Abstract
AimHome care nurses often use the Resident Assessment Instrument‐Home Care (interRAI‐HC) to assess health needs. However, this tool does not assess complexity. This study proposes to derive a complexity index (CI) from the interRAI‐HC using the operational definition of the dedicated COMID checklist (COmplexité Multidimensionnelle des prises en soins Infirmières à Domicile).DesignData were collected at the baseline assessment of the fraXity study (N = 231, aged ≥ 65), which relied on an observational longitudinal design.MethodsMeasures were the interRAI‐HC, from which the CI binary variables were computed and the COMID, used as a reference.ResultsTwenty‐six CI variables were computed from the interRAI‐HC, and all but three correlations were significant. The correlation between the CI score and the COMID score was ρ = 0.730 (p < .001).ConclusionsThe study demonstrates that complexity can be assessed directly from the interRAI‐HC by deriving a CI.
Highlights
In Switzerland and more in the canton of Geneva, home care has a central place in the delivery of curative, preventive, educational and palliative care
This study proposes to derive a complexity index (CI) from the interRAI-HC using the operational definition of the dedicated COMID checklist (COmplexité Multidimensionnelle des prises en soins Infirmières à Domicile)
The COMID is an instrument for assessing multidimensional complexity in home care nursing practice and is completed by home care nurses in addition to a comprehensive health assessment to support their clinical analysis of complexity
Summary
In Switzerland and more in the canton of Geneva, home care has a central place in the delivery of curative, preventive, educational and palliative care. Home care nurses are increasingly faced with patients with multiple clinical, chronic and fluctuating conditions (Valderas et al, 2009), who are at high risk of decompensation and hospital readmission (Joyce et al, 1981; Koné Pefoyo et al, 2015). Complexity can be broadly defined as a “multidimensional concept involving interactions between biological, socioeconomic, cultural, environmental and behavioral forces as health determinants” (Bonizzoni et al, 2018). The World Health Organization (WHO, 2009) posits that “a complex system is one where there are so many interacting parts that it is difficult, if not impossible, to predict the behavior of the Nursing Open. The World Health Organization (WHO, 2009) posits that “a complex system is one where there are so many interacting parts that it is difficult, if not impossible, to predict the behavior of the Nursing Open. 2021;8:815–823.
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