Thompson Cristina, Morris Darcy, Larkin Matthew, McWilliams Lucy, Vasquez-Hernandez Alejandro, Currie Jane
Centre for Health Service Development, University of Wollongong, Wollongong, New South Wales, Australia.
St Vincent's Hospital Sydney Homeless Health Service, Darlinghurst, New South Wales, Australia.
J Adv Nurs. 2025 Jul;81(7):4187-4197. doi: 10.1111/jan.16633. Epub 2024 Nov 25.
To explore specialist homeless health professionals' perceptions of gaps in homeless health care and understand whether these might be addressed through existing nursing scopes of practice.
Qualitative descriptive study.
Semi-structured interviews and focus groups with a purposive sample of 22 staff in nursing (11) and non-nursing (11) roles, engaged with a Homeless Health Service. Data were collected via videoconferencing and recordings transcribed verbatim. An exploratory framework guided deductive and inductive thematic analysis.
Service gap themes included the need for integration with mainstream health services, more specialised health professionals, and adaptations to the existing models of care. Addressing these gaps involved enhancements to the broad scope of nursing practice, workforce development by establishing homeless health as a nursing specialty and optimising organisational governance to minimise risk.
The most pressing homeless health service delivery gap was lack of health service integration, and it was unclear how this could be resolved through nursing scopes of practice. Other service gaps could be addressed through skilling nurses to practice preventative health care, as well as crisis management. Enhancing nurses' capability in physical and mental health assessment skills including alcohol and other drugs and procedural skills would support wraparound care for people experiencing homelessness. We conclude that a homeless health nursing specialty could be established that formalises the scope of practice of nurses in this field to ensure future post-graduate training aligns with service gaps.
This study identifies opportunities to optimise nursing scopes of practice to address Homeless Health Service gaps through reviewing models of care and nursing practice. For example, enhancing nurses' capability to provide preventative and wraparound care. This research may inform a development pathway to enhance education and training for nurses working with vulnerable populations.
COREQ 32-item checklist. No patient or public contribution.
探讨无家可归者健康领域专业医护人员对无家可归者医疗保健差距的看法，并了解这些差距是否可以通过现有的护理实践范围来解决。
定性描述性研究。
对一家无家可归者健康服务机构中22名从事护理（11名）和非护理（11名）工作的人员进行有目的抽样，开展半结构化访谈和焦点小组讨论。通过视频会议收集数据，并逐字转录录音。采用探索性框架指导演绎和归纳主题分析。
服务差距主题包括与主流医疗服务整合的需求、更多专业医护人员以及对现有护理模式的调整。解决这些差距需要扩大护理实践的广泛范围、通过将无家可归者健康确立为护理专业来发展劳动力，并优化组织管理以降低风险。
最紧迫的无家可归者健康服务提供差距是缺乏医疗服务整合，目前尚不清楚如何通过护理实践范围来解决这一问题。其他服务差距可以通过培训护士开展预防性医疗保健以及危机管理来解决。提高护士在身心健康评估技能（包括酒精和其他药物评估）和操作技能方面的能力，将有助于为无家可归者提供全面护理。我们得出结论，可以设立一个无家可归者健康护理专业，使该领域护士的实践范围正式化，以确保未来的研究生培训与服务差距相匹配。
本研究确定了通过审查护理模式和护理实践来优化护理实践范围以解决无家可归者健康服务差距的机会。例如，提高护士提供预防性和全面护理的能力。这项研究可能为加强针对弱势群体的护士教育和培训的发展路径提供参考。
采用COREQ 32项清单。无患者或公众参与。
