Evde Bakım Hizmeti Verecek Hemşirelerin Eğitimi Projesi


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 Type: Project Supported by Other Official Institutions
  • Begin Date: May 2006
  • End Date: June 2008

Project Abstract

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.