Home care nurses' and managers' work environment during the Covid-19 pandemic: Increased workload, competing demands, and unsustainable trade-offs.

Little research exists on how home care nursing personnel have experienced the Covid-19 pandemic. This qualitative study explores the work environment related challenges nurses and managers in home care faced during the pandemic. We discuss these challenges in relation to the Demand-Control-Support Model and reflect on how the organizational dynamics associated with them can be understood using the competing pressures model. During the pandemic, home care nurses and managers experienced both an increased workload and psychosocial strain. For managers, the increased complexity of work was a major problem. We identify three key takeaways related to sustainable crisis management: 1) to support managers' ability to provide social support to their personnel, 2) to increase crisis communication preparedness, and 3) to apply a holistic perspective on protective gear use. We also conclude that the competing pressures model is useful when exploring the dynamics of the work environment in complex organizational contexts.

Safety-II and the study of healthcare safety routines: Two paths forward for research

Safety routines such as the WHO surgical safety checklist and SBAR have gained widespread attention and implementation in healthcare. However, there has also been criticism. With the ongoing Covid-19 pandemic, the need for knowledge about how safety routines work in practice is larger than ever. In light of these obstacles, I suggest two approaches to the study of healthcare safety routines, based on a human factors perspective and a safety II mind-set that so far has gained little attention. The WHO surgical safety checklist, is used as an example. However, the suggestions presented here applies to other safety routines as well. The first approach is that instead of being preoccupied with what people do not do, investigate what they value with the routine. The perceived importance of different parts of the routine can expose the rationality behind the personnel's choice of actions when using the routine. Knowledge that could be used both to investigate the dynamics of everyday performance and for redesign and adjustment of the routine. The second approach is that instead of looking for failure, investigate and highlight when the routine works. Examples of when the routine works, i.e. avert adverse events, can be used both as positive reinforcement, and as an opportunity for learning with regards to everyday performance variability. Since a safety-II perspective is largely missing in the literature on healthcare safety routines, the two approaches suggested here comes with a huge potential for learning about how to improve safety. [ FROM AUTHOR] Copyright of Journal of Patient Safety & Risk Management is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Picking low hanging fruit - A scoping review of work environment related interventions in the home care sector.

Home care for elderly people is an important part of the social welfare system. The sector employs many people, especially women, and work environment issues are common. This review explores the scientific literature on organizational interventions that target the home care work environment. Altogether, 16 studies of varying quality met the inclusion criteria. The interventions identified involved organizational change, education and training, digitalization and scheduling. Many interventions were concerned with changing specific behaviors or with introducing new technology rather than tackling complex issues such as sick leave, stress or gender inequality. Employee participation increased the likelihood of success.