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Corrigendum to Assessing the Structural Characteristics of the Japanese Version of the Adult Social Care Outcomes Toolkit for Carers 评估日文版照顾者成人社会照顾结果工具包的结构特征的勘误表
Q4 NURSING Pub Date : 2023-03-03 DOI: 10.1177/10848223231163902
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引用次数: 0
Home-Based Primary Care for Older Adults: Matched Case-Control Evaluation of Program’s Impact on Healthcare Utilization 以家庭为基础的老年人初级保健:项目对医疗保健利用影响的匹配病例对照评估
IF 1.1 Q4 NURSING Pub Date : 2023-02-14 DOI: 10.1177/10848223231151975
S. M. Kling, Donn W. Garvert, A. Lessios, M. Yefimova, Marina Martin, Meera Sheffrin, M. Winget
Home-based Primary Care (HBPC) is an alternative model for homebound older adults. Healthcare utilization in HBPC was evaluated with a matched case-control design. Medical providers and social workers provided in-home visits. Enrolled patients were matched to controls on age, prior hospitalizations, and frailty risk. Difference-in-differences in utilization of primary care, specialty, and hospital services between 1-year pre- and 1-year post-enrollment were evaluated with hierarchical linear models. Analyses included 117 HBPC cases and 328 controls. HBPC cases had a significant increase in primary care visits compared to controls (7.8 ± 0.6; p < .0001) but significantly decreased utilization of in-clinic primary care visits (−3.2 ± 0.6; p < .0001). In-clinic specialty visits and hospital services did not differ between cases and controls (all p’s ≥ .75). Homebound patients accessed high-touch primary and social care, which is typically unachievable in clinic settings; however, additional work is needed to optimize services and target in-home care to impact healthcare utilization.
以家庭为基础的初级保健(HBPC)是居家老年人的另一种模式。采用匹配病例对照设计评估HBPC患者的医疗保健利用情况。医务人员和社会工作者提供了家访。入组患者在年龄、既往住院情况和衰弱风险方面与对照组相匹配。采用层次线性模型评估入组前1年和入组后1年对初级保健、专科和医院服务的利用差异。分析包括117例HBPC病例和328例对照。与对照组相比,HBPC病例的初级保健就诊次数显著增加(7.8±0.6;P < 0.0001),但门诊初级保健就诊利用率显著降低(- 3.2±0.6;p < 0.0001)。门诊专科就诊和医院服务在病例和对照组之间没有差异(p值均≥0.75)。居家患者获得了高接触初级保健和社会保健,这在诊所环境中通常是无法实现的;然而,还需要做更多的工作来优化服务和目标家庭护理,以影响医疗保健的利用。
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引用次数: 1
Providing Physical Assistance for Family or Friends: An Overview for the Home Health Care Professional—Part 2 为家人或朋友提供身体帮助:家庭保健专业人员概述-第2部分
IF 1.1 Q4 NURSING Pub Date : 2023-02-01 DOI: 10.1177/10848223221123270
Rodney L. Weir, Donald L. Hoover PT
This article is Part 2 of a 2-part series of articles addressing the needed educational and training support for informal caregivers who provide physical assistance in the home. Part 1, which was presented in a previous edition of Home Health Care Management & Practice (HHCMP), covered contemporary research on informal caregiver burden and addressed special challenges linked to provision of physical mobility assistance. Part 2, presented here, offers specific training recommendations for informal caregivers that may be provided by home health care professionals.
本文是由2部分组成的系列文章的第2部分,讨论为在家中提供物理帮助的非正式护理人员提供所需的教育和培训支持。第1部分是在《家庭保健管理与实践》(HHCMP)的上一版中提出的,涵盖了关于非正式照顾者负担的当代研究,并解决了与提供身体活动援助有关的特殊挑战。这里介绍的第2部分为非正式护理人员提供了具体的培训建议,这些建议可能由家庭保健专业人员提供。
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引用次数: 0
Data-Driven Analysis of Employee Churn in the Home Care Industry 家庭护理行业员工流失的数据驱动分析
IF 1.1 Q4 NURSING Pub Date : 2022-12-13 DOI: 10.1177/10848223221137354
Guillaume Vergnolle, N. Lahrichi
Annual turnover of home care workers represents a huge loss of revenue and is a key source of inefficiency in the home health care industry. In this article, we propose a data-driven approach to monitor employee churn and to capture the evolution of employee intent to leave. Unlike most papers in the literature, we use machine learning techniques to analyze over 2 million visits in the US, Canada, and Australia between 2016 and 2019. Results show that the gap between the number of hours worked and in the contract is the most important factor to predict employee intent to leave, which means an employee should be given as many hours as requested in the contract to improve retention. Secondary results show that having diverse shift lengths and continuity in services and patients seem to be associated with less turnover.
家庭护理人员的年营业额代表着巨大的收入损失,也是家庭医疗保健行业效率低下的主要原因。在本文中,我们提出了一种数据驱动的方法来监控员工流失,并捕捉员工离职意愿的演变。与文献中的大多数论文不同,我们使用机器学习技术分析了2016年至2019年间在美国、加拿大和澳大利亚的200多万次访问。结果表明,工作小时数与合同中的工作小时数之间的差距是预测员工离职意愿的最重要因素,这意味着应根据合同要求为员工提供尽可能多的工作时间,以提高留任率。次要结果表明,不同的轮班时间和服务和患者的连续性似乎与较少的人员流动有关。
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引用次数: 1
A Retrospective Cohort Study Evaluating the Association Between Implementation of a Digital Care Plan and Hospitalization Rates for Home Care Residents in the United Kingdom 一项回顾性队列研究评估数字护理计划的实施与英国家庭护理居民住院率之间的关系
IF 1.1 Q4 NURSING Pub Date : 2022-12-05 DOI: 10.1177/10848223221135560
N. Windle, Azeem Alam, Horus Patel, Jonathan M. Street, Megan Lathwood, Tessa Farrington, M. Maruthappu
Cera, a homecare provider, uses digital care plans (DCP), to streamline the provision of home care. DCP rollout is part of a larger digitization initiative, including carer visit reports collected through a mobile app and branch actions recorded in a web application supported by a secure central database. This retrospective cohort study aimed to assess the association of a DCP rollout with service user hospitalization rates. his study utilized retrospective data from 2 groups of service users, those for whom their first 30 days of Cera membership occurred prior to DCP rollout (pre-DCP group) versus those whose first 30 days of Cera membership occurred after DCP rollout (post-DCP group). The 30-day hospitalization rate was the primary outcome measure and was determined through a combination of carer reports, reporting from service users or their families, and branch staff follow-up. There were 55 hospitalizations among 392 users in the pre-DCP group in the 30 days after joining Cera (14.0% hospitalization rate), compared to 23 hospitalizations among 297 users in the post-DCP group (7.7% hospitalization rate). This represented a significant reduction in hospitalizations in the post-DCP group (6.3% absolute difference in hospitalization rate; 45% relative reduction; P < .001). This result was robust to multiple sensitivity analyses. The implementation of a DCP was associated with a 45% relative reduction in the 30-day hospitalization rate for new service users when compared to pre-DCP enrollment. These benefits could be further amplified by combining the DCP with additional initiatives aimed at the prediction and prevention of avoidable hospitalizations.
Cera是一家家庭护理提供商,它使用数字护理计划(DCP)来简化家庭护理的提供。DCP的推出是一项更大的数字化举措的一部分,包括通过移动应用程序收集的护理人员访问报告,以及在安全的中央数据库支持的网络应用程序中记录的分支机构行动。这项回顾性队列研究旨在评估DCP的推出与服务用户住院率的关系。他的研究利用了来自两组服务用户的回顾性数据,这些用户的前30名 Cera成员的天数发生在DCP推出之前(DCP前组),而前30天 Cera成员的天数发生在DCP推出后(DCP后组)。30天住院率是主要的结果衡量标准,通过护理人员报告、服务用户或其家人的报告以及分支机构工作人员的随访来确定。在30年中,DCP前组的392名用户中有55人住院 加入Cera后几天(14.0%的住院率),相比之下,DCP后组297名用户中有23人住院(7.7%住院率)。这表明DCP后组的住院人数显著减少(住院率绝对差异6.3%;相对减少45%;P < .001)。这一结果对于多重敏感性分析是稳健的。与DCP注册前相比,DCP的实施与新服务用户的30天住院率相对降低45%有关。通过将DCP与旨在预测和预防可避免住院的额外举措相结合,可以进一步扩大这些益处。
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引用次数: 0
“What Were They Thinking?”: The Exclusion of Medicare Home Health From Providing Supplemental Social Needs Benefits “他们在想什么?”:将家庭医疗保险排除在提供补充社会需求福利之外
IF 1.1 Q4 NURSING Pub Date : 2022-11-28 DOI: 10.1177/10848223221135576
W. Cabin
There is significant literature on social determinants of health (SDOH) to improve health outcomes. In response, Congress and the Centers for Medicare and Medicaid Services (CMS) have expanded Medicare Advantage Plans’ ability to cover SDOH-related services through supplemental benefits and Special Needs Plans (SNPs). Congress has not authorized Traditional Medicare to cover such services. A literature review indicates no studies of Medicare home health social worker awareness of this dichotomy and their resulting perceptions of the impacts of the lack of such coverage. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 44 home care social workers from 5 different home health agencies in the New York City metropolitan area between November 1, 2021, and May 31, 2022. Results indicate social workers lacked awareness of the dichotomy in coverage of SNPs and supplemental benefits in Medicare Advantage Plans and traditional Medicare. Once made aware of the dichotomy, 4 additional themes emerged from the interviews: documented patient needs were being ignored; the supplemental needs coverage permitted for Medicare Advantage plans should be extended to beneficiaries receiving traditional Medicare; and the lack of such coverage increased the risk of onset of mental and physical health conditions, and revolving door-admissions and costs. Policymakers are urged to consider adding coverage of special needs and supplemental benefits covered in Medicare Advantage to traditional Medicare, through Medicare home health.
关于改善健康结果的健康社会决定因素(SDOH)有大量文献。作为回应,国会和医疗保险和医疗补助服务中心(CMS)通过补充福利和特殊需要计划(snp)扩大了医疗保险优势计划的能力,使其涵盖与sdoh相关的服务。国会尚未授权传统医疗保险覆盖这些服务。一项文献综述表明,没有研究表明医疗保险家庭卫生社会工作者对这种二分法的认识,以及他们对缺乏这种覆盖的影响的看法。本文总结了一项初步的探索性研究,以解决文献空白,该研究基于2021年11月1日至2022年5月31日期间对纽约市大都会地区5家不同家庭卫生机构的44名家庭护理社会工作者的访谈。结果表明,社会工作者缺乏对医疗保险优势计划和传统医疗保险中snp和补充福利覆盖的二分法的认识。一旦意识到这种二分法,从访谈中出现了4个额外的主题:记录在案的患者需求被忽视了;医疗保险优势计划允许的补充需求覆盖范围应该扩展到接受传统医疗保险的受益人;而且,缺乏这种覆盖增加了精神和身体健康状况发生的风险,以及旋转门入院和费用。政策制定者被敦促考虑在传统医疗保险的基础上,通过医疗保险家庭健康,增加医疗保险优势的特殊需求和补充福利。
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引用次数: 2
Identification of Contributing Factors of Falls and Non-Fall Accidents Among Home Care Clients: A Retrospective Study Using Incident Reports 家庭护理客户中跌倒和非跌倒事故的影响因素的识别:一项使用事故报告的回顾性研究
IF 1.1 Q4 NURSING Pub Date : 2022-11-16 DOI: 10.1177/10848223221134095
Outi Kiljunen, P. Kankkunen, Tarja Välimäki
To prevent falls and other accidents among home care clients, it is essential to gather high-quality information on the factors contributing to the accidents. Incident reporting systems are used in home care units to generate information for risk management. This study aimed to explore the contributing factors of falls and non-fall accidents among home care clients and to evaluate the accuracy of the information on contributing factors gained from the incident reporting system. An existing dataset was used—safety incident reports concerning accidents involving home care clients. The incident reports (n = 323) were stored in the social- and health care organization’s incident reporting database from 2018 to 2020. The free-text narratives describing factors contributing to the event’s occurrence were analyzed using inductive content analysis, and the frequencies of the main category codes were recorded. The results were then compared with the frontline managers’ analyses of the narratives, where the managers used the classification of contributing factors provided by the system. According to incident reports, intrinsic (person-specific), behavior-related and extrinsic (environment-related) factors contributed to accidents among home care clients. Intrinsic and behavior-related factors were reported more often than extrinsic factors. The classified information on contributing factors did not correspond in all respects to the descriptions in the incident reports. To ensure high-quality information for safety management, incident reporting tools must be appropriate for use in the home care context. Both the reporter of an adverse event and the individual responsible for analyzing the report play essential roles in identifying contributing factors of accidents.
为了防止家庭护理客户的跌倒和其他事故,收集导致事故因素的高质量信息是至关重要的。家居护理单位使用事故报告系统,为风险管理提供信息。本研究旨在探讨居家照护客跌倒与非跌倒事故之成因,并评估事故报告系统所提供之成因资讯之准确性。使用了一个现有的数据集——涉及家庭护理客户的事故安全事件报告。事件报告(n = 323)从2018年到2020年存储在社会和医疗保健组织的事件报告数据库中。采用归纳内容分析法对事件发生因素的自由文本叙述进行分析,并记录主要类别代码的频率。然后将结果与一线管理人员对叙事的分析进行比较,在一线管理人员使用系统提供的促成因素分类。根据事故报告,内在(个人特定)、行为相关和外在(环境相关)因素导致家庭护理客户发生事故。内在因素和行为相关因素比外在因素更常被报道。有关促成因素的机密资料在各方面都不符合事件报告中的描述。为了确保安全管理的高质量信息,事故报告工具必须适合家庭护理环境。不良事件的报告人和负责分析报告的个人在确定事故的促成因素方面都起着至关重要的作用。
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引用次数: 0
Obstacles and Pathways on the Journey to Access Home and Community Care by Older Adults Living With HIV/AIDS in British Columbia, Canada: Thrive, a Community-Based Research Study 加拿大不列颠哥伦比亚省艾滋病毒/艾滋病老年人获得家庭和社区护理的障碍和途径:Thrive,一项基于社区的研究
IF 1.1 Q4 NURSING Pub Date : 2022-10-28 DOI: 10.1177/10848223221130504
Anna E. Vorobyova, Rana Van Tuyl, Claudette Cardinal, Antonio Marante, Patience Magagula, Sharyle Lyndon, S. Parashar
Older adults living with HIV (OALHIV) (i.e., age ≥50) now constitute over 50% of all people accessing HIV treatment in British Columbia (BC), Canada. As OALHIV age, the need for supportive care in non-acute settings, including home and community care (HCC), is increasing. The Thrive research project was co-created alongside OALHIV in BC to support people to thrive with a good quality of life (as contrasted with just surviving). Phase 1 of the project linked treatment and demographic records for 5603 OALHIV accessing care in BC. Phase 2 took a community-based research approach with semi-structured interviews to understand obstacles and pathways experienced by 27 OALHIV in accessing HCC. This article summarizes previously published Phase 1 findings and explores Phase 2 findings in-depth. On the HCC journey traveled by OALHIV in BC, there are four main junctures at which obstacles and pathways appear: (1) before referral, (2) during the referral process, (3) at the assessment, and (4) while receiving services. Obstacles are largely related to fluctuating HCC priorities and funding cuts tied to election cycles, requiring systemic and policy changes to enable positive outcomes and impacts in the provision of HCC services. These obstacles can be transformed into pathways through public policy and client-centered, culturally safe care.
在加拿大不列颠哥伦比亚省,感染艾滋病毒的老年人(即年龄≥50岁)目前占接受艾滋病毒治疗的所有人的50%以上。随着OALVIV年龄的增长,在非急性环境中对支持性护理的需求正在增加,包括家庭和社区护理(HCC)。Thrive研究项目是与OALVIV在不列颠哥伦比亚省共同创建的,旨在支持人们以良好的生活质量(与仅仅生存相比)茁壮成长。该项目的第一阶段将不列颠哥伦比亚省5603名OALVIV患者的治疗和人口统计记录联系起来。第二阶段采用基于社区的研究方法,进行半结构化访谈,以了解27名OALVIV在获得HCC方面遇到的障碍和途径。本文总结了先前发表的第一阶段研究结果,并深入探讨了第二阶段的研究结果。在不列颠哥伦比亚省OALVIV的HCC旅程中,出现障碍和途径的主要时刻有四个:(1)转诊前,(2)转诊过程中,(3)评估时,以及(4)接受服务时。障碍主要与HCC优先事项的波动和与选举周期相关的资金削减有关,需要进行系统和政策变革,以实现HCC服务提供的积极成果和影响。这些障碍可以通过公共政策和以客户为中心的文化安全护理转化为途径。
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引用次数: 0
Tele Homecare in Premature Infants’ Post-Discharge Early Follow-Up: A Narrative Review 远程家庭护理对早产儿出院后早期随访的影响
IF 1.1 Q4 NURSING Pub Date : 2022-10-18 DOI: 10.1177/10848223221127437
Atefeh Shamsi, Asghar Ehteshami, H. Zandi, Mahboobeh Namnabati
The study was conducted to review, categorize and organize early tele-homecare follow-up research in premature infants based on research type, the focus of tele-homecare, and measured outcomes. This narrative review was conducted in 2021 through international databases, including PubMed, Scopus, ProQuest, and Web of Science databases. Studies selected for this purpose included original articles on premature infants. We reviewed 16 out of 267 identified articles. These studies were analyzed according to general characteristics, elements, and characteristics of tele-homecare intervention. Based on the obtained data, most studies had been conducted in Nordic countries as the pioneer in tele homecare. Also, most of them were on the psychological status of premature infants’ parents. Phone calls, video consultation, and applications were considered dominant tele-homecare communication tools. Overall, the qualitative studies on parents’ and health providers’ views about tele homecare revealed its hidden aspects as a supportive tool. The tele-homecare studies were distributed across different fields and countries, resulting in positive outcomes for infants and parents. However, further studies in the long-term periods are recommended to follow up on premature infants.
根据研究类型、远程家庭护理的重点和测量结果,对早产儿早期远程家庭护理随访研究进行回顾、分类和整理。这篇叙述性综述是在2021年通过国际数据库进行的,包括PubMed、Scopus、ProQuest和Web of Science数据库。为此目的选择的研究包括关于早产儿的原创文章。我们审查了267篇确定的文章中的16篇。根据远程家庭护理干预的一般特征、要素和特征对这些研究进行分析。根据获得的数据,大多数研究都是在北欧国家进行的,北欧国家是远程家庭护理的先驱。此外,大多数是关于早产儿父母的心理状况。电话、视频咨询和应用程序被认为是主要的远程家庭护理通信工具。总体而言,对父母和医疗服务提供者对远程家庭护理的看法的定性研究揭示了其作为一种支持工具的隐藏方面。远程家庭护理研究分布在不同的领域和国家,对婴儿和父母产生了积极的结果。然而,建议对早产儿进行长期的进一步研究。
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引用次数: 1
Promoting Medication Management Skills Among Home Health Occupational Therapists: A Quality Improvement Project 提高家庭健康职业治疗师的药物管理技能:一项质量改进项目
IF 1.1 Q4 NURSING Pub Date : 2022-10-17 DOI: 10.1177/10848223221127438
S. Frye, S. Rushanan
Medication management is a national patient safety goal for home care practice. Medication management is an occupation within the scope of occupational therapy. Occupational therapists are able to assess and provide intervention for cognitive, visual, motor, process, environmental and personal factors that impact an individual’s ability to manage their medication independently. This quality improvement project describes a program developed to promote medication management competence in occupational therapists practicing in a large, academic home health agency. The quality improvement project consisted of an online module providing education on the Performance Assessment of Self-Care Skills (PASS) and a 1-hour training session combining didactic education with case-based learning. Pre-post assessment surveys revealed a 25% increase in perceived medication management competence after the intervention. Occupational therapists identified 4 barriers to medication management practice: role ambiguity, documentation challenges, pharmacology knowledge deficit, and reconciliation process barriers.
药物管理是家庭护理实践的国家患者安全目标。药物管理是职业治疗范围内的一种职业。职业治疗师能够评估并干预影响个人独立管理药物能力的认知、视觉、运动、过程、环境和个人因素。该质量改进项目描述了一项旨在提高在大型学术家庭卫生机构执业的职业治疗师药物管理能力的计划。质量改进项目包括一个在线模块,提供自我护理技能绩效评估教育,以及一个1小时的培训课程,将教学教育与案例学习相结合。评估前和评估后的调查显示,干预后的药物管理能力提高了25%。职业治疗师确定了药物管理实践的4个障碍:角色模糊、文件挑战、药理学知识不足和和解过程障碍。
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引用次数: 0
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Home Health Care Management and Practice
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