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| Foreword | |
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| Preface | |
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| Acknowledgements | |
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| Contributors | |
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| Reviewers | |
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| About the Authors | |
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| Clinical Operations & Client Care | |
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| Home Care: A Long and Proud History | |
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| Main Factors Underlying the Growth of Home Care | |
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| Home Care: A Proud History | |
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| Definitions of Home Care | |
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| Governmental and Accreditation Organizations | |
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| Home Care Today | |
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| Hospice | |
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| Medicare and Hospice | |
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| The Newest Home Care Services | |
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| Summary | |
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| Care and Services | |
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| Disciplines and Roles | |
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| Physicians | |
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| Registered Nurses | |
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| Licensed Practical or Vocational Nurses | |
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| Therapists | |
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| Physical Therapists | |
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| Occupational Therapists | |
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| Speech/Language Therapists | |
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| Social Workers | |
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| Home Care Aides | |
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| Durable Medical Equipment Companies | |
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| Plan of Care and Physician's Orders | |
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| Coordination of Services | |
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| Outcomes and Assessment Information Set (OASIS) | |
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| The Home Care Nurse Visit | |
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| Conducting the Home Care Nurse Visit | |
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| Organizing the Visit | |
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| Safety | |
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| Assessment | |
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| Implementation of Procedures/Treatments | |
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| Monitoring Medication Therapy | |
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| Teaching | |
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| Documentation | |
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| Medications and the Elderly | |
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| Medication Use and Misuse | |
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| Guidelines for Enhancing Compliance | |
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| Working with Clients' Caregivers | |
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| Identify High-Risk Areas | |
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| Psychological and Emotional Strain | |
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| Physical Strain | |
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| Set Priorities | |
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| Educate the Caregiver | |
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| Discharge Planning | |
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| Continuity of Care | |
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| Use of the Nursing Process in Discharge Planning | |
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| Assessment | |
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| Nursing Diagnosis | |
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| Planning | |
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| Implementation | |
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| Evaluation | |
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| Summary | |
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| Client Education | |
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| The Home Care Nurse-Educator | |
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| Theories of Learning/Teaching | |
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| Adult Learning Theory | |
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| Teaching/Learning Needs Assessment | |
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| Mental Status | |
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| Physical Status | |
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| Vision | |
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| Hearing | |
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| Motor Function | |
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| Literacy | |
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| Literacy Level | |
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| Determining Literacy Level | |
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| Cultural Background | |
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| Teaching | |
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| Development of a Teaching/Learning Plan | |
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| Assessing Learning Needs and Readiness to Learn | |
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| Identifying Goals and Developing Learning Objectives | |
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| Implementing the Plan | |
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| Evaluation of the Teaching/Learning Plan | |
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| Documentation of the Teaching/Learning Plan | |
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| Technology and Teaching | |
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| Summary | |
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| Infection Control | |
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| Chain of Infection | |
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| Infection-Control Program | |
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| Focused or Targeted Infection Surveillance | |
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| Employee Health | |
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| Infectious Organisms in Home Care | |
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| Pulmonary Tuberculosis | |
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| Pertussis | |
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| Influenza and Avian Influenza | |
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| HIV/AIDS and Hepatitis | |
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| Severe Acute Respiratory Syndrome (SARS) | |
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| Multidrug-Resistant Organisms | |
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| Methicillin-Resistant Staphylococcus Aureus (MRSA) | |
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| Community-Acquired Methicillin-Resistant Staphylococcus Aureus | |
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| Vancomycin-Resistant Enterococcus | |
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| Pediculosis and Scabies | |
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| Tools for Infection Control in Home Care | |
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| Hand Hygiene | |
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| Gloves | |
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| Transmission-Based Precautions | |
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| General Precautionary Guidelines | |
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| Contact Precautions | |
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| Droplet Precautions | |
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| Airborne Precautions | |
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| Airborne NIOSH-Approved Respirator/Mask | |
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| Immunocompromised Precautions | |
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| Home Care Bag Technique | |
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| Hazardous Waste and Contaminated Items | |
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| Equipment Cleaning and Biomedical Spills | |
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| Employee Evaluations | |
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| Client Care Procedures | |
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| Infection Reporting | |
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| Client Teaching | |
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| Summary | |
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| Safety and Environment | |
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| Conceptualizing Safety in Home Care | |
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| Who Makes Home Visits | |
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| Perception of Safety | |
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| Contributors to Safety | |
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| Phases of the Home Visit | |
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| Antecedent Phase | |
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| Getting to the Client's Home | |
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| Environmental Assessment | |
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| Client Assessment | |
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| Risky Diagnoses | |
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| Supplies and Equipment | |
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| Ergonomics | |
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| Medications | |
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| Pets | |
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| Nurse Self-Assessment | |
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| Agency Assessment | |
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| Making the Home Visit | |
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| Activities of Daily Living | |
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| Home Conditions | |
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| Leaving the Home and Returning to the Agency | |
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| The Threat of Violence | |
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| Summary | |
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| Infusion Therapy: High-Tech Home Care Concerns and Issues | |
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| Clinician Safeguards | |
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| Setting Priorities | |
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| Client Assessment for Home Infusion Therapy | |
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| Condition of the Client and the Environment | |
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| Therapy Administration | |
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| Health Care Provider | |
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| Infusion Access Devices | |
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| Subcutaneous Infusion Devices | |
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| Peripheral Intravenous Access Devices | |
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| Complications | |
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| Central Venous Access Devices | |
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| Peripherally Inserted Central Catheter | |
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| Non-Tunneled CVAD | |
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| Tunneled CVAD | |
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| Implanted CVAD (Implanted Port) | |
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| Pumps and Infusion-Delivery Systems | |
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| Intravenous Push (IV Push) Medications | |
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| Medication Delivery via Gravity or Dial-a-Flow Pumps | |
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| Stationary (Pole-Mounted) Pumps | |
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| Elastomeric Pumps | |
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| Ambulatory Pumps | |
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| Intraspinal Infusions | |
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| Infusion Adapters and Caps | |
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| Client and Caregiver Education | |
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| Summary | |
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| Administrative Operations | |
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| Leadership | |
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| Governance | |
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| Advisory Group | |
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| The Leadership Team | |
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| Home Care Administrator | |
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| Director of Nurses | |
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| Financial Services Leader | |
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| Information Management Leader | |
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| Performance Improvement and Quality Manager | |
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| Specialty Leadership Positions | |
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| Organizational Structure | |
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| Organizational Charts | |
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| Policies and Procedures | |
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| Policies Related to Client Safety | |
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| Planning, Designing, and Providing Services | |
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| Providing Services | |
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| Provision of Resources | |
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| Staffing Plans and the Provision of Care | |
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| Information Management Planning | |
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| Emergency Management Planning | |
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| Strategic Planning | |
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| Annual Program Evaluation | |
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| Evaluation of Scope of Care | |
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| Evaluation of Client Care | |
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| Financial Planning and Management | |
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| Prospective Payment System | |
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| Development of the Financial Plan | |
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| Budget Formats | |
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| Contracts | |
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| Contracts with Other Entities | |
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| Contract to Provide Services | |
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| Quality Management and Performance Improvement | |
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| Performance Improvement Plan | |
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| Compliance Plan | |
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| Summary | |
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| Legal Issues | |
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| Nursing Practice and Licensure | |
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| A Brief History of Licensure | |
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| Nurse Practice Acts | |
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| Standards of Practice | |
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| Regulatory Agents | |
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| Client Rights | |
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| Client Bill of Rights | |
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| Health Insurance Portability and Accountability Act (HIPAA) | |
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| Confidentiality | |
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| Client | |
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| Records | |
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| Informed Consent | |
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| Written Consent | |
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| Implied Consent | |
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| Informed Refusal | |
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| Client Self-Determination Act | |
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| Advance Directives | |
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| Living Will | |
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| Durable Power of Attorney for Health Care | |
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| Issues of Concern | |
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| Negligence and Neglect | |
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| Malpractice | |
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| Abuse | |
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| Abandonment | |
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| Tele-Health | |
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| Impact of the Legislative Process | |
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| Summary | |
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| Ethics in Home Care and Hospice | |
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| Overview of Ethics and Morality | |
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| Virtue and Communitarian Ethics | |
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| Communitarian Ethics | |
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| Virtue Ethics | |
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| Truthfulness | |
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| Compassion | |
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| Moral Courage | |
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| Equanimity | |
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| Just Generosity | |
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| Moral Agency | |
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| Autonomy | |
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| Vulnerability and Dependability | |
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| Competence | |
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| Dignity and Dementia | |
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| End of Life | |
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| Death Anxiety | |
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| Withholding and Withdrawing Life Support | |
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| Voluntary Stopping Eating and Drinking | |
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| Rule of Double Effect | |
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| Terminal Sedation | |
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| Physician-Assisted Suicide | |
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| Rational Suicide | |
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| Summary | |
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| Quality Improvement | |
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| Quality | |
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| Perspectives on Quality | |
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| Quality Improvement | |
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| Quality Experts | |
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| W. Edwards Deming | |
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| Joseph Juran | |
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| Philip Cosby | |
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| Health Care's History of Quality | |
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| Performance Improvement | |
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| Performance-Improvement Methods | |
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| Plan-Do-Check-Act | |
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| Focus | |
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| Joint Commission Model | |
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| Six Sigma | |
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| Performance Improvement Tools | |
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| Control Charts | |
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| Histograms | |
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| Run Charts | |
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| Line Graphs | |
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| Scatter Diagrams | |
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| Cause and Effect, Fishbone, or Ishikawa Diagrams | |
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| Flowcharts | |
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| Outcome-Based Quality Improvement Systems | |
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| Home Health Compare | |
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| Summary | |
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| Management of Human Resources | |
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| Recruitment of Staff | |
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| Orientation, Training, and Education | |
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| Organization Mission Statement | |
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| General Organization Policies | |
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| Competencies | |
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| Preceptorship | |
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| Retention of Staff | |
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| Exit Interview | |
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| Employment Satisfaction Survey | |
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| Management Visibility | |
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| Personnel Records | |
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| Summary | |
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| Informatics and Technology | |
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| History of Informatics in Health Care | |
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| Assessment of Client Needs | |
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| Types of Tnformatics/Technology in Home Care | |
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| Noncomputer Technologies | |
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| Tele-Home Care | |
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| Telemonitors and Videophones | |
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| Messaging Devices | |
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| Digital Cameras | |
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| Point-of-Care Documentation | |
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| Personal Digital Assistants | |
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| Advantages of Information Technology in Home Care | |
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| Clients | |
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| Caregivers | |
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| Home Care Professionals | |
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| Disadvantages of Information Technology in Home Care | |
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| Looking to the Future | |
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| Governmental Influences | |
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| Nongovernmental Influences | |
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| Summary | |
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| Glossary | |
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| Index | |