Table 8 Synthesised finding 5: Staffs'聽beliefs that risk of infection to clients and themselves is inevitable due to the nature and structure of home health care services
Category 16: The structure and nature of home health care, in itself, imply infection risk and challenges to infection prevention and control - |
Specifically, participants reported a certain level of unpredictability during home visits. Staff described attempting to establish clean fields and implement universal precautions in a home, which may lack what they perceived as adequate cleanliness and sanitization. (Pogorzelska-Maziarz 2020) (U) |
Cluttered and contaminated households presented nurses with a dilemma. Nurses indicated that they could not refuse to provide care because clients have a 鈥榬ight to receive healthcare鈥�, but at the same time there is a need for guidance on how to address contaminated households to minimize the spread of infectious microorganisms. (Wendt 2022) (U) |
In the context of homecare practice in the USA, nurses must adjust their level of care to what is covered by the patient鈥檚 insurance, which may require some patients to monitor their own clinical status more than they would in other clinical settings. (Dowding 2020) (C) |
Home health aides provided personal care to patients who had functional limitations. Home health aides consistently stated that they had no other health care professional to rely on to help with difficult tasks in patients鈥� homes, which may require assistance in other settings, such as turning or positioning physically dependent patients. While providing such care, home health aides had fears related to COVID-19 exposure risk. (Osakwe 2021) (U) |
Home health aides placed high priority on keeping patients safe at home and free from falls. This effort frequently compromised their ability to maintain hand hygiene practices, thus increasing potential COVID-19 risk. (Osakwe 2021) (U) |
Aides noted that the intimate nature of their work made it impossible to maintain physical distance, and this was a source of constant 鈥渨orrying鈥�. (Franzosa 2022) (C) |
Category 17: Lack of access to clear information, guidelines and communication |
Many home health aides described the unique challenge to keep their masks on in patients鈥� homes and the conflict with patient satisfaction. Mask wearing made it difficult for patients with hearing impairments to fully understand home health aides when speaking. As a result, HHAs reported being caught between maintaining infection prevention practices at the risk of achieving high patient satisfaction鈥攁 factor critical to being retained as a home health aide with patients. (Osakwe 2021) (C) |
To protect patients, participants went to the grocery store and pharmacy on their behalf, which increased their own risk for contracting COVID-19. Although sometimes they volunteered, other times they were asked. F6.3. Participants also worried about their own risk of contracting COVID-19, and nearly all felt that their dependence on public transportation increased this risk. (Sterling 2020) (U) |
Participants also worried about their own risk of contracting COVID-19, and nearly all felt that their dependence on public transportation increased this risk. Many participants reported using public transportation to get to their patients鈥� homes, to run errands for them, and to travel to their agency for supplies. (Sterling 2020) (U) |
Taken together, they tried balancing the risks of work with their own health and financial well-being. (Sterling 2020) (U) |
Many spoke about balancing the risks of caring for patients during the COVID-19 pandemic with the duty or 鈥渃alling鈥� they felt to help patients. (Sterling 2020) (U) |
It was clear that the participants saw the risk of becoming infected as part of their work. (Tavemark 2022) (U) |