Work system analysis of home nursing care and implications for medication errors

2005 ◽  
Author(s):  
K. L. Calvin ◽  
Gail R. Casper ◽  
Ben-Tzion Karsh ◽  
Patricia F. Brennan ◽  
Laura J. Burke ◽  
...  
Author(s):  
K.L. Calvin ◽  
Gail R. Casper ◽  
Ben-Tzion Karsh ◽  
Patricia F. Brennan ◽  
Laura J. Burke ◽  
...  

The purpose of this study was to examine the context of the provision of home nursing care for patients with congestive heart failure. A modified macroergonomic analysis and design work system analysis was undertaken in two phases with fourteen nurse participants: I) field observations of eight nurses for the collection of data on work elements and II) follow-up telephone interviews with six home care nurses. Open-ended questions were asked after the observations to identify clinical knowledge, policies, and procedures that influenced care decisions and practices. The telephone interviews focused on four different aspects of home health care delivery and were conducted using semi-structured questions. Results of the observations were translated into flowcharts and a summary report. The baseline findings described aspects of home medication management and its relevance to safety, quality of care, communication, and self-management.


2020 ◽  
Author(s):  
Yea-Ing Shyu ◽  
Chung-Chih Lin ◽  
Ching-Tzu Yang ◽  
Pei-Ling Su ◽  
Jung-Ling Hsu

BACKGROUND Wearable devices have been developed and implemented to improve data collection in remote health care and smart care. Wearable devices have the advantage of always being with individuals, enabling easy detection of their movements. In this study, we developed and implemented a smart-care system using smart clothing for persons with dementia and with hip fracture. We conducted a preliminary study to understand family caregivers’ and care receivers’ experiences of receiving a smart technology-assisted (STA) home-nursing care program. OBJECTIVE This paper reports the difficulties we encountered and strategies we developed during the feasibility phase of studies on the effectiveness of our STA home-nursing care program for persons with dementia and hip fracture. METHODS Our care model, a STA home-nursing care program for persons with dementia and those with hip fracture included a remote-monitoring system for elderly persons wearing smart clothing was used to facilitate family caregivers’ detection of elderly persons’ movements. These movements included getting up at night, staying in the bathroom for more than 30 minutes, not moving more than 2 hours during the day, leaving the house, and daily activities. Participants included 13 families with 5 patients with hip fracture and 7 with dementia. Research nurses documented the difficulties they encountered during the process. RESULTS Difficulties encountered in this smart-care study were categorized into problems setting up the smart-care environment, problems running the system, and problems with participant acceptance/adherence. These difficulties caused participants to drop out, the system to not function or delayed function, inability to collect data, extra costs of manpower, and financial burden. Strategies to deal with these problems are also reported. CONCLUSIONS During the implementation of smart care at home for persons with dementia or hip fracture, different aspects of difficulties were found and strategies were taken. The findings of this study can provide a reference for future implementation of similar smart-home devices.


2016 ◽  
Vol 53 (2) ◽  
pp. 133-142
Author(s):  
Kumiko Tanaka ◽  
Keiko Takeda ◽  
Keiko Suyama ◽  
Akiko Kooka ◽  
Satsuki Nakamura

Kontakt ◽  
2007 ◽  
Vol 9 (1) ◽  
pp. 32-41
Author(s):  
Mária Nemčeková ◽  
Mária Tabaková

2020 ◽  
Vol 27 (8) ◽  
pp. 1669-1680
Author(s):  
Siri Andreassen Devik ◽  
Hilde Munkeby ◽  
Monica Finnanger ◽  
Aud Moe

Background: Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care. Objective: The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care. Design and participants: Qualitative individual interviews were performed with 10 nurse managers with human resources responsibilities for healthcare workers in four nursing home wards and six home nursing care districts. Content analysis was used to analyse the data. Ethical considerations: The Norwegian Centre for Research Data granted permission for this study. Findings: The analysis resulted in seven subcategories that were grouped into three main categories: managers’ perception of the importance of the role, managers’ experiences of exercising the role and managers’ opportunities to fulfil the role. Challenges with conceptualizing ethics were highlighted, as well as lack of applicable tools or time and varying motivation among employees. Discussion: The leaders tended to perceive ethics as a ‘personal matter’ and that the need for and benefit of ethical support (e.g., ethics reflection) depended on individuals’ vulnerability, attitudes, commitment and previous experiences. The managers did not seem to distinguish between their own responsibility to support ethical competence and the responsibility of the individual employee to provide ethical care. Conclusions: Our findings suggest that nurse managers need support themselves, both to understand and to carry out their responsibilities to foster their staffs’ ethical conduct. Supporting staff in conducting ethically sound care requires more than organizing meeting places for ethical reflection; it also requires greater awareness and understanding of what ethical leadership means.


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