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Employing a participatory approach, the purpose of this paper is to identify possible areas for improvement in visiting nurses’ post-hospital medication management and to facilitate suggestions for changes in future practices.

Based on a previous study on visiting nurses’ post-hospital medication management, two workshops were conducted in a visiting nurse department in a Danish municipality.

The visiting nurses emphasised knowledge of patients’ basic needs and prioritised their performance of context-specific nursing assessments, with a preventive focus as a prerequisite for improved patient safety in post-hospital medication management.

The participatory approach can increase the acceptability and feasibility of changes regarding future practices and thereby reduce the gap between official documents and daily practice. Although the local development of suggestions for changes in practices does not provide general knowledge, a subsequent detailed description of the changes in practices can promote transferability to other healthcare settings after local adjustments are made.

Flexible home healthcare, with stable relationships enabling the continuous assessment of the patient’s needs and symptoms, along with subsequent adjustments being made in care and medical treatment, might enhance patient safety in post-hospital medication management.

This paper adds to the knowledge of the need for integrated care in medication management in patients’ homes. It argues for primary healthcare professionals as “experts in complexity” and suggests a reconsideration of the purchaser-provider division of care to patients with unstable health conditions and complex care needs during the first days following hospital discharge.

Home visiting is a strategy widely implemented to support families following the birth of a baby. There is a broad consensus that home visiting programmes are successful. But there is little understanding of factors moderating this success. The purpose of this paper is to examine the relationship between maternal involvement in a nurse home visiting programme, maternal depression, and adjustment to the parenting role.

A retrospective design was employed in which the medical records of 40 mothers who had been enroled in a nurse home visiting programme were examined. The number of nurse home visits from birth to six months, maternal depressive symptoms, Home Observation for Measurement of the Environment (HOME) and responsivity scores were examined. Mothers had been selected for the programme if they had a history of mental illness, were in a violent relationship, or reported drug or alcohol problems.

A significant, positive relationship was found between maternal involvement, positive HOME environment and maternal responsivity scores. Furthermore, the mothers with the highest scores for HOME environment and responsivity to their infant ' s cues at six months were mothers experiencing deteriorating symptoms of depression. These mothers had the highest levels of involvement with the programme. Despite their mothers’ deteriorating mental health, infants whose mothers received the greatest number of visits from a nurse received the greatest benefit ameliorating their risk for developing poor attachment and impaired behavioural, emotional and cognitive development.

This is the first study to examine the relationship between changes in maternal depression and programme outcomes in a home visiting programme. It is one of the first explorations of the relationship between maternal involvement and programme outcomes in a targeted nurse home visiting programme to prevent child maltreatment. The findings from this study are critical to future home visiting programme development and evaluation.

Discusses Nottingham’s approach to developing a public health role explicitly alongside traditional health visiting. Argues that their approach makes significant improvements to the health status of a selected deprived area.

The aims of this paper are to determine the state of visiting for women in the English prison system and to explore the relationship between women's mental health and visits in prison.

For the purpose of this paper the authors conducted a review of the literature. All literature published from 1983 onwards was included to coincide with the introduction of Pat Carlen's (1983) campaigning group Women in Prison (WIP). The review focused on all literature from England and Wales to reflect the National Criminal Justice System and used an inclusion criteria to achieve this.

The review revealed key themes including visit rejection, the importance of visits for maintaining identity and the contradicting emotions that women in prison experience when visited.

Social relationships and family ties are protective factors for prisoners' mental wellbeing, yet the number and frequency of visits to offenders in custody has declined. The potential role for prison visiting schemes to improve the mental wellbeing of women in custody is explored, including the implications for the education and training of staff and visitors involved in the visiting process.

Nurse home visiting programmes designed to reduce the likelihood of child maltreatment in families at risk have been widely implemented in Australia and overseas. The purpose of this paper is to examine the intensity and duration of maternal involvement in a nurse home visiting programme to prevent child maltreatment.

A retrospective, longitudinal design was employed. The clinical records of 40 mothers who had received nurse home visits following the birth of a new baby for at least six months, and had provided consent for their details to be accessed for research purposes, were selected for analysis. The influence of antenatal characteristics and well-being on maternal involvement in a nurse home visiting programme was examined using reliability of change indices.

Mothers with impaired family functioning reporting they experienced violence at home were more likely to leave the programme early and received fewer than the prescribed number of home visits compared to mothers who had been enroled into the programme for other complex psychosocial needs. At the same time, mothers enroled on the basis of impaired psychological functioning and who did not report violence in the home remained, and received more than the prescribed number of home visits over the course of their involvement.

Results showed that domestic violence increased the risk of poor engagement with a targeted nurse home visiting programme. At the same time, home visitors responded to complex individual and family needs by increasing the number of home visits accordingly. This theoretically based pilot research has helped to disentangle antecedents of maternal involvement and the subsequent impact on programme outcomes. Further investigation using a larger study sample is needed.

Child and family health (CAFH) services in Australia initially provide at least one nurse-home-visit following the birth of a child. Planning and referral then commences for the on-going provision of appropriate services to families. Unfortunately, services in rural and regional communities in Australia can be fragmented and poorly resourced. Little is known about CAFH nurses’ experiences of working with families in these communities. The purpose of this paper is to examine the way CAFH nurses work within a universal health service model that may be compromised by isolation, discontinuity and fragmentation.

Focus groups with 26 CAFH nurses from five rural, two regional and one urban community in New South Wales (NSW), Australia were conducted. A secondary, thematic analysis of the qualitative data were undertaken to reflect on change and continuity in the field of universal CAFH services. Analysis was driven by two key research questions: How do CAFH nurses experience their role in universal home-based CAFH services within rural and regional areas of Australia and, what unique factors are present in rural and regional areas that impact on their CAFH nursing role?

The experience of the CAFH nurses as presented by these data revealed a role that was family centred and concerned for the welfare of the family, yet compromised by the need to meet the disproportionately complex needs of families in the absence of a strong network of services. The opportunity to present the findings provides insight into the way in which families engage with available services in isolated communities. CAFH nurses in the study attempted to maintain service integrity by adapting to the unique context of their work.

It is important to understand the mechanisms through which CAFH nurses operate to work effectively with families referred to their service. This paper describes the way in which CAFH nurses work with families not meeting the threshold for more intensive and targeted home-visiting service delivery in rural and regional communities of NSW, Australia.

Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not suitable in the management of hospitals due to its peculiar nature of operations. This study investigates the conundrum of bureaucratic processes and health-care service delivery in government hospitals in Nigeria.

The study surveyed 600 outpatients and attendees visiting tertiary and government hospitals in Nigeria using descriptive design to obtained data from the respondents. A research instrument, questionnaire, was used to gather data. Out of the 600 outpatients visiting the 20 hospitals in government and tertiary hospitals, 494 responses were returned from the attendees. The study employed random sampling strategy to collect the information.

The findings of this study were that service delivery in government hospitals were in adverse position on all the four constructs of bureaucratic dimensions as against quality of service delivery in hospitals in Nigeria. It discovered that bureaucratic impersonality cannot impact on the quality of service delivery in government hospitals in Nigeria. Separation and division of labour among health workers have no significant effect on quality service delivery in government hospitals. Formal rules and regulations (administrative procedure, rules, and policies) prevent quality service delivery in government hospitals in Nigeria. Also, patient’s waiting time was not significant to the quality of service delivery in government hospitals.

The results are constrained with dimensions of bureaucratic processes. Thus, the implication of this study is that bureaucracy in the Nigerian public hospitals is an unnecessary marriage which should be carefully separated and de-emphasised for quality service delivery in the hospitals to thrive.

Largely, this study is practical essential as it unearths the irrelevant operations procedure that hinder progress in Nigerian hospitals.

The study accomplishes recognised importance to survey how bureaucracy impedes quality service delivery in government hospitals. This study has provided a vital clue to elements that will bring rapid attention to patients’outcome in Nigerian hospitals and health-care facilities which hitherto has not been emphasised. The study has contributed to the existing body of knowledge associated to healthcare service quality in developing country.

The study reported here aimed to evaluate the impact on parenting and the home environment of community volunteer home visiting offered during or soon after pregnancy to potentially vulnerable mothers. A cluster‐randomised study allocated Home‐Start schemes to intervention or comparison (existing services) conditions. Mothers were screened at routine health checks. Families in intervention and comparison areas were assessed at two and 12 months. The results showed that comparing families receiving support and those in comparison areas, there were few differences. There was a greater reduction in parent‐child relationship difficulties for supported families, but they offered their children fewer healthy foods. There was no evidence of enhanced parenting, organisation of the home environment or more appropriate use of health services. Comparing families receiving support with a second comparison group, living in intervention areas but not receiving support, no differences were found. The article concludes that a more structured approach may be required to make changes in parenting behaviour and the home environment.

In the UK, both anecdotal and research evidence points to ever greater and more sophisticated use of the Web to provide health information and advice. The study reported here adds to this research with an online survey of Internet users’ reported use of the Web to access information about health and their opinions about the advice that can be obtained there. Over a period of three weeks more than 1,300 people responded to an online questionnaire produced by The British Life and Internet Project; 81 per cent or 997 of the respondents were British. The prime purpose of the questionnaire was to obtain information on the characteristics of the users of health information Web sites, to obtain feedback regarding for what they used online health sites and what were the perceived outcomes associated with using online health information.

In this study, the authors investigate a different routing and scheduling problem in the field of home health care (HHC) management system. The purpose of this paper is to route and schedule the workday of health workers, assign the patients to suitable health workers, make accurate decisions to minimize costs, provide timely services and, in general, enhance the efficiency of HHC centers.

A mixed-integer linear programming model is developed to assign health workers to patients. The model considers health professionals with different skills, namely nurses and physicians. Additionally, three groups of patients are considered: patients who need a nurse, patients who need a physician and patients who need both. In the third group, the nurse must be present at the patient’s home following the physician’s visit in order to perform the required tasks.

The results of this study show a reduction in costs which results from the fewer health workers employed and dispatched in comparison with traditional approaches. With the help of our solution approach and model, HHC centers may not only successfully reduce their costs but also manage to meet their patients’ demands by assigning suitable nurses and physicians.

Previous studies have often focused on problems involving only one group of health professionals and rarely address problems involving multiple groups. The authors consider this a shortcoming, because in many cases, patients should be visited several times and by various health professionals.