Search

Background Links among homelessness, poor health and frequent hospitalisation are familiar to health services worldwide. Despite this, limited research has explored hospital-based Registered Nurses’ perspectives of homelessness healthcare. Aim This study explored the perspectives of hospital-based Registered Nurses, regarding provision of person-centred care for people who are homeless. Methods Interviews were conducted with twelve Registered Nurses working in a tertiary metropolitan hospital. Interview transcripts were analysed using a deductive thematic approach guided by Deci and Ryan’s self-determination theory (SDT). Findings Five themes emerged regarding provision of person-centred care for people who are homeless. First, people who are homeless frequently access the hospital as a safe place. Second, nurses often perceive homeless health problems as multifaceted and difficult to manage. Third, stigma creates a barrier to the delivery of hospital-based homelessness healthcare. Fourth, it is important to provide people who are homeless with a sense of choice. Fifth, there is a lack of suitable discharge options and connection between the hospital and community services. Discussion If care pathways within a hospital are not designed to adequately address the complex needs of people who are homeless, they are vulnerable to frequent re-admissions and extended lengths of stay. A non-judgmental attitude and providing a sense of choice are important approaches for hospital-based Registered Nurses when working with people who are homeless. Conclusion Hospital-based homelessness healthcare presents many challenges. The perceptions of Registered Nurses provide insight into the daily experience of caring for people experiencing homelessness within a hospital setting.

Problem Throughout the world people who are homeless experience high rates of hospitalisation. Nurses who work in hospitals have the potential to improve outcomes for this group. To date, a review of qualitative literature pertaining to hospital-based nursing for people who are homeless has been lacking. Aim To synthesize findings of contemporary qualitative studies related to hospital-based nursing care for people who are homeless in Organisation for Economic Cooperation and Development (OECD) nations. Design A systematic database search was conducted in mid-2017 using search terms: homeless*, hospital* and nurs*, combined by the Boolean operator ‘AND’. Inclusion and exclusion criteria that mandated publication year, language, method, quality, participants, and setting were applied. 341 abstracts were screened for relevancy resulting in the final inclusion of 8 qualitative and 2 mixed method studies. Findings Three overarching themes emerged; (1) Homelessness challenges rigid approaches to hospital-based care (2) Stigma impedes healthcare for people who are homeless (3) Hospitals can provide a platform to address homelessness. Discussion Delivering flexible, non-stigmatising nursing in a way that empowers people experiencing homelessness challenges hospitals around the globe. Research is needed to explore local approaches and subgroups within the homeless population. Conclusion Experiences of homelessness vary across nations and between cities necessitating local solutions. Within hospitals, if nurses can provide flexible, non-stigmatising care, they have potential to make a huge difference both the lives of individuals who are homeless and in the wellbeing of society as a whole.

In the absence of an effective vaccine and/or treatment, COVID-19 remains pandemic. It is only public health measures, such as social distancing (and these included school closures), that have prevented millions of infections and deaths. School closures followed a precautionary principle in that many previous epidemics (e.g. influenza) were mainly transmitted by children. This is supported by few studies and yet, these closures have significantly impacted parents and children. We are now in September 2020, with public health restrictions being lifted in an attempt to attenuate the negative economic impact of the pandemic. The easing of restrictions has led to a resurgence of COVID-19 in a second wave of infections. In the meantime, summer school holidays are coming to an end in the northern hemisphere and it is salutary to review the effects on viral surges due to school openings thus far. This review shows that as schools open, outbreaks that affect both pupils and staff occur probably due to failure to adhere to public health principles: hand washing, distancing etc. Reopenings should clearly be done slowly and cautiously so as to control potential COVID-19 outbreaks before they get out of hand. Reopenings may also require targeted closure of other establishments/facilities (such as restaurants and shops) so as to keep the locality's COVID-19 reproduction rate below 1.