Developing an index of risk management by collaboration between hospital nurses and home visiting nurses in home care setting

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K10762
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58050:Fundamental of nursing-related
• Research Institution: Tokyo Metropolitan Institute of Medical Science
• Principal Investigator: HARAGUCHI Michiko 公益財団法人東京都医学総合研究所, 社会健康医学研究センター, 主席研究員 (00517138)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 在宅医療 / 在宅看護 / 患者安全 / 連携 / リスクマネジメント

Outline of Final Research Achievements

The purpose of this study is developing an index of risk management by collaboration between hospital nurses and home visiting nurses in home care setting. Data were obtained from semi-structured interviews with 14 nurses. A qualitative and inductive analysis was applied to extract 40 items relating to cooperation and 20 items relating to risk management.　We conducted a questionnaire survey regarding the implementation status of these items, got the responses from 201 individuals（hospital nurses 206, home visiting nurses 118）For an index of collaboration, exploratory factor analysis identified 25-item, five-factor structure (cumulative contribution rate, 64.33%, cronbach's alpha 0.95).　For an index of risk management by collaboration,　exploratory factor analysis identified a 16-item, two-factor structure (cumulative contribution rate, 63.14%, cronbach's alpha 0.96).　 Confirmatory factor analysis showed that the index was suitable for evaluation.

Free Research Field

難病看護

Academic Significance and Societal Importance of the Research Achievements

日本の社会保障制度は、急性期治療を中心とした「病院完結型」の医療から「地域完結型」の医療への転換を目指しており、医療機関と訪問看護事業所の連携や在宅移行が急速に推進されている。一方で、医療機関と訪問看護事業所では、安全管理体制の法整備や組織運営に相違がある。そこで、本研究は医療機関と訪問看護事業所の看護師が、個別療養者の在宅療養生活のリスク管理も含めて連携し、在宅療養支援を計画・遂行するために、リスク管理の意識・情報・予防策を共有するリスク管理指標を開発した。医療機関と訪問看護事業所の看護連携における在宅安全管理に加えて、一体的・継続的な医療・看護および包括ケアの質の向上に寄与する。