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Introduction: Studies of older women's life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. Purpose: To explore the meaning of a good life for older widows with extensive home care needs. Materials and methods: Semi-structured interviews were carried out with eleven women, aged 80 and over (82–95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5–6 hours, mean 3). Data were analysed by reflexive thematic analysis. Results: The theme "This Day in My Home, the frame of my life" reflects the women's experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. Conclusion: A day at home may seem static, yet it mirrors life's dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home. [ABSTRACT FROM AUTHOR]

The scope and standards of professional nursing practice define and guide high-quality nursing care. This article describes the collaboration between the International Home Care Nurses Organization and the American Nurses Association to develop evidence-based scope and standards of practice relevant to home-based nursing around the world. This article describes the collaboration between the International Home Care Nurses Organization and the American Nurses Association to develop evidence-based scope and standards of practice relevant to home-based nursing around the world. [ABSTRACT FROM AUTHOR]

Based on literature analysis, the paper systematically summarizes the development history, grouping and payment mode of the Home Health Prospective Payment System (HHPPS) in the United States. The HHPPS has developed three versions since its establishment, and the grouping results are more refined and scientific, from the initial 80 home health resource groups to 432 home health resource groups. This method can effectively control expenses, but it requires a large amount of home health care data, scientific and complete expense settlement system and medical record management system. There are still some difficulties in the promotion and implementation in our country at this stage. Our country should learn from the HHPPS of the American, establish a unified and standardized evaluation system, develop and improve the home medical service information collection system, promote the development of home care services in various aspects, and finally realize the establishment of a scientific and effective payment model, so as to enable the sustainable development of home care service.

Aim: The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home‐based care (HBC) nurses' competencies. Design: A hybrid systematic narrative review was performed. Review Methods: The eligible studies were reviewed to identify the competencies measured by the instruments for HBC nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The methodological quality of the studies was evaluated using the Medical Education Research Study Quality Instrument and COSMIN checklist accordingly. Data Sources: Relevant studies were searched on CINAHL, MEDLINE (via PubMed), EMBASE, PsychINFO and Scopus from 2000 to 2022. The search was limited to full‐text items in the English language. Results: A total of 23 studies reporting 24 instruments were included. 12 instruments were adopted or modified by the studies while the other 12 were developed and psychometrically tested by the studies. None of the instruments encompassed all of the 10 home‐based nursing care competencies identified in an earlier study. The two most frequently measured competencies were the management of health conditions, and critical thinking and problem‐solving skills, while the two least measured competencies were quality and safety, and technological literacy. The content and structural validity of most instruments were inadequate since the adopted instruments were not initially designed or tested among HBC nurses. Conclusion: This review provides a consolidation of existing instruments that were used to assess HBC nurses' competencies. The instruments were generally not comprehensive, and the content and structural validity were limited. Nonetheless, the domains, items and approaches to instrument development could be adopted to develop and test a comprehensive competency instrument for home‐based nursing care practice in the future. Impact: This review consolidated instruments used to measure home‐based care nurses' competency. The instruments were often designed for ward‐based care nurses hence a comprehensive and validated home‐based nursing care competency instrument is needed. Nurses, researchers and nursing leaders could consider the competency instruments identified in this review to measure nurses' competencies, while a home‐based nursing care competency scale is being developed. Patient or Public Contribution: No patient or public contribution was required in this review. [ABSTRACT FROM AUTHOR]

Introduction Studies of older women’s life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. Purpose To explore the meaning of a good life for older widows with extensive home care needs. Materials and methods Semi-structured interviews were carried out with eleven women, aged 80 and over (82–95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5–6 hours, mean 3). Data were analysed by reflexive thematic analysis. Results The theme “This Day in My Home, the frame of my life” reflects the women’s experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. Conclusion A day at home may seem static, yet it mirrors life’s dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.

Abstract Background The Internet Plus Nursing Service (IPNS) is being instigated in all provincial-level regions throughout China, in which registered nurses (with more than five years of experience from qualified medical institutions) will provide services to those in their communities or homes after receiving online applications. The growing shortage of human resources in nursing is a critical issue for this project, so effective policies for recruiting and retaining nurses are critical. Objective This study aims to pinpoint the significant job characteristics that play a crucial role in shaping the job decisions of sharing nurses in the IPNS program, and to estimate the strength of job attributes. Methods A discrete choice experiment (DCE) was used to assess job attributes influencing sharing nurses’ preferences. A qualitative design, including in-depth interview and focus interview methods, was conducted to determine the inclusion of attributes. The final included six attributes were: work modes, duration per visit, income per visit, personal safety, medical risk prevention, and refresher training. This study was conducted at 13 hospitals in Guangdong Province, China, from April to June 2022, and a total of 220 registered sharing nurses participated in the survey. The multinomial logit model explored attributes and relative valued utility. Preference heterogeneity is explored via latent class analysis (LCA) models. Results A total of 220 participants answered the questionnaire. Income was the most influential characteristic of a sharing nursing position, followed by personal safety management, duration per visit, medical risk prevention, and refresher training, and nurses’ preferences differed among different types of classes. Conclusions Sharing nurses place most value on income and personal safety with career-related decisions, which indicates an urgent need to develop complete security for personal safety. This study can be helpful to decision-makers in the Chinese government.

Aim: To explore how nurses' professional discretion is operationalized in home care services that follow a purchaser–provider organization in Norway. Design: A qualitative descriptive study. Methods: Semi‐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. Results: The 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. Conclusion: Nurses 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. Impact: The 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. Implications: This 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. [ABSTRACT FROM AUTHOR]

Introduction: Considering Japan's aging society, the number of older individuals who die at home is expected to increase. In Japan, there are challenges in utilizing and promoting home‐visit nursing services at the end of life for community‐dwelling older adults. We examined the use of home‐visit nursing services at the end of patients' lives and the recommended use patterns of this service (utilization, timing of initiation, and continuity) that contribute to reducing the medical care and long‐term care costs (total costs) in the last 3 months of life. Design: This was a retrospective cohort study. Methods: We examined 33 municipalities in Japan, including depopulated areas. The analysis included 22,927 people aged 75 or older who died between September 2016 and September 2018. We used monthly medical care and long‐term care insurance claims data. Participants were classified into five groups based on their history of home‐visit nursing service use: (1) early initiation/continuous use, (2) early initiation/discontinued or fragment use, (3) not‐early initiation/continuous use, (4) not‐early initiation/fragment use, and (5) no use. Univariate and multivariate linear regression analyses were performed to examine the association between total costs in the last 3 months of life and patterns of home‐visit nursing service use. Results: Overall, the median age was 85, and 12,217 participants were men (53.3%). In the last half year before death, 5424 (23.7%) older adults used home‐visit nursing services. Multivariable linear regression analysis of the log10‐transformed value of total costs revealed that compared with the no use group, the early initiation/continuous use group was estimated to have 0.88 times (95% confidence interval: 0.84, 0.93) the total costs in the last 3 months of life (p < 0.001). Conclusion: Early initiation use of home‐visit nursing services may contribute to reducing total costs in the last 3 months of life for Japanese people aged 75 years or older living at home as they approach the end of life. Clinical relevance: When approaching the end of life, many older adults require daily life care and palliative care. Policymakers are strengthening end‐of‐life care for community‐dwelling older adults in Japan. Although the current results do not demonstrate the effectiveness of home‐visit nursing services, they provide a perspective from which to assess the use of home‐visit nursing services and its impact on older adults. The findings can be helpful in considering how to provide nursing care in home‐care settings for older adults who prefer to spend their final days at home. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study aims to evaluate the effects of education on home care of infected or suspected COVID-19 patients on the levels of knowledge, anxiety, and awareness of nursing students in Turkey. MATERIALS AND METHODS: The study is in quasi-experimental design. A sample of 158 volunteer students studying nursing at a private university in Turkey was formed. Data were collected using, descriptive information form, “Coronavirus Anxiety Scale,” “COVID-19 Awareness Scale,” and the “Knowledge of COVID-19 Home Care Test.” Pre-test was performed before the participants received education. Post-test was performed seven days after the intervention. SPSS version 25.0 was used for data analysis. “TREND checklist” was used for quasi-experimental/non-randomized evaluations to report the findings of the study. RESULTS: Anxiety levels decreased and the levels of awareness and knowledge on COVID-19 increased after receiving education on home care of infected or suspected COVID-19 patients (p < 0.001), indicating the effectiveness of the education. Education on home care of infected or suspected COVID-19 patients was an effective method to reduce anxiety and increase knowledge and awareness in nursing students. CONCLUSIONS: To contribute to community health, home care training can be given to nursing students, other people receiving home care, or providing home care to COVID-19 patients, infected or suspected COVID-19 patients.

BACKGROUND: La comunicazione riveste un ruolo fondamentale nell'ambito dell'assistenza infermieristica. L’OMS sottolinea l’importanza dell’utilizzo delle competenze comunicative da parte dell’infermiere nel garantire un elevato standard di assistenza. La comunicazione terapeutica mira a promuovere il benessere della persona con le sue esigenze, facilitare l'adesione al percorso di assistenza e instaurare una relazione di fiducia e rispetto reciproco tra l'infermiere e la persona. Questa forma di comunicazione rappresenta il fondamento cruciale su cui si basa un'assistenza domiciliare efficace. OBIETTIVI: L’obiettivo di questo progetto è analizzare le modalità con cui l’assistenza infermieristica domiciliare concorre nell’instaurare una relazione terapeutica con la persona assistita, la famiglia e il caregiver. METODI: Sono stati identificati l’ambito e il quesito di ricerca, quindi è stato formulato il PIO. Successivamente, è stata condotta una ricerca bibliografica attraverso la consultazione delle banche dati biomediche di CINAHL, EMBASE, Ovid MEDLINE(R) e SCOPUS per la ricerca degli articoli. RISULTATI: Sono stati inclusi 10 articoli. In ciascuno di essi, sono state individuate e messe in luce le varie modalità comunicative da parte dell’infermiere domiciliare nel contesto di assistenza domiciliare. CONCLUSIONI: Dai risultati emerge l'importanza della comunicazione terapeutica nel contesto dell'assistenza domiciliare; sono stati evidenziati i potenziali ostacoli che gli infermieri possono incontrare nell’attuare la comunicazione. Si viene a sottolineare la necessità di studi qualitativi in Italia per esplorare le tematiche emerse e approfondire la comprensione dell'effetto della comunicazione terapeutica sul benessere delle persone assistite.

Hospital readmission is an important indicator of inpatient care quality and a significant driver of increasing medical costs. Therefore, it is important to explore the effects of postdischarge information, particularly from home healthcare notes, on enhancing readmission prediction models. Despite the use of Natural Language Processing (NLP) and machine learning in prediction model development, current studies often overlook insights from home healthcare notes. This study aimed to develop prediction models for 30-day readmissions using home healthcare notes and structured data. In addition, it explored the development of 14- and 180-day prediction models using variables in the 30-day model. A retrospective observational cohort study. This study was conducted at Ajou University School of Medicine in South Korea. Data from electronic health records, encompassing demographic characteristics of 1819 participants, along with information on conditions, drug, and home healthcare, were utilized. Two distinct models were developed for each prediction window (30-, 14-, 180-day): the traditional model, which utilized structured variables alone, and the common data model (CDM)-NLP model, which incorporated structured and topic variables extracted from home healthcare notes. BERTopic facilitated topic generation and risk probability, representing the likelihood of documents being assigned to specific topics. Feature selection involved experimenting with various algorithms. The best-performing algorithm, determined using the area under the receiver operating characteristic curve (AUROC), was used for model development. Model performance was assessed using various learning metrics including AUROC. Among 1819 patients, 251 (13.80 %) experienced 30-day readmission. The least absolute shrinkage and selection operator was used for feature extraction and model development. The 15 structured features were used in the traditional model. Moreover, five additional topic variables from the home healthcare notes were applied in the CDM-NLP model. The AUROC of the traditional model was 0.739 (95 % CI: 0.672–0.807). The AUROC of the CDM-NLP model was high at 0.824 (95 % CI: 0.768–0.880), which indicated an outstanding performance. The topics in the CDM-NLP model included emotional distress, daily living functions, nutrition, postoperative status, and cardiorespiratory issues. In extended prediction model development for 14- and 180-day readmissions, the CDM-NLP consistently outperformed the traditional model. This study developed effective prediction models using both structured and unstructured data, thereby emphasizing the significance of postdischarge information from home healthcare notes in readmission prediction. [ABSTRACT FROM AUTHOR]

Aim: To illuminate nurses' experiences of communicating with families in home health care., Design: A qualitative inductive approach., Background: An increasing number of ageing and sick people are being granted home health care. Nurses' duties involve caring for both patients and their families, which includes the important task of meeting and talking with them., Methods: Fourteen registered nurses working in home health care in Sweden participated in individual narrative semistructured interviews. The interviews were analysed with content analysis. To make sure all components of the study were clear, the Standards for Reporting Qualitative Research checklist was used as a guide., Result: Communication with families was viewed as a crucial action for building rapport to facilitate the involvement and support of families in difficult situations. The nurses highlighted the struggles they sometimes faced in communication when they found it difficult to reach the family. When the communication was supportive for the family, the nurses felt that they were empowering the family members to empower themselves., Conclusion: This study highlights the vital role of communication in home health care nursing. Effective communication fosters trust and enables nurses to meet family needs., Implications for the Profession: Effective communication between nurses and families in home health care is crucial from a health care perspective. Building reciprocal relationships fosters trust, enabling nurses to efficiently identify and address family needs and enhancing the quality of care., Patient or Public Contribution: No patient or public contribution., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

To identify the association between home health nursing (HHN) and hospital readmissions for patients discharged after tracheostomy placement, we conducted a single-center prospective cohort study of children ages 0 to 21 years who underwent tracheostomy placement at Children's Hospital Los Angeles between 12/2016 and 2/2023 and were discharged to home. We collected demographic, clinical, and discharge variables for the index hospitalization to test the association between our primary exposure, HHN after discharge, and 30-day same-hospital all-cause, adjusting for potential confounders. Our population of 130 children was primarily male, of Hispanic/Latino ethnicity, and on public insurance. The majority of patients (57%) received HHN on discharge and the 30-day readmission rate was 14.6%. On multivariable analysis, HHN was not associated with readmission for children discharged on home mechanical ventilation [HMV; adjusted OR (aOR = 1.11; 95% CI: 0.30-4.02)] but was associated with lower odds of all-cause 30-day readmission in children discharged without HMV (aOR = 0.12; 95% CI: 0.02-0.81). Our findings support consideration for HHN as a hospital-to-home bridge for children after tracheostomy placement to decrease hospital readmissions and support parents and caregivers during this transition period., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

An expanding body of literature suggests that informal caregiver burden is a growing issue that negatively impacts care recipients, informal caregivers, and formal care providers. Costs associated with informal caregiver burden include risk to the informal caregiver's physical, emotional, and psychological well-being and increased potential to perpetrate violence. By identifying interventions to support informal caregivers, home healthcare nurses can help decrease the risk of negative outcomes and reduce the burden on informal caregivers. This paper examines home healthcare nurses' role in helping reduce the impact of informal caregiver burden, thereby reducing the risk for violence. By prioritizing caregiver burden as a critical area of focus in reducing violence risk, home healthcare organizations and the nurses who work for them can help address gaps in care while also recognizing the informal caregivers' critical role in caring for their loved ones., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: This study aims to evaluate the effects of education on home care of infected or suspected COVID-19 patients on the levels of knowledge, anxiety, and awareness of nursing students in Turkey., Materials and Methods: The study is in quasi-experimental design. A sample of 158 volunteer students studying nursing at a private university in Turkey was formed. Data were collected using, descriptive information form, "Coronavirus Anxiety Scale," "COVID-19 Awareness Scale," and the "Knowledge of COVID-19 Home Care Test." Pre-test was performed before the participants received education. Post-test was performed seven days after the intervention. SPSS version 25.0 was used for data analysis. "TREND checklist" was used for quasi-experimental/non-randomized evaluations to report the findings of the study., Results: Anxiety levels decreased and the levels of awareness and knowledge on COVID-19 increased after receiving education on home care of infected or suspected COVID-19 patients (p < 0.001), indicating the effectiveness of the education. Education on home care of infected or suspected COVID-19 patients was an effective method to reduce anxiety and increase knowledge and awareness in nursing students., Conclusions: To contribute to community health, home care training can be given to nursing students, other people receiving home care, or providing home care to COVID-19 patients, infected or suspected COVID-19 patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

This study explores the role of home care nurses in managing long-term illnesses (L-TI) within the French healthcare system, utilizing data from the SNDS. Focused on data from 2022, it categorizes nursing actions into medical procedures, care procedures, and nursing processes, revealing significant involvement in patient care. The findings highlight the crucial, evolving role of home care nurses in addressing the complex needs of millions suffering from chronic conditions like diabetes and cardiovascular diseases in France.

Introduction: The aging of the population requires an appropriate knowledge of the type of care that needs to be provided to inform healthcare policies. In Italy, neither home care nursing, nor the patient experiences have ever been described., Objectives: To describe the characteristics of nurses and care recipients involved in home care., Methods: A descriptive cross-sectional study conducted in 18 Italian Regions. Between April and October 2023, data from nurses and patients involved in home care were collected through two surveys. Psychosocial conditions in workplaces, missed care, and care experiences were assessed using validated tools. Descriptive statistics and Pearson's correlations were performed., Results: A total of 46 local healthcare units were included in this study, with a total of 2549 nurses and 4709 care recipients. Nurses (mean age 46.60; 79.48% female; 44.68% regional nursing diploma as the highest qualification) reported good working conditions (42.37; SD = 12.25; range = 0-100) and a high mean number of missed care activities (5.11; SD = 3.19; range 0-9). Most nurses (83.41%) reported high levels of job satisfaction, while 20.28% intended to leave their job. Patients (mean age 75.18; 57.57% female; 36.95% primary school), on the other hand, rated positively the care they had received (8.23; range = 0-10)., Conclusions: Despite the perception of critical issues at work and some missed care, satisfaction in nurses and patients was high. These data constitute a preliminary snapshot of the studied phenomena, which will be investigated through more in-depth analyses., (© 2024 Wiley Periodicals LLC.)

Purpose: To identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling., Method: This is a methodological study, with a quantitative approach, carried out with elderly people living in the city of Ribeirão Preto, SP, Brazil, from February to December 2018. For data collection, the demographic profile, Mini-Mental State Examination, diseases self-reported, functional independence measure, Lawton and Brody scale, geriatric depression scale, and self-perception of gait instruments were used. Tests of accuracy and association of risk factors with p ≤ 0.05 were performed., Findings: A total of 262 elderly people, aged over 80 years (55.7%), 71% of which were female and 42.7% were widowed, were included in the sample. A total of 82.1% had vascular diseases, 72.1% had diabetes, and 20.6% had depression. The predominant risk factors were difficulty performing instrumental activities of daily living (58.8%), cognitive dysfunction (43.5%), and depressive symptoms (26.3%). Difficulty performing instrumental activities of daily living had a sensitivity greater than 60%. The positive and negative predictive values were mostly greater than 50%. In the regression analysis, it was found that the elderly have a higher risk of suffering a fall if they present anxiety (p = 0.05), impaired physical mobility (p = 0.02), and difficulty to perform instrumental activities of daily living as risk factors (p = 0.03)., Conclusion: It was possible to identify the presence of risk factors for the diagnosis fall risk in adults (00303) in the clinical context of the elderly in home settings and contribute to the clinical validation of the taxonomy, increase the evidence and importance of the diagnosis, and generate new knowledge for gerontological nursing., Implications for Nursing Practice: To help nurses identify risk factors that lead elderly people to suffer falls at home and to implement preventive actions in their community with the support of their families., (© 2024 NANDA International, Inc.)

A patient with multiple comorbidities and an eight-year history of tracheostomy was being treated for tracheitis. At this point, she became incapable of using regular speaking valves, and multiple attempts to reintroduce the speaking valve failed. A Ferrer adjustable speaking valve (FASV) was designed with gradations of outflow closure, allowing air to go through the vocal cords for phonation. The FASV was offered to her through the compassionate use program at the FDA. At 20% initial closure, the patient was able to tolerate the valve and was advanced to 50% closure, at which point she could phonate partially. The use of the valve was terminated at the time of her transfer, 23 days after the initiation of use. This suggests the safety and possible efficacy of using an adjustable speaking valve earlier than regular valves, allowing patients to communicate earlier and further exercise their diaphragms., Competing Interests: Dr. Ferrer Biopharma holds the patent of the Ferrer Adjustable Speaking Valve (FASV), (Copyright © 2024, Cartaya et al.)

Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Many children with medical complexity (CMC) require the services of home health nurses (HHNs). Home health agencies (HHAs) hire, train, and manage nurses. For children to flourish, families, nurses, and HHAs must establish successful working relationships. Our objective was to understand the perspectives of parents and nurses about HHAs., Methods: In Illinois (IL) from 2019 to 2022, HHNs for and parents of children with invasive mechanical ventilation were interviewed. In North Carolina (NC) from 2012 to 2013, parents of CMC were interviewed, and from 2013 to 2014 HHNs participated in focus groups. Each dataset was initially analyzed separately for main themes relating to HHAs. Using collaborative thematic analysis, we determined themes common across datasets., Results: In IL, 23 mothers, 12 fathers, and 20 nurses were interviewed. In NC, 19 mothers, 6 fathers, and 1 grandmother were interviewed; and 4 focus groups of 18 nurses were conducted. Four common themes were identified. 1) HHAs do not have a uniform process for hiring and assigning nurses to cases. 2) HHAs have marked variability in training offered to nurses. 3) Shift scheduling, notifications, and communications with the HHAs frustrate parents and nurses. 4) Nurses and parents have little allegiance to specific HHAs; they frequently change agencies or work with several simultaneously., Conclusions: Parents and nurses perceive practices for hiring, training, and staffing as inconsistent, and experience communication challenges. HHA-level problems may contribute to issues with HHN retention and complicate the lives of the families of CMC. Further research about this critical health care sector is needed., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Violence towards formal and informal caregivers is a frequently occurring and complex international hazard in healthcare that has a negative impact on the physical and psychological health states of caregivers. However, little is known about the prevalence and type of violence towards formal and informal caregivers by care recipients in the home care settings. The aim of this review is to obtain insight into the prevalence of violence by home care recipients against formal and informal caregivers in home care settings and the types and consequences of violence. A systematic review was conducted between March and May 2023 using the PubMed, EMBASE, CINAHL, and PsycINFO databases. A methodological quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). Data collection was performed until May 2023. Out of 1087 screened articles, a total of 10 full texts were included after the screening process. Findings demonstrate that workplace violence is an understudied area of research. The few studies found in this review showed high prevalence rates of violence with risk for physical and mental injuries for formal caregivers. No information at all on violence against informal caregivers was available. Strategies for prevention and intervention against violence in the home care setting must be developed. To develop strategies, it is important to have more insight in the prevalence and types of violence. It is also important to explore violence against informal caregivers in research. Violence towards formal caregivers in home care settings is a common risk that negatively impacts the health status of caregivers. What is already known about the topic? • Workplace violence has a negative impact on the physical and psychological health state of formal caregivers. • There is a lack of knowledge on care recipient violence towards formal and informal caregivers in the home care setting. What this paper adds • No study was found that studied violence against informal caregivers; this review demonstrates the importance of exploring this topic. • In home care settings, formal caregivers are exposed to types of workplace violence that have little or no presence in the hospital setting • Sexual harassment and sexual aggression towards formal caregivers in the home care setting are underreported in the literature. [ABSTRACT FROM AUTHOR]