Hjemmesykepleiepraksis

Sæterstrand, Torill Margaret; Holm, Solrun G.; Brinchmann, Berit Støre

doi:10.18261/issn1903-2285-2015-01-02

Cited by 13 publications

(5 citation statements)

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“…They did not only carry out job tasks according to formal decision-making, regulations, or instructions from the healthcare service. This may seem surprising considering home care is a regulated practice with specified procedures for providing care [27,73].…”

Section: The Nurses' Professional Independencementioning

confidence: 99%

“…Nurses in home care may face challenges that are different from the hospital setting [23], navigating in working conditions adapted to a home more than a workplace, experiencing complexity and need for various expertise, being expected to work in unpredictable conditions, under time pressures, where the nurses continuously try to distribute their time fairly [1,24]. More research is needed on nursing practices and the role of nurses in home care services, including nurses' perceptions of their roles, what determines their practice and priorities, and how their work is organised [25][26][27]. Nursing plays a crucial role in home care as it interacts with several other professional groups [26].…”

Section: Introductionmentioning

confidence: 99%

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Exploring home-based care nurses’ mindset for nursing practices: a phenomenological study

Brenne

Hedlund

2022

BMC Nurs

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Background Home nursing is an essential aspect of healthcare and can address future health challenges. The nature of nursing and its practical applications are of particular interest, as nursing involves technical knowledge, rational procedures, and diverse skills. It is consequential to explore nursing practices in context to understand how nurses navigate their work. This study aimed to explore the characteristics of home care nurse practices and how nurses solve tasks in the context of nursing in home care. Methods This is an exploratory qualitative research study using a descriptive phenomenological approach. We reported following the COREQ guidelines. Fifteen in-depth interviews with nurses from four Norwegian municipalities were conducted and analysed according to stepwise inductive analysis. Results The analysis revealed three main patterns that characterise nursing practices in home care: ‘To be vigilant’, ‘To be an all-rounder’, and ‘To act with independence’. The content and distinction of these patterns are discussed through a theoretical framework of ‘clinical mindlines’. There are multiple mindlines and complex realities for home-based care nursing. The nurses displayed great sensitivity in their practice, were knowledgeable about where they focused their attention, adapted their actions to the context, and demonstrated their independence as professionals. Conclusion Nurses’ vigilance and contextual insight are critical to their practice approach and task-solving abilities. These professionals need to manage emergent organisations and exercise independence and professional judgment when adapting their work to the context of home care patients. Future health policy should not strictly be based on standardised guidelines; depending on the context, it is also appropriate to focus on nurses’ practical knowledge and the importance of mindlines.

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Section: The Nurses' Professional Independencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring home-based care nurses’ mindset for nursing practices: a phenomenological study

Brenne

Hedlund

2022

BMC Nurs

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“…Home care is central to meeting these challenges (Andrade et al, 2017; Ellner & Phillips, 2017), and home nursing has become a multifaceted and complex health care service that involves an ever‐increasing number of tasks (Andrade et al, 2017; Martinsen et al, 2018; Saeterstrand et al, 2015). In this study, home care is regarded as a part of local public and primary health care services and includes home nursing as a specific service.…”

Section: Introductionmentioning

confidence: 99%

“…Previous research on management using the PPS model indicates that it is a good tool for achieving the goal of better resource utilization in home care services; however, it does not address how the purchaser's instructions are understood and implemented (Holm, 2017; Saeterstrand et al, 2015). At the same time, research has also shown that organizational forms inspired by NPM did not deliver on their own goals and that there were significant undesirable side effects (Siltala, 2013; Simonet, 2013).…”

Section: Introductionmentioning

confidence: 99%

Nurses' professional discretion in the purchaser‐provider split in home care in Norway

Brenne

Hedlund

2023

Journal of Advanced Nursing

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AimTo explore how nurses' professional discretion is operationalized in home care services that follow a purchaser–provider organization in Norway.DesignA qualitative descriptive study.MethodsSemi‐structured interviews with open‐ended questions were used, and data were collected from in‐depth interviews with 15 registered nurses working in home care in four Norwegian local authority areas between April and November 2020. Braun and Clark's six‐step analysis was used to analyse the empirical data.ResultsThe analysis yielded two main themes, namely ‘The purchaser's instructions: facilitating and constraining care’ and ‘Professional discretion meets the purchaser–provider organisation of healthcare,’ with five associated codes.ConclusionNurses are dependent on an organizational framework due to the complexity of health care services and the number of tasks involved. At the same time, they perform considerable compensatory work and need the ability to be flexible to enable this work and to perform actions related to the unforeseen needs of individual patients or those involving professional discretion.ImpactThe purchaser–provider model both facilitates and constrains nursing practice and professional responsibility in home nursing. Home nursing services need to be well organized because of their complexity and the wide variety of tasks they involve. In this context, the element of constraint is associated with the need for flexibility and professional discretion. Despite a strict framework, the nurses perform additional and compensatory tasks. Reforms inspired by ‘New Public Management,’ such as the purchaser–provider split, limit the workload for nurses; however, there is still a need to exercise discretion. The findings of this study may help home care managers and health policy‐makers understand the interaction between management logic and health care logic, leading to a more appropriate organization of health care services where the nurses, as actors, gain more trust.ImplicationsThis study highlights home care nurses' opportunities to exercise discretion in an organizational framework that strives towards standardization. The nurses' ability to exercise discretion is important for individual and holistic patient care. At the same time, an organizational framework is needed because nurses cannot attend to all the needs the patients may have, as this will overload both home health services and the nurses.

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“…We have been unable to find studies undertaken in a Norwegian context exploring what influence municipal health care providers' IPC specifically focusing on older patients' transition in the municipal health and care services. However, several studies have explored what influence IPC within and across health care sectors [3,21,[32][33][34][35][36][37]. The studies have multiple perspectives and focus on interactions between health care providers in diverse settings.…”

Section: Introductionmentioning

confidence: 99%

Municipal healthcare professionals’ interprofessional collaboration during older patients’ transitions in the municipal health and care services: a qualitative study

Eika

Hvalvik

2022

BMC Health Serv Res

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Background Interprofessional collaboration is vital to assist patients towards a healthy transition in the municipal health and care services. However, no study has so far investigated municipal health care providers’ inter-professional collaboration during older patients’ transition in the municipal health and care services. The aim of this study is therefore to describe and explore what influence health care providers’ inter-professional collaboration within and across municipal facilities during older patients’ transitions in the municipal health and care services. Method The study has a descriptive, interpretive design. Focus group interviews and individual interviews with municipal health care providers different professions were performed. Results Municipal health care providers’ inter-professional collaboration during older patients transitions in the municipal health and care services was challenging. Two main themes were identified: The patient situation itself and Professional. Personal, and Practical circumstances. The results show that the municipal priority of patients staying at home as long as possible facilitated inter-professional collaboration across the short-term care facility and the home care services. Inter-professional collaboration across facilities with the long-term care facility was downgraded and health care providers in this facility had to cope as best they could. Conclusion Prioritising and facilitating inter-professional collaboration between the short-term care facility and the home care services, contributed to health care providers experiencing doing a proper and safe patient assistance. Yet, this priority was at a cost: Health care providers in the long-term care facility, and in particular registered nurses felt squeezed and of less worth in the municipal health and care services. It was a strain on them to experiencing unplanned and often rushed patient transition into long-term care facility. To focus on municipal inter-professional and inter-facility collaboration during patients in transition to long-term care placement is vital to maintain the patients, and the health care providers working in these facilities.

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Hjemmesykepleiepraksis

Cited by 13 publications

References 0 publications

Exploring home-based care nurses’ mindset for nursing practices: a phenomenological study

Exploring home-based care nurses’ mindset for nursing practices: a phenomenological study

Nurses' professional discretion in the purchaser‐provider split in home care in Norway

Municipal healthcare professionals’ interprofessional collaboration during older patients’ transitions in the municipal health and care services: a qualitative study

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