Home Based Nurses Safety Training

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.