PMID: 18718160Aug 23, 2008Paper

Understanding risk and safety in home health care: the limits of generic frameworks

Quality in Primary Care
Caroline McGrawCharlotte Humphrey

Abstract

Patient safety and adverse events in primary care are receiving increasing attention from policy makers, professional bodies and researchers. Various taxonomic models have been developed to specify the factors that predispose to adverse events in hospital settings. These are assumed to have general applicability across different healthcare settings. However, they have never been applied to home health care. This study helps define the value of one such model in a domiciliary setting. The principal purpose of the study was to understand the circumstances in which the involvement of local authority-funded home carers as well as NHS-funded district nurses in medication-related activities for older people living at home in the UK might jeopardise patient safety. The study was undertaken in two contrasting sites. One was in London and the other in the Midlands. District nurses and home carers were purposively selected to take part in semi-structured interviews. The data were used to construct a taxonomic model that specified the factors that predispose older people to adverse events when medication-related responsibilities are transferred from district nursing to home care services. The new taxonomy was compared to the taxonomic mod...Continue Reading

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