Contributing causes to adverse events in home care and potential interventions to reduce their incidence

2018 ◽  
Vol 31 (5) ◽  
pp. 178-185 ◽  
Author(s):  
G. Ross Baker ◽  
Virginia Flintoft ◽  
Anne Wojtak ◽  
Regis Blais
Keyword(s):  
Adverse Events ◽  
Home Care ◽  
Home Care Services ◽  
Care Staff ◽  
Home Environments ◽  
Organization And Management ◽  
Care Services ◽  
Task Team ◽  
Communication And Coordination ◽  
Medication Related Events

The increasing complexity of home care services, pressures to discharge patients quicker, and the growing vulnerabilities of home care clients all contribute to adverse events in home care. In this article, home care staff in six programs analyzed 27 fall- and medication-related events. Classification of contributing causes indicates that patient and environmental factors were common in fall events, while organization and management factors along with patient, task, team, and individual factors were common in medication-related events. Home care settings create specific challenges in identifying and mitigating risks. Some factors, such as variations in home environments, are difficult to address. However, changing care coordination structures and communication methods could ameliorate other factors, including poor communications among staff and limited team and cross-sector communication and coordination. Ensuring that medication ordering and administration processes are optimized for home environments would also contribute to safer care.

scholarly journals Who Is Doing What in Home Care Services?

2021 ◽  
Vol 18 (19) ◽  
pp. 10504
Author(s):  
Berit Irene Helgheim ◽  
Birgithe Sandbaek
Keyword(s):  
Home Care ◽  
Registered Nurses ◽  
Health Workers ◽  
Care Service ◽  
Home Care Services ◽  
Smartphone Application ◽  
Care Staff ◽  
Care Services ◽  
Patient Work ◽  
Assistant Nurses

(1) Background: This paper investigates the distribution of work hours by activity, for the main staff categories in home care services in three rural Norwegian municipalities. In Norway these categories are registered nurses, assistant nurses and assistant health workers. (2) Methods: The three categories of home care staff recorded 20,964 eligible observations over 8 weeks. We identified 19 activities, which were recorded. The majority of staff used a smartphone application for the time measuring, while some staff used a manual form for reporting purposes. (3) Results: The registered nurses (RNs) spent 32% of their time on direct patient work, while driving accounted for 18%. Direct patient work and driving accounted for the majority of activities performed by assistant nurses (48% and 29%, respectively) and assistant health workers (70% and 17%, respectively). (4) Conclusions: The demand for home care services is increasing in terms of both size and complexity. Simultaneously, there is a growing shortage of skilled staff. RNs is the group with the least face-to-face time with patients. To meet the patients’ needs, it is necessary to discuss and modify existing home care service systems in order to use resources appropriately and effectively.

scholarly journals Working with colleagues and other professionals when caring for people with dementia at the end of life: home care workers’ experiences

2019 ◽  
Vol 3 (4) ◽  
pp. 567-583
Author(s):  
Jill Manthorpe ◽  
Tushna Vandrevala ◽  
Ruth Abrams ◽  
Kritika Samsi
Keyword(s):  
Home Care ◽  
Home Care Services ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
People With Dementia ◽  
Care Workers ◽  
Informal Practices ◽  
Home Care Workers ◽  
Care Agency

Caring for people with dementia often necessitates inter-professional and inter-agency working but there is limited evidence of how home care staff work as a team and with professionals from different agencies. Through analysis of semi-structured interviews, we explored the experiences of home care workers (n = 30) and managers of home care services (n = 13) in England (2016‐17). Both groups sought to collaboratively establish formal and informal practices of teamwork. Beyond the home care agency, experiences of interacting with the wider health and care workforce differed. More explicit encouragement of support for home care workers is needed by other professionals and their employers.

scholarly journals Fallhendelser hos eldre i hjemmetjenesten i en norsk kommune- omfang og omstendigheter

2015 ◽  
Vol 11 (1) ◽  
pp. 165�
Author(s):  
Rita Solbakken ◽  
Terese Bondas
Keyword(s):  
Adverse Events ◽  
Home Care ◽  
Institutional Care ◽  
Home Care Services ◽  
Descriptive Statistics ◽  
Elderly Persons ◽  
Follow Up Study ◽  
Care Services

<strong>Fall events in elder recipients of home care services in a Norwegian municipality- incidence and circumstances</strong><br />Falls in institutional care are adverse events that have been well documented. Falls among elderly in home care services have not previously been studied in Norway. The aim of this study was to register the incidence and circumstances surrounding falls occurring in home-care services for elderly persons in a medium-sized Norwegian municipality. Descriptive statistics was applied in a three-month follow up study. Totally 440 homebound elderly aged 65 years or more and receiving home care services or safety alarm were included in this study. In total 101 falls, represented by 72 persons were documented. Sixty six percent reported no injury related to the fall, but 34% had injuries, ranging from bruises to fractures and hospitalization. In 24 % the circumstances were unknown, for the rest there was no particular cause documented. The findings will be used to study the development of care and prevention of falls with elder persons in home care services.

scholarly journals Choice and control for older people using home care services: how far have council-managed personal budgets helped?

2014 ◽  
Vol 15 (4) ◽  
pp. 210-219 ◽  
Author(s):  
Parvaneh Rabiee ◽  
Caroline Glendinning
Keyword(s):  
Home Care ◽  
Older People ◽  
Public Funding ◽  
Home Care Services ◽  
Care Staff ◽  
Staff Support ◽  
Content Type ◽  
User Choice ◽  
Care Services ◽  
And Control

Purpose – The purpose of this paper is to report the experiences of older people who use council-managed personal budgets (PBs) to fund home care services and their satisfaction with the level of choice and control they are able to exercise. Design/methodology/approach – Data were collected from 18 older people from eight home care agencies across three councils in England. All interviews were semi-structured and face-to-face. Findings – Despite some optimism about improvements in choice and flexibility experienced by older people using home care services, the findings from this small study suggest that the gap between the “ideal” of user choice and the “reality” of practice continues to be significant. The level of choice and control older people felt able to exercise to tailor home care services to their personal needs and preferences was restricted to low level choices. Other choices were constrained by the low levels of older people's PBs and council restrictions on what PBs can be spent on. Older people's understanding of limitations in public funding/pressures on agencies and their reluctance to play an active consumer role including willingness to “exit” from unsatisfactory care arrangements appeared to further challenge the potential for achieving greater choice and control through council-managed PBs. Originality/value – The English government's policy emphasis on personalisation of care and support and new organisational arrangements for managed PBs aim to promote user choice and control. This is the first study to report the experiences of older people using managed PBs under these new arrangements. The paper highlights areas of interests and concerns that social care staff, support planners and commissioners may need to consider.

Confidence in Home Care Services Questionnaire

2006 ◽  
Author(s):  
Janice D. Crist ◽  
Humberto Velazquez ◽  
Ian Durnan ◽  
Diana Ramirez Figueroa
Keyword(s):  
Home Care ◽  
Home Care Services ◽  
Care Services

scholarly journals Differences in the Effectiveness of Long-Acting Injection and Orally Administered Antipsychotics in Reducing Rehospitalization among Patients with Schizophrenia Receiving Home Care Services

2019 ◽  
Vol 8 (6) ◽  
pp. 823
Author(s):  
Hsiao-Fen Hsu ◽  
Chia-Chan Kao ◽  
Ti Lu ◽  
Jeremy C. Ying ◽  
Sheng-Yu Lee
Keyword(s):  
Treatment Group ◽  
Home Care ◽  
Second Generation ◽  
Home Care Services ◽  
Rehospitalization Rate ◽  
Treatment Groups ◽  
Psychiatric Rehospitalization ◽  
Care Services ◽  
Long Acting

The current study explored the differences in the effectiveness of first and second generation long-acting injections and orally administered antipsychotics in reducing the rehospitalization rate among patients with schizophrenia receiving home care services in a medical center in Southern Taiwan. Longitudinal data between 1 January 2006, and 31 December 2015, were collected retrospectively. Patients were classified into three treatment groups: First generation antipsychotic (FGA) long-acting injection (LAI), second generation antipsychotic long-acting injection (SGA) (LAI), and oral antipsychotics. The primary outcomes were the rehospitalization rate and the follow-up time (duration of receiving home care services) until psychiatric rehospitalization. A total of 78 patients with schizophrenia were recruited. The average observation time was about 40 months. The oral treatment group tended to be older with a higher number of female patients and a lower level of education. The FGA treatment group tended to have a higher frequency and duration of hospitalization before receiving home care services. We found no significant differences in the follow-up time or psychiatric rehospitalization rate after receiving home care services among the three treatment groups. We propose that oral and LAI antipsychotics were equally effective when patients received home care services. Our results can serve as a reference for the choice of treatment for patients with schizophrenia in a home care program.

scholarly journals ‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Snoen Glomsås ◽  
Ingrid Ruud Knutsen ◽  
Mariann Fossum ◽  
Kristin Halvorsen
Keyword(s):  
Qualitative Study ◽  
Home Care ◽  
Health Care Quality ◽  
Care Service ◽  
User Involvement ◽  
Home Care Services ◽  
Care Quality ◽  
Service Users ◽  
Care Services ◽  
Welfare Technology

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

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