Qualität in der ambulanten Pflege – Übersichtsarbeit über die relevanten struktur-, prozess- und ergebnisbezogenen Versorgungsaspekte

Abstract

IntroductionBeing cared for in one's own home environment is of great significance for many people in need of care. In addition to care provided by relatives, the care provided by professional home care services is also important. More and more people in need of care are being cared for by relatives together with or solely through such home care services. Because of this, the issue of quality and quality measurement in home care has become increasingly important. The prerequisite for measuring and assessing quality is the definition of specific requirements for medical and nursing care. A comprehensive quality framework for home care has not yet been developed. The aim of this review is to provide an overview of the current situation in home care and to identify relevant aspects of care subsequently. Finally, these aspects of care should be presented in a framework model. MethodsIn order to describe the situation in home care, a review was conducted based on the Joanna Briggs Institute methodology of a scoping review. The literature was analysed, and the relevant aspects of care were derived by using an inductive approach. Furthermore, these aspects of care were assigned to quality dimensions defined for health care (e. g., patient safety, patient-centeredness) and merged into a quality model of home care. ResultsA total of 222 publications were included, and 17 aspects of home care were identified. These involved structural aspects of care and aspects of care for shaping relationships with people in need of care and their family carers, as well as aspects of support for people in need of care and their family carers. Furthermore, process-related and outcome-related aspects of care were identified. The comparison of these aspects with the defined quality dimensions showed that each of these quality dimensions is covered by at least one aspect of care. This results in a comprehensive quality model for home care which can serve as a framework for measuring and assessing quality in home care. ConclusionThe aspects of care identified can be used for the development of instruments such as routine data-based quality indicators and thus allow for the measurement, presentation and assessment of quality in home care.