Home Health Nurse Decision-Making Regarding Visit Intensity Planning for Newly Admitted Patients: A Qualitative Descriptive Study

Despite patients referred to home health having diverse and complex needs, it is unknown how nurses develop personalized visit plans. In this qualitative descriptive study, we interviewed 26 nurses from three agencies about their decision-making process to determine visit intensity and analyzed data using directed content analysis. Following a multifactorial assessment of the patient, nurses relied on their experience and their agency’s protocols to develop the personalized visit plan. They revised the plan based on changes in the patient’s clinical condition, engagement, and caregiver availability. Findings suggest strategies to improve visit planning and positively influence outcomes of home health patients

How Home Health Nurses Plan Their Work Schedules: A Qualitative Descriptive Study

Aims and objectives: To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. Background: Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. Design: Qualitative descriptive design. Methods: Semi-structured interviews were conducted with 20 registered nurses who had \u3e2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analysed using conventional content analysis. Results: Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritise visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients. Conclusion: Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments. Relevance to clinical practice: Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organisational priorities to facilitate continuity of care and support nurses while alleviating the burnout associated with high productivity requirements

The Impact of Telehealth Services Offered by Home Care Agencies on Patient Safety

There is little available research about how home care agencies attempt to address patient safety during the nurse virtual healthcare visit. The purpose of this quantitative correlational study was to determine, during the delivery of telehealth care by a home care agency, to what extent the level of education of the registered nurse, the level of education of the director of the home care agency, and the clinical decision support system (CDSS) impact patient safety. The framework for the study was the complex sociotechnological systems model. Data from the 2007 National Home and Hospice Care Survey were analyzed using logistic regression analysis. The results of the analysis revealed that during the delivery of telehealth care by home care agencies, the level of education of the registered nurse and the level of education of the homecare agency director have statistically significant relationships to patient safety (routine video monitoring; p = .02). Additionally, the findings of the study showed that during the delivery of telehealth care by home care agencies, the CDSS has a statistically significant relationship to patient safety (staff use of CDSS guidelines; p = .001). The findings of this study could contribute to professional practice and social change by highlighting the levels of education at the home care level and the benefit of hiring trained professionals to understand patient safety tools such as CDSS guidelines and routine video monitoring