Home nursing service

   Home nursing is a part of nursing care, the purpose of which is to assist those in need of help to maintain their state of health and coping ability in the best way possible. Teamwork is an extremely important part of home nursing, since the patients are often visited by representatives of different areas of specialisation. Communication-based co-operation creates preconditions to teamwork where everybody knows their role and gives their best (Pace 1998).
  Most often, home nursing services in Estonia are used by 65-85 years old people, while the main age groups may be different in city and rural surroundings. Based on health problems, clients requiring home nursing services may be categorised as follows: cardiovascular diseases, neurological conditions, lesions and skin problems, cognitive and behaviour disorders (patients with psychical problems), degenerative changes of the motor apparatus, geriatric problems, chronic obstructive lung disease, pains, specific diseases and injuries requiring non-active treatment (infusion treatment, oxygen treatment, dialysis, diabetes, epicystostomy, tracheotomy and colostomy treatment, persons in terminal condition and their problems) (Home Nursing Manual 2004).
   In Estonia, home nursing is defined as qualified nursing care provided under doctor’s orders for the treatment and/or efficient coping in home environment of patients recovering from an acute disease, suffering from a chronic disease or with limited functional capacity (Home Nursing Manual 2004). Pursuant to the Development Plan of Estonian Nursing Care Network, in Estonian health care, home nursing service is a developing type of service, for which reason it is important to know the opinion of home nurses, service providers, and patients as service consumers alike regarding the essence of high quality nursing care services and the existing possibilities for ensuring the quality of home nursing care services (Development Plan of Estonian Nursing Care Network 2001).
   Upon provision of high-quality home nursing service, both the nursing process and its management play an important role. Nursing process is a systematic activity in the course of which the patient’s nursing care needs are determined within the framework of co-operation between the nurse and patient, and condition assessment, activity planning and evaluation of patient satisfaction and nursing care results takes place (Al-Kandari 1998). Nursing management proceeds from the objective and not from rules, system and work tasks only; it is based on common values and concordance, stimulates to take initiative and leads to activity. Nursing management contains a lot of the following: independence, responsibility and feeling of duty upon pursuing of common goals (Dencker 2003).