Attitudes of home-visiting nurses toward risk management of patient safety incidents in Japan

Abstract

Background In situations of home care, patients and their family members must address problems and emergencies themselves. For this reason, home-visiting nurses (HVNs) must practice risk management to ensure that patients can continue receiving care in the comfort of their homes. The purpose of this study was to examine HVNs’ attitudes toward risk management. Methods This study adopted a qualitative description approach. Semi-structured interviews were conducted to collect information on HVNs’ risk management behavior and their attitudes toward it. Participants comprised 11 HVNs working at home-visiting nursing agencies in a prefecture of Japan. Transcribed interviews were analyzed using content analysis. Results Nurses’ attitudes toward risk management comprised the following themes: (i) predicting and avoiding risks, (ii) ensuring medical safety in home settings, (iii) coping with incidents, and (iv) playing the role of administrators in medical safety, which was answered only by administrators. Conclusions When practicing risk management, home-visiting nurses should first assess the level of understanding of the patient and family, followed by developing safety measures tailored to their everyday needs. These results further suggest that administrators should take actions to foster a working environment conducive to risk management. These actions include coordinating duties to mitigate risk and improve the process of reporting risks. This study provides a baseline for future researchers to assist patients and families requiring medical care services of this nature.

Contributing factors involved in the safety of elderly people with chronic illness in home healthcare: a qualitative study

“…Limited access to paraclinical services like immediate access to laboratory or radiology services was another barrier to patient safety in the present study. Considering the above, it can be argued that the home environment suffers from serious limitations for delivering optimal care, especially for elderly patients with chronic diseases, which should be addressed properly according to the patient’s condition before comprising the patient safety 50 51…”

Development of a scale measuring home-visiting nurses’ attitudes toward patient safety: a cross-sectional study

“…The items pertaining to the HVNs’ attitudes toward patient safety were created in reference to the content of an interview survey the researchers had conducted in advance [ 12 ]. For the initial items, we sought the opinions of university faculty members and graduate students majoring in community nursing and made revisions to determine whether they showed attitudes toward patient safety.…”

“…Another important aspect of ensuring patient safety is consulting information from incident reports related HVNs to and home care. However, one study [ 2 ] found that among the 70% HVNs who experienced incidents, 40% did not report their incidents. Further, notably, most incidents that occur in the absence of HVNs are not reported [ 3 ].…”

“…Therefore, research on effective practices implemented in a home care environment is needed [ 11 ]. As an attitude toward risk management, HVNs need to tailor care to patients and their families and work with them to prevent adverse events [ 12 ]. To support the stability of a patient’s life, HVNs must be aware of the risks in patients’ daily lives and safeguard patient safety according to the characteristics of home-visiting nursing.…”

“…Thus, it is necessary to develop a scale measuring HVNs’ attitudes toward patient safety based on the relevant occupational characteristics. This study was developed based on a previous interview survey conducted by the researchers [ 12 ] that clarified HVN’s attitudes toward patient safety from three perspectives: cognitive, emotional, and behavioral. Through such a scale, it may be possible to encourage HVNs to reflect on their own behavior and actively perform their duties, which could improve patients’ safety.…”