Patient safety culture in home care settings in Sweden: a cross-sectional survey among home care professionals

TeamSTEPPS® in Home Health

TeamSTEPPS is a patient safety model that uses a collection of tools and best practices to optimize team performance. It has been widely adopted in the inpatient setting but clinician autonomy has been a barrier in its use. A home healthcare agency began using TeamSTEPPS® and found that it has a positive impact on nurse retention through the use of situational awareness and mutual support tools. Small improvements were made in OASIS outcomes and 30-day hospital readmissions through the use of handoffs and huddles.

Home Healthcare Medication Safety risks among older adults with chronic diseases: a qualitative study

BACKGROUND

Older adults receiving home care often face significant safety risks related to medication management due to their chronic diseases and complex health needs. Despite the increasing reliance on home healthcare services, the specific factors contributing to medication safety risks in this demographic remain inadequately explored.

OBJECTIVE/AIM

This study aims to explore the key factors involved in medication safety risks among older adults with chronic diseases receiving home healthcare in Iran.

METHODS

Qualitative research employing conventional content analysis was conducted using Graneheim and Lundman's approach. was conducted in three home care centers in Tehran (Iran) from August 2020 to July 2022. Data were collected through semi-structured interviews with 7 nurses, 2 supervisors, 2 nursing assistants (experts in non-nursing careers), 1 home care inspector (expert of the Deputy of Treatment), and 3 family caregivers in home settings, along with four participatory observations and visual methods (narrative photography) focusing on medication safety challenges. The trustworthiness of the research was evaluated using Lincoln and Guba's four criteria for qualitative studies.

FINDINGS

Factors associated with medication safety risks were found to rely on its major components Patients' attribution, Families' characteristics, Home care centers' condition, Health caregivers' characteristics, and the Homes' situations, where these factors all account for various medication safety risks. Indeed, a medication safety risk can be attributed to more than one of the factors associated with medication safety risk by participants at home.

CONCLUSION

As a result, the analysis of factors associated with medication safety risks highlights a complex interplay among various elements, including patients, families, home care centers, health caregivers, and the home environment. These interconnected factors are crucial for identifying the diverse medication safety challenges faced by participants in home settings. A comprehensive understanding of these dynamics is essential for improving medication safety protocols and enhancing health outcomes for this vulnerable population.

Quality and Safety of Proximity Care Centered on the Person and Their Domiciliation: Systematic Literature Review

The quality and safety of health care are a priority for health organizations and social institutions to progressively provide people with a higher level of health and well-being. It is in the development of this path that home care currently represents an area of gradual investment and where health care services and the scientific community have shown interest in building circuits and instruments that can respond to needs. The purpose of this article is to identify areas and criteria for quality and safety in home care. The method used was a systematic review registered in PROSPERO (CRD42022380989). The search was systematically carried out in CINAHL Plus with Full Text, MEDLINE with Full Text and Psychology and Behavioral Sciences Collection, using the following criteria: articles published in Portuguese and English, from January 2017 to November 2022. The results of the analysis of the articles showed areas of quality and safety in home care with their respective dimensions and operational criteria. We concluded that there are three areas: the intervention with the patient, with proximity and patient-centered care, which integrates the individual care plan and the proximity of professionals to the patient and family; the intervention of care and service management, with care management and clinical governance that includes the integrated model of health care, goal management, and context management; and the intervention related to training and professional development, where we have the skills and training of professionals.