Categories and subcategories obtained from participants’ statements regarding the concept of patient safety in home care
| Categories | subcategories | Participants’ statements |
| Risk assessment and prevention | Identifying risks Assessing the severity of the risk Risk prevention | NU 2: The home environment is full of hazards. The nurse should be able to quickly identify the hazards in the patient’s environment at any time and have a suitable solution for him/her. NU 3: I am always aware of the patient. Whenever something happens to him, I have to identify it before it occurs and find a way to prevent it. FA 5: Some nurses start to look around the patient’s bed from the very beginning when they enter our home, and if they see, for example, the bed endangers the patient, they tell me to change it immediately. |
| Team-participatory care | Family cooperation and participation Nurse cooperation and participation Patient cooperation and participation Home care centre cooperation Insurance cooperation | NU 1: The role and cooperation of the family is very important. If the family does not cooperate, in many places you cannot care, and maintain the patient’s safety. On the other hand, you have to cooperate with the family, it is a two-way process. NU 2: Many families take on a lot of work themselves. They are very involved in the work. Because it is not possible single-handedly. FA 6: The center should be able to cooperate with me whenever I cannot provide medicine for the patient and/or medical equipment so that I can keep the patient safe. Insurance should also work with me to approve the patient’s prescription. PT 7: I work with my nurse a lot to get well soon. It’s important for me to do whatever she says. |
| Safety culture | Organisational Learning Team work Open communication Non-punitive feedback and response to error Common understanding of the importance of safety | NU 2: Sometimes we have a good supervisor and if I tell him my problem, he provides me with what I need quickly; and I see, for example, the person in charge of the equipment comes quickly and fixes the ventilator. I am comfortable in terms of patient safety in such circumstances. NU 1: I say that nurses should be constantly trained and all of them should always know the importance of safety and what it means and give it priority. The center should regularly hold training classes for safety, similar to a hospital. FA 5: Once I remember the nurse gave a wrong drug to my patient. She begged me not to tell the center because she would be fired. If she talks about her problems to the physician and supervisor, they would tell her what to do and the patient would be safe. |
| Multidimensional safety | Environmental safety Equipment safety Pharmaceutical safety Psychological safety Economic safety Body and soul safety | NU 3: The first thing that matters to me is the life of the patient and the patient himself. Also, one of my most important principles in patient safety is the patient’s peace of mind and communication with him. FA 5: It is very important for the patient to be able to afford it. Sometimes it happens that my patient needs a certain medicine and I cannot buy it because of its high cost. FA 6: The nurse should be able to hold the equipment in a way that it is not damaged. She should train me even how to take care of it so that it is less worn out. On the other hand, the nurse should know how to inject the medicine so that the patient is not harmed. PT 8: I want my bed to be comfortable so that the bed does not bother my back. I should not be in front of the window when the wind blows because I’ll catch a cold. My bed should be in a corner so no one hits the oxygen concentrator. |
| Antecedents of patient safety in home care | Commitment of members Adequate resources and its proper use Controlled environmental conditions Support of affiliated centres (centre, hospital and insurance) Patient self-efficacy Competence of care providers | NU 2: It doesn't matter whether it’s me or my family, we should all pay attention to safety. Even the center itself or the hospital with which it has a contract should pay special attention to this issue. NU 3: From the beginning of entering the house, one should pay attention to the environment around the house and control the dangerous environment for safe care. FA 4: My insurance should support me so that I can provide the necessary facilities to my patient. PT 9: I always tell myself that if I want I can do it, I can get better, get up sooner and try to avoid any problems. NU 1: This means that the nurse or the conscientious assistant nurse should always consider ethics. The nurse should be knowledgeable and use the nursing skills well. She should be very up-to-date. On the one hand, she should be able to take care of the home environment and she should manage a seriously ill patient well and control problems. FA 4: Some nurses know how to manage well. Apparently, those who have higher experience are better in this management. I think the knowledge and experience of the nurse is very important. PT 7: The presence of skilled nurses calms me down. Then, I think a good and kind nurse knows how to work. My nurse knows how to work. She is experienced. She treats me patiently. NU2: During the time of Corona, the center should have provided more support and should have provided us with tools and equipment and sufficient personal protective equipment. FA5: It was very difficult to follow the infection control protocols so that the patient would not get corona at home, but we tried our best. |
| Consequences of patient safety in home care | Maintaining the safety and comfort of the patient Maintaining the safety and comfort of the family Maintaining the safety and comfort of the nurse Patient healthcare improvement | NU 2: For me, the nurse can bring peace and security so that there is no problem for anyone to complain to me about. FA 6: I feel comfortable with my wife, who has no problem, and I feel comfortable with myself. PT 8: It’s very important that something happens and then I get better. I want to get well soon. |
FA, family caregiver; NU, nurse; PT, patient.