Eliciting nurses’ perspectives to improve health information exchange between hospital and home health care

Sarzynski, Erin M.; Ensberg, Mark; Parkinson, A. D.; Fitzpatrick, Laurie; Houdeshell, Laura; Given, Charles W.; Brooks, Kevin

doi:10.1016/j.gerinurse.2018.11.001

Cited by 27 publications

(48 citation statements)

References 50 publications

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“…This is in line with a previous Norwegian study showing that the lack of possibilities for medication information exchange is a threat to patient safety, as it may lead to potentially harmful medical errors [10]. Other studies show the following obstacles for HIE in the clinical work of nurses and MDs: incomplete information, poor medication management and technology issues [8,13,14].…”

Section: Fragmentation Of Information Systemssupporting

confidence: 89%

“…Previous studies show that fragmented medication information causes poor communication and a lack of information flow across services and levels of care, which can lead to potentially harmful medication errors [6,10,11]. Within the primary health care services, studies show the lack of medication information exchange as a reason for medication errors [12][13][14]. Several other national and international studies report problems with accurate information about a patient's current medication list and how this lack of information can potentially affect medication safety and quality of care [12,[15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Challenges Faced by Health Professionals in Obtaining Correct Medication Information in the Absence of a Shared Digital Medication List

Manskow

Kristiansen

2021

Pharmacy

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Information about patient medication use is usually registered and stored in different digital systems, making it difficult to share information across health care organisations. The lack of digital systems able to share medication information poses a threat to patient safety and quality of care. We explored the experiences of health professionals with obtaining and exchanging information on patient medication lists in Norwegian primary health care within the context of current digital and non-digital solutions. We used a qualitative research design with semi-structured interviews, including general practitioners (n = 6), pharmacists (n = 3), nurses (n = 17) and medical doctors (n = 6) from six municipalities in Norway. Our findings revealed the following five challenges characterised by being cut off from information on patient medication lists in the current digital and non-digital solutions: ‘fragmentation of information systems’, ‘perceived risk of errors’, ‘excessive time use’, ‘dependency on others’ and ‘uncertainty’. The challenges were particularly related to patient transitions between levels of care. Our study shows an urgent need for digital solutions to ensure seamless, up-to-date information about patient medication lists in order to prevent medication-related problems. Future digital solutions for a shared medication list should address these challenges directly to ensure patient safety and quality of care.

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Section: Fragmentation Of Information Systemssupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Challenges Faced by Health Professionals in Obtaining Correct Medication Information in the Absence of a Shared Digital Medication List

Manskow

Kristiansen

2021

Pharmacy

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“…Several challenges discussed by HHC staff were related to the uniqueness of the setting in which care was provided and their potential negative impacts upon patient safety. These have been reported in previous work in the HHC setting 24 as well as other residential settings, including nursing homes. 18 The unpredictability of the home environment including issues with sanitation and cleanliness were perceived as a major barrier in providing effective patient care.…”

Section: Discussionsupporting

confidence: 77%

Home Health Staff Perspectives on Infection Prevention and Control: Implications for Coronavirus Disease 2019

Pogorzelska-Maziarz

Chastain

Mangal

et al. 2020

Journal of the American Medical Directors Association

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Objectives The role of home healthcare (HHC) services in providing care to vulnerable, often frail individuals with chronic conditions is critical. Effective infection prevention and control (IPC) in HHC is essential to keeping both healthcare workers and patients safe, especially in the event of an emerging infectious disease outbreak. Prior to the COVID-19 pandemic, we explored successes and challenges with IPC from the perspectives of HHC staff. Design Qualitative descriptive study Setting and Participants From May to November 2018, we conducted in-depth telephone interviews with 41 staff from 13 agencies across the nation. Methods Transcripts were coded by a multidisciplinary coding team, and several primary and subcategories were identified using directed content analysis. Results Four primary categories were generated, including: 1) Uniqueness of Home Healthcare, 2) Infection Prevention and Control as a Priority, 3) Importance of Education, 4) Keys to Success and Innovation. Participants perceived that IPC plays a big part in patient safety and reducing rehospitalizations, and protection of patients and staff was a major motivator for compliance with IPC. The identified challenges included the unpredictability of the home environment, patient/family dynamics, the intermittent nature of HHC, and staffing issues. Education was seen as a tool to improve staff, patient, caregiver and families’ compliance with IPC. Keys to success and innovation included: a leadership focus on quality, using agency infection data to improve quality, and a coordinated approach to patient care. Conclusions and Implications This qualitative work identified barriers to effective IPC in HHC, as well as important facilitators that HHC agencies can use to implement policies and procedures to improve patient care and keep staff safe. Leadership prioritization of infection prevention and control is key to implementing appropriate infection prevention and control policies and may be especially important in midst of a crisis such as COVID-19.

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“…Moreover, the safety of home health care required the improvement of older patients’ and their family caregivers’ knowledge and feelings of responsibility to be involved in home health care and remove their misperceptions about home health care. Patients and carers generally have inadequate level of health literacy (48), leading to more weight being given to the medication process rather than the following up of other health‐related and preventive advice (38). There is also evidence that they do not necessarily realise the complication of long‐term therapies that are more common among older patients (44).…”

Section: Discussionmentioning

confidence: 99%

Transitional ‘hospital to home’ care of older patients: healthcare professionals’ perspectives

Dolu

Naharcı

Logan

et al. 2020

Scandinavian Caring Sciences

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Background Transitional care is a key area of care provision to older people with chronic and complex health conditions and is associated with the quality of care delivered in the healthcare system. Aims This study aimed to explore the perspectives of healthcare providers, including nurses and physicians, regarding transitional care from hospital to home in an urban area of Turkey. Methods A qualitative study using a thematic analysis method was carried out. In‐depth semi‐structured interviews were held with eight clinical nurses and five general physicians involved in the provision of healthcare services to older patients in the transitional care process from hospital to home. Findings The thematic analysis of in‐depth semi‐structured interviews with 13 healthcare professionals led to the development of the following themes: ‘uninterrupted chain of care transfer’, ‘commitment to meet patient’s needs’ and ‘support and removing ambiguities’. Conclusions Key factors impacting on the quality and safety of transitional care and continuity of healthcare are communication and collaboration between healthcare staff and settings, and older patients’ as well as family caregivers’ awareness and their feelings of responsibility towards the continuity of care at home.

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Eliciting nurses’ perspectives to improve health information exchange between hospital and home health care

Cited by 27 publications

References 50 publications

Challenges Faced by Health Professionals in Obtaining Correct Medication Information in the Absence of a Shared Digital Medication List

Challenges Faced by Health Professionals in Obtaining Correct Medication Information in the Absence of a Shared Digital Medication List

Home Health Staff Perspectives on Infection Prevention and Control: Implications for Coronavirus Disease 2019

Transitional ‘hospital to home’ care of older patients: healthcare professionals’ perspectives

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