Experiences and challenges of the use Subacute and Acute Dysfunction in the Elderly‐SAFE Work team coordinators experiences and challenges in the introduction and use of SAFE in home‐based nursing: A qualitative study from the Norwegian context

Abstract

Old age is the leading cause of impaired bodily function, which gradually increases healthcare service needs. To offer the best possible care in the home and to be able to detect health‐related functional impairment at an early stage, it is necessary to carry out systematic and structured observations. The assessment tool Subacute and Acute Dysfunction in the Elderly (SAFE) has been developed explicitly for these structured observations. This study aims to explore the experiences and challenges of home‐based care work team coordinators (WTCs) regarding the introduction and use of SAFE. Method The present qualitative study was performed following Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. The data were collected through individual interviews (n = 3) and focus group (FG) interviews (n = 7). The interview transcripts were analysed using the Gioia method. Results Five aggregated dimensions were identified: Varying acceptance of SAFE, Structuring and quality‐assurance of home‐based nursing practice, Obstacles for the integration of SAFE in daily practice, Acceptance and use of SAFE require continuous supervision and SAFE contributes to increased quality of nursing care. Conclusion The introduction of SAFE contributes to a structured follow‐up of functional status in patients receiving home care. In order to incorporate the tool into home care practice, it is essential to set aside time to introduce the tool and to support nurses' use of it by offering continuous supervision.

Home Care Nurses’ Experiences of the Use and Introduction of the Subacute Functional Decline in the Elderly Instrument

“…It was intended to give training in the use of SAFE and the follow-up of the results. In addition, it was given a medical equipment bag to all executive nurses ( Abudayya et al, 2023 ).…”

“…In 2020, a collaboration with VID Specialized University, Faculty of Health Sciences—Institute of Nursing, and the Frogner district of Oslo municipality's home care service was established ( Abudayya et al, 2023 ). The purpose of this collaboration was to gain insight into home care nurses’ perspectives on the use of SAFE.…”

“…Recent studies indicate that SAFE can enhance a structured follow-up of frail older people ( Naess et al, 2017 , 2023 ). Identification of the challenges nurses are facing in the process of implementing a new assessment tool, such as SAFE, may ensure the correct use of the tool ( Abudayya et al, 2023 ). However, the use of SAFE and the nurse's perception of the tool has not been addressed.…”