title: Ethics and safety in home care: perspectives on home support workers.
abstract: Home support workers (HSWs) encounter unique safety issues in their provision of home care. These issues raise ethical concerns, affecting the care workers provide to seniors and other recipients. This paper is derived from a subproject of a larger Canada-wide study, Safety at Home: A Pan-Canadian Home Care Safety Study, released in June 2013 by the Canadian Patient Safety Institute. Semi-structured, face-to-face, audiotaped interviews were conducted with providers, clients and informal caregivers in British Columbia, Manitoba and New Brunswick to better understand their perceptions of patient safety in home care. Using the BC data only, we then compared our findings to findings of other BC studies focusing on safety in home care that were conducted over the past decade. Through our interviews and comparative analyses it became clear that HSWs experienced significant inequities in providing home care. Utilizing a model depicting concerns of and for HSWs developed by Craven and colleagues (2012), we were able to illustrate the physical, spatial, interpersonal and temporal concerns set in the context of system design that emphasized the ethical dilemmas of HSWs in home care. Our data suggested the necessity of adding a fifth domain, organizational (system design). In this paper, we issue a call for stronger advocacy for home care and improved collaboration and resource equity between institutional care and community care.
authors.affiliation: Professor Emeritus, School of Nursing, University of Victoria, Victoria, BC.
authors.forename: Janet
authors.initials: J
authors.lastname: Storch
authors.affiliation: Home Care Nurse, Vancouver Island Health Authority, Research Assistant, School of Nursing, University of Victoria, Victoria, BC.
authors.forename: Cherie Geering
authors.initials: CG
authors.lastname: Curry
authors.affiliation: Chief of Professional Practice and Nursing, Vancouver Island Health Authority, Victoria, BC.
authors.forename: Lynn
authors.initials: L
authors.lastname: Stevenson
authors.affiliation: Assistant Professor, School of Nursing, Dalhousie University, Halifax, NS.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Macdonald
authors.affiliation: Research Scientist, Victorian Order of Nurses of Canada, Montreal, QC.
authors.forename: Ariella
authors.initials: A
authors.lastname: Lang
mesh_terms: D000368:Aged; D001955:British Columbia; D003299:Cooperative Behavior; D004993:Ethics, Nursing; D005851:Geriatric Nursing / Q000941:ethics*; D006699:Home Care Services / Q000941:ethics*; D006801:Humans; D033183:Interdisciplinary Communication; D007406:Interview, Psychological; D007857:Leadership; D061214:Patient Safety