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There is growing recognition that patients can and should be engaged in the identification of patient safety incidents arising during their experiences across health systems. In this article, we describe the benefits that can be harnessed from engaging patients in reporting patient safety incidents; identify opportunities to support patient engagement in reporting and learning from patient safety incidents; and describe the potential role of health leaders in connecting patient experience and patient safety using patient-reported patient safety incident data.

Background Building research capacity in nursing academic units continues to be a challenge. There are a number of external contextual factors and internal factors that influence individual faculty as well as the collective to engage successfully in research.Purpose The overall aim of this opinion article is to provide an overview of the current external and internal, processes and structures, relevant to capacity of nursing faculty to engage in research.Methods To inform the external context, we reviewed national research funding trends for nursing. To inform the internal context, we provided an exemplar of the internal processes and structures designed to support research capacity building within our academic unit.Results Canadian Institutes of Health Research funding trends for research grants led by nurse principal applicants increased between 2010 and 2013, followed by a steady decline. In 2017 to 2018, there were only 24 research grants led by nurse principal applicants. These external challenges coupled with the traditional internal barriers, such as the imbalance between teaching and research time, threaten research capacity for nursing academics.Conclusion Organizational strategies to promote research capacity within academic nursing units are a necessary requirement to move forward.

Background:Most prelicensure nursing students receive little to no training in providing care for patients who receive epidural analgesia, despite exposure in clinical settings and the potential for devastating adverse effects. To develop and pilot an epidural workshop for senior nursing students using standardized patients (SPs), and to evaluate feasibility and learner outcomes.Method:A 4-hour epidural workshop consisted of a large group lecture and demonstration, small-group practice scenarios, and individual learner evaluation with SPs. Learning outcomes were evaluated using a performance checklist and critical thinking rubric, and pre- and posttests.Results:Participants scored well on the performance-based evaluation (mean score of 86% items performed correctly) and rated the workshop highly. However, learners and instructors made several recommendations for improving the learning module for future sessions.Conclusion:This pilot project demonstrated that an epidural analgesia workshop using SPs is feasible and results in positive learning outcomes and high satisfaction with senior nursing students. [This pilot project demonstrated that an epidural analgesia workshop using SPs is feasible and results in positive learning outcomes and high satisfaction with senior nursing students. [J Nurs Educ.2018;57(6):359–365.]

Background:Medication errors have been shown to occur 4 times more often in the community compared to the hospital setting. Therefore, identifying the patient-related factors within the community that contribute to an increased occurrence of medication errors is required. Objective:To assess patients’ knowledge and understanding of their medications in order to determine risk for medication errors. Methods:This quantitative descriptive study used a convenience sample of participants filling their prescriptions at one independent pharmacy in Canada. The study used descriptive statistics including frequencies and correlations. Further multiple regressions were conducted to explore the relationship between the patient factors and medication knowledge and use. Results:A total of 33.5% of respondents indicated that they know what medication they are currently taking, and that they know why they taking their current medications. Decreased knowledge of medication taken was significantly associated with likelihood of a medication error by 3.6 times (P= .048). Increased age (P= .01) and the death of a spouse (P= .01) correspond to a decreased knowledge of medications. Those with less education appeared to have decreased understanding as to why they are taking their medications (P= .01). The odds of experiencing a medication error increased with multiple medications. Also, changes in medication dose increased the probability of experiencing a medication error by 2.2 times. This study however had a small sample size. Conclusions:With identification and understanding of patient factors that influence the incidence of medication error, we can increase awareness and determine solutions to decrease risk of medication error in clinical practice.

As the COVID-19 pandemic unfolded, community pharmacies adapted rapidly to broaden and adjust the services they were providing to patients, while coping with severe pressure on supply chains and constrained social interactions. This study investigates whether these events had an impact on the medication incidents reported by pharmacists. Results indicate that Canadian pharmacies were able to sustain such stress while maintaining comparable safety levels. At the same time, it appears that some risk factors that were either ignored or not meaningful in the past started to be reported, suggesting that community pharmacists are now aware of a larger set of contributing factors that can lead to medication incidents, notably for medication incidents that can lead to harm.

Introduction: While primary care is often the first point of contact for adolescents with depression, more than half of depressed adolescents are either untreated or undertreated. A scoping review had been completed to summarize approaches for achieving quality integrated care in primary care focused on adolescent depression.Methods: The scoping review followed the methodological framework for scoping studies from Arksey and O’Malley. Articles were grouped into themes and mapped to 6 quality domains for integrated care from the practice integration profile survey and 3 levels of stakeholders based on WHO’s definition for health systems (patient/family, primary care team, and national/sub-national health system).Results: A total of 868 records were screened resulting in 22 articles at the patient/family-level (5/22), the primary care team-level (18/22), and the national/sub-national health system-level (16/22). The results highlighted multilevel approaches to support the delivery of quality integrated care for adolescent depression in primary care: (1) population-focused using patient registries, routine screening based on standardized algorithms, and patient-centered strategies, (2) team-driven where primary care clinicians collaborate with mental health clinicians as part of a primary care team, (3) evidence-based delivery of mental health services across the integrated care pathway from screening to follow-up visits, and (4) measurement-guided by leveraging the electronic health record infrastructure to learn from patient outcomes.Conclusion: More research is needed on how to provide quality integrated care for adolescent depression, specifically on patient engagement and retention, grounded in the frontline experiences of patients, families, and clinicians and supported by national and/or sub-national guidelines. A learning system could help integrate mental health services in primary care in a way that is consistent across the national and/or sub-national health system.

Background: Medication errors can cause substantial harm to patients and may lead to significant costs within a health care system. As such, there is value in identifying patient-related risk factors for medication errors. The objectives of this study were to identify patient-related risk factors associated with self-reported medication errors and to determine whether the risk factors differed between hospital and community settings.Methods: The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in 8 countries was the primary data source. Univariate analyses were used to determine significant explanatory variables (p< 0.05) for inclusion in weighted logistic regression models. Two regression models were developed: one to identify overall patient-related risk factors and the other to determine whether these factors differed between hospital and community settings.Results: The final study population consisted of 9944 adults. Patient-related risk factors significantly associated with self-reported medication errors were the number of medications being taken, sex, age and country of residence. Approximately 4 out of every 5 self-reported medication errors occurred in the community setting.Conclusions: A substantial percentage of patients with chronic diseases in the countries covered by the survey experienced medication errors, with most errors occurring in the community setting. Several patient-related risk factors were associated with these errors. Greater emphasis on national incident reporting systems and greater sharing of knowledge across nations could help to identify strategies to overcome these problems. More specifically, strategies to increase reporting of and learning from medication errors, as well as education about potential patient-related risk factors, are recommended.