Tracheostomy Care
Tracheostomy is a surgically created hole through the front of the patient’s neck and into the windpipe (trachea). It provides an air passage to help the patient breathe when the usual route for breathing is somehow obstructed or impaired.When neuromuscular disease weakens the muscles used for breathing, many people benefit greatly from non-invasive ventilation (NIV) through face mask and nasal plugs. However, as a person’s breathing capacity deteriorates, this often leads to switching to tracheostomy.
The more common reason for switching to tracheostomy is that after successfully using NIV for some time, a person’s breathing muscles weaken further with progression of a severe neuromuscular disease.
Tracheostomy care might be visually hard and complicated at first but with proper knowledge and practice, it is one of the basic skills our certified nurses possess. We make sure our nurses provide safe and competent care and understand the immediate post-operative and long-term management of tracheostomy care. Thus, high risk of complications such as infection, impaired ventilation, and airway obstruction among others must be prevented. We believe in adhering to evidence-based guidelines to avoid poor outcomes and skilled bedside nursing care can prevent any complication.
Star Home Nurses help patients maintain a positive outlook about living with tracheostomy whether it is temporary or permanent.
Colostomy Care
When the colon, rectum or anus is unable to function normally because of a disease or injury, or needs to rest from normal function, the body must have another way to eliminate waste.A colostomy is an opening called a stoma that connects the colon to the surface of the abdomen. This provides a new path for the waste material and gas to leave the body.
People say that having a stoma is permanent but that’s not always the case. Some stomas are temporary. It’s dependent on the individual circumstances of the illness and if the stoma is for relieving symptoms and giving the bowels a break. A lot of people have temporary stomas to aid symptoms of Crohn’s disease, ulcerative colitis, diverticulitis, sepsis, and accidents. Whilst others due to the above mentioned have permanent stomas, it is simply down to the progression of the illness. Stomas do not discriminate, people can have them from any age.
While still in the hospital after a surgery, the patient and the family will be educated about the care of the colostomy. Living with a colostomy will require a modification of your lifestyle. Star Home Nursing offers support and assistance to patients and families by providing guidance in making the necessary adjustments and preventing complications while aiming to improve the patient’s quality of life.
BiPAP and CPAP Care
The Difference between a BiPAP and a CPAPBilevel Positive Airway Pressure (BiPAP) is a form of non-invasive ventilation (NIV), meaning the pressure is applied by wearing a mask. The mask is connected to tubing that is connected to a machine. Like CPAP machines, BiPAP machines are small, easy to operate, and are relatively quiet. They offer pressure above what is in room air to help a person breathe easier while sleeping or during flare ups.
CPAP stands for Continuous Positive Airway Pressure. It applies a continuous pressure during inhalation and exhalation. This pressure acts as a “splint” to keep airways open while a person exhales. This prevents soft tissue in the upper airway from collapsing and causing sleep apnea. This helps keep a person’s oxygen levels from dropping while sleeping.
CPAP also reduces blood return to the heart so it doesn’t have to work as hard to pump blood through the body. So, CPAP can also be useful for treating heart failure.
Use of BiPAP and CPAP at Home
BiPAP and CPAP machines can be used in the home setting. It has to be prescribed by a doctor, and usually involves sleep study. It has long been suspected that daily use of BiPAP while sleeping improves the quality and length of life especially for people living with severe COPD. It also reduces hospital admissions due to flare ups, and improves outcomes and reduces length of stays, for those who do require hospital admissions.Care of patients with BiPAP and CPAP must be highly individualized, therefore ongoing assessment is important to ensure the safe and effective application of the devices. The reinforcement of education to family members is one of our utmost priorities.
Star Home Nursing provides certified nurses to make sure that the condition of the patient will be stable, and to avoid or minimize the anticipated requirement for frequent adjustments to mechanical ventilation.
Ventilation Patient Care
Mechanical ventilation in the home is not a new idea. With the development of positive pressure ventilators, home use of these devices with tracheostomies emerged as a viable technology.Why is Home the Preferred Location for Long-Term Mechanical Ventilation?
Ideally, the preferred location for long-term mechanical ventilation is in the home because costs are reduced, quality of life is enhanced, patients are reunited with their families and loved ones which greatly enhances normal development and relationships. Home mechanical ventilation also reduces exposure to hospital-borne infections.
Star Home for Home Nursing provide patients with nurses who have intensive care experience and background in order to identify causative factors that may disturb comfort and to provide interventions to promote comfort while receiving mechanical ventilation. Our nurses come in on top of handling the equipment and takes the responsibility to care for the patient as a whole and all its aspects to attain the purpose of care.
Care Feeding Tube or palliative care feeding tube
Star Home Nursing’s Health Care Team handles patients of all ages with medical conditions, diseases, disorders which require the use of feeding tubes. Tubes are used as nutritional support for patients who would otherwise be unable to attain proper nutrition by mouth. Some people use tubes as assistance while also taking food by mouth, others are fed solely by their tubes.There are many different options for feeding through a tube. A patient can be bolus fed, which is where a designated amount of formula or blenderized food is pushed through a syringe a few times a day, or a patient can be on continuous feeds where they must be hooked up to a small pump which regulated formula into their body consistently.
Bolus feeds are normally associated with patients who use tubes on a more intermittent basis than their sole nutrient factor, and whose bodies can tolerate larger volumes of fluid at one time. Many people with feeding tubes are sustained by doctor prescribed formula. This formula contains all the proper nutrients a person would receive from eating orally. Continuous feeds are normally associated with patients who have trouble absorbing nutrients, and who are unable to tolerate large volumes of formula at a time. Continuous can mean: 24/7 feeding, only at night feeding, or feeding for a certain amount of hours during the day. The feeding preference, rate of feeding and time frame are determined by a doctor or dietician depending on the patient’s caloric needs.
Eating is a basic and essential function to human life. Living without something that is within ones nature takes a heavy toll on the individual. We understand that our patients and their families do not take the decision to place a feeding tube lightly. Normally before tube placement, the patient had experienced excessive weight loss, showed loss of vital nutrition in blood tests, and a severe decrease in life quality.
Star Home Nurses help their patients understand the benefits and importance of the feeding tube in order to thrive and maintain an adequate nutritional status.
Urinary Catheter Insertion
Urinary catheterization is a common healthcare intervention used to manage urinary dysfunction. Our certified nurses can perform this procedure at home and will give patients and their families detailed advice about looking after the catheter.TYPES OF CATHETERS
Intermittent catheters are usually designed to be used once and then thrown away. It is used when a person is unable to empty the bladder naturally. Doctor’s recommend this catheterization for people with the following conditions:- Urinary retention
- Incontinence
- Severe bladder problems that could result in kidney damage
- Spina bifida
- Spinal cord injury
- Certain neurological conditions
- After certain types of surgery of the prostate, genitals, or after abdominal hysterectomy
Star Home Nurses will assist and provide guidance in preventing infections and other complications by educating the patient and family regarding ways to minimize the risks, as well as how to cope and do regular activities of daily living with the catheter in place.
Blood Sugar Monitoring
Diabetes is ranked second behind congestive heart failure as the primary diagnosis entry into home care.The role of Star Home Nurses oftentimes begin as patients are discharged from hospitals and rehabilitation centers early in the course of illness which requires more sophisticated nursing management at home. They serve as the liaison among members of the health care team, patients and family members. These nurses eventually develop a complete overview of a patient’s medical regimen and, therefore, responsibility for the coordination of care.
Star Home Nursing believes that adherence to the medication regimen is crucial to good diabetes control. Unfortunately, there are multiple reasons for why patients are unable to take their prescribed medications. Most of the time, it is the lack of knowledge and understanding about when to take certain medications and the importance of taking them at the indicated time. Adherence to the medication regimen is not just dependent on whether a patient will do what is medically indicated, but rather whether the patient has the knowledge, cognitive skills, and physical ability to follow the recommendations.
Our nurses aim to encourage patients to take charge of their diabetes. A perceived loss of control related to homebound status and need for home health services, as well as previous life experiences and familiarity with the more traditional model of medical care may cause these patients to feel ill-equipped to manage their diabetes. With coaching, patients can develop the skills and confidence needed to participate fully in their diabetes management. Patients who are self-directed but physically unable to fully participate in their self-management may need assistance with the process.
Use of motivational interviewing makes a difference in the way our nurses approach behavior modification for their patients. It is not about what a home care nurse or health care provider wants a patient to do, but rather what the patient sees as important and doable. Our paradigm shift is in providing the tools and reasons for change, investigating and negotiating change strategies, assessing readiness for change and identifying the barriers that prevent changes from occurring. The shift is not in promoting patient autonomy, but also educating families to allow patient focused goal setting.
Star Home Nursing helps the patients and their families to cope with this challenge in order to maintain a good quality of life for them.
Intravenious Infusion Therapy at Home
The development of specialized nursing allied technologies is rapidly moving infusion therapy from the hospital to the home. Some patients are too ill to eat and require intravenous infusion to stay hydrated. However, many patients are otherwise well enough to be at home, but need IVs because the medications they are prescribed can be taken only by this route. In other words, there is no other reason for them to be in the hospital.Star Home Nurses are accustomed to working with sharps, performing hand hygiene and using proper protective equipment for invasive procedures. Phlebotomy or IV insertion done at home is no different. Prevention of complications is an important goal in IV insertions as some of these include: infiltration, hematoma, air embolism, phlebitis and or thrombophlebitis, extravascular injection and many others.
At home, a patient receiving treatment can enjoy the comfort sleeping in his own bed, eating home cooked meals, and wearing his own clothes. The reduced stress and improved feeling of well-being the patient feels contributes powerfully to the healing process.
