Utilization of available technology and ensuring documentation is inapplicable records and tracking systems.
The nurse administrative position manages a department or a clinical speciality. The key responsibility is to bring the experience, skills, and knowledge gained in previous clinical practice. Such skills are brought together to provide operational management and strategic leadership to nursing staff in healthcare organizations. The considerable skills that an administrator should possess are analytical, to enable them to dissect each problem and find the possible solutions on how to improve them. Communication skills will allow the administrator to pass information skillfully to departmental staff mates. Technical skills, attention to detail, and interpersonal skills are other vital traits (WU et al., 2022). The ability to guide people through without leaving anyone behind, leadership skills are an essential skill the administrator possesses.
A chief nursing officer representing the administrator role has primary responsibilities to undertake. A nurse officer must collaborate with the committee members and board directors to set performance goals. Frequent performance reviews to form a benchmark for improvement. Medical staff coordination, development of policy and procedures, facilitating professional activities, budget formulation, and management. An administrator monitors compliance with the laws and regulations, recruitment and hiring, scheduling nursing shifts, and representing nursing staff in meetings. Nurse administrators can work in the hospitals to implement and develop departmental produced goals and policies, prepare budgets and reports and evaluate and direct nursing staff. In physician offices, they collaborate with medical and administrative staff to hire and train nurses while managing billing and record-keeping. Nurse administrators also work in residential care facilities to supervise, oversee finances and facilitate maintenance and managing resident’s care.
There are different types of nurse administrator roles present. The first one is the nurse administrator, who is often employed at residential care facilities. The primary responsibility is to oversee nursing staff ensure compliance with laws and regulations, and improve patient care. The other role is the chief nursing officer role. The prominent place of work is in hospitals. They direct and manage nursing activities, design and implement patient care strategies, collaborate with the leadership, and maintain and handle the budgeting (Kieft et al.,2014). A nurse manager supervises nursing staff at hospitals and physicians’ offices; they perform scheduling, patient care policy formulation, hiring and training, and conflict resolution. A nursing director is another type of nursing administrator role. The nurse director works in various healthcare facilities, supervises nursing staff, prepares to monitor budgets, coordinates with physicians and other staff, and addresses patients’ needs.
From the clinical roles; nurse executive and chief nursing officer, I choose the principal nursing officer role of the clinical and administrative functions. This is a higher role compared to the clinical executive role. The discussion presents the processes. For the effectiveness of home care delivery, a higher authority role needs to be incorporated due to policymaking and recruitment. The position that suites this is the administrative role of a chief nursing officer. This position manages all the other administrative types of roles that work hand in hand to provide home care services. On the other hand, a top administrator is distanced from patient care.
Adequate home care delivery dramatically relies upon the patient-nurse work environment and the resources implied in-home care delivery. A research study carried out on Dutch nurses to comprehend how their work environment contributes to positive patient experience reported that. One of the focus groups in the research included nurses in-home care and nursing home care. The nurses mentioned that the essential elements to improve patient experience in the quality of nursing care, there need to be clinically competent nurses, collaborative working relationships, autonomous nursing practise, adequate staffing, managerial support, and patient-centred culture and control over nursing practice. Some of the inhibiting factors mentioned included the cost-effectiveness policy. The nurses feel pressured to increase productivity and report a high administrative workload. These factors do not improve patient experience on the quality of nursing care (Kieft et al.,2014). The chief nursing officer needs to be part of enhancing and ensuring effective in-home care. We have seen that the chief nursing officer’s policy formulation roles and coordination roles are best suited to facilitate the implementation of home care effectiveness.
The chief nursing officer’s responsibility is recruitment in collaboration with the nursing manager since having highly competent staff improves patient care effectiveness. The chief nursing officer needs to advise the nursing manager on the specific qualification and skills required to employ a nursing executive who will deliver effective care. The second step is policy formation on what to do and what not to do during patient care at home to promote effectiveness. It is only through collaboration that goals are achieved. A chief nursing officer needs to be in partnership with other administrative roles of the clinic to work towards a specific purpose. The chief nursing officer should ensure communication and set clear goals for both the executive and the patient during home care to achieve patient care effectiveness.
CONCLUSION
In conclusion, the first step to contribute to effective home care is to acquire the unique skilled profession through graduate-level training. At this stage, nurses specialize and get knowledge of the needed skills to attend to patients at home. A clinical administrator is responsible for the daily functions of health and medical services. He manages healthcare facilities and departments. The roles of a clinical administrator may include quality improvement, compliance regulation, overseeing staff duties and schedules, supplies, maintenance, and record-keeping of medical supplies. An effective home care delivery needs to be: appropriate to a patient’s needs, be in the right place, and the right person should administer the right time with skills and experience. For Effective home care delivery to be achieved, resources right from recruitment need to be streamlined. The policies set in place; a budget also needs formulation to avoid a lack of finances when taking care of a patient. The chief nursing officer needs to coordinate with the staff members and create clear, precise goals. A regular evaluation also needs to be done to form a benchmark.
REFERENCES
American Academy of Ambulatory Care Nursing. (2016). Scope and standards of practise for registered nurses in care coordination and transition management. Pitman, NJ: Author.
Clark, M. J. (2015). Population and Community Health Nursing (6th Edition). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780133846584
Kieft, R. A., de Brouwer, B. B., Francke, A. L., & Delnoij, D. M. (2014). How nurses and their work environment affect patient experiences of the quality of care: a qualitative study. BMC health services research, 14(1), 1-10.
WU, C., LAM, C. H., XHAFA, F., TANG, V., & IP, W. (2022). Domesticating Homecare Services. In IoT for Elderly, Aging and eHealth (pp. 67-86). Springer, Cham.
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