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

Table 3 Ten main solutions to patient safety threats in homecare

RANK	Proposed solutions to homecare safety threats	Total Priority Score	Types of contributing factors to safety and quality in home health care	Type of activity
1.	Encourage family members to participate in care and offer them free training	97.7	Carers	Education & Family Involvement
2.	Carers to receive training on the use of equipment, safe patient transfers and how to physically support the patients so that they do not hurt themselves or the patient	97.4	Carers	Education
3.	Carry out reviews for family members acting as carers to ensure that they are coping	96.4	Clinicians & Carers	Review and supervision
4.	To have home visits from a community dementia nurse in order to identify those at risk, the triggers and signs and any changes in the condition	96.1	Clinicians & Carers	Review and supervision
5.	Carers to attend regular training on all aspects of dementia care and management of certain behaviours	95.4	Carers	Education
6.	Train carers in the basics of giving medication and vital signs check	94.4	Carers	Education
7.	Offer special training in dementia for GPs	94.1	Clinicians	Organization of care & Education
8.	Encourage relatives or carers to attend appointments with the patient	94.1	Clinicians	Family Involvement
9.	Make adjustments and provide safe care in the home environment	93.8	Home environment	Safety proofing
10.	Carers to have regular supervision by a senior person to support them and to identify any additional training requirements	93.5	Carers	Review and supervision

(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)

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