Work-related factors influencing home care nurse intent to remain employed

Many western countries are experiencing a substantial shortage of home-care nurses due to the increasing numbers of care-dependent people living at home. In-depth knowledge is needed about what home-care nurses find attractive about their work in order to make recommendations for the recruitment and retention of home-care nursing staff. The aims of this explorative, qualitative study were to gain in-depth knowledge about which aspects home-care nurses find attractive about their work and to explore whether these aspects vary for home-care nurses with different levels of education. Discussions were conducted with six online focus groups in 2016 with a total of 38 Dutch home-care nurses. The transcripts were analysed using the principles of thematic analysis. The findings showed that home-care nurses find it attractive that they are a "linchpin", in the sense of being the leading professional and with the patient as the centre of care. Home-care nurses also find having autonomy attractive: autonomy over decision-making about care, freedom in work scheduling and working in a self-directed team. Variety in patient situations and activities also makes their work attractive. Home-care nurses with a bachelor's degree did not differ much in what they found attractive aspects from those with an associate degree (a nursing qualification after completing senior secondary vocational education). It is concluded that autonomy, variety and being a "linchpin" are the attractive aspects of working in home care. To help recruit and retain home-care nursing staff, these attractive aspects should be emphasised in nursing education and practice, in recruitment programmes and in publicity material. K E Y W O R D Sattractiveness, autonomy, home care, nurses

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Attractiveness of working in home care: An online focus group study among nurses

Groot

Maurits

Francké

2017

“…A Belgian study found that task autonomy, social support and opportunities for learning could buffer workplace stresses (Vander Elst et al, ). A recently published Canadian study (Tourangeau, Patterson, Saari, Thomson, & Cranley, ) confirmed our findings that HCN retention was related to a number of modifiable factors including: income stability, meaningfulness of work, continuity of care, positive relationships with supervisors, work‐life balance, and satisfaction with salary and benefits. One factor related to retention in this study that was not revealed in our review included nurses’ perceptions of the quality of care provided by their organisation (Tourangeau et al, ).…”

Section: Discussionsupporting

confidence: 86%

Optimization of home care nurses in Canada: A scoping review

Ganann

Weeres

Lam

et al. 2019

Nurses are among the largest providers of home care services thus optimisation of this workforce can positively influence client outcomes. This scoping review maps existing Canadian literature on factors influencing the optimisation of home care nurses (HCNs). Arskey and O'Malley's five stages for scoping literature reviews were followed. Populations of interest included Registered Nurses, Registered/Licensed Practical Nurses, Registered Nursing Assistants, Advanced Practice Nurses, Nurse Practitioners and Clinical Nurse Specialists. Interventions included any nurse(s), organisational and system interventions focused on optimising home care nursing. Papers were included if published between January 1, 2002 up to May 15, 2015. The review included 127 papers, including 94 studies, 16 descriptive papers, 6 position papers, 4 discussion papers, 3 policy papers, 2 literature reviews and 2 other. Optimisation factors were categorised under seven domains: Continuity of Care/Care; Staffing Mix and Staffing Levels; Professional Development; Quality Practice Environments; Intra‐professional and Inter‐professional and Inter‐sectoral Collaboration; Enhancing Scope of Practice: and, Appropriate Use of Technology. Fragmentation and underfunding of the home care sector and resultant service cuts negatively impact optimisation. Given the fiscal climate, optimising the existing workforce is essential to support effective and efficient care delivery models. Many factors are inter‐related and have synergistic impacts (e.g., recruitment and retention, compensation and benefits, professional development supports, staffing mix and levels, workload management and the use of technology). Quality practice environments facilitate optimal practice by maximixing human resources and supporting workforce stability. Role clarity and leadership supports foster more effective interprofessional team functioning that leverages expertise and enhances patient outcomes. Results inform employers, policy makers and relevant associations regarding barriers and enablers that influence the optimisation of home care nursing in nursing, intra‐ and inter‐professional and inter‐organisational contexts.

“…This study incorporated a cross-sectional survey design and is part of a larger study examining factors influencing HC nurses' retention (Tourangeau et al 2017). In study phase 1 focus group, HC nurses identified factors that influenced their decision to remain in or leave HC (Tourangeau et al 2014).…”

Section: Methodsmentioning

confidence: 99%

“…One element of focus group discussions focused on occupational hazards faced in HC work. In study phase 2, HC nurses were invited to complete a survey developed from focus group findings and previous literature to understand their intention to remain employed and those factors influencing these intentions (Tourangeau et al 2017). This paper reports on the phase 2 survey responses of the 14 occupational hazards with specific focus on their prevalence across different geographical settings.…”

Section: Methodsmentioning

confidence: 99%

Occupational hazards for home care nurses across the rural-to-urban gradient in Ontario, Canada

Wong

Saari

Patterson

et al. 2017

Self Cite

The purpose of this paper was to describe occupational hazards for nurses working in home care (HC) and explore how they differ across the rural-to-urban gradient. Responses (n = 823) from a cross-sectional survey conducted in 2012 of HC nurses registered to practise nursing in the Province of Ontario, Canada were used. Using chi-square analysis and posthoc pairwise tests with a Bonferroni correction, 14 occupational hazards were individually tested for differences between four geographical settings (rural, town, suburban or urban areas). Our study reports that in addition to common occupational hazards that all HC nurses experience, the frequency of experiencing some hazards varies based on geographic setting. These specific hazards include exposure to: aggressive pets, environmental tobacco smoke, oxygen equipment, unsafe neighbourhoods and pests. Findings from this study suggest that a relationship exists between where a patient's home is located and the types of occupational hazards that may be experienced by HC staff. This research is useful for HC organisations in developing staff training programmes to recognise and manage occupational hazards that workers are likely to encounter. Home healthcare and policy leaders may use these findings to develop and implement educational and other strategies to reduce risk and manage exposures across the rural-to-urban gradient.