Collaborative visits by hospital specialist nurses with homecare nurses: A nationwide, cross-sectional, web-based survey

Abstract

Objective: Hospital-based specialist nurses (clinical nurse specialists and certified nurses) are increasingly conducting patient home visits along with homecare nurses due to the increasing necessity of home care for persons with multiple medical needs. However, not much is known about such visits. Thus, this study examines collaborative visits by specialist nurses. Methods: A web-based questionnaire survey was sent to specialist nurses in Japan specializing in (1) wound care, (2) cancer palliative care, and (3) chronic disease care. Multiple logistic regression analyses were performed to identify the factors involved in collaborative visits, focusing not only on the individual but also on hospital/community characteristics. Results: Data from 1,027 specialist nurses were analyzed. Among them, 45.6%, 21.4%, and 18.3% of wound care, cancer palliative care, and chronic disease nurses, respectively, conducted collaborative visits. For nurses specializing in wound and cancer palliative care, holding managerial positions was associated with providing collaborative visits. Wound care nurses from hospitals in municipalities with fewer hospital beds per capita tended to conduct collaborative visits, whereas cancer palliative nurses in communities with a higher aging rate provided more collaborative visits. For chronic disease nurses, more working hours as specialists, lower participation rates in community-based multidisciplinary gatherings, and working in hospitals with open community consultation services promoted collaborative visits. Conclusions: Hospital and community factors are associated with collaborative visits, suggesting a need for hospital-wide and policy-supported efforts to further increase collaborative visits.