Adopting Standards for the Development of Nursing Competency in Home Care Home care nursing encompasses a wide range

of health services delivered at home and the community as well to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social or therapeutic treatment and/or assistance with the essential activities of daily living. It does not only include present situation but more so to deliver continuing care at home. There has been changes brought on the demands of the need of health services in the Middle East not just in the hospital but people, especially of the geriatric age, with longer life expectancy have an increased need for home and continuing care. We have come up with a realization on how to improve the delivery of homecare services on the basis of comparing the standards of homecare with the Joint International Commission (JCI) from those of the Accreditation Canada International (ACI). This has been made to inform us of the development of practice competencies for healthcare providers working in home health care and to identify the things that are yet to be addressed or what seems to be deficient in the current practice. This review of the standards of home care practice provides the background for the development of a consensus process amongst us on a final list of competencies and standards for home care registered nurses. Listed below are the standards for each accrediting body and which aspects are not addressed to the other and vice versa. 1. JCI STANDARDS
1.1 International Patient Safety Goals (IPSG) 1.2 Patient Access and Assessment (PAA) 1.3 Patient Rights and Responsibilities (PRR) 1.4 Patient Care and Continuity of Care (PCC) 1.5 Patient Medication Management (PMM) 1.6 Patient and Family Education (PFE)

2. ACI STANDARDS
2.1 The organization plans and designs its home care services based on client need. 2.2 The organization works with contracted service providers such as health care staffing agencies to deliver home care services. 2.3 The organization provides the staff, equipment, communication tools and other resources needed to provide home care services. 2.4 The organization uses a team approach to deliver home care services. 2.5 The organization has qualified, educated, and competent staff and service providers. 2.6 The organization promotes the well-being and work life balance of each staff member and service provider. 2.7 The organization coordinates timely access to home care services for clients, families and referring organizations. 2.8 The organization respects the rights of clients and their families and obtains informed consent to deliver home care services. 2.9 The organization develops a comprehensive service plan for each client based on service goals. 2.10 The organization manages medications in a safe and accurate manner. 1

1.7 Improvement in Quality and Patient Safety (IQS) 1.8 Infection Prevention and Control (IPC) 1.9 Management and Safety of the Environment (MSE) 1.10 Staff Qualifications and Education (SQE)

Adopting Standards for the Development of Nursing Competency in Home Care
1.11 Governance and Leadership (GAL) 1.12 Communication and Information Management (CIM 7. Improvement in Quality and Patient Safety (IQS) 2.11 The organization prepares clients and families for planned transfers and end of service. 2.12 The organization keeps client records accurate, up-to-date, and secure 2.13 The organization bases its home care services on research, evidence- based guidelines, and best practice information. 2.14 The organization promotes safety in the service environment. 2.15 The organization regularly evaluates the quality of its home care services.

ACI standards addresses the competencies with the organization as the basis to deliver services in a way that helps clients maintain their independence and maximize their quality of life. On the other hand, JCI standards are organized around the important functions common to all health care organizations. The standards are grouped by those functions related to providing patient care and those related to providing a safe, effective, and well-managed organization. These functions apply to the entire organization as well as to each department, unit, or service within the organization. Standards of the JCI (refer to 1st column) were pointed out in the ACI except that there was no specific emphasis on the Infection Prevention and Control (1.8). However, it should be undertaken in 2.14 of the ACI for the promotion of safety in the service environment. Moreover, contracted service providers such as health care staffing agencies ( see 2.2) and providing the staff, equipment, communication tools and other resources needed to provide home care services (see 2.3) are not indicated in the JCI standards. The results of the review presented in this report have provided evidence of the vast array of diverse competencies required for the unique and complex practice of home health nursing. Accreditation Canada International (ACI) standards are broadly familiar with the Joint International Commission (JCI), and those standards deliver the complexity and scope of home health nursing practice. Accordingly, it is recommended that all standards form each accreditor be adapted as needed and utilized for us to come up with the best framework for our own home care nursing.

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