[Feasibility of implementing the multidimensional complexity assessment tool (COMID) in home care: a qualitative study]

Clinical complexity is an emerging issue, particularly for nurses, who often lack appropriate tools to assess it in daily practice. This is especially relevant in home care, where patients and their social networks are cared for by teams of nurses who must address various challenges in providing personalised care to people with complex needs or circumstances.

To explore the feasibility of implementing the COMID tool to assess the complexity of nursing care in home-care services in Canton Ticino, Switzerland.

A descriptive qualitative study was conducted. Nurses involved in direct care and nurses with coordination responsibilities were invited to participate in focus groups. The collected data were examined using thematic analysis.

Two focus groups were conducted with a total of 19 participants. Three main themes emerged from the thematic analysis: characteristics of the COMID, implementation of the COMID and education. Two subthemes, advantages and disadvantages, were identified within the first theme. Four subthemes emerged within the second theme: barriers, facilitating factors, implementation strategy and opportunities. No additional subthemes emerged for the third theme. Participants emphasised the ease of use of the COMID but noted that its definitive implementation could depend on the support of local health policies.

Nurses consider the COMID a valid tool for daily clinical practice. Its implementation in the home-care context of Canton Ticino nevertheless requires sustainable local health policies, organisational support and specific education.