Background Near-miss recognition is important in home-visit nursing because it enables patient-safety risks to be identified before they reach older clients in less regulated home environments. This study investigated factors related to near-miss recognition among home-visit nurses caring for older adults and visualized these factors using quantitative content analysis. Methods A cross-sectional anonymous online questionnaire was conducted among home-visit nurses in Japan with at least 3 years of experience. Of 237 collected responses, 177 were valid and included in the analysis. Participants reported the patient-safety risk category and provided free-text descriptions of factors related to near-miss recognition. Japanese text was analyzed using KH Coder in two steps: automatic word-frequency extraction followed by manual vocabulary refinement. A co-occurrence network was generated using the Jaccard index. Results Near-miss recognition was frequently reported in medication management, visit scheduling, and physical assistance. The co-occurrence network highlighted four factors: client participation in medication management, team-based sharing of visit schedules, physical assistance via comprehensive observation, and experience-based sensitivity to subtle incongruity. Recognition involved procedural actions and experience-based judgments. Participants monitored clients’ residual capacities and residential environments to ensure patient safety. Conclusions Near-miss recognition in home-visit nursing for older adults was supported by client participation, team-based sharing, comprehensive observation, and experience-based sensitivity. These results suggest the need to compare near-miss recognition across various care settings and translate experience-based judgment into explicit knowledge to support patient safety for novice home-visit nurses.
HAIDA et al. (Wed,) studied this question.