Reporting adverse events—Swedish Registered Nurses experience in a municipal home care context

Pejner, Margaretha Norell; Kihlgren, Annica

doi:10.1002/nop2.223

Cited by 5 publications

(7 citation statements)

References 19 publications

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“…However, a challenge was also highlighted in this process: when it came to reporting incidents, HVNs recognize the need to report adverse events, but these events are underreported because of shame [ 37 ]. In this study, HVNs experienced stress related to the lack of anonymity in reporting, given that home-visiting nursing agencies are typically small.…”

Section: Discussionmentioning

confidence: 99%

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

Yoshimatsu

Nakatani

2022

BMC Nurs

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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.

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Section: Discussionmentioning

confidence: 99%

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

Yoshimatsu

Nakatani

2022

BMC Nurs

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“…This was regarded as a time consuming and complex task to accomplish, partly because of the negative character of their feedback to the HCAs. This complexity regarding reporting and communicating adverse events in home health care has been highlighted in a prior study demonstrating that reporting of adverse events that involve colleagues is considered distressing by nurses [ 47 ]. The eMAR used in this study allowed nurses to observe inaccuracies in delegated tasks.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ Perspectives on an Electronic Medication Administration Record in Home Health Care: Qualitative Interview Study

2022

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Background eHealth is considered by policy makers as a prerequisite for meeting the demands of health care from the growing proportion of older people worldwide. The expectation about what the efficiency of eHealth can bring is particularly high in the municipal home health care sector, which is facing pressure regarding resources because of, for example, earlier discharges from hospitals and a growing number of patients receiving medications and treatments at home. Common eHealth services in home health care are electronic medication administration records (eMARs) that aim to communicate delegated tasks between professionals. However, there is an extensive gap in the research on how technology affects and is experienced by home health care professionals. Objective The objective of this paper is to shed light on how home care nurses experience eMARs in a Swedish municipality. Methods This qualitative interview study was conducted among home health care nurses using eMARs to facilitate communication and signing of delegated nursing tasks. The analysis of the interviews was performed using constructivist grounded theory, according to Charmaz. Results Of the 19 day-employed nurses in the municipality where an eMAR was used, 16 (84%) nurses participated in the study. The following two categories were identified from the focus group interviews: nurses become monitors and slip away from the point of care. The nurses experienced that they became monitors of health care through the increased transparency provided by the eMAR and the measurands they also applied, focusing on the quantitative aspects of the delegated nursing tasks rather than the qualitative aspects. The nurses experienced that their monitoring changed the power relations between the professions, reinforcing the nurses’ superior position. The experience of the eMAR was regarded as transitioning the nurses’ professional role—away from the point of care and toward more administration—and further strengthened the way of managing work through delegation to health care assistants. Conclusions Previous analyses of eHealth services in health care showed that implementation is a complex process that changes health care organizations and the work of health care professionals in both intended and unintended ways. This study adds to the literature by examining how users of a specific eHealth service experience its impacts on their daily work. The results indicate that the inscribed functions in an eHealth service may affect the values and priorities where the service is in use. This presents an opportunity for future research and for health care organizations to assess the impacts of specific eHealth services on health care professionals’ work and to further examine the effects of inscribed functions in relation to how they may affect actions and priorities at individual and organizational levels.

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“…In addition, if procedures are not strictly followed, it is more likely that preventable adverse events will occur (Henriksen et al, 2009). Considering the homecare environment and working conditions, it has been reported that professionals do not feel confident with new procedures (Pejner & Kihlgren, 2019). Strong safety management is also needed in long‐term professional homecare.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the homecare environment and working conditions, it has been reported that professionals do not feel confident with new procedures (Pejner & Kihlgren, 2019). Strong safety management is also needed in long-term professional homecare.…”

Section: Discussionmentioning

confidence: 99%

National registry‐based data of adverse events in Finnish long‐term professional homecare in 2009–2019

Kivimäki

Stolt

Katajisto

et al. 2022

Journal of Clinical Nursing

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Aims and objectives:The aim of this study was to discover the nature of the adverse events in Finnish long-term professional homecare reported by professionals, and to identify the circumstances in which adverse events occur and their consequences.Background: Adverse events are incidents causing unintended and unnecessary harm to older people at home. Safety is a basic human right and a fundamental prerequisite for independent living among older people at home. Few studies have focused on both long-term professional homecare environment and the safety of older people. Design:The research was a descriptive registry-based study.Methods: This study consisted of adverse events (N = 61248) in Finnish public longterm professional homecare (2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019). Data were described using frequencies and percentages. STROBE statement checklist was chosen for reporting the study process.Results: By profession, practical nurses and registered nurses reported the most of adverse events (89.8%). These were either critical incidents (78.3%) or near misses (20.0%) and concerned medicine, injuries and accidents, information flow or management. Consequences for older people were usually rated from no-harm to moderate harm. For long-term professional homecare, image harm, extra financial costs, noharm and prolonged care for older people were among the consequences. Personnel frequently observed the older people afterwards and informed older people of adverse events, yet some of actions were unknown.Conclusions: Many harmful adverse events are considered harmless for older people.Sometimes this can lead to unmet care needs or missed care. The degree of harm needs to be assessed in terms of physical, mental and social health with the HaiPro reporting system for homecare.Relevance to clinical practice: An understanding and a comprehensive view of the situation and holistic assessment of care needs includes safety and safety risks to increase safety and feeling of safety for older people at home.

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Reporting adverse events—Swedish Registered Nurses experience in a municipal home care context

Cited by 5 publications

References 19 publications

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

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

Nurses’ Perspectives on an Electronic Medication Administration Record in Home Health Care: Qualitative Interview Study

National registry‐based data of adverse events in Finnish long‐term professional homecare in 2009–2019

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