Community-health nursing practice is a pivotal aspect of present-day health reforms. In Quebec, Canada, the recent introduction of a population-based approach has entailed increasing the resources allocated to health promotion and disease prevention. Semistructured interviews were conducted with nurses and managers (N = 69) in an effort to understand how these new resources are reflected in nursing practice. Three classes of factors emerged as key conditions for change: contextual and historical, training and professional-development, and work-organization factors. The authors propose courses of action respecting these conditions to provide support for community-health nursing practices that incorporate a contemporary population-based approach.
Patient safety is an important global issue. While it is well known that patients can suffer from adverse events in nursing care, there is a lack of knowledge as to how they experience them.
To examine adverse events in nursing care as they are experienced by patients and relatives.
This was a retrospective study taking both a qualitative and a quantitative approach. It was based on data regarding 242 adverse events in nursing care, as reported by patients and relatives to Sweden's Medical Responsibility Board, content analysis was used to analyse the reports.
Patients' and relatives' experiences were analysed into four categories of adverse events, as concerning participation, clinical judgement, nursing intervention and the essentials of care.
The reports were classified by the Medical Responsibility Board, without a standardized system. The adverse events reported were few in number and were reported by patients and relatives only.
Lack of participation has negative consequences and contributes to adverse events. Adverse events occur through missed care as well as through carer errors.
Nurses need to improve their skills that support patient participation. Patient participation needs to be incorporated into nurses' duties.
Resources for patients to participate in their own care needs to be a priority underpinning policy-making in health systems. Nursing education systems need to teach students about the value and benefits of involving patients in their care.