Home Based Nurses Safety Training
Question
Write an essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least five (5) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. T
Identify a clinical question related to your work environment, write the question in PICOT format and perform a literature search on the identified topic.
Purpose
To enable the student to identify a clinical question related to a specified area of practice and use medical and nursing databases to find research articles that will provide evidence to validate nursing interventions regarding a specific area of nursing practice.
Review the Application Case Study for Chapter 3: Finding Relevant Evidence to Answer Clinical Questions as a guide for your literature search.
Guidelines
1. Identify a clinical question related to your area of clinical practice (HOME HEALTH NURSING) and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.
2. Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).
3. Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.


Solution
Home Based Nurses Safety
Training
Nurses are known to provide the most crucial services to
patients and are always close to them. Therefore, the welfare of nurses is
important in ensuring the wellbeing of patients under any circumstances.
Home-based nurses often operate in highly vulnerable environments and hence are
likely to face a myriad of unforeseen challenges. For instance, they often take
care of patients suffering from mental disorder and the elderly. Such patients
have for a long time been associated with aggressive behavior towards nurses.
The aggression is capable of affecting the nursing outcomes and can affect both
the nurse and the patients. Therefore, it is imperative for home-based nurses
to be given safety training to equip them with the necessary skills to deal
with such situations.
Clinical Question
Among
nurses in home-based nursing (P), does personal safety training (I) as opposed
to no safety training (C) help to prevent the effects of aggressive patients
(O) in six months (T).
Why it is a Clinical
Problem
Healthcare
workers, especially nurses, are often exposed to acts of aggression by their
patients. As stated by Huang et al. (2003), patients' aggressive behaviors have
profound consequences on the nurse practitioners. Studies have revealed that
home-based nurses are exposed to physical and verbal abuses when discharging
their duties. The result includes depression, fear, anxiety, frustration,
stress, and feeling of fatigue. Most importantly, such forms of aggression have
dire consequences on the care of patients (Huang et al., 2013). As a result,
home-based nurses ought to be trained to deal with violence and aggression to
reduce the impacts of such vices. Some patients may not welcome the idea of
home-based nurses for several reasons. Some may see them as a threat to their
privacy or as a form of interference with their independence. In most cases,
when provoked by pain that may emanate from needles, such patients may lash out
at their caregivers. Whenever this occurs, both the caregiver and the patient
are affected in providing quality care.
Studies have also suggested that aggressive behavior against
nurses is most common among patients who suffer from mental illnesses. As Lata
et al. (2021) asserts, 90% of patients suffering from mental illnesses are
often cared for in their homes. Therefore, there is a high possibility of
aggression against home-based caregivers considering the condition of the
patients. Based on the available data from India, 77% of home base caregivers
reported having experienced cases of aggressive behaviors while taking care of
patients in the comfort of their homes (Lata et al., 2021). Therefore, this
suggests that nurses face a real problem that requires the attention of
policymakers to solve. Mental health is one of the main problems that the
healthcare sector is confronted with. According to Holst and Skar (2017),
mental illnesses account for 15% of the global disease burden. Due to this
problem, nurses ought to be equipped with the right skills to take care of the
situation of such patients.
However, despite the prevalence of aggressive behavior among
mentally ill patients, nurses who take care of them lack the knowledge of how
to handle them whenever they turn aggressive. Safety training is one of the
ways to equip home-based nurses with the skills and knowledge they need to
handle any situation of aggression should they occur as they discharge their
duties (Kawile, 2021). There is a great need for the concerned authorities to
evaluate the available caregivers' training programs for effectiveness in
equipping them with the skills to handle aggressive behaviors. The idea is
based on acknowledging that caregivers' knowledge of managing aggressive
behaviors is often enhanced by implementing the caregivers' training programs.
Caregivers' training programs equip them with the skills to identify the
etiological factors associated with aggression and, hence, develop measures to
counter such vices. Besides, they can also identify the warning signs of
aggression and apply de-escalation strategies to handle the behaviors.
Comparing Articles
Among the articles chosen for this study, the article by Lata
et al. titled "Effectiveness of a Home-Based Training
Program on Caregivers Knowledge in Managing Aggressive Behavior of Patients
with Mental Illness" stands out. The reason is that it provides all the
aspects of the topic that need to be understood. To begin with, although the
study conveyed was conducted in India, the article contains important
statistical information that provides greater insight into the problem and is
capable of sparking reactions from those concerned. For example, the article
states that "In India, more than 90% of patients with chronic mental
illness stayed with their family members." (Lata et al., 2012).
Nonetheless, the same may be replicated elsewhere in the world. Furthermore,
the clinical intervention in this study is of grave importance and requires
full information to diagnose properly and come up with better intervention
measures. However, all the other four articles are devoid of statistical
information on the topic.
Another important aspect of the chosen article was published
in 2021. It carries the most recent information increasing its relevance to
modern society in terms of solving the clinical problem mentioned. Among the
other four articles, only one was published in 2021. One was published in 2017.
The other is 2013, and the last one was in 2003. Using the most recent
information to make decisions on matters of importance, such as the clinical
problem in question. The research presented by the article was well structured
with clearly formulated objectives. The study was quantitative and utilized
ANOVA to analyze the data. Although there are other quantitative studies among
the selected articles, this article's research seems more insightful than the
rest. The results are also presented in a manner that is easy to understand. The
findings and conclusion are clear and concise for the audience to
understand.
The article has a direct link to the topic compared to the
rest as it establishes how training assists caregivers in gaining the required
skills to deal with aggression. Although the topic of study conveyed in the
article is narrowed down to aggression by mentally ill patients, the results
are relevant and can be applied to other patients who are also characterized by
aggressive behaviors. After the study, caregivers gained better skills in
dealing with aggressive behaviors than before the training. Therefore, its
findings support the notion presented by the clinical issue in this study.
Therefore, in the quest to establish the results of the clinical issue as
presented in the PICOT, this particular article will be the most relevant for
use. Nevertheless, this does not disregard all the other articles as they will
also be used to inform the clinical issue.
To conclude, the study is about home-based nurse training to
assist them in gaining skills and knowledge important in dealing with cases of
aggression among patients. The study is based on the PICOT question,
"Among nurses in home-based nursing (P), does personal safety training (I)
as opposed to no safety training (C) help to prevent the effects of aggressive
patients (O) in six months (T)." The home-based care nurses care for
patients in their home settings where they might feel that their privacy has
been invaded or may not feel comfortable. In most cases, such patients are mentally
ill or the elderly. Therefore, this puts the welfare of the nurse and that of
the patient in jeopardy. Therefore, the home-based nurse needs to gain vital
skills that will assist them in managing such cases should they occur.
Nonetheless, the current training programs are wanting.
Therefore, there is a great need to ensure that such programs are reviewed to
establish their effectiveness in equipping nurses with the crucial skills.
After that, suitable training programs should be established to assist nurses
in equipping themselves with the skills in question.
Conclusion
In conclusion, the study is about home-based nurse training
to assist them in gaining skills and knowledge important in dealing with cases
of aggression among. The home-based care nurses attend to patients in their
home settings where they might feel that their privacy has been invaded or may
not feel comfortable. In most cases, such patients are mentally ill or the
elderly. Therefore, this puts the welfare of the nurse and that of the patient
in jeopardy. Therefore, the home-based nurse needs to gain vital skills that
will assist them in managing such cases should they occur. Nonetheless, the
current training programs are wanting. Therefore, there is a great need to
ensure that such programs are reviewed to establish their effectiveness in
equipping nurses with the crucial skills. After that, suitable training
programs should be established to assist nurses in equipping themselves with
the skills in question.
References
Holst, A., & Skär,
L. (2017). Formal caregivers’ experiences of aggressive behaviour in older
people living with dementia in nursing homes: A systematic review. International
journal of older people nursing, 12(4), e12158.
Huang, H. L., Kuo, L.
M., Chen, Y. S., Liang, J., Huang, H. L., Chiu, Y. C. & Shyu, Y. I. L.
(2013). A home-based training program improves caregivers' skills and dementia
patients' ggressive behaviors: a randomized controlled trial. The
American journal of geriatric psychiatry, 21(11), 1060-1070.
Huang, H. L., Shyu, Y.
I. L., Chen, M. C., Chen, S. T., & Lin, L. C. (2003). A pilot study on a
home‐based caregiver training program for improving caregiver self‐efficacy and
decreasing the behavioral problems of elders with dementia in Taiwan. International
journal of geriatric psychiatry, 18(4), 337-345.
Kawile, E. Y.
(2021). Testing effectiveness of orem’s theory-based training for
home-based mental health care in improving knowledge, self-care practices, and
resilience among primary caregivers of mentally ill patients in Dodoma Tanzania (Doctoral
dissertation, The University of Dodoma).
Lata, K., Ajesh Kumar,
T. K., Khakha, D. C., & Deep, R. (2021). Effectiveness of a Home Based Training
Program on Caregivers Knowledge in Managing Aggressive Behavior of Patients
With Mental Illness. Home Health Care Management & Practice, 10848223211039448.




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