Nursing Visits Research Articles

Preoperative nursing visit reduces preoperative anxiety and postoperative complications in patients with laparoscopic cholecystectomy

Background:Anxiety is a kind of emotional disorder caused by acute conditions or trigger. It is manifested in the components of the autonomic nervous system, for instance, stress, anxiety, nervosity, and discomfort. Most patients with anxiety are more active, nervous, and alert to various stimuli. Inappropriate management of early postoperative anxiety will not only prolong recovery but also increase the risk of other complications. We conduct a randomized clinical trial to investigate the influences of nursing visits against the preoperative anxiety and postoperative complications in patients undergoing laparoscopic cholecystectomy (LC).Methods:This is a single center, placebo-controlled randomized trial, which will be performed from August 2020 to December 2020. The trial is performed in accordance with the SPIRIT Checklist for randomized studies. It is authorized by the Ethics Committee of Taizhou Hospital of Zhejiang Province (D20211-34). Two hundred patients undergoing LC will be included in this study. Patients are randomly divided into 2 groups: experiential group (n = 100) or control group (n = 100). The experimental group is given preoperative nursing visit to each patient 1 day before the operation, whereas the control group did not receive the preoperative nursing intervention. The patients in experience group also received education on the surgery team and the environment of operating room, the process of anesthesia, advantages of laparoscopic surgery, and the postoperative care from recovery room to discharge. The primary outcomes include State-Trait anxiety level and postoperative visual analogue scale. Secondary outcomes include total consumption of analgesics and postoperative complications.Results:Figure (a) will show the comparison of outcomes between 2 groups.Conclusion:The preoperative nursing visit may decrease the anxiety and the complications after operation in patients receiving LC.Trial registration:This study protocol is registered in Research Registry (researchregistry5924).

Home Care Nursing Visits and Same-Day Emergency Department Use: Which Patients Are Most at Risk?

Home care patients are a growing group of community-dwelling older adults with complex care needs and high health service use. Adult home care patients are at high risk for emergency department (ED) visits, which is greater on the same day as a nursing visit. The purpose of this study was to examine whether common nursing indicators modified the association between nursing visits and same-day ED visits. A case-crossover design within a retrospective cohort of adult home care patients in Ontario. A total of 11,840 home care nursing patients were analyzed. Home care patients who received a home nursing visit were more likely to go the ED afterhours on the same day with a stronger association for visits not admitted to the hospital. Having a urinary catheter increased the risk of a same-day ED visit (OR: 1.78 (95% CI 1.15-1.60) vs. 1.21 (95% CI 1.15-1.28)). No other clinical indicator modified the association. The findings of this study can be used to inform care policies and practices for home care nurses in the management of indwelling urinary catheter complications. Further examination of system factors such as capacity and resources available to respond to catheter related complications in the community setting are recommended.

Factors Influencing 30‐Day Readmission to the Hospital during Home Health Services

Research ObjectiveOur purpose was to investigate agency‐level and clinical variables that influence 30‐day hospital readmissions during home health (HH) services. The objective was exploration of variables that predict or protect against 30‐day hospital readmission, from real‐world HH operations data.Study DesignThis retrospective cohort study used one, northern California HH agency’s de‐identified electronic health record to investigate variables relating to 30‐day hospital readmissions during HH services. Binary logistic regression was used to build the most parsimoniously fitted model, with no more than 3 predictors in the model due to sample size. Fit criteria included statistical significance of predictors, little multicollinearity among the predictors, a significant omnibus model test, a nonsignificant Hosmer‐Lemeshow statistic for goodness of fit, and clinical meaningfulness of the predictors to benefit HH organizations in their attempts to reduce preventable 30‐day readmissions. t tests and chi‐square tests were used to compare characteristics differentiating readmission and nonreadmission cohorts.Population StudiedThe final, eligible sample consisted of 130 discharged patients seen between July 2016 and January 2018; 55 patients had a 30‐day hospital readmission and 75 patients did not have a 30‐day hospital readmission during HH services.Principal FindingsA significant model emerged with two variables associated with risk, and one variable protective against, 30‐day hospital readmission during HH services: 1) full code status designation (AOR = 3.324, P = .004); 2) the difference between nursing visits made and ordered (AOR = 0.779, P = .000); 3) speech ability (the M1230 OASIS form item for HH developed by the Centers for Medicare and Medicaid services) (AOR = 1.621, P = .031). Patients with full code status designations in place were more than 3 times more likely to have a readmission to the hospital within 30 days of starting HH services than those with DNR and no code status recorded combined. Patients with 30‐day readmission had significantly fewer nursing visits than originally ordered at the beginning of their HH episode, than patients without 30‐day hospital readmission (t = ‐3.374, P = 0.001). For every one more nursing visit made, there was a 22% lesser chance for a patient to experience 30‐day hospital readmission during their HH service. The proportion of patients having experienced 30‐day hospital readmission during HH services were scored as having significantly more speech disability than the proportion of patients not having experienced 30‐day hospital readmission during HH services (χ2 = 11.124, P = .025). In regression, for every incremental increase in severity of speech disability as scored on the OASIS M1230, patients were 1.6 times more likely to experience a 30‐day hospital readmission during their HH service than patients with less severe speech disability.ConclusionsHH agencies can potentially improve quality to reduce 30‐day hospital readmissions, by adhering to nursing visits, and care planning with patients/families to reduce risks of readmission such as speech disability and full code designation.Implications for policy or practiceFuture studies can validate these predictor variables and increase sample size and generalizability through more HH study sites. Quality improvement activities in HH agencies can enhance reduction of 30‐day hospital readmission during HH services by focusing on risks and protectors of readmission.

What Variables Contribute to the Achievement of a Preferred Home Death for Cancer Patients in Receipt of Home-Based Palliative Care in Canada?

Home is often deemed to be the preferred place of death for most patients. Knowing the factors related to the actualization of a preferred home death may yield evidence to enhance the organization and delivery of healthcare services. The objectives of this study were to measure the congruence between a preferred and actualized home death among cancer patients in receipt of home-based palliative care in Canada and explore predictors of actualizing a preferred home death. A longitudinal prospective cohort design was conducted. A total of 290 caregivers were interviewed biweekly over the course of patients' palliative care trajectory between July 2010 and August 2012. Cross-tabulations and multivariate analyses were used in the analysis. Home was the most preferred place of death, and 68% of patients who had voiced a preference for home death had their wish fulfilled. Care context variables, such as living with others and the intensity of home-based nursing visits and hours of care provided by personal support workers (PSW), contributed to actualizing a preferred home death. The intensity of emergency department visits was associated with a lower likelihood of achieving a preferred home death. Higher intensity of home-based nursing visits and hours of PSW care contribute to the actualization of a preferred home death. This study has implications for policy decision-makers and healthcare managers. Improving and expanding the provision of home-based PSW and nursing services in palliative home care programs may help patients to actualize a preferred home death.

Home Dialysis in the Coronavirus Disease 2019 Era.

The coronavirus disease 2019 pandemic has had a significant impact on patients with end-stage kidney disease and their care, especially given the potential for severe coronavirus disease 2019 in those with a depressed immune status. Patients receiving in-center hemodialysis have been particularly affected by this pandemic because of their need to travel multiple times a week to receive treatment. Although patients on home dialysis are able to avoid such exposure, they face their own unique challenges. In this review, we will discuss the challenges posed by the coronavirus disease 2019 pandemic for patients on home dialysis, the impact of coronavirus disease 2019 on various aspects of their care, and the resultant rapid adaptations in policy/health-care delivery mechanisms with implications for the future care of patients on home dialysis.

Supporting African American Mothers during Nurse Home Visits in Adopting Safe Sleep Practices.

Nurses providing home visits were concerned that some mothers were not routinely using safe sleep practices for their newborns and infants. The purpose of this study was to listen to how home visit nurses offer education to their African American clients about the safe to sleep guidelines during the prenatal and postpartum periods and discuss ways nurses could support mothers to be more successful in using safe sleep practices. A focus group was conducted with home visit nurses who partner with pregnant mothers and follow them through the first 2 years of their child's life. We asked the nurses to discuss how they offer information and education to their African American clients about safe sleep practices and what could be done to support adoption of the guidelines. A qualitative narrative approach was used for data analysis. Seventeen home visit nurses participated in the focus group. We identified two overall themes with eight subthemes. The first theme focused on nurses' perceptions about challenges some mothers have in following the recommendations. The second theme included nurses' perspectives on how to better promote the safe sleep message and educating mothers within their cultural context. Expectant and new mothers need advice and knowledge about the Safe to Sleep guidelines that provide ways to decrease risk of infant death. Nurses must be aware of their clients' culture and beliefs so they can offer support and information on infant safety within that context.

Improving Fourth Trimester Support via Newborn Medicine In-Home Visits in Cleveland, Ohio

Background There has been increasing awareness that new mothers lack adequate support during the fourth trimester. In the suburbs of Cleveland, Ohio (metropolitan area of > 2 million people) there are only a few lactation consultants (IBCLCs) who regularly do in-home visits and post-discharge nursing visits are prioritized for the smallest and sickest neonates. Mothers of newborns often need to bring their babies to numerous outpatient pediatric and lactation visits during the first few weeks of life. These frequent trips outside of the home increase stress and interfere with …

Leaders Share Policy Updates on COVID, and Much, Much More

Leaders Share Policy Updates on COVID, and Much, Much More

Community Care and Visiting Nursing Services in Denmark, Sweden, the United States, and Japan

Community Care and Visiting Nursing Services in Denmark, Sweden, the United States, and Japan

Use of health and support services by people living with dementia in the community setting.

To determine the access to and use of health-care services by people with dementia in the community. A retrospective cross-sectional analysis of the Australian Government Department of Veterans' Affairs (DVA) administrative claims data was conducted. Veterans and their spouses with one or more dementia claims between 1 January 2000 and 30 June 2016, who were aged ≥45years at the time of the claim and who were still alive and living in the community on 30 June 2017, were included. We assessed the proportions of people with dementia who received medical, pharmacy and medicines, allied health services, and home care supports from 1 July 2016 to 30 June 2017. A total of 10171 people with dementia were included. They had a median age of 89years, 60% were female, and 63% lived in a major city. Over the one-year study period, 98% visited the GP and 99% had medicines dispensed at a pharmacy. Eighty-two per cent saw a specialist, and 19% saw a geriatrician. Thirty-one per cent received a DVA-funded dose administration aid to support medication administration, and 19% received a home medicines review. Less than half had claims for occupational therapist services (48%), community nursing (48%), physiotherapists (41%) or dentist visits (33%). Fifty-eight per cent received home care supports, for example domestic assistance. Many people living with dementia in the community do not access all of the health-care or support services available to them. Ensuring that people with dementia and their carers are supported to access the services available to assist them live in the community setting for as long as possible is important.

Let There Be PEACE: Improving Continuous Symptom Monitoring in Hospice Patients.

ObjectiveTo ensure that a standardized method of continuous symptom monitoring was available to hospice patients enrolled at our institution.Patients and MethodsThe Palliative/End-of-Life/Assessment/Care Coordination/Evidence-Based Program (PEACE) seeks to enhance the provision of hospice care through symptom control and patient support. We conducted a quality improvement initiative between November 1, 2015, and March 31, 2017, following Define-Measure-Analyze-Improve-Control methodology to improve hospice care at a rural hospice. The gap in our current hospice model was a standardized method of continuous symptom monitoring. We aimed to explore ways in which technology-assisted care coordination could enhance end-of-life and hospice care. We measured continuous symptom assessments through co-developed condition management protocols (CMPs), technology-assisted care pathways (TACPs), nursing visits, length of stay, respite days, and satisfaction survey data from patients, caregivers, and hospice staff. At baseline, no continuous symptom monitoring was being performed. Baseline data for our enrolled population was compared with data from patients who were eligible, but opted out.ResultsWe monitored 50 patients using CMP and TACP. The mean ± SD number of skilled nursing visits per patient in the enrolled population compared with those who were eligible but opted out was 13.7±7.6 vs 14.2±10.5, respectively. In response to the survey question, “Because of the overall program, I felt supported and confident at home,” 74% (37 of 50) of patients and caregivers answered, “always.”ConclusionPEACE enhanced hospice care through symptom control and patient support through CMP and TACP. PEACE is a unique and feasible care platform for hospice patients, with high patient and caregiver satisfaction.

Cost of managing patients with venous leg ulcers.

The aim of this study was to estimate costs associated with the management of patients with venous leg ulcers (VLUs) from the perspective of the UK National Health Service (NHS). The analysis was undertaken through the Secure Anonymised Information Linkage Databank which brings together and anonymously links a wide range of person‐based data from around 75% of general practitioner (GP) practices within Wales (population coverage ~2.5 million). The data covered an 11‐year period from 2007 to 2017. All patients linked to the relevant codes were tracked through primary care settings, recording the number of GP practice visits (number of days with an event recorded), and wound treatment utilisation (eg, dressings, bandages, etc.) Resources were valued in monetary terms (£ sterling) and the costs were determined from national published sources of unit costs. This is the first attempt to estimate the costs of managing of VLUs using routine data sources. The direct costs to the Welsh NHS are considerable and represent 1.2% of the annual budget. Nurse visits are the main cost driver with annual estimates of £67.8 million. At a UK level, these costs amount to £1.98 billion. Dressings and compression bandages are also major cost drivers with annual Welsh estimates of £828 790. The direct cost of managing patients with VLUs is £7706 per patient per annum, which translates to an annual cost of over £2 billion, when extrapolated to the UK population. The primary cost driver is the number of district nurse visits. Initiatives to reduce healing times through improving accuracy of initial diagnosis, and improved evidence‐based treatment pathways would result in major financial savings.

TT4 ROBOTIC-ARM ASSISTED TOTAL KNEE SURGERY: AN ECONOMIC ANALYSIS

Previous studies on Medicare populations have shown improved outcomes and decreased 90-day episode-of-care costs with robotic assisted total knee arthroplasty (rTKA). The purpose of this study was to evaluate the expenditures and utilization following rTKA in the under 65 y/o population. TKA procedures were identified using the OptumInsights Inc. database. A two-year window was studied. The procedures were stratified in two groups: the rTKA or manual (mTKA) cohorts. Propensity score matching (PSM) was performed at 1:5. Utilization and associated costs were analyzed for 90 days following the index procedure. 357 rTKA and 1785 mTKA were included in this analysis. Within the 90 days following the surgery, patients who had robotic assisted procedures were less likely to utilize inpatient services (2.24 vs. 4.37%; p=0.0444) and skilled nursing visits (SNF) (1.68 vs. 6.05%; p<0.0001). No patients in the robotic TKA group went to inpatient rehab while 0.90% of the manual cases went to an inpatient rehabilitation facility. Patients who utilized a home health aide in the rTKA arm utilized significantly fewer days of home health (5.33 vs. 6.36 days; p=0.0037). Cost associated with the utilization of these services was lower in the rTKA arm; the overall post-surgery expenditures were $1,332 less in the rTKA arm ($6,857 vs. $8,189; p=0.0018). The 90-day global expenditures (index plus post-surgery) were $4,049 less in the rTKA arm ($28,204 vs. $32,253; p<0.0001). Lastly, length of stay (LOS) after surgery was nearly a day less for the rTKA arm (1.80 vs. 2.72 days; p<0.0001). Robotic assisted TKA was associated with shorter LOS, reduced utilization of services and reduced 90-day payer costs when compared to the manual TKA.

Congruence between Preferred and Actual Place of Death for Those in Receipt of Home-Based Palliative Care.

Background: Understanding the factors that affect the congruence between preferred and actual place of death may help providers offer clients customized end-of-life care settings. Little is known about this congruence for cancer patients in receipt of home-based palliative care. Objectives: This study aims to determine the congruence between preferred and actual place of death among cancer patients in home-based palliative care programs. Design: A longitudinal prospective cohort study was conducted. Congruence between preferred and actual place of death was measured. Both univariate and multivariate analyses were used to assess the determinants of achieving a preferred place of death. From July 2010 to August 2012, a total of 290 caregivers were interviewed biweekly over the course of their palliative care trajectory from entry to the program and death. Results: The overall congruence between preferred and actual place of death was 71.72%. Home was the most preferred place of death. The intensity of home-based nursing visits and hours of care from personal support workers (PSWs) increased the likelihood of achieving death in a preferred setting. Conclusions: The provision of care by home-based nurse visits and PSWs contributed to achieving a greater congruence between preferred and actual place of death. This finding highlights the importance of formal care providers in signaling and executing the preferences of clients in receipt of home-based palliative care.

Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period.

To describe paediatric postdischarge concerns manifesting in the first 96hr after hospital discharge. Analysis of nursing documentation generated as part of a randomized controlled trial evaluating the effect of a nurse home visit on healthcare re-use. We analysed home visit records of 651 children (age <18) hospitalized at a large Midwestern children's hospital in 2015 and 2016 who were enrolled in the trial. Registered nurses documented concerns in structured fields and free-text notes in visit records. Descriptive statistics were used to summarize visit documentation. Free-text visit notes were reviewed and exemplars illustrative of quantitative findings were selected. Overall, nurses documented at least one concern in 56% (N=367) of visits. Most commonly, they documented concerns about medication safety (15% or 91 visits). Specifically, in 11% (N=58) of visits nurses were concerned that caregivers lacked a full understanding of medications and in 8% (N=49) of visits families did not have prescribed discharge medications. Pain was documented as present in 9% of all visits (N=56). Nurses completed referrals to other providers/services in 12% of visits (N=78), most frequently to primary care providers. In 13% of visits (N=85) nurses documented concerns considered beyond the immediate scope of the visit related to social needs such as housing and transportation. Inpatient and community nurses and physicians should be prepared to reconcile and manage discharge medications, assess families' medication administration practices and anticipate social needs after paediatric discharge. Little empirical data are available describing concerns manifesting immediately after paediatric hospital discharge. Concerns about medication safety were most frequent followed by concerns related to housing and general safety. The results are important for clinicians preparing children and families for discharge and for community clinicians caring for discharged children.

Demand for community-based care services and its influencing factors among the elderly in affordable housing communities: a case study in Nanjing City

BackgroundCommunity-based care services refers to the professional services provided at home to the elderly with formally assessed demands. The growth of the elderly population has increased the demand for these services, and this issue is even worse in the affordable housing community (AHC) of China. Understanding of elderly’s demands for different types of community-based care services and its determinations would enable the implementation of appropriate incentive schemes to promote utilization of community-based care services in the AHCs of China.MethodsGuided by previous studies, a conceptual framework was developed. Then, a questionnaire was designed and a community based survey was conducted from May 10–20, 2018 in Daishan AHC of Nanjing City, China. Four hundred eight participants from 25,650 elderly people were selected by systematic random sampling technique. Binary logistic regression was applied to the data about the elderly’ primary demands for community-based care services in the AHC, to quantify the elderly’s demands and explore related individual-level factors.ResultsThe finding indicates that more than 50% of respondents had the demand for an elderly care hotline, building health archives, on-call nursing and doctor visits, medical lectures, regular medical examinations and sporting fitness. The binary logistic regression models revealed that the primary demands of the elderly for community-based care services were influenced by distinct factors.ConclusionsOur findings help clarify different types of community-based care services and provide fresh information about the demand for community-based care among the elderly in AHCs. Several policy implications are discussed to enhance the efficiency of community-based care service provision.

A Qualitative Study of Increased Pediatric Reutilization After a Postdischarge Home Nurse Visit.

The Hospital to Home Outcomes (H2O) trial was a 2-arm, randomized controlled trial that assessed the effects of a nurse home visit after a pediatric hospital discharge. Children randomized to the intervention had higher 30-day postdischarge reutilization rates compared with those with standard discharge. We sought to understand perspectives on why postdischarge home nurse visits resulted in higher reutilization rates and to elicit suggestions on how to improve future interventions. We sought qualitative input using focus groups and interviews from stakeholder groups: parents, primary care physicians (PCP), hospital medicine physicians, and home care registered nurses (RNs). A multidisciplinary team coded and analyzed transcripts using an inductive, iterative approach. Thirty-three parents participated in interviews. Three focus groups were completed with PCPs (n = 7), 2 with hospital medicine physicians (n = 12), and 2 with RNs (n = 10). Major themes in the explanation of increased reutilization included: appropriateness of patient reutilization; impact of red flags/warning sign instructions on family's reutilization decisions; hospital-affiliated RNs "directing traffic" back to hospital; and home visit RNs had a low threshold for escalating care. Major themes for improving design of the intervention included: need for improved postdischarge communication; individualizing home visits-one size does not fit all; and providing context and framing of red flags. Stakeholders questioned whether hospital reutilization was appropriate and whether the intervention unintentionally directed patients back to the hospital. Future interventions could individualize the visit to specific needs or diagnoses, enhance postdischarge communication, and better connect patients and home nurses to primary care.

38 A Retrospective Review Evaluating the Institution of Nurse Clinic Visits for the Treatment of Burn Patients Being Managed at Home

Abstract Introduction Most burn injuries can be managed at home, however appropriate follow up care is vital to prevent complications. Our center developed an outpatient dressing and care algorithm aimed at improving patient outcomes and optimizing the use of healthcare providers. The algorithm consisted of scheduling patients discharged home from the burn emergency department with a nurse visit (NV) within 3 days of discharge and a provider visit (PV) 1 week later. All NV could be converted to PV prn. The purpose of this study was to evaluate the effectiveness and safety of our nurse clinic visits. Methods This was a retrospective study of outpatients managed using the new care algorithm over a 1-year period. Patients whose NV was converted (CV) to a PV were compared to those who were not converted (NCV). Basic descriptive statistics were calculated. Results The charts of 259 patients scheduled for NVs were reviewed, mean age was 24.3 years and 51% were male. The population consisted primarily of Caucasians (47%) and Hispanics (35%). Most patients had a payor source with private insurance (40%) and Medicaid (31%) being the most common. Initial presentation to the burn ED was 1.56 days post injury, mean TBSA was 1.58% and most injuries involved the hands (36%) and arms (28%). The most common mechanism was scald (56%) followed by contact (28%). The most common dressing was petroleum gauze (41%) followed by silver impregnated foam (39%). NVs were converted to PV for 16% of the population. The most common reason for conversion was discharge from clinic (33%), followed by worsening (24%), therapy needs (24%) and change in dressing (19%). When CV patients were compared to NCV there were no significant difference in age, gender, past medical history, burn history (time to presentation, TBSA, mechanism, area of injury) or dressing type with the exception of enzymatic debriders (p=.0226). Native Americans (p=0.0257) and patients with Workman’s Compensation (p=0.026) were more likely to be converted to a PV. Hispanic patients were less likely to be converted to PV (p=.0357). The charges for NV ranged from $120-$185/visit with an average reimbursement of $60.88. Conclusions Overall compliance with the scheduling of nurse visits was poor. However, when scheduled per the algorithm, nurse visits were safe and effective, decreasing provider workload while still allowing for patients to be seen in a timely manner. Applicability of Research to Practice Ongoing education and monitoring of compliance is needed to further evaluate the safety and utility of nurse visits.

Home Health Agency Factors Associated With Acute Care Hospitalization and Emergency Department Use.

We linked the Medicare Provider Utilization and Payment Data for Home Health and the Home Health Compare data for the year 2016 to identify home healthcare agency (HHA) characteristics associated with acute care hospitalization (ACH) or emergency department (ED) use. The study cohort consisted of 9,800 HHAs. Beta regression was used to examine the association between average age, race/ethnic composition, number of skilled nursing visits, number of therapy visits, percentage of dual eligible patients, HHA ownership, HHA location, Medicare tenure, proportion of patients with a diagnosis of schizophrenia, stroke, diabetes, depression, chronic obstructive pulmonary disease (COPD), heart failure, cancer and Alzheimer disease, and ACH or ED use. After controlling for HHA-level characteristics, variations in HHAs' ACH and unplanned ED visits were found. For-profit HHAs were significantly less likely to have patients with ACH. (Odds ratio = -0.05, p = 0.020), HHAs in the Midwest, South, and West had lower odds of ACH. HHAs that serve more than 50% Black patients had significantly decreased odds (β = -0.16, p < 0.001) of ACH. A 1-unit increase in the proportion of patients with a diagnosis of schizophrenia, COPD, stroke, heart failure, and Alzheimer disease was associated with increased odds of hospitalization. For each unit increase in the number of skilled nursing visits, the odds of ACH increased by 0.02 (p = 0.001). For-profit and nonprofit HHAs had a significant decrease in the odds of unplanned ED visits (p < 0.05). An increase in the proportion of patients with COPD was associated with increased odds of unplanned ED visits (p < 0.001). HHA characteristics are associated with hospitalization and ED use without hospitalization. These characteristics point to variation in quality of care measured by ACH and ED use.

Expanding Use of Nurse Home Visiting for Community Psychiatric Care in Japan

In Japan, Community-based integrated care systems are being built in response to a super-aged society and policies of de-institutionalization. In this paper, we present findings and discussion of our review about Japanese psychiatric home visit nursing services provided by Home Visit Nursing Stations (HVNS). We have examined documents, investigated the implementation rate and summarized findings of the surveys of home visiting services from 2006 to 2016. The number of users of psychiatric home visiting services during 2007 to 2015 increased from 13,532 to 52,203. From 2013 to 2015 there was a large increase in user numbers, from 31,248 to 52,208. The implementation rate of psychiatric home visiting also increased steadily from 35.5% in 2006 to 58.3% in 2016. These changes reflected the impact of policy on psychiatric service usage in Japan. We should be able to detect the outcome of psychiatric home visiting nursing in influencing patient’s quality of daily life and their recovery.