Nurses' activities and time management during home healthcare visits

Aim To describe nurses’ activities and time management during HHC visits from the perspective of master’s‐level nursing students. Background The shift from community‐based hospitals to home‐based, person‐centred services for patients with a variety of acute or chronic health problems challenges nurses’ professional competence and time management during home healthcare visits. Design and methods A cross‐sectional study in accordance with STROBE guidelines. Observation sheets (n = 196) from two municipal home healthcare organisations were analysed with descriptive quantitative analysis. Ethical issues and approval While no external ethical committee evaluation was necessary for this quality improvement study, research ethical principles were followed. Results The nurses spent 50% of each eight‐hour shift on indirect patient contact activities and about 38% on direct patient contact activities. The majority of activities underlying the home visits could be linked to long‐term illnesses: medication (57%), blood samples (23%), wound care (17%) or measurement of blood pressure (14%). Patient education was offered during only 3.5% of visits. Limitations The accuracy of the students’ observations is related to their individual capacity to objectively and selectively observe. Conclusions There were a number of activities conducted for the patient, to promote continuous intra‐ and interprofessional patient care, but fewer nursing activities conducted with the patient. To ensure integrated, person‐centred, safe patient care, vital reforms are needed. Relevance to clinical practice The appropriate balance between indirect and direct patient contact activities should be discussed intra‐ and interprofessionally, delineated and made explicit in nurses’ work plans and nursing documentation, alongside discussions pertaining to relevant resource allocation