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Designed for the Unique Needs
of Homecare Providers
This site provides homecare clinicians with access to chronic care management models, best practices and downloadable resources for homecare patients.
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"The body of knowledge that serves as the rationale for nursing practice determines the areas of specialty to develop as well as the manner in which that knowledge is organized, tested and applied." -Carper, 1978
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Diabetes
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Coping
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Plan
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| The plan of care should include measurable specific patient goals that are realistic. It needs to include buy-in and understanding on the part of the patient and caregiver taking into consideration culture, ethnicity, tradition, individual preferences and economic circumstances. |
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Plan characteristics should include:
- Includes a defined time frame.
- Developed with the patient and reflects what the patient wants to achieve.
- Considers patient’s readiness to change.
- Outlines the support they need to make changes.
- Includes individualized interventions to meet patient’s goals*.
*Under implement category you will find tools to help you carry out patient goals.
Important to consider when doing your plan of care:
- Target goals for A1c (including preprandial and postprandial target goals)
- Target goals for blood pressure
- Target goals for cholesterol (LDL, HDL, Triglycerides).
- Current recommended standards of clinical care
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Plan
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