Experiences of hospitalised homeless adults and their health care providers in OECD nations : a literature review

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.