District nurses’ preventive home visits to 75-year-olds: An opportunity to identify factors related to unsafe medication management

2014 ◽  
Vol 42 (8) ◽  
pp. 786-794 ◽  
Author(s):  
Annica Lagerin ◽  
Axel C. Carlsson ◽  
Gunnar Nilsson ◽  
Jeanette Westman ◽  
Lena Törnkvist
Keyword(s):  
Medication Management ◽  
Home Visits ◽  
Preventive Home Visits ◽  
District Nurses

Effects of preventive home visits by district nurses on self-reported health of 75-year-olds

2015 ◽  
Vol 17 (01) ◽  
pp. 56-71 ◽  
Author(s):  
Helena Sherman ◽  
Susanne Söderhielm- Blid ◽  
Christina Forsberg ◽  
Anita Karp ◽  
Lena Törnkvist
Keyword(s):  
Local Community ◽  
Controlled Trial ◽  
Home Visits ◽  
Well Being ◽  
County Council ◽  
Control Group ◽  
Preventive Home Visits ◽  
District Nurses ◽  
Before And After ◽  
Reported Health

AimThe aim of this study was to analyse the effects of preventive home visits (PHVs) by district nurses (DNs) on the self-reported health of 75-year-olds, including changes in self-reported health after the visits. The study also investigated whether or not the participants believed the visit was useful.BackgroundThere is a need for methods that promote health among older persons so that they can remain healthy as long as possible. One such method is PHVs. In Sweden, the Stockholm County Council decided to implement such visits to 75-year-olds.MethodsThe study was a cluster-controlled trial carried out in Stockholm. Sixteen healthcare centres (HCCs) were randomly selected from five geographic medical areas in the county. Eight were assigned to the study group (SG) and eight to the control group (CG). The 75-year-olds registered at these centres (SGn=176, CGn=262) filled in a questionnaire before and after the intervention. Each SG member received a PHV from a DN, and the CG was treated as usual.FindingsAt follow-up, both the groups reported decreased health and well-being. However, the SG reported a significant reduction in pain as an effect of the PHV. Participants in the SG reported increased knowledge of local community and county council services, more contacts with their HCCs and increased use of medication. The PHV had no effect on health behaviour. The CG reported significantly more problems in the categories of activities of daily living (ADL) and breathing/circulation. Eighty-four per cent of the participants reported that the PHV was somewhat useful, useful or very useful.

scholarly journals District nurses’ experiences of preventive home visits to 75-year-olds in Stockholm: a qualitative study

2015 ◽  
Vol 17 (05) ◽  
pp. 464-478 ◽  
Author(s):  
Annica Lagerin ◽  
Lena Törnkvist ◽  
Ingrid Hylander
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
Qualitative Content Analysis ◽  
Home Visits ◽  
Good Health ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Older Person ◽  
Preventive Home Visits ◽  
District Nurses

AimsThis study had two aims: to describe the dialogue between district nurses (DNs) and older people in preventive home visits (PHVs) from the perspective of the DNs, and to identify barriers to and facilitators of this dialogue as perceived by the DNs.BackgroundThe number of older people is rapidly increasing in all western countries, and as people’s age increases, the probability that they will have multiple diseases also increases. Planned actions are therefore needed to promote health and prevent diseases among older people so they can remain in good health and live in their homes for as long as possible. In Sweden, PHVs to 75-year-olds by DNs are one such action.MethodsThis qualitative study included five group interviews with 20 DNs. Data were analysed with qualitative content analysis.FindingsDNs’ experiences of barriers to and facilitators of a successful health dialogue were sorted into five domains. Together, these domains provided a systematic description of the interaction between the DN and the older person in the PHV. The domains included: establishing trustful contact, conducting a structured interview, making an overall assessment, proposing health-promoting activities and offering follow-up. The barriers and facilitators could be related to the older person, the DN or the home environment. The latent content of the interviews was evident in three themes that were related to the DNs’ experiences of barriers and facilitators. These themes illustrated professional dilemmas that the DNs had to resolve to achieve the purpose of the PHV. The study demonstrates that the interaction between a DN and an older person in a PHV can be described as a complex social process in which the DN balances a personal and professional approach, combines a person-oriented and a task-oriented approach and employs both a salutogenic and pathogenic perspective.

Extent and quality of drug use in community-dwelling people aged ≥75 years: A Swedish nationwide register-based study

2017 ◽  
Vol 48 (3) ◽  
pp. 308-315 ◽  
Author(s):  
Annica Lagerin ◽  
Lena Törnkvist ◽  
Gunnar Nilsson ◽  
Kristina Johnell ◽  
Johan Fastbom
Keyword(s):  
Drug Use ◽  
Older People ◽  
Home Visits ◽  
Community Dwelling ◽  
Inappropriate Drug ◽  
Preventive Home Visits ◽  
Inappropriate Drug Use ◽  
District Nurses ◽  
Community Dwelling Older People

Aims: It is important for district nurses and other health professionals in primary care to gain more insight into the patterns and quality of drug use in community-dwelling older people, particularly in 75-year-olds, who have been the target of preventive home visits. This study aimed to examine the extent and quality of drug use in community-dwelling older people and to compare drug use in 75-year-olds with that of older age groups. Methods: Data from 2013 on people aged ≥75 years were obtained from the Swedish Prescribed Drug Register. Those living in the community (671,940/739,734 people aged ≥75 years) were included in the study. Quality of drug use was assessed by using a selection of indicators issued by the Swedish National Board of Health and Welfare. Results: The prevalence of polypharmacy and of many drug groups increased with age, as did several indicators of inappropriate drug use. However some drug groups, as well as inappropriate drugs, were prevalent in 75-year-olds and declined with age, for example diabetes drugs, drugs with major anticholinergic effects and nonsteroidal anti-inflammatory drugs. Conclusions: The substantial use of some drugs as early as 75 years of age confirms the value of including drug use as a topic in preventive home visits to 75-year-olds. The finding that polypharmacy and many measures of inappropriate drug use increased with age in community-dwelling older people also underscores the importance of district nurses’ role in continuing to promote safe medication management at higher ages.

scholarly journals Health team for the elderly: a feasibility study for preventive home visits

2017 ◽  
Vol 18 (03) ◽  
pp. 242-252 ◽  
Author(s):  
Berit Seiger Cronfalk ◽  
Astrid Fjell ◽  
Nina Carstens ◽  
Lars Malvin Kvinge Rosseland ◽  
Arvid Rongve ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Health Care ◽  
Older People ◽  
Home Visits ◽  
The Elderly ◽  
Risk Assessments ◽  
Multiprofessional Team ◽  
Rural Municipality ◽  
Preventive Home Visits ◽  
Health Team

The aim was to describe the development, utilization and feasibility of a model of preventive home visits, in an urban and a rural municipality in Norway. Background Older people >65 years will rise significantly in coming years. Increased age is associated with risk of disability, illness and need for public health services. Preventive home visits is assumed to help older people to maintain their functional level longer, delaying disease and thus delaying the need for health care. Method Descriptive explorative design describing the development, utilization and feasibility of preventive home visits in two different settings. All 77-year-old persons living at home in an urban municipality and all 75 years and older in a rural municipality were invited to participate. A questionnaire including a substantial number of tests concerning; fall, nutrition, polypharmacy and cognitive impairment was used by Health Team Nurses as base for a risk assessment. Pilot studies were conducted to validate the questionnaire including an inter-rater reliability study of the risk assessment tool. A multiprofessional team, Health Team for the Elderly met each week to evaluate risk assessments and make recommendations to be sent to each respective general practitioner. Data were analysed using descriptive and inferential statistics. In total, 167 persons (109 from the urban municipality and 58 from the rural municipality) participated, corresponding to 60% of the approached individuals. The mean time for the visits was 108 minutes (SD 20). Missing data were identified for; Do you feel safe in your municipality (17.5%) and Are you looking forward to ageing (11.4%). In total, 36 persons (21.7%) were identified with increased risk for developing illness. We suggest that a structured model of preventive home visits and collaboration between highly specialized health care professionals are important factors for reliable health promoting risk assessments of elderly home dwellers.

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