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Open Access An Exploratory Study of Mandated Safety Measures for Home Visiting Case Managers Étude exploratoire sur les mesures de sécurité obligatoires imposées aux gestionnaires de cas qui font des visites à domicile

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Abstract:

The purpose of this qualitative focus group study was to assess staff perceptions of the implementation and effectiveness of safety measures mandated for home visiting case managers. A participatory action research framework was used to conduct 5 focus groups of case managers employed by a state mental health system in the United States. The participants were employed by a program to provide case management for the severely and persistently mentally ill in the community. Safety measures instituted after the homicide of a visiting case manager were found to be effective in some agencies but not in others. There was variability between agencies in the strictness with which safety protocols, accountability procedures, accompanied visits for high-risk situations, and training were implemented. Contextual factors influenced perceptions of safety. Mandatory safety measures for home visiting health workers may be feasible but further research is necessary to explore risks and contextual factors.

French
Cette étude qualitative avait pour but d'évaluer les perceptions des gestionnaires de cas à l'égard de la mise en œuvre et de l'efficacité de mesures de sécurité obligatoires destinées à ceux et celles qui font des visites à domicile. Les chercheurs se sont appuyés sur un cadre de recherche-action pour mener cinq groupes de discussion formés de gestionnaires de cas employés au sein d'un programme de services en santé mentale d'un État américain — ces gestionnaires intervenant auprès de personnes souffrant de maladie mentale grave et persistante. Les mesures de sécurité adoptées à la suite de l'homicide d'un gestionnaire de cas en visite sont jugées efficaces par certaines agences, mais pas par d'autres. La rigueur avec laquelle on met en œuvre ces différentes mesures, dont les protocoles de sécurité, méthodes de reddition des comptes, visites accompagnées dans les situations à risque élevé et programmes de formation, varie d'un établissement à l'autre. Par ailleurs, certains facteurs contextuels pourraient influer sur la perception quant à la sécurité. Imposer des mesures de sécurité à tous les prestateurs de soins à domicile est une solution envisageable, mais il faudra entreprendre d'autres recherches pour analyser les risques et les facteurs en jeu.

Keywords: CASE MANAGEMENT; COMMUNITY HEALTH NURSING; HOME VISITING; MENTALLY ILL PERSONS; WORKPLACE VIOLENCE

Document Type: Research Article

Publication date: December 1, 2007

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