Prioritizing problems in and solutions to homecare safety of people with dementia: supporting carers, streamlining care

Table 2 Top ten problems leading to patient safety threats in homecare

RANK	Proposed problems leading to homecare safety threats	Total Priority Score	Type of the actor or setting related to homecare safety problems	Type of the contributory factor leading to homecare safety problems
1.	Reduced GP budgets, day centres and social care/services resources	82.7	System & organizational	Resources
2.	Professional carers lacking proper training and qualifications	81.6	Clinicians	Knowledge and skills
3.	Family carers lacking training and education	79.8	Carers	Knowledge and skills
4.	Patient neglecting themselves	78.4	Patient	Support
5.	Social isolation	78.2	Patient & Carers	Support & Relationship
6.	Patient forgetting to take the medication	77.1	Patient	Support
7.	Unsafe design of home environment	77.1	Home environment	Setting
8.	Poor mobility and falls	75.7	Patient	Support
9.	Family members unable to manage the patient	75.7	Carers	Knowledge and skills & Support
10.	Health deterioration in family members due to burden of caring	74.9	Carers	Support

(Clinicians scored problems using the following criteria: frequency, severity, inequity, economic impact and responsiveness to solution (Table 1). The scoring options were 1 for “yes (e.g. this problem is common)”, 0 for “no (e.g. this problem is uncommon)”, 0.5 for “unsure (e.g. I am unsure if this problem is common)” and blank for “unaware e.g. I do not know if his problem is common)”. Total Priority score is the mean of the scores for each of the five criteria and is ranging from 0 to 100. Higher ranked problems received more “Yes” responses for each of the criteria and a higher score)

ISSN: 1471-2318