Long-Term Care Nurses' Experiences With Patient Safety Incident Management: A Qualitative Study

BACKGROUND

Global trends in the aging population will increase the demands for long-term care (LTC) resources. Due to recent pressures to deliver more complex care, there is further risk to resident safety in LTC. Emphasis on the management and the delivery in safe and quality resident care in LTC is required.

PURPOSE

The purpose of this study was to describe nurses' experiences with patient safety incident (PSI) management involving residents living in LTC.

METHODS

Using a qualitative descriptive approach, 9 nurses were recruited in 3 LTC homes. Semistructured interviews were conducted, and data were analyzed using inductive content analysis.

RESULTS

Three main categories emerged: commitment to resident safety, workplace culture, and emotional reaction.

CONCLUSIONS

Providing nurses with an opportunity to share their PSI management experiences highlights the current factors influencing frontline resident safety in LTC. Study results can inform nursing practice and policy development to support PSI identification and management.

Quilting emergent advanced practice nursing educator identity: an arts-informed approach

OBJECTIVES

Arts-informed pedagogy in the graduate nursing classroom is used to support the integration of theory with advanced practice nursing (APN) competencies (Canadian Nurses Association, 2008, 2019).

METHODS

Using the patterns of knowing (Carper, 1978; Chinn & Kramer, 2018), Iwasiw & Goldenberg's curriculum development model (2015) and practice development (McCormack, Manley, & Titchen, 2013), two course professors facilitated the delivery of an innovative arts-informed approach in a nursing graduate program, the Quilt.

RESULTS

The Quilt was meant to invite graduate students to critically reflect and create a visual depiction of their emergent identities as advanced practice nurse educators (APNEs). As three graduate student authors, we reflect on our experiences engaging with arts-informed pedagogy to explore the features of the collective APNE identity. The design and delivery of the Quilt is described.

CONCLUSIONS

Finally, we discuss the lessons learned, and the value of arts-informed pedagogy to support the meaningful integration of theory amongst graduate nursing students becoming APNEs.

Immunosuppression and Chagas disease; experience from a non-endemic country

Reactivation of Chagas disease in the chronic phase may occur when immunosuppression is established, sometimes resulting in high parasitaemia and severe clinical manifestations such as meningitis and meningoencephalitis. Although this situation is being increasingly described, there is still scarce information. This retrospective observational study was performed in three Tropical Medicine Units of Barcelona (Spain) included in the International Health Programme of the Catalan Health Institute (PROSICS). The objective of the study was to describe epidemiological, clinical, microbiological, prognostic and therapeutic data from patients with Chagas disease and any kind of immunosuppressive condition attended in these three institutions from January 2007 to October 2014. From 1823 patients with Chagas disease attending these three centres during the study period, 38 (2%) had some kind of immunosuppressive condition: 12 patients had human immunodeficiency virus infection, 8 patients had neoplasia, 4 patients underwent organ transplantation and 14 patients had an autoimmune disease. Eight (21.1%) patients had cardiac involvement, and six (15.8%) patients had gastrointestinal involvement. Acute Trypanosoma cruzi infection was detected in two Spanish patients. Thirty-one (81.6%) patients received treatment with benznidazole, of whom 17 (54.8%) had some kind of adverse event. No patient had a severe manifestation or reactivation of Chagas disease. Patients with Chagas disease under immunosuppressive conditions are being increasingly described, especially in non-endemic countries. More information about this topic is required and international consensus in the diagnosis, treatment and follow up of these patients must be established to reduce the morbidity and mortality.