hospital

1. Health care agencies

3. Specialized care centers
Specialized care centers provide services for a specific population or
group. They are usually located in easily accessible locations within a
community.

4. Day Care Centers
• Day care centers have a variety of purposes.
• Some centers care for healthy infants and children whose
parents work. Some also care for children with minor
illnesses.
• Elder care centers and senior citizen centers provide a
place for older adults to socialize and to receive care while
family members are working.
• Some day care centers provide health-related services and
care to people who do not need to be in a health care
institution eg preeclampsia clinic but cannot be at home
alone.

5. Contd…
• Day care centers are also available for people with special
needs (e.g., cerebral palsy), people with chemical and
physical dependency, and mentally ill patients.
• Nurses who work in day care centers administer medication
and treatments, conduct health screenings, teach, and
counsel.

6. Ambulatory Care Centers and Clinics
They deliver medical care on an outpatient basis. Many
ambulatory care centers and clinics offer walk-in services and are
often located in convenient areas such as shopping malls, drug
stores, grocery stores, etc. They are often called convenient care
clinics. These clinics have dramatically improved access to care for
those with other barriers to health care.
It is called ambulatory care because it is medical care provided on
an outpatient basis. The word ambulatory refers to walking. So,
when a patient attends a hospital for treatment but doesn't stay the
night-ambulatory care services are employed to monitor the health of
such patients.

7. • These settings include medical offices and clinics,
ambulatory surgery centers, hospital outpatient
departments, and dialysis centers.
• Nurses in ambulatory care centers and clinics provide technical
services, determine the priority of care needs, and provide teaching
about all aspects of care. Surgical centers are another form of
ambulatory care center.

8. Mental Health Centers
Mental health centers may be associated with a hospital or
may provide services as an independent agency.
The services provided may be crisis centered or may involve
long-term counseling.
Patients receive outpatient care through a variety of
interventions, including individual and group counseling,
medications, and assistance with independent living. Crisis
intervention centers are also mental health centers.

9. • They typically provide 24-hour services for people who are prone to
suicide, drug or alcohol abusers, or people in abusive situations.
These centers also provide services for victims of rape and abuse,
victims of disaster etc. Nurses who work in mental health centers
must have strong communication and counseling skills and must be
thoroughly familiar with community resources specific to the needs of
patients being served in order to make appropriate referrals.
• Some common examples of crisis intervention include suicide
prevention telephone hotlines, hospital-based crisis
intervention, and community-based mental health services
mobilized during a disaster.

10. Rural Health Centers
Rural health centers are often located in geographically remote areas
that have few health care providers. Many rural health centers serve as
the patient's primary health provider for the care of minor acute
illnesses as well as chronic ill nesses.
Patients who are seriously ill or injured are given emergency care and
then transported to the nearest large hospital. Nurses who practice
independently usually do so in collaboration with a physician who
approves protocols for care. Many rural health care settings no access
to information about diagnosis and treatment of ill ness through
telecommunication and computers.

11. Schools health services
• School nurses are often the major source of health assessment, health
education, and emergency care for the children.
• The role of the school nurse reflects changes in the society itself: Children
in schools today are from many different racial and ethnic groups, have
varying socioeconomic backgrounds, and have more complex disabilities
that require expert knowledge and skills for management during school
hours.
• School nurses provide many different services, including maintaining
immunization records, providing emergency care for physical and mental
illnesses, administering prescribed medications, conducting routine health
screenings (e.g., vision, hearing, scoliosis), and providing health information
and education.

12. Homeless Shelters
• Homeless shelters are usually living units, such as an apartment
building or home, temporary places that provide housing for
people who do not have regular shelter.
• The homeless are at an increased risk for illness or injury because
of factors such as exposure to the elements, exposure to
violence, drug and alcohol addiction, poor nutrition, poor
hygiene, and over crowding.
• Services provided by nurses in homeless shelters include
immunizing children, teaching pregnant women, treating
infection and illnesses, referring for diagnosis and treatment of
STIs, and providing information about maintaining health.

13. Rehabilitation Centers
• Rehabilitation centers specialize in services for patients requiring
physical, psychological, social or vocational rehabilitation.
• These centers may be free-standing or associated with a hospital. The
goal is to return patients to optimal health and to the community as
independent members of society.
• Rehabilitation centers often use a multidisciplinary team composed of
physicians, nurses, physiotherapists, occupational therapists, and
counsellors. The role of the nurse includes direct care teaching and
counseling. The practice of rehabilitation nursing is based on a
philosophy of encouraging independent self-care within the patient's
capabilities.

14. Home Health Care
• Home health care is a wide range of health care services that can be
given in your home for an illness or injury. Home health care is usually
less expensive, more convenient, and just as effective as care you get in a
hospital or skilled nursing facility
• The range of home health care services a patient can receive at home is
limitless. Depending on the individual patient's situation, care can range
from nursing care to specialized medical services, such as laboratory
workups, physical, occupational, and/or speech therapy
• Home health care is provided through community health departments and home
health agencies.
• These agencies provide many different health related services, including skilled
nursing assessment, teaching and support of patients and family members, and
direct care for patients.

15. Contd…
• The importance of home health care is evidenced by many
factors. Early discharge from hospitals due to the increasing
cost has created a new, acutely ill population that needs skilled
care at home.
• Increasing numbers of older people, having multiple chronic
illnesses can be kept alive and relatively comfortable in their
own homes with sophisticated technology.
• Health care consumers demand that services be human and
that provisions be made for a dignified death at home.

16. Contd…
• Nurses who provide care in the home make assessments and
provide physical care, administer medications, teach and
support family members. They also collaborate with other
health care providers, such as physicians, physical therapists,
occupational therapists and social workers to plan and
provide care.

17. Health care services for seriously ill and dying
• It includes:
• Respite care
• Hospice services
• Palliative care

18. Hospice Services
Hospice Services Hospice is a program of palliative and supportive care
services providing physical, psychological, social, and spiritual care for
dying people, their families, and other loved ones.
The interdisciplinary hospice team:
• Manages the patient's pain and symptoms
• Assists the patient with emotional, psychological, and spiritual aspects of
dying
• Provides needed drugs, medical supplies, and equipment .
• Instructs the family on how to care for the patient
• Delivers special services such as speech and physiotherapy when
needed.

19. Contd…
• Makes short-term inpatient care available when pain or
symptoms become too difficult to treat at home, or the
caregiver needs respite.
• Provides bereavement care and counseling to surviving family
and friends
• The hospice nurse combines the skills of the home care nurse
with the ability to provide daily emotional support to dying
patients and their families. Hospice nurses are espe cially skilled
in pain and symptom management. Their focus is on improving
the quality of life rather than merely pro longing its length, and
on preserving dignity for the patient in death.

20. Respite Care
Respite care is a type of care provided for caregivers of home bound ill,
disabled, or older patients.
The main purpose is to give the primary caregiver some time away
from the responsibilities of day-to-day care.
Professionals or volunteers may provide care in an adult day care
center or in the patient's home. In most instances, the care is provided
by trained nursing assistants or volunteers. Professional nurses provide
information about how to access respite care and may make referrals.

21. Palliative care
• Palliative care evolved from the hospice experience but also exists
outside of hospice programs. It is not restricted to the end of life and
can be used from the point of initial diagnosis.
• Palliative care, which may be given in conjunction with medical
treatment and in all types of health care settings, focuses on the relief
of physical, mental, and spiritual distress.
• The goal of palliative care is to prevent and relieve suffering by early
assessment and treatment of pain and other physical problems (such
as difficulty breathing, nausea, fatigue, and problems with sleeping).
Like hospice care, palliative care is provided by an interdisciplinary
team.