Two recent studies of nursing homes and home-based care emphasize how communication breakdowns between care team members can undermine patient safety.

A Swedish study of 112 assistant nurses in nursing homes found these frontline caregivers serve as crucial safety monitors, describing themselves as “the nurse’s eyes and ears” for patient well-being. The assistant nurses reported observing residents for medication side effects and health changes, then reporting concerns to registered nurses. However, the study revealed a significant disconnect: 81% of assistant nurses rarely or never participate in ward rounds with doctors, primarily because they aren’t invited to these medical team meetings.

This exclusion occurs despite assistant nurses expressing strong interest in attending ward rounds and having valuable patient observations to contribute. The research also uncovered knowledge gaps in assistant nurses’ understanding of drug-related problems and potentially inappropriate medications — gaps that became more evident when responses were compared with objective knowledge assessments. While assistant nurses generally felt confident about their medication knowledge, more detailed questioning revealed areas where additional training could improve patient safety.

The study found that 75% of assistant nurses had suspected medication side effects in residents, and 83% had reported these concerns to nurses, demonstrating their active role in safety monitoring.

Supporting findings came from a separate home-based care review found that clear communication, well-defined roles and personnel continuity are essential for successful care arrangements among nurses, care recipients and family caregivers. When the same nurses work consistently with families, trust develops and care quality improves.

The home-based care review also revealed that family caregivers often feel burdened by having to adjust their personal schedules around nursing visit times. Researchers found that families initially resist professional nursing support, but trusting relationships can develop when nurses provide proactive education about health conditions and maintain consistent staffing. Frequent staff changes, conversely, leave families feeling anxious and uncertain about their care quality.