Advanced Practice Nurses' Experiences on Patient Safety Culture in Hospital-Based Home Healthcare: A Qualitative Descriptive Study

Abstract

Purpose: Despite the increasing interest in patient safety, most research have been conducted in hospital settings, thereby demonstrating an overall lack of research regarding patient safety culture in home healthcare. South Korea has three types of home healthcare services based on hospitals, public health centers, and long-term care insurance. Home healthcare nurses in hospitals require a master's degree and advanced nursing skills. They play important roles in ensuring patients' safe transition into home health care. This study aimed to explore the experience of patient safety culture among South Korean advanced practice nurses in hospital-based home healthcare.

Methods: This qualitative descriptive study was conducted through purposive sampling, whereby twenty advanced practice nurses involved in home healthcare were recruited from twelve hospitals located in three different cities throughout South Korea. Face-to-face semi-structured interviews were conducted, and the collected data were analyzed through inductive and deductive content analyses.

Results: Three main categories were finally confirmed: (a) teamwork climate, (b) safety climate, and (c) working condition. The sub-categories of the teamwork climate included the collaboration between patients, caregivers, and nurses, collaboration within medical institutions, and collaboration among the individuals involved in community partnerships. The sub-categories of the safety climate included nurses' commitment to patient safety, the associated institutions' commitment to patient safety, and the government's commitment to patient safety. The sub-categories of the working condition included the frontline working environments and the associated institutions' support aimed at ensuring effective working environments.

Conclusion: Cultivating patient safety culture is crucial for ensuring the safe transition of patients from acute care hospitals to home healthcare. This study revealed significant aspects of patient safety culture in hospital-based home healthcare, allowing for the continuum of care among the associated patients. Such aspects include communicating with caregivers, building community partnerships, understanding unexpected home environments, and enhancing the safety of nurses.