Adverse events experienced by homecare patients: a scoping review of the literature.
ABSTRACT The paper summarizes the results of a scoping review that focused on the occurrence of adverse events experienced by homecare patients.
The literature search covered published and grey literature between 1998 and 2007. Databases searched included: MEDLINE, EMBASE, CINAHL and EBM REVIEWS including the Cochrane Library, AGELINE, the National Patient Safety Foundation Bibliography, Agency for Healthcare Research and Quality and the Patient Safety Net bibliography.
Papers included research studies, review articles, policy papers, opinion articles and legal briefs. Inclusion criteria were: (i) homecare directed services provided in the home by healthcare professionals or caregivers; (ii) addressed a characteristic relevant to patient experienced adverse events (e.g. occurrences, rates, definitions, prevention or outcomes); and (iii) were in English. Data extraction A pool of 1007 articles was reduced to 168 after analysis. Data were charted according to six categories: definitions, rates, causes, consequences, interventions and policy.
Eight categories emerged: adverse drug events, line-related, technology-related, infections and urinary catheters, wounds, falls, studies reporting multiple rates and other. Reported overall rates of adverse events ranged from 3.5 to 15.1% with higher rates for specific types. Few intervention studies were found. Adverse events were commonly associated with communication problems. Policy suggestions included the need to improve assessments, monitoring, education, coordination and communication.
A standardized definition of adverse events in the homecare setting is needed. Prospective cohort studies are needed to improve estimates and intervention studies should be undertaken to reduce the risk that homecare patients will experience adverse events.
SourceAvailable from: Regis Blais[Show abstract] [Hide abstract]
ABSTRACT: This paper explores the policies and practices that are needed to improve the safety of home care in light of the most recent evidence about home care safety in Canada. Four areas for policy and practice change are addressed: 1) the promotion of effective communication processes in home care through cross-sector collaboration, case management and technology innovations; 2) screening for safety risk factors; 3) standardizing care processes, packaging and equipment; and 4) supporting family/caregivers and strengthening clients' ability to engage in therapeutic self-care. Evidence-based strategies for change are presented within the context of the evidence about home care safety issues. Copyright © 2014 Longwoods Publishing.Healthcare quarterly (Toronto, Ont.) 10/2014; 17(3):42-7. DOI:10.12927/hcq.2014.24019
[Show abstract] [Hide abstract]
ABSTRACT: Given that integrated care includes many different aspects, this paper seeks to design a comprehensive research approach and explains how this approach is applied in the CORTEXS research project on integrated care in the Flemish Community in Belgium. A systemic view on integrated care is translated into a multi-level, multi-disciplinary, multi-method and multi-stakeholder research design. A phased approach of taxonomy development and literature review, comparative case studies, social lab activities and valorisation initiatives is devised in order to link fundamental research with strategic valorisation of the research results. While this innovative comprehensiveness is seen as a major strength, it is acknowledged that the research design comes with certain risks that need to be tackled.12/2014; Vol. 17(3–4):105–115. DOI:10.1177/2053434514562082