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Consensus-Based Safety Recommendations for Informal Home Care: A Mixed Methods Study.

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Τίτλος: Consensus-Based Safety Recommendations for Informal Home Care: A Mixed Methods Study.
Συγγραφείς: Abed N; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain.; Miguel Hernandez University of Elche, Elche, Spain., Neves VR; Federal University of São Paulo, São Paulo, Brazil., Perez VM; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain.; Miguel Hernandez University of Elche, Elche, Spain., Ortola DM; Denia Health District, Alicante, Spain., García VF; Denia Health District, Alicante, Spain., Knezevic B; University Hospital Centre Zagreb, Zagreb, Croatia., Sousa P; Public Health Research Centre, Comprehensive Health Research Center (CHRC), Lisbon, Portugal.; NOVA National School of Public Health, NOVA University, Lisbon, Portugal., Strametz R; Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), RheinMain University of Applied Sciences, Wiesbaden, Germany., Guilabert M; Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain., Mira JJ; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain.; Miguel Hernandez University of Elche, Elche, Spain.; Salud Alicante-Sant Joan Health District, Alicante, Spain.
Πηγή: Research in nursing & health [Res Nurs Health] 2026 Oct; Vol. 49 (5), pp. 543-552. Date of Electronic Publication: 2026 Apr 15.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley Country of Publication: United States NLM ID: 7806136 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-240X (Electronic) Linking ISSN: 01606891 NLM ISO Abbreviation: Res Nurs Health Subsets: MEDLINE
Imprint Name(s): Original Publication: New York, Wiley.
Ιατρικοί όροι (MeSH): Home Care Services*/standards , Patient Safety*/standards , Caregivers* , Consensus*, Humans
Περίληψη: As home-based care expands globally, informal caregivers are responsible for medical and nursing responsibilities, raising serious concerns about safety and risk management. This study proposes expert-informed, safety recommendations tailored to informal caregiving in home settings. The study used a six-phase mixed methods design combining a Consensus Development Conference (CDC) process with elements of Failure Modes and Effects Analysis (FMEA). In the first five phases, 13 healthcare professionals, hereafter referred to as "the professionals" (10 nurses, one physician, one occupational therapist, and one social worker), engaged in deliberations and risk assessments. The professionals agreed on 15 caregiving domains such as medication administration, mobility, and caregiver well-being, mapped them to 53 home caregiving procedures, identified 160 potential failure modes (errors), and rated the effect severity of each failure mode. This process led to the development of an initial set of 450 safety recommendations. In the final phase, a multidisciplinary expert review conducted by the research team merged overlapping items, eliminating redundancies and ensuring accuracy, confirming 53 procedures, 147 distinct failure modes (errors), refining 213 procedure failure mode effect associations, and consolidating the corpus to 288 recommendations. The resulting recommendations are intended to guide the development of safety guidance for informal caregiving in home settings. These recommendations are considered expert-derived guidance, since end users did not participate in the study.
(© 2026 The Author(s). Research in Nursing & Health published by Wiley Periodicals LLC.)
References: Public Health Nurs. 2022 Jul;39(4):876-897. (PMID: 34967458)
Health Technol Assess. 1998;2(3):i-iv, 1-88. (PMID: 9561895)
Res Social Adm Pharm. 2018 May;14(5):418-426. (PMID: 28528023)
Nurs Res. 2023 Nov-Dec 01;72(6):E180-E190. (PMID: 37733650)
Int Wound J. 2023 Nov;20(9):3802-3820. (PMID: 37277908)
Front Public Health. 2022 Aug 24;10:901457. (PMID: 36091500)
Home Healthc Nurse. 2007 Mar;25(3):151-5; quiz 156-7. (PMID: 17353705)
Health Aff (Millwood). 2015 Jan;34(1):21-9. (PMID: 25561640)
Sci Rep. 2025 Jul 8;15(1):24375. (PMID: 40628820)
J Clin Epidemiol. 2014 Apr;67(4):401-9. (PMID: 24581294)
BMC Health Serv Res. 2023 May 10;23(1):467. (PMID: 37165357)
J Appl Res Intellect Disabil. 2020 Mar;33(2):111-125. (PMID: 31390116)
Am J Med Qual. 2022 Nov-Dec 01;37(6):535-544. (PMID: 36250651)
Healthcare (Basel). 2024 May 13;12(10):. (PMID: 38786412)
J Relig Health. 2021 Apr;60(2):787-803. (PMID: 32889677)
Palliat Support Care. 2024 Apr;22(2):236-242. (PMID: 37278216)
Harefuah. 2014 May;153(5):280-4, 304. (PMID: 25112120)
Workplace Health Saf. 2015 Nov;63(11):512-22; quiz 523. (PMID: 26268486)
Implement Sci. 2022 Oct 29;17(1):75. (PMID: 36309746)
BMC Palliat Care. 2025 Sep 26;24(1):230. (PMID: 41013473)
J Patient Saf. 2024 Sep 1;20(6):410-419. (PMID: 39051764)
J Healthc Qual Res. 2023 Nov-Dec;38(6):327-328. (PMID: 37236907)
Res Nurs Health. 2026 Oct;49(5):543-552. (PMID: 41983590)
Front Med (Lausanne). 2024 Nov 05;11:1494771. (PMID: 39564498)
Grant Information: CA22152 COST (European Cooperation in Science and Technology)
Contributed Indexing: Keywords: consensus recommendations; home care; informal caregivers; patient safety; risk management
Entry Date(s): Date Created: 20260415 Date Completed: 20260903 Latest Revision: 20260905
Update Code: 20260905
PubMed Central ID: PMC13539635
DOI: 10.1002/nur.70074
PMID: 41983590
Βάση Δεδομένων: MEDLINE
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  Data: <searchLink fieldCode="AU" term="%22Abed+N%22">Abed N</searchLink>; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain.; Miguel Hernandez University of Elche, Elche, Spain.<br /><searchLink fieldCode="AU" term="%22Neves+VR%22">Neves VR</searchLink>; Federal University of São Paulo, São Paulo, Brazil.<br /><searchLink fieldCode="AU" term="%22Perez+VM%22">Perez VM</searchLink>; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain.; Miguel Hernandez University of Elche, Elche, Spain.<br /><searchLink fieldCode="AU" term="%22Ortola+DM%22">Ortola DM</searchLink>; Denia Health District, Alicante, Spain.<br /><searchLink fieldCode="AU" term="%22García+VF%22">García VF</searchLink>; Denia Health District, Alicante, Spain.<br /><searchLink fieldCode="AU" term="%22Knezevic+B%22">Knezevic B</searchLink>; University Hospital Centre Zagreb, Zagreb, Croatia.<br /><searchLink fieldCode="AU" term="%22Sousa+P%22">Sousa P</searchLink>; Public Health Research Centre, Comprehensive Health Research Center (CHRC), Lisbon, Portugal.; NOVA National School of Public Health, NOVA University, Lisbon, Portugal.<br /><searchLink fieldCode="AU" term="%22Strametz+R%22">Strametz R</searchLink>; Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), RheinMain University of Applied Sciences, Wiesbaden, Germany.<br /><searchLink fieldCode="AU" term="%22Guilabert+M%22">Guilabert M</searchLink>; Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain.<br /><searchLink fieldCode="AU" term="%22Mira+JJ%22">Mira JJ</searchLink>; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain.; Miguel Hernandez University of Elche, Elche, Spain.; Salud Alicante-Sant Joan Health District, Alicante, Spain.
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  Data: As home-based care expands globally, informal caregivers are responsible for medical and nursing responsibilities, raising serious concerns about safety and risk management. This study proposes expert-informed, safety recommendations tailored to informal caregiving in home settings. The study used a six-phase mixed methods design combining a Consensus Development Conference (CDC) process with elements of Failure Modes and Effects Analysis (FMEA). In the first five phases, 13 healthcare professionals, hereafter referred to as "the professionals" (10 nurses, one physician, one occupational therapist, and one social worker), engaged in deliberations and risk assessments. The professionals agreed on 15 caregiving domains such as medication administration, mobility, and caregiver well-being, mapped them to 53 home caregiving procedures, identified 160 potential failure modes (errors), and rated the effect severity of each failure mode. This process led to the development of an initial set of 450 safety recommendations. In the final phase, a multidisciplinary expert review conducted by the research team merged overlapping items, eliminating redundancies and ensuring accuracy, confirming 53 procedures, 147 distinct failure modes (errors), refining 213 procedure failure mode effect associations, and consolidating the corpus to 288 recommendations. The resulting recommendations are intended to guide the development of safety guidance for informal caregiving in home settings. These recommendations are considered expert-derived guidance, since end users did not participate in the study.<br /> (© 2026 The Author(s). Research in Nursing & Health published by Wiley Periodicals LLC.)
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  Data: Public Health Nurs. 2022 Jul;39(4):876-897. (PMID: <searchLink fieldCode="PM" term="%2234967458%22">34967458)</searchLink><br />Health Technol Assess. 1998;2(3):i-iv, 1-88. (PMID: <searchLink fieldCode="PM" term="%229561895%22">9561895)</searchLink><br />Res Social Adm Pharm. 2018 May;14(5):418-426. (PMID: <searchLink fieldCode="PM" term="%2228528023%22">28528023)</searchLink><br />Nurs Res. 2023 Nov-Dec 01;72(6):E180-E190. (PMID: <searchLink fieldCode="PM" term="%2237733650%22">37733650)</searchLink><br />Int Wound J. 2023 Nov;20(9):3802-3820. (PMID: <searchLink fieldCode="PM" term="%2237277908%22">37277908)</searchLink><br />Front Public Health. 2022 Aug 24;10:901457. (PMID: <searchLink fieldCode="PM" term="%2236091500%22">36091500)</searchLink><br />Home Healthc Nurse. 2007 Mar;25(3):151-5; quiz 156-7. (PMID: <searchLink fieldCode="PM" term="%2217353705%22">17353705)</searchLink><br />Health Aff (Millwood). 2015 Jan;34(1):21-9. (PMID: <searchLink fieldCode="PM" term="%2225561640%22">25561640)</searchLink><br />Sci Rep. 2025 Jul 8;15(1):24375. (PMID: <searchLink fieldCode="PM" term="%2240628820%22">40628820)</searchLink><br />J Clin Epidemiol. 2014 Apr;67(4):401-9. (PMID: <searchLink fieldCode="PM" term="%2224581294%22">24581294)</searchLink><br />BMC Health Serv Res. 2023 May 10;23(1):467. (PMID: <searchLink fieldCode="PM" term="%2237165357%22">37165357)</searchLink><br />J Appl Res Intellect Disabil. 2020 Mar;33(2):111-125. (PMID: <searchLink fieldCode="PM" term="%2231390116%22">31390116)</searchLink><br />Am J Med Qual. 2022 Nov-Dec 01;37(6):535-544. (PMID: <searchLink fieldCode="PM" term="%2236250651%22">36250651)</searchLink><br />Healthcare (Basel). 2024 May 13;12(10):. (PMID: <searchLink fieldCode="PM" term="%2238786412%22">38786412)</searchLink><br />J Relig Health. 2021 Apr;60(2):787-803. (PMID: <searchLink fieldCode="PM" term="%2232889677%22">32889677)</searchLink><br />Palliat Support Care. 2024 Apr;22(2):236-242. (PMID: <searchLink fieldCode="PM" term="%2237278216%22">37278216)</searchLink><br />Harefuah. 2014 May;153(5):280-4, 304. (PMID: <searchLink fieldCode="PM" term="%2225112120%22">25112120)</searchLink><br />Workplace Health Saf. 2015 Nov;63(11):512-22; quiz 523. (PMID: <searchLink fieldCode="PM" term="%2226268486%22">26268486)</searchLink><br />Implement Sci. 2022 Oct 29;17(1):75. (PMID: <searchLink fieldCode="PM" term="%2236309746%22">36309746)</searchLink><br />BMC Palliat Care. 2025 Sep 26;24(1):230. (PMID: <searchLink fieldCode="PM" term="%2241013473%22">41013473)</searchLink><br />J Patient Saf. 2024 Sep 1;20(6):410-419. (PMID: <searchLink fieldCode="PM" term="%2239051764%22">39051764)</searchLink><br />J Healthc Qual Res. 2023 Nov-Dec;38(6):327-328. (PMID: <searchLink fieldCode="PM" term="%2237236907%22">37236907)</searchLink><br />Res Nurs Health. 2026 Oct;49(5):543-552. (PMID: <searchLink fieldCode="PM" term="%2241983590%22">41983590)</searchLink><br />Front Med (Lausanne). 2024 Nov 05;11:1494771. (PMID: <searchLink fieldCode="PM" term="%2239564498%22">39564498)</searchLink>
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