Safety in home care: a broadened perspective of patient safety

被引:77
作者
Lang, Ariella [1 ]
Edwards, Nancy [1 ]
Fleiszer, Andrea [1 ]
机构
[1] Univ Ottawa, Sch Nursing, Ottawa, ON, Canada
基金
加拿大健康研究院;
关键词
home care; home healthcare; home nursing; patient safety; safety;
D O I
10.1093/intqhc/mzm068
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background. Home care is the most rapidly growing segment of the Canadian healthcare system. Overwhelmingly, research on patient safety has been conducted within institutional settings, resulting in a significant knowledge gap about safety in homecare. Given the dramatic increase in the amount, acuity and complexity of health care being provided in the home and community, it is essential to develop our understanding of safety in this sector. Objective. The objective of this paper is to describe the landscape of safety in home care in Canada. Method. This pan-Canadian initiative included three phases: a literature review, 20 key informant interviews and an invitational roundtable. Data were synthesized using a content analysis approach. Results. Patient safety is a failure of systems rather than of humans; there are many change processes required to create safe environments; organizational culture and workplace factors are critical. Patients have a key role to play in their care and thus must be part of the patient safety discourse. Themes central to safety in home care are: the inextricably linked relationships and communication among clients/families and caregivers/providers; unregulated and uncontrolled settings, autonomy and isolation; the multidimensionality of safety (physical, emotional, social, functional); a diminishing focus on prevention, health promotion and chronic care; challenges of human resources and maintenance of competence. Conclusion. Addressing safety in home care and mitigating the risks presents unique challenges and requires a major rethink of underlying institutionally oriented assumptions and guiding frameworks.
引用
收藏
页码:130 / 135
页数:6
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