School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran.
BMJ Open Qual. 2023 Jul;12(3). doi: 10.1136/bmjoq-2023-002335.
Patients receiving home care are often elderly people with chronic illnesses that increasingly experience patient safety barriers due to special care needs.
The present study was conducted to determine the factors involved in the safety of elderly patients with chronic illnesses receiving home care.
A qualitative study with a conventional content analysis method was conducted in home care agencies of Tehran, Iran from August 2020 to July 2022. For data generation, semistructured interviews were conducted with 11 nurses, 2 nurse assistants, 1 home care inspector (an expert working at the deputy of treatment) and 3 family caregivers. Moreover, four observational sessions were also held. Data analysis was done using the five-step Graneheim and Lundman method.
According to the results, the facilitators of the safety of the elderly patients with chronic illnesses included the family's participation, nurse's competence, efficiency of the home care agency management and patient's participation in patient safety. The barriers to patient safety included problems created by the family, nurse's incompetence, inefficiency of the home care agency, patient's prevention of patient safety, home care setting limitations and health system limitations.
The majority of the factors involved in the safety of elderly patients with chronic diseases receiving home care had dual roles and could serve as a double-edged sword to guarantee or hinder patient safety. Identification of the facilitators and barriers can assist nurses and the healthcare system in planning and implementing patient safety improvement programmes for elderly patients with chronic illnesses.
接受家庭护理的患者通常是患有慢性病的老年人，由于特殊的护理需求，他们越来越多地面临患者安全障碍。
本研究旨在确定接受家庭护理的慢性病老年患者安全相关的因素。
这是一项在 2020 年 8 月至 2022 年 7 月于伊朗德黑兰的家庭护理机构进行的定性研究，采用常规内容分析法。为了生成数据，我们对 11 名护士、2 名护士助理、1 名家庭护理检查员（在治疗部门工作的专家）和 3 名家庭护理者进行了半结构式访谈。此外，还进行了 4 次观察会议。使用 Graneheim 和 Lundman 方法的五步分析法进行数据分析。
根据研究结果，慢性病老年患者安全的促进因素包括家庭的参与、护士的能力、家庭护理机构管理的效率以及患者对患者安全的参与。患者安全的障碍因素包括家庭造成的问题、护士的能力不足、家庭护理机构效率低下、患者对患者安全的预防、家庭护理环境的限制以及医疗系统的限制。
接受家庭护理的慢性病老年患者安全相关的大多数因素都具有双重作用，可以成为保障或阻碍患者安全的双刃剑。识别促进因素和障碍因素可以帮助护士和医疗保健系统为慢性病老年患者规划和实施患者安全改进计划。
