The nature of safety problems among Canadian homecare clients: evidence from the RAI-HC reporting system

J Nurs Manag. 2009 Mar;17(2):165-74. doi: 10.1111/j.1365-2834.2009.00974.x.


Aim(s): The purpose of this study was to identify the nature of patient safety problems among Canadian homecare (HC) clients, using data collected through the RAI-HC((c)) assessment instrument.

Background: Problems of patient safety have been well documented in hospitals. However, we have very limited data about patient safety problems among HC clients.

Method(s): The study methodology involved a secondary analysis of data collected through the Canadian home care reporting system. The study sample consisted of all HC clients who qualified to receive a RAI-HC assessment from Ontario, Nova Scotia and Winnipeg Regional Health Authority for the 2003-2007 reporting period. There were a total of 238 958 cases available for analysis; 205 953 from Ontario, 26 751 from Nova Scotia and 6254 from Winnipeg Regional Health Authority.

Results: New fall (11%), unintended weight loss (9%), new emergency room (ER) visits (7%) and new hospital visits (8%) were the most prevalent potential adverse events identified in our study. A small proportion of the HC clients experienced a new urinary tract infection (2%).

Conclusion(s): Understanding clients' risk profiles is foundational to effective patient care management.

Implications for nursing management: We need to begin to develop evidence about best practices for ameliorating safety risk.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Home Care Services*
  • Humans
  • Male
  • Manitoba
  • Medical Errors / prevention & control*
  • Middle Aged
  • Nova Scotia
  • Ontario
  • Risk Assessment
  • Risk Management* / statistics & numerical data
  • Safety*