The Rising Demand for Private Duty Nurses

Private duty nursing care (PDN) is skilled nursing care provided in the patient's residence and sometimes at different healthcare institutes. PDN provides individual and continuous skilled care for patients with complex or specific needs. Private duty nursing staff includes licensed practical nurses, nurses' aides, registered nurses, who develop personalized plan for both short and long term care that includes

  • Personal services
  • Companionship
  • Medically-necessary care
  • Respite visit for caregivers

PDN are usually required during

  • Post-surgery care
  • Traumatic brain injuries
  • Terminal illness

In addition to providing care in the home, the nurse also accompanies patients outside of the home for activities that take patients away from home during the day.

Who is covered under private duty nursing care?

Patient under medical coverage:

  • Regular medical coverage
  • Pregnant woman coverage
  • Patient's medical needs

A patient requires continuous and substantial nursing care by a licensed nurse under following circumstances

  • When patient requires prolonged intravenous nutrition and drug therapy
  • When patient depends upon ventilation for prolonged period
  • When patient depends on respiratory support, including tracheal suction and tracheostomy care

However, the following conditions restrict the provision of care under PDN

  • A patient receiving hospice under any medical care may not receive PDN services related to the treatment of the illness
  • A patient receiving personal care service or Home Health Aide may not be provided a PDN during the same time period.

PDN and their primary responsibilities

  • Since PDN is a one-to-one interaction, their responsibilities encompasses the following aspects
  • Taking medical history of patient in collaboration with other members of the healthcare providers such as physician and dietician
  • Administration of medications and treatments as prescribed by physician
  • Changing dresses, bandages and contraptions as prescribed
  • Day-to-day patient interaction
  • Assisting patient in self-care including bathing needs, dental care needs or hair and nail care needs
  • Monitoring and supervising diet with consideration to dietician advice and medical conditions
  • Checking vital signs of patient
  • Planning to prevent bed sores if a patient is bed ridden. Contractures and muscle wasting is to be provided
  • Treating and providing remedies when alterations are observed
  • Helping with range of motion exercises - active and passive depending on the physical conditions
  • Documenting patient's condition and highlighting significant changes and report to the physicians and to the families
  • Preparing meals and feeding the patient
  • Escorting to appointments
  • Assisting with ambulation
  • Treating orthopaedic disorders, genetic disorders, diabetes, short bowl syndrome and controlling infections
  • Measuring height and weight of patient as instructed by physicians
  • Providing tracheotomy, palliative, paediatric, Alzheimer's/Dementia, ostomy care and wound care
  • Preventing falls, infections, pressure ulcers and brain and spinal cord injuries
  • Maintaining optimum health and well-being of the patient
  • PDN also involves family in the care plan. They should be informed and updated of the current status of the patient and is encouraged to assist and participate in the delivery of care.

Skilled nursing means assessment, interventions, judgements and evaluation of interventions requiring education, training and experience of licensed nurse. PDN must be appointment under the direction of a physician.

PDN eligibility criteria

  • A private duty nursing should meet
  • Medical eligibility criteria that requires continuous skilled nursing assessment and care on a daily basis, from the time the nurse is authorized to provide care
  • General eligibility criteria that requires PDN to work at home. They are dependent on medical technologies to sustain life
  • PDN should have at least one year of clinical experience
  • They should have training in first aid and basic life support
  • They should attend different nursing seminars and forums

Nursing has a vast scope on healthcare and services. Private Duty Nursing demands have increased to home-bound patients and in long term facilities posing some discrepancies to health delivery services. PDN professionals also work as freelancers or through hospital and nursing agencies, delivering healthcare services to patients or two.

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