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Structural Barriers to High-Quality Home Healthcare Nursing: What Home Health Nurses Want Medicare Policy Makers and Agency Administrators to Know.
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- Author(s): Narayan, Mary Curry
- Source:
Home Health Care Management & Practice; Feb2024, Vol. 36 Issue 1, p3-11, 9p- Subject Terms:
HOME nursing; MEDICAL quality control; COMMUNITY health nurses; PSYCHOLOGICAL burnout; HEALTH services administration; HEALTH services accessibility; ETHICS; JOB qualifications; SOCIAL workers; INTERVIEWING; PATIENT-centered care; SATISFACTION; MEDICAL care; QUALITATIVE research; VALUE-based healthcare; DOCUMENTATION; COMPARATIVE studies; HOSPITAL nursing staff; WAGES; PSYCHOLOGY of caregivers; DESCRIPTIVE statistics; RESEARCH funding; HEALTH equity; ELECTRONIC health records; FINANCIAL management; MEDICARE - Source:
- Additional Information
- Subject Terms:
- Abstract: Previous research indicates home health nurses (HHNs) worry that current home health care trends are threatening their ability to provide high-quality nursing care. High-quality nursing requires patient-centered and culture-sensitive care. These 2 attributes are indicators of high-quality nursing care. In this qualitative study, 20 HHNs were interviewed to discover their insights into 2 research questions: What barriers affect HHNs' ability to provide patient-centered, culture-sensitive, high-quality nursing care and how do these barriers affect HHNs and patients? Participants were professional HHNs who provided skilled intermittent care to diverse patient populations in their homes. Participants believed that a lack of time, high productivity requirements, pay-per-visit compensation, documentation burden, EMR systems, and the "industrialization" of HHNs' practice create structural barriers to high-quality home health nursing. Medicare was perceived as contributing to the barriers with burdensome documentation requirements and regulations that impeded holistic patient-centered care. Nurse participants indicated that the effects of these barriers were nurse stress, burnout, moral distress, and intent to leave; lower patient outcomes and satisfaction; and healthcare disparities. Additional research about the structural barriers were reviewed and found to support the nurses' perceptions of barriers to high-quality nursing care. In a value-based purchasing system, agencies need to support high-quality nursing care by tackling the barriers to its practice. To address the barriers comprehensively, agencies can institute policies that mirror the American Nurses Credentialing Center's Pathway to Excellence ®. Medicare policy makers should examine how present policies adversely affect high-quality nursing care. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Home Health Care Management & Practice is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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