Home Healthcare Nurses Research Articles

Nurses' Experiences of Communicating With Families in Municipal Home Health Care.

To illuminate nurses' experiences of communicating with families in home health care. A qualitative inductive approach. An increasing number of ageing and sick people are being granted home health care. Nurses' duties involve caring for both patients and their families, which includes the important task of meeting and talking with them. Fourteen registered nurses working in home health care in Sweden participated in individual narrative semistructured interviews. The interviews were analysed with content analysis. To make sure all components of the study were clear, the Standards for Reporting Qualitative Research checklist was used as a guide. Communication with families was viewed as a crucial action for building rapport to facilitate the involvement and support of families in difficult situations. The nurses highlighted the struggles they sometimes faced in communication when they found it difficult to reach the family. When the communication was supportive for the family, the nurses felt that they were empowering the family members to empower themselves. This study highlights the vital role of communication in home health care nursing. Effective communication fosters trust and enables nurses to meet family needs. Effective communication between nurses and families in home health care is crucial from a health care perspective. Building reciprocal relationships fosters trust, enabling nurses to efficiently identify and address family needs and enhancing the quality of care. No patient or public contribution.

Exploring communication challenges in dementia care: Insights from home healthcare nurses

ObjectivesCare for people living with dementia predominantly takes place at home and is often characterized by multiple hospitalizations throughout the lengthy disease trajectory. Care transitions from the hospital often involve home health care. The purpose of this study was to explore communication challenges experienced by home health nurses to inform communication training needs for home-based dementia care. MethodsSeven audio-recorded focus group discussions were held with home health nurses (n = 31) from a large home care agency serving rural and urban counties. Focus group transcripts were thematically analyzed. ResultsWe identified the following themes highlighting communication challenges for home health nurses: addressing potential risk for harm or injury, patient vulnerability, care partner needs, shifting decision-making to surrogate, and discrepancy in home health goals and family needs. These themes identified specific care transition conversation topics and communication content imperative for dementia-specific staff training. ConclusionsTopics for communication skills training to improve person-centered dementia care were identified. These findings inform the future development of a home health staff communication curriculum for dementia care. Advanced communication skills are necessary to ensure these conversations take place and are engaged with sensitivity. Practice implicationsOur study informs the development of communication training on key communication topics in nurse-delivered and home healthcare interventions aimed at improving dementia care.

Reducing Violence Risk: Home Healthcare Nurses and Early Identification of Informal Caregiver Burden.

An expanding body of literature suggests that informal caregiver burden is a growing issue that negatively impacts care recipients, informal caregivers, and formal care providers. Costs associated with informal caregiver burden include risk to the informal caregiver's physical, emotional, and psychological well-being and increased potential to perpetrate violence. By identifying interventions to support informal caregivers, home healthcare nurses can help decrease the risk of negative outcomes and reduce the burden on informal caregivers. This paper examines home healthcare nurses' role in helping reduce the impact of informal caregiver burden, thereby reducing the risk for violence. By prioritizing caregiver burden as a critical area of focus in reducing violence risk, home healthcare organizations and the nurses who work for them can help address gaps in care while also recognizing the informal caregivers' critical role in caring for their loved ones.

Current Status of Nursing Home Distribution in China: ANational Cross-Sectional Study.

Population aging is a challenge that the whole world is facing, especially in China. This study aims to investigate the current distribution status of nursing homes in China using spatial epidemiology methods. Cross-sectional study in China. The data were obtained from the Integrated Civil Affairs Government Service Platform 'China County Statistical Yearbook' for 2020 and the 'China City Statistical Yearbook' for 2020. Using global Moran's index to test the clustering of nursing homes, inter-group and intra-group Theil index was utilised to differentiate the sources of differences. The coupling coordination analysis was conducted to explore the coordination. Geographically weighted regression was utilised to investigate the impact of economic development and aging on nursing home resources. All analyses were conducted by Arcgis 10.8 and R Studio 4.3.2. Global Moran's index indicated that the distribution of nursing homes in China exhibited clustering. The Theil index values for institutions and beds at the national county were 0.32450 and 0.30675. However, upon comparing provinces and regions, it was found that the differences across the country mainly stem from within provinces (contribution rate: institutions 65.0%; beds 73.0%) and within regions (contribution rate: institutions 99.0%; beds 91.0%). The majority of districts and counties had a coupling coordination index of institutions and bed numbers, both of which were < 0.5. The development of nursing home resources in China has been rapid, generally presenting a balanced state, but further optimisation is needed. This study established a foundation for the targeted distribution of essential public services, focusing on nursing home healthcare resources tailored to the needs of older persons. The study underscored the urgent need for targeted elderly care policies, emphasising the optimisation of resource distribution to enhance the overall quality of care provided to the aging population. The study did not involve humans.

Decisional needs for older adults, home health care nurses and dental hygienists during team-based oral health assessments in ordinary home settings – a qualitative study

BackgroundParticipation by all actors involved in health planning is a prerequisite for person-centred care and healthy ageing. Understanding the multiple knowledge needs and the values that shape oral health assessments in home settings is important both to enable participation in oral health planning and to contribute to healthy ageing.ObjectiveThe aim of this study was to investigate decisional needs during oral health assessments in ordinary home settings from the perspectives of older adults, home health care nurses and dental hygienists.MethodsData was collected in ordinary home settings through 24 team-based oral assessments and 39 brief, semi-structured interviews including older adults (n = 24), home health care nurses (n = 8) and dental hygienists (n = 7). Data was analysed using content analysis with a deductive approach. The analysis was guided by the Ottawa Decision Support Guide.ResultsThe analysis revealed that all participants considered participation in decision-making important but until now, older adults might not have participated in making decisions regarding oral health issues. The older adults considered participation important because the decisions had a strong impact on their lives, affecting their health. The professionals considered decision-making important for knowing what step to take next and to be able to follow up and evaluate previous goals and treatments. Organizational and personal barriers for shared decision-making among home health care nurses and dental hygienists were identified. Of the 24 older adults, 20 had different oral health conditions that objectively indicated the need for treatment. An initial important decision concerned whether the older adult wanted to make an appointment for dental care, and if so, how. Another decisional conflict concerned whether and how assisted oral care should be carried out.ConclusionIt is important for key participants in ordinary home settings to participate in interprofessional teams in home health care. To further anchor this in theory, conceptual models for professionals from different care organizations (municipal care, dental care) need to be developed that also involve older adults as participants. Future research could bridge theory and practice by including theories of learning while exploring interorganizational oral health planning in home settings.

Family perspectives on and experiences with advance care planning in nursing homes: A thematic synthesis.

To synthesize family members' experiences and perspectives on advance care planning (ACP) in nursing homes. The thematic synthesis is reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. A systematic search of the APA PsycINFO, CINAHL Plus, Embase and PubMed databases is initially conducted in October 2022, and the search is updated in January 2024. Qualitative studies that presented family members' quotes regarding advance care planning in nursing homes published in a peer-reviewed journal were included. Screening and data extraction were independently performed by two reviewers, and any discrepancies were resolved with the assistance of the third author. A total of 1027 articles were identified, and 23 articles were included in the full-text review. Subsequently, a total of 17 studies were ultimately included, and 127 quotes were extracted and analysed. The main findings were categorized into three themes: (1) invitation to conversation and care, (2) the resident's surrogate and (3) nurses. Considering the importance of family members' roles in ACP conversations in a nursing home setting, this study provided an in-depth understanding of family members' perceptions and experiences of ACP by synthesizing qualitative studies. Family members' lack of knowledge regarding the timing and pursuits of ACP was also identified. The findings of this study provide synthesized qualitative evidence of family members' perspectives on ACP, which can inform care and treatment in nursing homes. As this study synthesizes the experiences of family members in nursing homes about ACP, the findings of this study contribute to reflecting family members' experiences and providing evidence for nursing home healthcare professionals. This study reports the experiences of family members in ACP nursing homes. The findings of this study contribute to reflecting family members' experiences and building evidence for nursing home healthcare professionals.

Comparison of psychopathology, purpose in life and moral courage between nursing home and hospital healthcare workers during the COVID-19 pandemic

The COVID-19 pandemic deeply affected healthcare workers, although the impact may have differed according to different workplace contexts. The aim of this current research was to compare the psychopathology presented by hospital versus nursing home healthcare workers during the COVID-19 pandemic and to analyse the predictive role of purpose in life and moral courage in the appearance of psychopathology. This was an observational, cross-sectional study carried out on a sample of 108 healthcare workers, 54 each from a hospital or nursing homes, who were recruited during the 5 and 6th waves of the COVID-19 pandemic in Spain. Various self-reported scales were used to assess anxiety, depression, acute/post-traumatic stress disorder, drug and alcohol abuse, burnout, purpose in life, and moral courage. Compared to the hospital healthcare workers, nursing home healthcare workers had higher scores and a higher prevalence of anxiety (74.1% vs. 42%), depression (40.7% vs. 14.8%), and post-traumatic stress disorder (55.6% vs. 25.9). In the overall sample, purpose in life was a protective factor against psychopathology (OR = 0.54) and burnout (OR = 0.48); moral courage was a protective factor against depression (OR = 0.47) and acute stress (OR = 0.45); and exposure of family/friends to SARS-CoV-2 was a risk factor for acute stress (OR = 2.24), post-traumatic stress disorder (OR = 1.33), and higher burnout depersonalisation subscale scores (OR = 1.84). In conclusion, the increased presence of psychopathology in nursing home healthcare workers may be influenced by workplace and occupational contexts, personal factors such as exposure of family/friends to SARS-CoV-2, or internal dimensions such as purpose in life and moral courage. This knowledge could be useful for understanding how a future epidemic or pandemic might affect the mental health of healthcare workers in different labour contexts.

Using Failure Mode and Effects Analysis to Decrease Risk When Developing a Home Health Nurse Residency Program.

New graduate nurses are traditionally not recruited for home health care (HHC). Due to staffing shortages, a HHC agency was interested in hiring graduate nurses, but there was concern about associated risks. The purpose of this quality improvement project was to develop a nurse residency program to safely transition graduate nurses to the HHC setting. After initial program design, analysis using a failure mode effects analysis (FMEA) was conducted, and risk mitigation strategies were applied. The overall risk of onboarding graduate nurses in HHC was reduced by 42% after applying harm reduction tactics identified from the FMEA. The FMEA was found to be a useful tool to prospectively identify areas of concern and apply harm reduction tactics prior to nurse residency implementation.

Systematic Review and Psychometric Properties Analysis of First-, Middle-, and Top-Level Nurse Manager’s Core Competencies Instruments

Purpose. Healthcare organisations need to define the role of the nurse manager in light of recent global health developments. For this purpose, several core competencies essential for each hierarchical management level need to be assessed. Different measurement instruments have been developed to assess nurse managers’ competencies. This systematic review summarises the characteristics and psychometric properties of existing instruments measuring first-, middle-, and top-level nurse managers’ competencies. Methods. Following PRISMA guidelines for reporting and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines, 789 articles were retrieved from PubMed, Scopus, CINAHL, and APA PsycINFO databases with no time limitation. The review protocol was registered on PROSPERO (CRD42023425854). Results. Ten tools were identified, assessing one or more competencies among nurse managers: Competency Elements for Nurse Managers of Tertiary General Hospitals, NICA-NL, HCCI, I-FLNMMCS, NMCI, Chase Nurse Manager Competency Questionnaire, CASHN, Questionnaire for Head Nurses’ Managerial Competencies, Nurse Manager EBP Competency Scale, and the Home Healthcare Nurse Manager Assessment Tool. Conclusion. Following the COSMIN assessment, the Chase Nurse Manager Competency Instrument was the most comprehensive among the included instruments, and the CASHN questionnaire scored highest on methodological quality and level of evidence. These instruments can be used in clinical practice to evaluate competencies and as a basis for developing managerial training courses.

“Walking Along a Difficult Path Towards Reward”: Home Healthcare Nurses’ Work Experiences and Satisfaction

The growing demand for skilled personnel and the challenges faced by home healthcare (HHC) underscore the significance of these issues for nurses’ job satisfaction and daily experience of working in this field. The aim of the study was to explore the lived experience and job satisfaction of HHC nurses working in Greece. A qualitative study with semi-structured interviews was conducted. The data were collected from November to December 2021. The analysis was based on thematic analysis by Braun and Clarke. Data were organized with Atlas.ti v8. The sample consisted of 9 nurses (8 female and 1 male), with mean value of 10.22 years of working experience in the field of HHC. Four main themes emerged during the thematic analysis: “Nurse as a guest” “Understanding the world of home healthcare,” “Walking along a difficult path towards reward,” and “Looking forward to a better tomorrow.” Nurses’ descriptions gave the framework of working conditions in HHC and the uniqueness of this working environment, highlighting at the same time the factors that positively or negatively affect their job satisfaction. This valuable knowledge could act as a basis for the development of new targeted strategies, with the goal of creating a healthy, productive environment that would strengthen the desire of nurses to work in HHC.

Comparing multiple infection control measures in a nursing home setting: a simulation study.

Compare the effectiveness of multiple mitigation measures designed to protect nursing home residents from infectious disease outbreaks. Agent-based simulation study. Simulation environment of a small nursing home. We collected temporally detailed and spatially fine-grained location information from nursing home healthcare workers (HCWs) using sensor motes. We used these data to power an agent-based simulation of a COVID-19 outbreak using realistic time-varying estimates of infectivity and diagnostic sensitivity. Under varying community prevalence and transmissibility, we compared the mitigating effects of (i) regular screening and isolation, (ii) inter-resident contact restrictions, (iii) reduced HCW presenteeism, and (iv) modified HCW scheduling. Across all configurations tested, screening every other day and isolating positive cases decreased the attack rate by an average of 27% to 0.501 on average, while contact restrictions decreased the attack rate by an average of 35%, resulting in an attack rate of only 0.240, approximately half that of screening/isolation. Combining both interventions impressively produced an attack rate of only 0.029. Halving the observed presenteeism rate led to an 18% decrease in the attack rate, but if combined with screening every 6 days, the effect of reducing presenteeism was negligible. Altering work schedules had negligible effects on the attack rate. Universal contact restrictions are highly effective for protecting vulnerable nursing home residents, yet adversely affect physical and mental health. In high transmission and/or high community prevalence situations, restricting inter-resident contact to groups of 4 was effective and made highly effective when paired with weekly testing.

Video training of nursing home healthcare workers in palliative care

ObjectivesThe provision of palliative care in nursing homes (NHs) is of paramount importance, a realism underscored by the frailty and medical complexity of the residents. However, palliative care (PC) education...

Healthcare service use and medical outcomes of tracheostomy-dependent children: a nationwide study

BackgroundDespite the rising trend of tracheostomies in children, there is a lack of comprehensive resources for families to navigate the challenges of living with a tracheostomy, emphasising the need for...

Predictors of Nurses’ Talent Retention in MSME-run Home Healthcare Centre in Chennai

This research aims to identify the elements accountable for retaining talent among home healthcare nurses in Chennai. The researchers adopted a descriptive approach. The sample size of this research study is 217 respondents who are nurses from the micro, small and medium enterprises (MSME) corporate centre at Nandanam, covering its areas within Chennai city. The tool used for this study purpose was the questionnaire, consisting of eight constructs: training, compensation, cohesion, autonomy, workload, non-monetary benefits, nurses’ satisfaction and nurses’ retention. The socio-demographic factors such as age, gender, qualification, annual income, employment type, experience, marital status and designation were considered. Data analysis was done using SPSS 21.0. The reliability measures ensured the consistency of the data set. Percentage analysis, descriptive statistics, Pearson correlation and multiple regression are the statistical tests used. Important discussions were given in the article related to the Indian healthcare sector.

Knowledge of caretakers regarding management of patients diagnosed with Type II diabetes mellitus admitted in selected hospital, Kolar

Diabetes mellitus is a metabolic disease, involving inappropriately elevated blood glucose levels. Patients are discharged from hospitals and rehabilitation centers in the continuum of care than ever before. It’s been the vital role of home health care nurses is increasingly important as patients are discharged from hospitals and rehabilitation centers early in the course of illness and require more sophisticated nursing management at home. The study aimed to understand the Knowledge of Caretakers regarding the Management of patients Diagnosed with Type II Diabetes Mellitus by using a Structured Knowledge Questionnaire. A descriptive survey design was adopted among 70 caretakers at R.L. Jalappa hospital &amp; Research center by using a purposive sampling technique. After obtaining the IEC clearance and permission from the concerned authorities followed by data collection carried out by using validated structured Knowledge questionnaire. Data was analyzed using SPSS version 20.0 descriptive statistics &amp; inferential statistics such as frequency, percentage and chi-square.The study results revealed that,90.4% of caretakers had inadequate knowledge and remaining with moderate knowledge with 9.6% and none of them found to have adequate knowledge. There was found no significant association between the knowledge and selected socio demographic variables. Therefore the study highlighted that, it’s a significant to emphasize the awareness regarding management of patients diagnosed with Type II Diabetes mellitus and to enhance the knowledge of caretakers.

Status of Telenursing and Future Use Intentions in Home Health Care in the Post-COVID-19 Era

This study aimed to investigate the current status and workload of telenursing by home healthcare nurses in the post-COVID-19 era, where telenursing has become indispensable, and identify factors that influence the intention to use telenursing. This study employed a cross-sectional descriptive approach based on an online survey. A total of 137 active home care nurses were surveyed for over 6 weeks starting in December 2022. Among the participants, 33.8% (N = 44) responded that they were currently using telenursing services. Most telenursing was conducted for consultation and education, using various technologies. The intention to use telenursing was significantly higher among individuals with higher educational levels and telenursing experience. The greater the social influence, which indicates the extent to which people around them believe that telenursing should be used, and more positive the attitudes toward telenursing, the higher the intention to use it. A clear definition of telenursing is required to improve people’s understanding of telenursing before its official implementation in Korea. Telenursing may be used to provide health care education and consultation while maintaining the continuity of care not only for patients receiving home health care but also for community-dwelling patients. To recognize and evaluate current telenursing practices, telenursing content should be recorded accurately. Finally, attitudes toward telenursing and social influence must be considered when developing strategies to improve nurses’ intentions to use and activate telenursing in the near future.

Palliative Care Practices and Knowledge of Home Care Nurses in Saudi Arabia: A Cross-Sectional Study.

Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area.

Pilot Study to Determine the Effectiveness of a Home Health Nursing Simulation.

Demand for home care has increased due to the expansion of preventive care, people living longer with chronic conditions, and the need for healthcare services as the baby boom population ages. Nurses must be prepared to meet the needs of patients and families in the home setting. Home care nursing simulations have been utilized as a teaching-learning strategy in baccalaureate nursing education, yet less is known about their use with practicing home care nurses and associate degree nursing students. The purpose of this pilot study using simulation was to prepare practicing nurses and student nurses to respond using nursing skills and clinical judgment. The convenience sample consisted of associate degree nursing students (n = 9), practicing home healthcare nurses (n = 8), and nursing faculty (n = 2). The Simulation Effectiveness Tool - Modified (SET-M) Survey (Leighton et al., 2015) was utilized for data collection. Participants perceived the home healthcare simulation to be an effective practice experience with high overall agreement for Pre-briefing, Scenario-Confidence, Scenario-Learning, and Debriefing. The findings of this study provide data to support partnerships to provide home care simulation experiences for associate degree nursing students and practicing home care nurses.

Factors Affecting Nurses’ Willingness to Use Information and Communication Technology Devices in Home Healthcare Nursing Tasks: Hypothesis Testing With Path Analysis Using a Technology Acceptance Model

Factors Affecting Nurses’ Willingness to Use Information and Communication Technology Devices in Home Healthcare Nursing Tasks: Hypothesis Testing With Path Analysis Using a Technology Acceptance Model

IDENTIFYING NEW ADRD DIAGNOSES IN HOME HEALTH CARE PATIENTS USING NATURAL LANGUAGE PROCESSING OF NURSES’ NOTES

Abstract Patients at risk of developing Alzheimer’s Disease and Related Dementias (ADRD) admitted to home health care (HHC) may show signs of the disease before receiving a formal diagnosis. HHC nurses are uniquely positioned to observe signs of patients’ cognitive symptoms and may record them in free-text notes in the electronic health record (EHR). We applied natural language processing (NLP) to approximately 1.8 million nurses’ notes to identify signs and symptoms of ADRD in a retrospective cohort of 56,652 patients receiving care from a large HHC agency. In a subset of 38,032 patients starting HHC without an ADRD diagnosis, we used survival analysis competing risks models to examine associations between NLP-derived indicators of ADRD constructs during the HHC episode and new ADRD diagnoses during a four-year follow-up period, adjusting for patient demographics, clinical characteristics, and functional status derived from structured standard assessment tools. By the end of follow-up, 23% of the patients were newly diagnosed with ADRD, while 35% died without a diagnosis. We observed higher 4-year cumulative incidence rates of ADRD when more ADRD-related symptoms were present in the nurses’ notes (e.g., confusion only, 0.35, 95% CI: 0.32; 0.38, memory loss only, 0.38, 95% CI: 0.36, 0.39; both, 0.52, 95% CI: 0.48, 0.56; none, 0.10, 95% CI 0.097, 0.103). These findings indicate that data from free-text notes taken during HHC serve as significant predictors for potential ADRD diagnoses. Such information can facilitate prompt specialist referrals, allowing for early diagnosis and potentially more effective treatments during the disease’s initial stages.