By: Portia Wofford
Home health clinicians play an essential role in caring for patients who are:
At risk of developing sepsis
Recovering from sepsis or septic shock
Home health providers are vital in preventing hospital admissions and readmission among sepsis patients. According to the CDC, sepsis is the body’s extreme response to an infection. It is a potentially life-threatening medical emergency.
Many patients receiving home healthcare services have chronic medical conditions and comorbidities that put them at risk for infection, including COVID-19 and sepsis. According to the Global Sepsis Alliance, COVID-19 can cause sepsis. Research suggests that COVID-19 may lead to sepsis due to several reasons, including:
Direct viral invasion
Presence of a bacterial or viral co-co-infection
Age of the patient
According to Homecare Magazine, approximately 80% of people with COVID-19 will have a mild course and recover without hospitalization. The remaining 20% of patients with COVID-19 may develop sepsis and be admitted. Patients with severe illness will need home health care.
A study published in Medical Care by the National Institutes of Health (NIH) suggests that when strategically implemented, home health care can play an essential role in reducing hospital readmissions for patients recovering from sepsis. According to Home Health Care News, the study points out that sepsis survivors who were less likely to return to the hospital if they:
Received a home health visit within 48 hours of hospital discharge
Had at least one additional visit and
Had physician visit within their first week of discharge
Home health care can contribute to early detection of sepsis
Early detection is critical. For each hour treatment initiation is delayed after diagnosis, the mortality rate increases 8%. Home health nurses can monitor and educate patients and their caregivers on signs and symptoms to report to include. Additionally, home healthcare agencies can provide screening tools that fill the gaps in identifying at-risk patients during transitions from inpatient to outpatient settings.
Home health provides case management for chronic comorbidities
Some comorbidities like Type 2 Diabetes, chronic heart disease, and dementia were associated with sepsis risk in almost all infection types. Those with other chronic illnesses, cancer, and an impaired immune system are also at increased risk. Monitoring can help reduce risks.
Nurses can review and coordinate care to adjust medications, evaluate treatments and interventions, and refer for appropriate treatment.
When it comes to serious complications, our sepsis program effectively:
Prevents infections that can lead to sepsis
Recognizes sepsis symptoms before they become severe
Rapidly responds if sepsis symptoms occur by initiating appropriate treatments and referrals
Follows-up with care to ensure continued recovery
Hospice of the Midwest’s sepsis program promotes quality of care and improves outcomes for those at risk for developing or recovering from sepsis.Pandemic Relief via legislation, CMS waivers, and enforcement discretion
CMS permits HHAs to provide all necessary telehealth during the emergency period
Must be physician-ordered and on the plan of care
Does not replace in-person visits (telehealth or telephonic visits are not billable visits)
Allows for HHA to supplement in person visits for patients who might refuse more frequent visits or senior living or other congregate living facilities that might be restricting access to HHA personnel.
The Home Health Face to Face visit may also be provided by telehealth but must be performed utilizing 2-way audio and visual programs.
In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world.
Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients.
In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether.
Telehealth Tools
Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:
Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
Video: Abode Healthcare staff may conduct remote visits with patients through Doxy.me. (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.
Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.
Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.
CMS clarification on homebound status for COVID-19 patients and those at high risk of contracting:
Non-Physician Home Health Certification Authority
Allows patient to be under the care of an NPP to the extent permitted under state law