{"title":"The challenge of risk prevention in home healthcare-An interview study with nurses in municipal care.","authors":"Jonatan Lekman, Erik Lindén, Mirjam Ekstedt","doi":"10.1111/scs.13181","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Safety in home healthcare has garnered increased attention as more people are receiving care for complex conditions at home. The prerequisites for providing safe care at home differ from those in hospitals. Malnutrition, falls, pressure ulcers and inappropriate medication commonly follow poor risk assessments, causing unnecessary suffering and costs. Therefore, risk prevention in home healthcare needs to be prioritised and studied more closely.</p><p><strong>Aim: </strong>To describe nurses' experiences of performing risk prevention in municipal home healthcare.</p><p><strong>Methods: </strong>Qualitative inductive approach, using semi-structured interviews with 10 registered nurses in a municipality in southern Sweden. Data underwent qualitative content analysis.</p><p><strong>Findings: </strong>The analysis resulted in three main categories and one overarching theme describing nurses' experiences of risk prevention in home healthcare. Getting everyone onboard comprises the categories: Managing safety while respecting the patient's self-determination, which covers patient participation, the strategic importance of respecting different views of risks and information and the fact that healthcare workers are guests in the patient's home. Finding ways to make it work touches upon the relational aspect, including next-of-kin and promoting a common understanding to prevent risks. Being squeezed between resources and requirements refers to ethical dilemmas, teamwork, leadership and organisational prerequisites.</p><p><strong>Conclusion: </strong>Patient habits, living conditions and limited awareness of risks is a challenge in risk prevention in home healthcare, where patient participation plays a pivotal role. Risk prevention in home healthcare needs to be initiated at an early stage of disease and ageing and should be seen as a process where early health-promoting interventions can prevent the development and accumulation of risks over time. Long-term cross-organisational collaborations and patients' physical, mental and psychosocial conditions also need to be taken into account.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Journal of Caring Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/scs.13181","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/5/24 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Safety in home healthcare has garnered increased attention as more people are receiving care for complex conditions at home. The prerequisites for providing safe care at home differ from those in hospitals. Malnutrition, falls, pressure ulcers and inappropriate medication commonly follow poor risk assessments, causing unnecessary suffering and costs. Therefore, risk prevention in home healthcare needs to be prioritised and studied more closely.
Aim: To describe nurses' experiences of performing risk prevention in municipal home healthcare.
Methods: Qualitative inductive approach, using semi-structured interviews with 10 registered nurses in a municipality in southern Sweden. Data underwent qualitative content analysis.
Findings: The analysis resulted in three main categories and one overarching theme describing nurses' experiences of risk prevention in home healthcare. Getting everyone onboard comprises the categories: Managing safety while respecting the patient's self-determination, which covers patient participation, the strategic importance of respecting different views of risks and information and the fact that healthcare workers are guests in the patient's home. Finding ways to make it work touches upon the relational aspect, including next-of-kin and promoting a common understanding to prevent risks. Being squeezed between resources and requirements refers to ethical dilemmas, teamwork, leadership and organisational prerequisites.
Conclusion: Patient habits, living conditions and limited awareness of risks is a challenge in risk prevention in home healthcare, where patient participation plays a pivotal role. Risk prevention in home healthcare needs to be initiated at an early stage of disease and ageing and should be seen as a process where early health-promoting interventions can prevent the development and accumulation of risks over time. Long-term cross-organisational collaborations and patients' physical, mental and psychosocial conditions also need to be taken into account.
期刊介绍：
Scandinavian Journal of Caring Sciences is an established quarterly, peer reviewed Journal with an outstanding international reputation. As the official publication of the Nordic College of Caring Science, the Journal shares their mission to contribute to the development and advancement of scientific knowledge on caring related to health, well-being, illness and the alleviation of human suffering. The emphasis is on research that has a patient, family and community focus and which promotes an interdisciplinary team approach. Of special interest are scholarly articles addressing and initiating dialogue on theoretical, empirical and methodological concerns related to critical issues. All articles are expected to demonstrate respect for human dignity and accountability to society. In addition to original research the Journal also publishes reviews, meta-syntheses and meta-analyses.
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