The safety and involvement of older patients and their carers in the home

Project summary

Background

Little is known about patient safety in the home, (Madigan 2007, Lang et al. 2008, Masotti et al. 2010) despite patients increasingly experiencing some form of continued care within their own home. Research in the acute care setting may not translate, as the home environment is unique and not designed for health care (Lang et al. 2008, McGraw et al. 2008). Burgeoning literature predominately from Canada reveal a concerning number of adverse events that occur in the home, particularly after discharge from hospital (76% of patients suffered an adverse event post discharge) (Forster,2003). The experts hint that home care could have a higher potential for adverse events than hospitals (Woodward et al. 2002, Masotti  et al. 2009). Those at higher risk of experiencing adverse events are the elderly, depressed, that have co-morbidities and behavioural problems (Madigan 2007, Masotti et al. 2010). Further research is needed to identify other contributory factors of adverse events in the home, (Masotti et al. 2007) particularly in the UK. Within the home, a significant number of older people have carers to help with their care, who may transform their quality of care, safety outcomes and patient involvement in their care (Donelan et al. 2002). This project begins with an exploratory study on the adverse events, their contributory facts, safety interventions, and the role of carers/self in patient safety in the home of older patients.

Research questions:

• What are the common adverse events in the home?
• What are the contributory factors to these adverse events & processes of care?
• What safety interventions exist/are required to ameliorate safety in the home?
• What is the self management role of patients in their safe/unsafe care?
• What role do formal and informal carers play in this care?
• What can psychological theories (e.g. Theory of Reasoned Action) tell us about patient and carer involvement in older patients’ safety?