Abstract
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.
Highlights
During recent decades, mental health care has undergone structural changes intended to bring people with serious mental illness (SMI), such as psychosis or personality disorders, closer to the everyday life of the community
To get in contact with registered nurses’ (RNs) working in the field of community mental health settings (CMHS) for people with SMI, heads of departments in five municipalities were contacted by telephone and by letter informing them about the study and asking for permission to perform the study
The second category, Terms of daily living, consisted of five subcategories. It covered the overall areas of legislation and organization, along with professionals’ knowledge, housing, and daily activity that constitute the external framework of CMHS
Summary
Mental health care has undergone structural changes intended to bring people with serious mental illness (SMI), such as psychosis or personality disorders, closer to the everyday life of the community. The World Health Organization (WHO) has assumed a leading role in bringing this change about, striving to move mental health care from hospitals to community mental health settings (CMHS). Patient safety is defined by the WHO as “the absence of preventable harm to a patient during the process of health care”. Following the reform of mental health care, the concept and content of patient safety need to be discussed in the context of this area of care and the partially new factors influencing patient safety. The present study focuses on registered nurses’ (RNs) perceptions of patient safety in CMHS for people with SMI
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