Delivery of high-tech home care by hospital-based nursing units in Quebec: clinical and technical challenges.
BACKGROUND
The role that hospital-based nurses should play in the delivery of high-tech home care, and how they should be supported in that role, are topics that remain understudied. Our research objective was to document how hospital-based nursing teams perceive and deal with the clinical and technical challenges associated with the provision of high-tech home care.


METHODS
Four home care interventions were selected: antibiotic intravenous therapy, parenteral nutrition, peritoneal dialysis and oxygen therapy. A self-administered survey was sent to all hospital-based units providing these interventions in the province of Quebec, Canada (n = 154; response rate: 70.8%). We used descriptive statistical analyses to derive mean values for scores on either a five- or a six-level Likert scale.


RESULTS
Despite variation across the four interventions, our results indicate that while nursing teams believe these interventions increase patients' autonomy, they also recognize that they generate anxiety and impose constraints on patients' lives. Nurses must increase efforts to deal with both clinical and technical challenges and help patients overcome the barriers to appropriate use of home care technologies.


CONCLUSIONS
While nursing teams generally perceive high-tech home care as beneficial, they still experience significant technical and clinical challenges. Some of these challenges could be addressed by strengthening professional training initiatives, while others require broader home care policy interventions.
Lehoux
Pascale
P
Department of Health Administration, University of Montreal Researcher, Groupe de recherche interdisciplinaire en santé, Montreal, QC. pascale.lehoux@umontreal.ca
Richard
L
L
Pineault
R
R
Saint-Arnaud
J
J
D000223:Adaptation, Psychological; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence / Q000592:standards; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D018718:Home Infusion Therapy / Q000451:nursing*; D006801:Humans; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D010102:Oxygen Inhalation Therapy / Q000451:nursing*; D016331:Parenteral Nutrition, Home / Q000451:nursing*; D010353:Patient Education as Topic; D010530:Peritoneal Dialysis / Q000451:nursing*; D026684:Personal Autonomy; D011792:Quebec; D012647:Self-Assessment; D011795:Surveys and Questionnaires