Kivimäki Taina, Stolt Minna, Katajisto Jouko, Charalambous Andreas, Suhonen Riitta
Department of Nursing Science, University of Turku, Turku, Finland.
Satakunta Hospital District, Pori, Finland.
J Clin Nurs. 2023 Feb;32(3-4):548-557. doi: 10.1111/jocn.16312. Epub 2022 Apr 3.
The aim of this study was to discover the nature of the adverse events in Finnish long-term professional homecare reported by professionals, and to identify the circumstances in which adverse events occur and their consequences.
Adverse events are incidents causing unintended and unnecessary harm to older people at home. Safety is a basic human right and a fundamental prerequisite for independent living among older people at home. Few studies have focused on both long-term professional homecare environment and the safety of older people.
The research was a descriptive registry-based study.
This study consisted of adverse events (N = 61248) in Finnish public long-term professional homecare (2009-2019). Data were described using frequencies and percentages. STROBE statement checklist was chosen for reporting the study process.
By profession, practical nurses and registered nurses reported the most of adverse events (89.8%). These were either critical incidents (78.3%) or near misses (20.0%) and concerned medicine, injuries and accidents, information flow or management. Consequences for older people were usually rated from no-harm to moderate harm. For long-term professional homecare, image harm, extra financial costs, no-harm and prolonged care for older people were among the consequences. Personnel frequently observed the older people afterwards and informed older people of adverse events, yet some of actions were unknown.
Many harmful adverse events are considered harmless for older people. Sometimes this can lead to unmet care needs or missed care. The degree of harm needs to be assessed in terms of physical, mental and social health with the HaiPro reporting system for homecare.
An understanding and a comprehensive view of the situation and holistic assessment of care needs includes safety and safety risks to increase safety and feeling of safety for older people at home.
本研究旨在发现芬兰专业长期居家护理中专业人员报告的不良事件的性质，确定不良事件发生的情况及其后果。
不良事件是指在家中对老年人造成意外且不必要伤害的事件。安全是一项基本人权，也是老年人居家独立生活的基本前提。很少有研究同时关注长期专业居家护理环境和老年人的安全。
本研究是一项基于登记处的描述性研究。
本研究包括芬兰公共长期专业居家护理（2009 - 2019年）中的不良事件（N = 61248）。数据采用频率和百分比进行描述。选择STROBE声明清单来报告研究过程。
按职业划分，执业护士和注册护士报告的不良事件最多（89.8%）。这些不良事件要么是严重事件（78.3%），要么是未遂失误（20.0%），涉及药物、伤害与事故、信息流或管理。对老年人的后果通常从无伤害到中度伤害进行评级。对于长期专业居家护理而言，形象损害、额外财务成本、无伤害以及老年人护理时间延长均属于后果。工作人员之后经常对老年人进行观察，并告知他们不良事件，但有些行动并不为人所知。
许多有害的不良事件被认为对老年人无害。有时这可能导致护理需求未得到满足或护理被遗漏。需要使用居家护理的HaiPro报告系统，从身体、心理和社会健康方面评估伤害程度。
对情况的理解和全面认识以及对护理需求的整体评估包括安全和安全风险，以提高居家老年人的安全性和安全感。
