Low-value home-based nursing care: A national survey study

Area of Science:

• Nursing
• Healthcare Management
• Quality Improvement

Background:

• Home-based nursing care is expanding, necessitating an evaluation of care efficiency.
• Not all provided nursing care is effective or efficient, leading to low-value practices.
• Reducing low-value care can enhance efficiency, job satisfaction, patient safety, and healthcare sustainability.

Purpose of the Study:

• To identify low-value home-based nursing care practices.
• To determine the prevalence of these practices.
• To explore factors influencing their provision by nurses and nursing assistants.

Main Methods:

• Quantitative, cross-sectional study design.
• Online survey with Likert scales and open-ended questions administered to nurses and nursing assistants.
• Data analyzed using descriptive statistics and linear regression.

Main Results:

• 776 healthcare professionals participated nationwide.
• Top low-value practices included routine washing, default zinc cream use, daily head-to-toe washing, urinary catheter bag reuse, and bladder irrigation.
• Influencing factors comprised practitioner advice, care plan directives, client requests, team habits, and a desire to please clients.
• Higher education and age over 40 were linked to less low-value care.

Conclusions:

• Frequent low-value nursing practices exist in home care settings.
• Factors like limited clinical autonomy and managing client demands contribute to these practices.
• Findings provide a basis for developing de-implementation strategies to reduce low-value care.