National registry-based data of adverse events in Finnish long-term professional homecare in 2009-2019.

AIMS AND OBJECTIVES: The aim of this study was to discover the nature of the adverse events in Finnish long-term professional homecare reported by professionals, and to identify the circumstances in which adverse events occur and their consequences. BACKGROUND: Adverse events are incidents causing unintended and unnecessary harm to older people at home. Safety is a basic human right and a fundamental prerequisite for independent living among older people at home. Few studies have focused on both long-term professional homecare environment and the safety of older people. DESIGN: The research was a descriptive registry-based study. METHODS: This study consisted of adverse events (N = 61248) in Finnish public long-term professional homecare (2009-2019). Data were described using frequencies and percentages. STROBE statement checklist was chosen for reporting the study process. RESULTS: By profession, practical nurses and registered nurses reported the most of adverse events (89.8%). These were either critical incidents (78.3%) or near misses (20.0%) and concerned medicine, injuries and accidents, information flow or management. Consequences for older people were usually rated from no-harm to moderate harm. For long-term professional homecare, image harm, extra financial costs, no-harm and prolonged care for older people were among the consequences. Personnel frequently observed the older people afterwards and informed older people of adverse events, yet some of actions were unknown. CONCLUSIONS: Many harmful adverse events are considered harmless for older people. Sometimes this can lead to unmet care needs or missed care. The degree of harm needs to be assessed in terms of physical, mental and social health with the HaiPro reporting system for homecare. RELEVANCE TO CLINICAL PRACTICE: An understanding and a comprehensive view of the situation and holistic assessment of care needs includes safety and safety risks to increase safety and feeling of safety for older people at home.

Research utilisation among nursing teachers in Finland: a national survey.

Evidence-based nursing practices using the latest knowledge require nursing education and further education based on the latest research findings. Anyhow, research utilisation by nursing teachers is poorly known. The aim of this study was to assess research utilisation by nursing teachers and connections of teachers background, further education and research activity variables to research utilisation on nursing education. A descriptive, cross-sectional survey design was used. A structured questionnaire specifically designed for this study which focused on research utilisation by nursing teachers were used. Data were collected from all nursing schools in Finland using a survey via the Internet. Participating nursing teachers totaled 339, with a response rate of 46%. The mean age of teachers was 51years and most had master's degrees, although 12% had a licentiate or PhD. Most nursing teachers had taken further education, were members of research and development teams and had publications. Research utilisation in nursing teaching was connected to teachers age, nursing diploma, academic degree, work experience, official title, further education, research and development activities and publication activity. Conclusion is that nursing teachers with doctoral degrees make better use of research on nursing education than those with master's degrees.

Nurses perceptions of older patients integrity in long-term institutions.

AIM: This article reports on a study into nurses' perceptions of how the integrity of older patients is maintained in long-term care institutions in Finland. BACKGROUND: Patient integrity is an important aspect of ethical decision-making in nursing care and respect for integrity is central to good care. Problems may occur in the maintenance of older patients' integrity because of reduced communication skills and decision-making authority. Data collection was by means of a purpose-designed structured questionnaire in a sample of 222 nurses from four purposively selected long-term institutions in 2004. The response rate was 74%. The questionnaire consisted of a background data sheet and integrity items in three categories: psychological, physical and social integrity. RESULTS: The nurses gave the highest ratings for the maintenance of physical integrity, particularly for respectful and gentle touching. Nonetheless, according to nurses patients were often tied to their bed or chair. The second highest ratings were give to the maintenance of social integrity. Most nurses felt that the patients had good contact with the outside world, mainly family members. On the other hand loneliness was a more common problem for older people in institutions. The maintenance of psychological integrity received the lowest rating. Satisfaction with the job and with the quality of service provided correlated positively with the nurses' views on the maintenance of patient integrity. CONCLUSION: Nurses take the view that patient integrity is maintained reasonably well in long-term institutions. There are, however, some problematic areas that require special attention, particularly in the maintenance of psychological integrity. Future research needs to look at how patients and their relatives view the situation and to explore different training delivery options that can help raise the ethical quality of nursing care.