Hospital in the home nurses' assessment decision making: an integrative review of the literature

Aim: To describe what is currently known about nurses' assessment decisions when providing care to patients at home or in their usual place of residence. Methods: In August 2018, an integrative literature review using a systematic approach was conducted using specific search terms to search Informit, MEDLINE and Cumulative Index of Nursing and Allied Health Literature (CINAHL). The literature search was not limited by date, and included published papers or unpublished dissertations written between 1980 and 2018. Results: In total 25 full papers were assessed for inclusion in this review; seven met the inclusion criteria. Three themes were identified from this review: i) nurse education and experience; ii) assessment informing decision-making and iii) knowing the patient. Conclusion: Nurses' education, experience, abilities, prior learning, beliefs, attitudes and values are key factors in the delivery of home-based nursing care, and strongly influence how assessments, clinical judgements and decisions are made. Impact Statement: An understanding of home based nurses' decisions and response to clinical deterioration is needed to inform Hospital in the Home nursing-specific curricula.