Research on Abuse in Home Care: A Scoping Review

Home care is the preferred care option for most people who need support; yet abuse exists in these settings toward both home care workers and clients. There are no existing reviews that assess the scope of current research on abuse in home care, and tangentially related reviews are dated. For these reasons, a scoping review is warranted to map the current state of research on abuse in home care and examine current interventions in this field. Databases selected for searching were Medline and EMBASE on OVID, Scopus, and the following databases in EBSCOhost: Academic Search Complete, AgeLine, and Cumulative Index to Nursing and Allied Health Literature. Records were included if: (a) they were written in English; (b) the participants were home care workers or clients age 18 years or older; (c) they were published in journals; (d) they undertook empirical research; and (e) they were published within the last 10-year period. Following Graham et al. (2006), the 52 included articles are categorized as either knowledge inquiry or as intervention studies. We find three themes among knowledge inquiry studies: (1) prevalence and types of abuse in home care, (2) abuse in the context of living with dementia, and (3) working conditions and abuse. Analysis from the intervention studies suggest that not all organizations have specific policies and practices to prevent abuse, and no existing interventions to protect the well-being of clients were identified. Findings from this review can inform up-to-date practice and policymaking to improve the health and well-being of home care clients and workers.

Safety Considerations for Home Care Providers

Home care is one of the fastest growing industries in the United States, projected to continue increasing as the population ages. However, there are unique safety concerns associated with home care compared to the more controlled hospital or clinic settings, such as driving distractions, potentially dangerous neighborhoods, and in-home risks categorized as environmental, biological, chemical, and emotional. Each home is essentially a new worksite with its own set of safety hazards, increasing the need for home care providers to be aware of safety risks in these ever-changing environments. Ensuring worker safety is essential to the recruitment and retention of home care workers. This article discusses safety risks unique to home care and offers solutions that increase the safety of home care providers. Education around workplace violence, implementation of evidence-based practices, and establishing and adhering to safety policies are paramount.

Nursing Students' Home Care Learning Delivered in an Innovative 360-Degree Immersion Experience

BACKGROUND

Health care is delivered to patients in the community, frequently in their own homes. New graduates need to be prepared for this unique nursing role to care for patients in the home health setting.

PURPOSE

The purpose of this study was to assess student satisfaction with an innovative pedagogy to teach home health nursing using an immersion experience. The immersion experience delivered the home health nursing activity using 360-degree footage and zoom in pictures presented via a web platform.

METHODS

This study used a descriptive cross-sectional design with convenience sampling of 81 nursing students enrolled in the third semester of an associate degree program. Data were collected through an online survey eliciting anonymous feedback.

RESULTS

Participant feedback revealed this new pedagogy engaged nursing students and received overwhelmingly positive responses. A review of student feedback through written comments provided further support that this immersion experience exceeded expectations.

CONCLUSION

The 360-degree immersion home care experience provided problem-based learning that positively impacted student self-reported satisfaction and perceived learning.

Direct-Read Fluorescence-Based Measurements of Bioaerosol Exposure in Home Healthcare

Home healthcare workers (HHCWs) are subjected to variable working environments which increase their risk of being exposed to numerous occupational hazards. One of the potential occupational hazards within the industry includes exposure to bioaerosols. This study aimed to characterize concentrations of three types of bioaerosols utilizing a novel fluorescence-based direct-reading instrument during seven activities that HHCWs typically encounter in patients’ homes. Bioaerosols were measured in an indoor residence throughout all seasons in Cincinnati, OH, USA. A fluorescence-based direct-reading instrument (InstaScope, DetectionTek, Boulder, CO, USA) was utilized for all data collection. Total particle counts and concentrations for each particle type, including fluorescent and non-fluorescent particles, were utilized to form the response variable, a normalized concentration calculated as a ratio of concentration during activity to the background concentration. Walking experiments produced a median concentration ratio of 52.45 and 2.77 for pollen and fungi, respectively. Fungi and bacteria produced the highest and lowest median concentration ratios of 17.81 and 1.90 for showering, respectively. Lastly, our current study showed that sleeping activity did not increase bioaerosol concentrations. We further conclude that utilizing direct-reading methods may save time and effort in bioaerosol-exposure assessment.