When we think of patient safety we automatically think of hospitals and yet the reality is that a significant part of a patient’s care is managed at home either by themselves or by family members who become their carers. Patient safety doesn’t start or end at the hospital door; it extends into our homes, where people continue their recovery, manage chronic conditions, or receive ongoing care.
Our homes are usually places of comfort and familiarity, but they can also be risky environments and have hazards we are not really aware of until we become ill or frail. Our homes present unique challenges when it comes to maintaining patient safety. We might be recovering from surgery, managing a chronic illness, or receiving post-treatment care. Patients and their caregivers play a crucial role in ensuring safety outside the structured environment of a healthcare facility.
Key aspects of patient safety at home:
- Medications:
- The medications we are on, especially if we are on a few, can be confusing. What are they for, what are they called, when are they taken and so on. All of this is not helped when the medications prescribed often come in different boxes or are from different manufacturers or may be different colours, shapes and sizes despite being the same medication. In patient safety we talk a lot about design and designing out error. This variation is increasing the chance of taking the wrong dose, missing a dose or taking the wrong medication at the wrong time.
- Falls:
- I know from very personal experience about the impact of falls, especially to the frail and elderly patients. Falls are a significant risk, and can result in serious harm. We often put in simple modifications, such as installing handrails, removing trip hazards, and ensuring adequate lighting, after the event. Being proactive in this instance is much more important. Falls prevention should be one of our top priorities in healthcare.
- Infection Control:
- Clearly maintaining a clean environment is crucial for infection control, but this is not always as easy as it sounds in our homes. Regular handwashing obviously but what about things like proper disposal of medical waste? What about patients who are unable to clean their houses because of a particular illness or treatment.
- Communication with healthcare providers:
- We are not very good at speaking up at the best of times. Certain generations who are at most risk really don’t ‘want to bother anyone’ when it comes to receiving care or help at home. How can we ensure that patients are given the opportunity to talk about what they need and who is obligated to meet those needs?
- Emergency preparedness:
- For certain patients, those at risk of heart attacks or stroke or those having chemotherapy for example may need to access emergency care quickly. This includes knowing how to access emergency services, having a list of emergency contacts, and ensuring that necessary information is readily available. Simply keeping a list of medications and the treatments or medical history within easy reach will help.
- Nutrition and hydration:
- How many times have you heard ‘they didn’t want to eat and drink because it meant moving’, they didn’t want to drink because it meant they had to go to the toilet more frequently’. Proper nutrition and hydration are clearly fundamental to recovery but also to overall well-being. Patients who are dehydrated get confused, they also can get dizzy and fall more easily. The same if they haven’t eaten enough. There are many consequences of not eating or drinking properly.
These are just a few of the considerations that I will be exploring over the coming weeks.
Conclusion:
Patient safety at home is rarely if ever talked about. I think it is vital we start the conversation now. It is not about preventing patients from accessing healthcare when they need it – that is still extremely important. But… If we can prevent patients from experiencing incidents or accidents at home, if we can help patients and their carers provide care in the comfort of their home surrounded by everything they are familiar with, if we can reduce the number of patients that need to go into hospital unnecessarily then this can only be a positive thing. Caring at home has unique challenges and I think we need to study that and help contribute to better outcomes and improved quality of life for patients.
PATIENT SAFETY NOW 