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

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

To explore the feasibility of implementing a specific tool, the multidimensional complexity assessment tool (COMID), for assessing the complexity of nursing care within 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 subsequently 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 subthemes were identified for the third theme. Participants emphasised that the COMID was easy to use, but noted that its definitive implementation could depend on support from local health policies.

Nurses consider the COMID a valid tool for daily clinical practice. Its implementation in the home-care setting of Canton Ticino nevertheless requires sustainable local health policies capable of providing appropriate support.