Research Information System
Özhan Elbaş H. N.(Executive), Göçmen Baykara Z., Bulut H., Çobanoğlu N., Güler Demir S., Demirsoy Ü. N., et al.
Project Supported by Other Official Institutions, 2006 - 2008
PROJECT FOR THE TRAINING OF
NURSES TO PROVIDE HOME CARE
Home care is a health service that is
gaining increasing importance both in Turkey and in the world. Among the
primary reasons for this are a greater incidence of chronic and degenerative
diseases among the elderly population, problems encountered in sustaining
health care services, recent developments in medical technology and consumer
preferences. Provision of nursing care away
from the adverse conditions of a hospital environment, in the familiar
surroundings of the patients where their loved ones are present, has a positive
impact in the individual’s recovery process. Individuals are visited in their
homes according to their health condition, and arrangements regarding their
treatment and care are made in a timely manner . Home care services must be
provided by trained professionals. Home care services offered in Turkey are
limited to projects and practices implemented by a number of disease-specific
societies and certain institutions. The scarcity of trained human resources to
work in this field is a barrier to the fulfillment of home care services.
Home-care
nursing training is part of the graduate and postgraduate curricula of nursing
schools; however, there are no postgraduate programs related to home care
nursing. Home care services in Turkey are regulated by the “By laws for the
Delivery of Care Services at Home” and are in the process of development (2005).
However, home care services are not currently included in the reimbursement
systems in the desired form.
A congress
on home care services was held for the first time in Turkey in 1998. The Home
Care Society, established in Istanbul on 18 August 2005, is continuing to work
on the development of home care services.
Because home care nursing requires a wider range and greater continuity
of nursing services than in a hospital setting, development of practices as
well as management and leadership skills related to this service is of
considerable importance Therefore, in order to offer this service, which is
anticipated to rapidly spread out in the near future, with the desired quality,
it is believed that certification should be required of the health care
providers who will deliver home care services.
As a
result of the changes occurring in the health care system today, and the
addition of home care services to the range of community-based health care
service concepts, it is expected that nurses graduating from nursing schools
will work in health care services that include provision of home care, rather
than the traditional health care model. This development has made it essential
for nurse trainers to develop curricula intended to ensure proficiency of newly
graduated nurses in providing care at home and to ensure that home care nursing
practices are carried out effectively. Further, the requirement for a
multi-disciplinary and multi-sectoral service approach to home care today, and
an increased need to reduce the costs of health care services, have made it
inevitable for nurses to closely follow newly developed technologies, while
creating a need for a sufficient number of nurses with the necessary level of
expertise to provide home care services.
As
mentioned before, nurses play an important role in providing sustainable care
to individuals who need nursing care at home. Therefore, it goes without saying
that training of nurses who will deliver home care services by professionals
with expertise in the field would both increase the quality of home care and
have a positive impact on improving community health. Recognizing the lack of
training programs in the country that can be qualified as adequate for this
purpose, the “Project for the Training of Nurses to Provide Home Care” was
designed in a collaborative effort by Gazi University School of Nursing and
Gazi University Faculty of Medicine, and two courses entitled “Home Care Nurse
Training Course” were planned within the project’s scope. This presentation
contains outcomes related to the first of these courses.
The project was planned as an action research intended to improve home
care services by increasing the knowledge and experience of nurses who will
deliver home care services. In order to reach this objective two Home Care
Nurse Training Courses was organized. Associate and bachelor of science graduates
whose diplomas had been approved by the Ministry of Health were admitted to the
courses. The duration of the course was two weeks (96 hours). At the end of the
course, the nurses who receive a score of 80 over 100 for theoretical knowledge
and the patient care plans prepared during home visits, were awarded a “Home
Care Nursing Certificate”. The data obtained from the project were evaluated on
the SPSS 11.0 software package. Percentage calculations and the significance of
the differential between two averages test were used to evaluate data.
Forty-one nurses participated in the courses that was organized within
the scope of the project. Of the trainees, 92.7% were women, with an average
age of 28.8±5.51. The proportion of nurses with bachelor of science or master degrees was 56.1%. Of these, 51.2% had a total working experience of
0-5 years, and 75.6% had worked in the unit for 0-5 years. While 41.5% of the
participants worked in the medical and surgical unit, only 4.9% worked in the
home care unit. The proportion of trainees who reported not having attended any
scientific program associated with home care nursing was 92.7%, and none had
participated in any course on the subject. The participating nurses’ average
pretest score was 46.49± 9.14,
compared with a final test score average of 87.90±6.00, measured over a total
score of 100. The differential between the two averages was found to be
statistically significant (p< 0.05).
Following the home visits, the participants were found to have
identified risk of trauma, impaired/risk of impaired tissue integrity, pain,
ineffective health maintenance in their patients in terms of nursing diagnoses.
At the end of the course the participants stated that the training had
updated their professional knowledge, that the course content was adequate and
comprehensive, that the teaching method used by the trainers increased the
course’s impact, and that the training materials were adequate as positive
feedback; and that class periods were limited and discussions were constricted,
as their negative feedback.
In conclusion, in the Home Care Nursing Training Courses, which was
implemented as part of a project that was the first of its kind in Turkey, the
knowledge score averages of the nurses marked a significant increase. In
addition, the nurses gained experience related to home care nursing practices.
Based on these results, development, support to, and ensuring continuity of
similar training programs is recommended.
*Results with related to the first
course of Project for the Training
of Nurses to Provide Home Care
was presented at the 5th International Conference on Health
Care Systems coordinated by
University of Wisconsin-Milwaukee at
USA on October 13-15 2008.