Department of Health and Caring Sciences, Linnaeus University, Kalmar/Växjö, Sweden.
Växjö Municipality, Växjö, Sweden.
Scand J Caring Sci. 2023 Dec;37(4):1067-1078. doi: 10.1111/scs.13181. Epub 2023 May 24.
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.
To describe nurses' experiences of performing risk prevention in municipal home healthcare.
Qualitative inductive approach, using semi-structured interviews with 10 registered nurses in a municipality in southern Sweden. Data underwent qualitative content analysis.
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.
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.
随着越来越多的人在家中接受复杂疾病的护理，家庭医疗保健的安全性受到了更多关注。家庭护理安全的前提条件与医院不同。营养不良、跌倒、压疮和用药不当通常是由于风险评估不当引起的，导致不必要的痛苦和成本。因此，家庭医疗保健中的风险预防需要优先考虑并进行更深入的研究。
描述护士在市政家庭保健中进行风险预防的经验。
采用定性归纳法，对瑞典南部一个市的 10 名注册护士进行半结构式访谈。对数据进行了定性内容分析。
分析产生了三个主要类别和一个涵盖护士在家中进行风险预防的经验的总体主题。让每个人都参与进来包括以下内容：在尊重患者自主权的同时管理安全，包括患者参与、尊重不同风险观点和信息的战略重要性以及医疗保健工作者是患者家中的客人。找到解决问题的方法涉及到人际关系方面，包括亲属和促进共同理解以预防风险。在资源和需求之间被挤压涉及到道德困境、团队合作、领导力和组织前提。
患者的习惯、生活条件和对风险的有限认识是家庭医疗保健中风险预防的挑战，患者参与起着关键作用。家庭医疗保健中的风险预防需要在疾病和衰老的早期阶段开始，并被视为一个过程，在这个过程中，早期的健康促进干预措施可以防止风险随着时间的推移而发展和积累。长期的跨组织合作以及患者的身体、心理和社会心理状况也需要考虑在内。
