Facilitating planned home death: A qualitative study on home care nurses' experiences of enablers and barriers

Abstract

Aim: The aim of this study was to explore home care nurses' experience of enablers and barriers for planned home death in municipal health care. Design: A focused ethnography. Methods: This qualitative study collected data from 20 semi-structured interviews of home care nurses and 8.5 h of participant observations. Data was analyzed using thematic analysis. Results: The findings in our study show that home care nurses consider supportive cultures, a commitment to safety and continuity when facilitating planned home deaths and family rotations to be enablers for planned home deaths. Barriers to planned home deaths involve a lack of palliative experience affecting confidence, shortages of nurses and medical supplies and night shift challenges. Conclusion: This study underscores the need for supportive organizational cultures, ongoing education and improved communication and staffing policies to enhance the quality of care and the experiences of patients and home care nurses, especially in the context of planned home deaths. Impact: The study adds knowledge to the evidence base of the practice of facilitating planned home deaths. The findings of the study could offer valuable insights for shaping future policies or devising effective implementation strategies. Reporting Method: Adherence to the COREQ guidelines for reporting qualitative research was maintained. Patient or Public Contribution: No patient or public contribution. What Does this Article Contribute to the Wider Global Clinical Community?: Identified enablers and barriers provide a new perspective, contributing to a comprehensive understanding of planning home deaths. The study emphasizes supportive cultures, safety commitment and family rotations as crucial for planned home deaths, guiding healthcare professionals to adopt best practices and enhance palliative care quality.