Medicine and Health Sciences Commons^™

Barriers To Adherence To Standard Precautions Among Community Health Workers: A Scoping Review, Margaret D. Adejumo, Melanie Baker, Davina Porock

Research outputs 2022 to 2026

Aim: This review aims to map available evidence on the adherence level and barriers to standard precautions among home-based community health workers. Methods: A scoping review using the JBI protocol searched multiple databases (Medline, CINAHL, PsycINFO and Web of Science) as well as Google Scholar for published articles on standard precaution practices of community health workers during home visits. Search terms included “standard precautions”, “guideline adherence”, “community health” and “home care”. Two-stage screening (title/abstract and full-text) was conducted to select relevant articles. Results: Eight eligible studies yielded three major themes: home environment context, individual factors and organisational factors. Findings indicated …

Perspectives Of Home Care Nurses On Frailty And Resilience In Older Adults Living At Home, Lisa Foley

Seton Hall University Dissertations and Theses (ETDs)

The population of older adults is growing rapidly in the United States. As more people are living to an advanced age, they are often managing a multitude of chronic illnesses and disabilities while continuing to live at home. Frailty is a common condition that affects how one ages and the condition is associated with dependency and poor health outcomes. Resilience is considered to be a protective factor against health stressors that lead to frailty in older adults. Perspectives of home care nurses were obtained by semi-structured interviews which described how older adults live at home with frailty and demonstrate resilience. …

Language-Based Strategies That Support Person-Centered Communication In Formal Home Care Interactions With Persons Living With Dementia, Reanne G. Mundadan

Electronic Thesis and Dissertation Repository

Background. Several studies recommend language-based strategies for communication with persons living with dementia. Language-based strategies improve coherence, clarity, reciprocity, and continuity of interactions. Person-centered communication (PCC) strategies are the gold standard, including facilitation, recognition, validation, and negotiation. Only one study has examined the overlap between language-based strategies and PCC in long-term care. Little is known about which language-based strategies support PCC in home care. Accordingly, this study investigated the overlap between language-based strategies and PCC in home care interactions. Method. Conversation analysis of 30 audio-recorded routine care interactions between home care workers and persons living with dementia was conducted. The …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

Development Of An Experienced Quality Measure For Clients, Informal And Formal Caregivers In Home Care In The Netherlands: A Participatory Action Research, Roy Haex, Theresa Thoma-Lürken Phd, Anna J.H.M. Beurskens Phd, Sandra M.G. Zwakhalen Phd, Rn

Patient Experience Journal

To optimise home care provision and to identify potential improvements in the care process, it is important to gain insight into the care experiences that influence care quality. The aim was to develop a qualitative experienced quality measure for home care in The Netherlands, facilitating conversations between clients and caregivers in generating possible points of improvement for the primary care process. A participatory action research design to develop the measure following three iterative cycles, using various data sources in evaluating requirements related to the goal, feasibility in care setting, and usability in the care process. The final design comprises an …

Prevalence Of Sensory Impairments In Home Care And Long-Term Care Using Interrai Data From Across Canada, Dawn M. Guthrie, Nicole Williams, Atul Jaiswal, Paul Mick, Hannah M. O'Rourke, M. Kathleen Pichora-Fuller, Walter Wittich, Rinku Sutradhar

Health Sciences Faculty Publications

Background

In the general population, sensory impairments increase markedly with age in adults over 60 years of age. We estimated the prevalence of hearing loss only (HL), vision loss only (VL), and a combined impairment (i.e., dual sensory loss or DSL) in Canadians receiving home care (HC) or long-term care (LTC).

Methods

Annual cross-sectional analyses were conducted using data collected with one of two interRAI assessments, one used for the HC setting (n = 2,667,199), and one for LTC (n = 1,538,691). Items in the assessments were used to measure three mutually exclusive outcomes: prevalence of VL only, …

The Interrai Chess Scale Is Comparable To The Palliative Performance Scale In Predicting 90-Day Mortality In A Palliative Home Care Population, Nicole Williams, Kirsten Hermans, Joachim Cohen, Anja Declercq, Ahmed Jakda, James Downar, Dawn M. Guthrie, John P. Hirdes

Health Sciences Faculty Publications

Background: Prognostic accuracy is important throughout all stages of the illness trajectory as it has implications for the timing of important conversations and decisions around care. Physicians often tend to over-estimate prognosis and may under-recognize palliative care (PC) needs. It is therefore essential that all relevant stakeholders have as much information available to them as possible when estimating prognosis.

Aims: The current study examined whether the interRAI Changes in Health, End-Stage Disease, Signs and Symptoms (CHESS) Scale is a good predictor of mortality in a known PC population and to see how it compares to the Palliative Performance Scale (PPS) …

Careless, Brenna Holland

Capstones

About This Project

I began working on this project six months ago, but my interest in the home care industry can be traced much further back. In the mid-aughts, my grandfather was diagnosed with Alzheimer’s. Hoping to live independently for as long as possible, he sought out the help of an in-home health aide. It was then that he learned he fell into a coverage gap; one that, even today, prevents many Americans from accessing home care services.

Faced with two options—father-son cohabitation or an institution—my grandfather moved in with my family, where he slipped into a catatonic depression prompted …

Caregiver Decision-Making Concerning Involuntary Treatment In Dementia Care At Home, Vincent Ra Moermans, Angela Mhj Mengelers, Michel Hc Bleijlevens, Hilde Verbeek, Bernadette Dierckx De Casterle, Koen Milisen, Elizabeth Capezuti, Jan Ph Hamers

Publications and Research

Background: Dementia care at home often involves decisions in which the caregiver must weigh safety concerns with respect for autonomy. These dilemmas can lead to situations where caregivers provide care against the will of persons living with dementia, referred to as involuntary treatment. To prevent this, insight is needed into how family caregivers of persons living with dementia deal with care situations that can lead to involuntary treatment.

Objective: To identify and describe family caregivers’ experiences regarding care decisions for situations that can lead to involuntary treatment use in persons living with dementia at home.

Research design: A qualitative …

Health Service Experiences And Preferences Of Frail Home Care Clients And Their Family And Friend Caregivers During The Covid-19 Pandemic, Lori E. Weeks, Sue Nesto, Bradley Hiebert, Grace Warner, Wendy Luciano, Kathleen Ledoux, Lorie Donelle

Nursing Publications

Objective: The COVID-19 pandemic has brought about a major upheaval in the lives of older adults and their family/friend caregivers, including those utilizing home care services. In this article, we focus on results from a qualitative component added to a pragmatic randomized controlled trial that focuses on the experiences of our study participants during COVID-19. A total of 29 participants responded to the COVID-19 related questions focused on their health services experiences and preferences from March-June 2020 including 10 home care clients and 19 family/friend caregivers in the provinces of Ontario and Nova Scotia, Canada. Results: Many participants were affected …

Evaluation Of Opioid Disposal Process For Aurora At Home Hospice Patients, Andre Cernasov, Alexander Schwank, Marianne Klumph, Kavita Sharma

Scientific Day

No abstract provided.

Developing A Resiliency Bundle For Home Care Nurses, Candace Unger

Nursing DNP Projects

Home care (HC) nurses are experiencing increased stress related to workload, isolation on the job, and COVID-19 restrictions. A literature review found numerous interventions effective in reducing nurse burnout through building resiliency and decreasing moral distress. The purpose of this evidence-based project was to improve resiliency and decrease the risk of burnout in HC nurses through the introduction of a resiliency bundle. Based on the evidence, the following priority interventions for a resiliency bundle were chosen: a) gratitude strategies, b) connecting with co-workers, c) storytelling, and d) resiliency training. Duffy’s Quality-Caring Model and Neal’s Theory of Home Health Nursing Practice …

Nursing Care For The Newborn And The Mother After Childbirth - Postpartum Phase, Home Care, Doruntina Ismaili, Kaltrina Azizi

UBT International Conference

Childbirth is a joyous event when a woman gives birth to a child she desires. Despite the pain and embarrassment, childbirth is the long-awaited peak of pregnancy and the beginning of a new life. However, childbirth is also a critical time for the health of the mother and her baby. The postpartum phase is an essential period for a mother and her baby. The postpartum period includes a critical transitional time for a woman, her newborn, and her family, on a physiological, emotional, and social level.The postpartum period, or puerperium, begins about an hour after birth and includes the following …

The Little Things: Exploring Perceptions And Experiences Of Client And Family-Centred Care Through Photovoice, Sonia Nizzer, Stacey Ryan, Sandra M. Mckay

Patient Experience Journal

Healthcare in Canada is undergoing a paradigm shift, moving away from a prescriptive approach to care delivery to one that prioritizes clients and their families at the center of their care. In the homecare sector, this approach is commonly referred to as client- and family-centred care (CFCC), a philosophy emphasizing the need for point-of-care providers to partner with those receiving care and their families in a way that is respectful and attuned to their individual needs and goals. This philosophy helps homecare agencies like VHA Home HealthCare deliver care to families that embraces what is most important to them. At …

Caring Near And Far By Connecting Community-Based Clients And Family Member/Friend Caregivers Using Passive Remote Monitoring: Protocol For A Pragmatic Randomized Controlled Trial, Lorie Donelle, Sandra Regan, Michael Kerr, Merrick Zwarenstein, Michael Bauer, Grace Warner, Wanrudee Isaranuwatchai, Aleksandra Zecevic, Elizabeth Borycki, Dorothy Forbes, Lori Weeks, Bev Leipert, Emily Read

Nursing Publications

Background: Significant chronic disease challenges exist among older adults. However, most older adults want to remain at home even if their health conditions challenge their ability to live independently. Yet publicly funded home care resources are scarce, private home care is expensive, and family/friend caregivers have limited capacity. Many older adults with chronic illness would require institutional care without the support from family member/friend caregivers. This role raises the risk of physical health problems, stress, burnout, and depression. Passive remote monitoring (RM), the use of sensors that do not require any action by the individual for the system to work, …

House Calls Are Reaching The Tipping Point — Now We Need The Workforce, Thomas Cornwell

Journal of Patient-Centered Research and Reviews

Home-based primary care (HBPC) improves the lives of high-cost, frail, homebound patients and their caregivers while reducing costs by keeping patients at home and reducing the use of hospitals and nursing homes. Several forces are behind the resurgence of HBPC, including the rapidly aging population, advancements in portable medical technology, evidence showing the value of HBPC, and improved payments for HBPC. There are 2 million to 4 million patients who could benefit from HBPC, but only 12% are receiving it. The number of these patients is expected to double over the next two decades. This requires a larger and better …

Registered Nurses' Intention To Use Electronic Documentation Systems: A Mixed Methods Study, Sarah Ibrahim

Electronic Thesis and Dissertation Repository

BACKGROUND: Home care in Ontario has become the fastest growing sector and cornerstone of the healthcare system. As a result of the increased shift to the home care sector in Ontario, there have been several health information technology (HIT) initiatives to improve the quality and delivery of health care services to patients. This is exemplified with the province-wide development and implementation of electronic documentation systems (EDS). Electronic documentation systems have the potential to ensure timely, up-to-date and comprehensive patient health and care-related information is available and accessible to healthcare providers such as registered nurses regardless of their physical location. Access …

Examining Eshift Through The Caregiver Policy Lens: A Content Analysis, Ashlee A. Worrall

Electronic Thesis and Dissertation Repository

Purpose: This research study intended to understand how a new model of palliative home care in Ontario, Canada called eShift aligned with the needs of caregivers who cared for a family member at the end-of-life.

Methods: A qualitative secondary analysis using a deductive content analysis of 14 caregiver interviews, three decision-maker interviews, and six home care agency documents collected in a three-year study and were analyzed using The Caregiver Policy Lens framework.

Findings: The eShift model of care met caregivers’ needs through timely access to respite, education, collaborating with the health care team, and physical and psychological support. Caregivers were …

Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven

Journal of Patient-Centered Research and Reviews

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing …

“Older Adults And Their Experiences With Home Care And Assisted Living”, Faith Robinson

Thinking Matters Symposium Archive

As the state of Maine and the U.S. population at large continues to age, discussion about future care and living arrangements for older adults has become an increasingly relevant issue. Older adults are often faced with a range of options for housing, including staying in their home in their community while receiving home care services, or moving to an assisted living facility.

Currently a gap in the research exists as to the attitudes, perceptions, and lived experiences of the older adults themselves around these decisions, experiences, and the meaning of “home” in our older years. This study aims to provide …

Risk Of Medication Errors In The Home: An Integrative Literature Review, Maria M. Crescenzi

Honors Undergraduate Theses

Regardless of the setting, medication errors are of great concern when associated with an individual’s health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant …

Developing And Testing Quality Indicators For Seriously-Ill Home Care Clients In Ontario, Lisa Harman

Theses and Dissertations (Comprehensive)

Introduction Currently in Ontario, there is no set of quality indicators for use in palliative care settings. Palliative care research tends to focus heavily on those with cancer diagnoses, and therefore potentially misses those with other life limiting illnesses. The current study aims to develop a preliminary set of quality indicators relevant for seriously-ill individuals for use in the community. Methods Secondary analysis of Resident Assessment Instrument for Home Care (RAI-HC) data from 2006-2013 (n=263,767) was used to develop QIs thought to be relevant to the needs of seriously-ill home care clients. Seriously-ill clients were defined as those with a …

Reciprocity: Caring For America's Caregivers, Courtney Dunn

The Downtown Review

Should families be forced to choose between the health of a caregiver and patient? Through the eyes of a woman caring for her husband with Alzheimer's disease, we see that family caregivers suffer tremendous amounts of stress while caring for the patient. Despite the time and efforts required to care for someone with Alzheimer's disease, people every day choose this as an alternative to out-of-home care. This often leads to depression, anxiety, and physical stress which can result in series medical issues. Considering the increase of people with Alzheimer's disease in the United States, this article argues that support programs …

Effect Of Home Telehealth On Vterans With Chronic Heart Failure, Yolanda Major

Walden Dissertations and Doctoral Studies

More than 5 million Americans have heart failure, with approximately 5% of those affected being veterans. As the number of patients with CHF continues to rise, new treatment options are needed to improve the quality of care. Current studies show Telehealth is one treatment option. The purpose of this scholarly project was to determine if veterans diagnosed with CHF were able to maintain optimal weight and blood pressure following participation in Care Coordination Home Telehealth (CCHT) program. The CCHT program provides care to veterans, through the use of monitoring devices placed in their home. Bandura's self-efficacy theory was used as …

Examining Quality Indicator Rates For Older Home Care Clients With Dual Sensory Impairment (Dsi) And Exploring The Heterogeneity Within Dsi., Jacob G S Davidson, Dawn M. Guthrie

Theses and Dissertations (Comprehensive)

Older adults with impairments in both hearing and vision, called dual sensory impairment (DSI), are at an increased risk of negative health outcomes such as impaired communication and difficulties with mobility. It is unknown whether DSI is associated with potential quality of care issues. This study used a set of home care quality indicators (HCQIs) to examine potential quality issues in older clients (65+) with DSI. Further, it looked to explore how HCQI rates differed based on the geographic region of care and whether the client’s level of hearing and vision impairment was related to certain HCQIs. The HCQIs were …

Developing An Optimal Model For Infant Home Visitation, Isaac Atuahene

Doctoral Dissertations

The United States, Great Britain, Denmark, Canada and many other countries have accepted home visitation (HV) as a promising strategy for interventions for infants after births and for their mothers. Prior HV studies have focused on theoretical foundations, evaluations of programs, cost/benefit analysis and cost estimation by using hospital/payer/insurance data to prove its effectiveness and high cost. As governments and private organizations continue to fund HVs, it is an opportune time to develop and formulate operations research (OR) models of HV coverage, quality and cost so they might be used in program implementation as done for adult home healthcare (HHC) …

Need Based Instructional Program On Care Competency Of Informal Care Givers For Chronic Renal Failure Patients At Home, Mukesh Kumar Mr, Rajesh Kumar Sharma Mr, Mahalingam

Manipal Journal of Nursing and Health Sciences

Introduction: Majority of patients with Chronic Renal Failure (CRF), Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) depends on their family and friends, to manage their chronic illness throughout the course of illness. Appropriate home care of CKD can help to prevent or delay the progression of illness. Methods: A pre-experimental study with quantitative approach was undertaken on 45 care givers of CKD patients with the objective to study the improvement in competency regarding home care through administration of an instructional programme and information booklet. The program and the booklet consisted information on nutritional management, rest and exercises, …

Data Sharing Between Home Care Professionals: A Feasibility Study Using The Rai Home Care Instrument, Dawn M. Guthrie

Kinesiology and Physical Education Faculty Publications

Background: Across Ontario, home care professionals collect standardized information on each client using the Resident Assessment for Home Care (RAI-HC). However, this information is not consistently shared with those professionals who provide services in the client’s home. In this pilot study, we examined the feasibility of sharing data, from the RAI-HC, between care coordinators and service providers.

Methods: All participants were involved in a one-day training session on the RAI-HC. The care coordinators shared specific outputs from the RAI-HC, including the embedded health index scales, with their contracted physiotherapy and occupational therapy service providers. Two focus groups were …

A Comparison Of Home Care Quality Indicator Rates In Two Canadian Provinces, Dawn M. Guthrie, Amanda M. Mofina

Kinesiology and Physical Education Faculty Publications

Background. Home care is becoming an increasingly vital sector in the health care system yet very little is known about the characteristics of home care clients and the quality of care provided in Canada. We describe these clients and evaluate home care quality indicator rates in two regions. Methods. A cross-sectional analysis of assessments completed for older (age 65+) home care clients in both Ontario (n=102,504) and the Winnipeg Regional Health Authority (n=9,250) of Manitoba, using the Resident Assessment Instrument for Home Care (RAI-HC). This assessment has been mandated for use in these two regions and the indicators are generated …

Reducing Heart Failure In An Era Of Reform, Sandra M. Kurpela

Evidence-Based Practice Project Reports

Heart failure (HF) affects an estimated 5 million Americans, with 550,000 new patients diagnosed yearly (American Heart Association, 2004). Despite advancements, readmissions for HF remain high. Management is especially important due to recent legislation that penalizes hospitals with excessive readmissions. The purpose of this evidence-based project (EBP) was to determine if a chronic disease HF management program with advance practice nurse, home care, and telehealth would affect hospital readmission 4 weeks post-discharge. Orem’s Self-Care Deficit Nursing Theory and the Iowa Model guided this system change. The project used a longitudinal experimental pre- and post-test design with convenience sample from two …