Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.

General medical practice in China:evaluation of urban community health care service functions based on a rough set reduction theory

Objective:This study aims to achieve an empirical evaluation on the functional performances of urban community health care services in fi ve administrative districts of Nanchang city in China.Methods:In order to increase effectiveness,data collected from fi ve administrative districts of Nanchang city were processed to exclude redundant information.Rough set reduction theory was brought in to evaluate the performances of community health care services in these districts through calculating key indices’weighed importance.Results:Comprehensive evaluation showed the score rankings from high to low as Qing-yunpu district,Xihu district,Qingshanhu district,Donghu district,and Wanli district.Conclusion:The objective performance evaluation had actually reflected the general situation(including social-economic status)of community health care services in these administrative districts of Nanchang.Attention and practical works of community health service management were needed to build a more harmonious and uniform community health care service system for residents in these districts of Nanchang.

Health professionals’perspective on the impact of community health care reform in different regions of China

Objective:Changes in supplying community health services,degree of satisfaction,and pol-icy suggestions are presented from the perspectives of health professionals in different regions of China with the purpose of further facilitating comprehensive reform of community health services.Methods:Based on geographic location and economic level of development,eight cities were selected and 12 community health service institutions were chosen by random sampling from each city.A questionnaire survey was conducted by the health professionals.Results:With respect to working enthusiasm,reduction in antibiotic drug use,social image and trust of patients,more health professionals in middle and western China showed positive feed-backs than those in eastern China.With respect to preliminary results of the reform,performance and salary,and health care insurance policies,health professionals’satisfaction levels in middle and western China were higher than in eastern China.The health professionals in middle and western China were more concerned about equipment,infrastructure and increasing training op-portunities.The health professionals in both eastern and middle China accentuated improving the variety of essential drugs covered by health insurance,while health professionals in eastern China suggested performance-related payment reform.Conclusions:The performance of health professionals in middle and western China was improved more signifi cantly through comprehensive reform than that of health professionals in eastern China.For health professionals in middle and western China,it is essential to strengthen infrastructure and increase professional training,while health professionals in middle and eastern China would like to see an increase in the variety of essential drugs,and those in eastern China require strengthening performance-related payment reform.

Separation of Revenue and Expenditure increases first contact care in community health centers among community residents

Objective:To evaluate the impact of Separation of Revenue and Expenditure(SRE)on the first contact care in community health centers(CHCs)among community residents.Methods:Data was obtained through questionnaire survey before and after the pilot.Residents who visited CHCs within two weeks before the conduction of the surveys were included in this study.This study employed a pre-post quasi-experiment design and multiple regression models were specified based on the Andersen theoretical framework.Results:Multiple logistic regression analysis showed that the rate of first contact care in CHCs increased by 28.3%(P=0.000).Conclusions:SRE has increased the first contact care in CHCs among the community residents.