Interprofessional Collaboration in Fall Prevention: Home Care Providers’ Experience

Sunday, 30 July 2017: 9:10 AM

Kyeongra Yang, PhD, MPH
Lienhard School of Nursing, Pace University, Pleasantville, NY, USA
Keville Frederickson, EdD
Lienhard School of Nursing, Pace Univeristy, Pleasantville, NY, USA

Purpose: Approximately 12 million individuals currently receive home care because of acute illness, chronic diseases, or permanent disability (National Association for Home Care & Hospice, 2010). Diabetes is one of the most frequently encountered conditions in home care (Jones, Harris-Kojetin, & Valverde, 2012). Researchers have found that older adults with diabetes are at high risk for falls (Yau et al., 2013) largely due to poor balance and loss of pressure sensitivity related to diabetic-related neuropathy (Maurer, Burcham, & Cheng, 2005; Morrison, Colberg, Mariano, Parson, & Vinik, 2010; Schwartz et al., 2002). Falls contribute to about 54% of unintentional injuries in older adults and are a leading cause of death in adults 65 years or older and home care providers have become major players in fall prevention among community-dwelling populations (Centers for Disease Control and Prevention, 2014). Research suggests that a multifactorial fall risk assessment can effectively identify the risk of falls among patients receiving home care (James, Kimmons, Schasberger, & Lefkowitz, 2014). An inter-professional team approach also has been identified as the key to improving the quality of fall prevention among older adults at risk of falling in home care settings (Baxter & Markle-Reid, 2009). The purpose of the study was to understand home care providers’ inter-professional collaborative experience in providing fall prevention in home settings.

Methods: The study employed a qualitative, descriptive approach through a series of focus groups. Recruitment began after Institutional Review Board (IRB) approval was obtained both from the University and home visiting agency. To be eligible, participants had to be a homecare provider working with patients 65 years or older who are at risk for falls. Study flyers were distributed via agency email listserv at a home care agency in New York to recruit the sample. The focus group (approximately one hour) took place in a quiet and private setting to protect participant confidentiality. Focus group discussions were audio-recorded, transcribed, and coded for content analysis.

Results: Twenty-nine home care providers participated in three focus groups and included nurses (n=12), physical therapists (n=10), occupational therapists (n=5), one social worker and one speech therapist. Twenty-six (89.7%) were female and the mean age was 44.8 years (SD: 10.2). The average number of years of job experience with home care was 11 (SD: 7.8, Range: 2-33) and the years in their profession ranged from 2 to 46 years (Mean ± SD: 18.8 ± 11.3). The themes that emerged included, “teaming up” for patient care and communicating through emails, texts, phone calls, and/or in-person meetings with team members; reaching out to team members perceived to have more knowledge or a “better scope” or a “better handle” on both practice issues as well as more experience in specific settings; and working in an agency as a team was a facilitator in providing care yet working with external home caregivers was identified as a challenge.

Conclusions: This study explored the experiences of home care providers toward inter-professional collaboration. Participants reported that effective inter-professional collaboration is essential to ensure the quality of care and improve patient outcomes; therefore, it is imperative to explore best strategies to enhance inter-professional collaboration in a home care setting.