Seniors managing multiple medications: using mixed methods to view the home care safety lens.

Background: Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs.

Making research integral to home care services.

Home care is the fastest growing segment of the Canadian healthcare system, yet research on patient safety has been conducted predominantly in institutional settings. This is a case example of how Victorian Order of Nurses Canada, a national not-for-profit home and community care provider, embedded a nurse researcher to create an environment in which health services research flourished. This model strategically propelled important issues such as home care safety on to the national research and policy agendas and helped leverage change in multiple levels of the healthcare system.

Responsibility for Canada's healthcare quality agenda: the home and community sector.

In their study on the current state of the quality agenda in the Canadian healthcare system, Sullivan and colleagues interviewed healthcare leaders across Canada who predominantly represent the hospital care sector. The home and community sector is under-represented in research and discussions about quality and patient safety, despite the fact that it is the fastest-growing sector in healthcare. Patient safety research in home care has been spearheaded by VON Canada and the Canadian Patient Safety Institute since 2005.

Association of thymectomy with infection following congenital heart surgery.

Background: Congenital absence of the thymus can lead to profound immunodeficiency, suggesting that thymic function during fetal development is essential to normal lymphocyte development. How vital the thymus after birth is to human immune competence and regulation is not known. Routine thymectomy, especially at an early age, may influence immunity, and therefore the risk of infection, autoimmunity, or malignancy.

The primary healthcare nurse practitioner in Ontario: a workforce study.

The role of the primary healthcare nurse practitioner (NP-PHC) has a long history in Ontario. In this paper, we describe the evolution of the role with a focus on geographic distribution, a profile of client populations and the services provided by NP-PHCs. Comparisons will be made to findings from previous studies and reports on the NP-PHC role in Ontario.

The acute care nurse practitioner in Ontario: a workforce study.

In spite of the long history of nurse practitioner practice in primary healthcare, less is known about nurse practitioners in hospital-based environments because until very recently, they have not been included in the extended class registration (nurse practitioner equivalent) with the College of Nurses of Ontario. Recent changes in the regulation of nurse practitioners in Ontario to include adult, paediatric and anaesthesia, indicates that a workforce review of practice profiles is needed to fully understand the depth and breadth of the role within hospital settings. Here, we present information obtained through a descriptive, self-reported survey of all nurse practitioners working in acute care settings who are not currently regulated in the extended class in Ontario.

Telephone nursing: an emerging practice area.

Governments across Canada and internationally are implementing nurse telephone advice services to their populations as a means to address healthcare access issues. This paper briefly reviews the international and Canadian history of telephone nursing services and outlines the research that has established the relative safety of these services to patients. The standards, competencies and decision systems that support safe tele-practice are reviewed.