The challenge of risk prevention in home healthcare—An interview study with nurses in municipal care

Abstract

AbstractBackgroundSafety in home healthcare has garnered increased attention as more people are receiving care for complex conditions at home. The prerequisites for providing safe care at home differ from those in hospitals. Malnutrition, falls, pressure ulcers and inappropriate medication commonly follow poor risk assessments, causing unnecessary suffering and costs. Therefore, risk prevention in home healthcare needs to be prioritised and studied more closely.AimTo describe nurses' experiences of performing risk prevention in municipal home healthcare.MethodsQualitative inductive approach, using semi‐structured interviews with 10 registered nurses in a municipality in southern Sweden. Data underwent qualitative content analysis.FindingsThe analysis resulted in three main categories and one overarching theme describing nurses' experiences of risk prevention in home healthcare. Getting everyone onboard comprises the categories: Managing safety while respecting the patient's self‐determination, which covers patient participation, the strategic importance of respecting different views of risks and information and the fact that healthcare workers are guests in the patient's home. Finding ways to make it work touches upon the relational aspect, including next‐of‐kin and promoting a common understanding to prevent risks. Being squeezed between resources and requirements refers to ethical dilemmas, teamwork, leadership and organisational prerequisites.ConclusionPatient habits, living conditions and limited awareness of risks is a challenge in risk prevention in home healthcare, where patient participation plays a pivotal role. Risk prevention in home healthcare needs to be initiated at an early stage of disease and ageing and should be seen as a process where early health‐promoting interventions can prevent the development and accumulation of risks over time. Long‐term cross‐organisational collaborations and patients' physical, mental and psychosocial conditions also need to be taken into account.