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Cited by 79Nursing education and managementNursing Roles and PracticesGeriatric Care and Nursing Homes

Optimization of home care nurses in Canada: A scoping review

Open access
Ganann, Rebecca, Weeres, Annette, Lam, Annie, Chung, Harjit, Valaitis, Ruta·2019·Health & Social Care in the Community
DOI 10.1111/hsc.12797PMC PMC6851676
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Abstract

Nurses are among the largest providers of home care services thus optimisation of this workforce can positively influence client outcomes. This scoping review maps existing Canadian literature on factors influencing the optimisation of home care nurses (HCNs). Arskey and O'Malley's five stages for scoping literature reviews were followed. Populations of interest included Registered Nurses, Registered/Licensed Practical Nurses, Registered Nursing Assistants, Advanced Practice Nurses, Nurse Practitioners and Clinical Nurse Specialists. Interventions included any nurse(s), organisational and system interventions focused on optimising home care nursing. Papers were included if published between January 1, 2002 up to May 15, 2015. The review included 127 papers, including 94 studies, 16 descriptive papers, 6 position papers, 4 discussion papers, 3 policy papers, 2 literature reviews and 2 other. Optimisation factors were categorised under seven domains: Continuity of Care/Care; Staffing Mix and Staffing Levels; Professional Development; Quality Practice Environments; Intra-professional and Inter-professional and Inter-sectoral Collaboration; Enhancing Scope of Practice: and, Appropriate Use of Technology. Fragmentation and underfunding of the home care sector and resultant service cuts negatively impact optimisation. Given the fiscal climate, optimising the existing workforce is essential to support effective and efficient care delivery models. Many factors are inter-related and have synergistic impacts (e.g., recruitment and retention, compensation and benefits, professional development supports, staffing mix and levels, workload management and the use of technology). Quality practice environments facilitate optimal practice by maximixing human resources and supporting workforce stability. Role clarity and leadership supports foster more effective interprofessional team functioning that leverages expertise and enhances patient outcomes. Results inform employers, policy makers and relevant associations regarding barriers and enablers that influence the optimisation of home care nursing in nursing, intra- and inter-professional and inter-organisational contexts.

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  • A scoping review identified that interaction and communication between health care providers were key contributors to optimizing home care.

    “A scoping review identified that interaction and communication between health care providers were key contributors to optimizing home care [49].”

    From The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping (2023) · cites this paper as [49]

    The Results (Factors influencing optimisation based on each domain; page unavailable) identify opportunities for team interaction and communication and describe poor communication as a barrier. The review, however, examines optimisation of home care nurses in Canada, while the claim broadens this to optimising home care generally. (LLM, conf=0.84)

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Cites

Flagged first, then by citations

1 of the 116 references couldn’t be matched to a known paper.

Research works printed but not linked: 22

  1. Baumann, A., Underwood, J., Blythe, J., Ciliska, D., Ehrlich, A., Akhtar‐Danesh, N., … Dragan, A. (2006). Better data: Better performance; Community health nursing in Ontario (pp. 1– 51). Ontario.
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  5. Canadian Homecare Association. (2011). Home care nursing in Ontario (pp. 1– 8). ON, Canada: Ontario Home Care Association.
  6. Canadian Hospice Palliative Care Association. (2006). The Pan‐Canadian gold standard for palliative home care; Towards equitable access to high quality hospice palliative and end‐of‐life care at home (pp. 1– 20). Ottawa, ON Canadian Hospice Palliative Care Association.
  7. Caplan, E. (2005). Realizing the Potential of Home Care: Competing for Excellence by Rewarding Results: A Review of the Competitive Bidding Process Used by Ontario's Community Care Access Centres (CCACs) to Select Providers of Goods and Services Contributors Elinor Caplan. Toronto, ON: Community Care Access Centres Procurement Review.
  8. Cote, A., & Fox, G. (2007). The future of homecare in Canada; Roundtable outcomes and recommendations for the future (pp. 1– 24). Ottawa, ON: Victorian Order of Nurses Retrieved from http://www.von.ca/future_homecare_report_en.pdf
  9. Dash, A. (2007a). Nursing pioneers. The Registered Practical Nursing Journal, Fall, (pp. 9).
  10. Dash, A. (2007b). Maximizing potential: An innovative workplace initiative has enabled Saint Elizabeth Health Care to make improvements in interdisciplinary collaboration and nursing utilization. Registered Practical Nursing Journal, 8– 8.
  11. Denton, M., Zeytinoglu, I. U., & Davies, S. (2003). Organizational change and the health and well‐being of home‐care workers; Final report (pp. 1– 130). Hamilton, ON.
  12. Doran, D., Hayes, L. J., Nahm, S., Zou, P., Rizk, P., Bai, C., & Laporte, D. (2012). Building and sustaining a quality nursing workforce in home and community care; Interim progress report (pp. 1– 39). Toronto, ON.
  13. Doran, D., Pickard, J., Harris, J., Coyte, P., Macrae, A., Laschinger, H., Carryer, J. (2004). Management and delivery of community nursing services in Ontario: Impact on the quality of care and the quality of worklife of community‐based nurses (pp. 21). Ottawa, ON: Canadian Health Services Research Foundation Retrieved from https://www.cfhi-fcass.ca/Migrated/PDF/ResearchReports/OGC/doran_final.pdf
  14. Hermus, G. (2012). Home and community care in Canada: An economic footprint. Ottawa, ON: ©2012 The Conference Board of Canada https://www.conferenceboard.ca/temp/2974948c-b544-43a4-8626-b17567823d30/12-306_HomeandCommunityCare_PRT.pdf
  15. Home Care Sector Study Corporation. (2003a). Canadian home care human resources study: Final report (pp. 1– 48).
  16. Home Care Sector Study Corporation. (2003b). Canadian home care human resources study: Technical report (pp. 1– 99).
  17. Kushner, C., Baranek, P., & Dewar, M. (2008). Home care: Change we need; Report on the Ontario health coalition's home care hearings (pp. 1– 57).
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  19. Shamian, J., Mildon, B., Goodwin, S., Norton, R., & Talosi, R. (2006). Of systems and side effects: Mobility in home care personnel: Final report (pp. 1– 35). Ottawa, ON.
  20. Underwood, J., Deber, R., Baumann, A., Dragan, A., Laporte, A., Alameddine, M., & Wall, R. (2009). Demographic profile of community health nurses in Canada 1996–2007 (pp. 1– 51). Hamilton, ON: McMaster University, Nursing Health Services Research Unit.
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Authors
Ganann, R., Weeres, A., Lam, A., Chung, H., & Valaitis, R.
Affiliations
  • McMaster University (CA)
  • Registered Nurses' Association of Ontario (CA)
Corresponding author
Ganann, Rebecca
ORCID
Venue
Health & Social Care in the Community
Publisher
Wiley
Published
2019-06-24
Volume
27
Issue
5
Pages
e604-e621
ISSN
  • 0966-0410 (ISSN-L)
  • 1365-2524
DOI
10.1111/hsc.12797
PMC
PMC6851676
OpenAlex
W2955520425
Cited by
79
References
116
Citations by year
2026: 8 · 2025: 9 · 2024: 25 · 2023: 8 · 2022: 11 · 2021: 16 · 2020: 2
FWCI
1.47
Type
journal article
Language
en
Open access
Licence
Locations
  • Health & Social Care in the Community (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Research and Theory › Nursing education and management
  • Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
home care nursing, staffing levels, professional development, interprofessional collaboration, scope of practice, nursing technology, nurse recruitment and retention, nursing pay, workload management, continuity of care
MeSH terms
Canada, Clinical Competence, Community Health Nursing, Community Health Services, Home Care Services, Humans, Leadership, Public Health Nursing, Decision Support Systems, Clinical

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