Transitions of care can increase risks for patient safety events. This systematic review examined the effectiveness of interventions aimed to increase patient safety during transitions of care between the hospital and home. The authors identified several interventions from previously published studies which increased patient safety and/or patient satisfaction and identified factors that contribute to effective transitions of care (i.e., nurse follow-up, pre-discharge patient education, and contact with local healthcare services).

Providing in-home care for home-dwelling adults presents unique patient safety challenges. This qualitative study with 13 registered nurses in Sweden explored how nurses ensure safe home health care among home-dwelling older patients. Findings highlight the importance of continuity of care, trust between patients, caregivers, and nurses, and adapting safety requirements to meet environmental conditions and maintain a sense of home.

Children with complex home care needs, such as children with cancer, are particularly vulnerable to medication errors. This longitudinal study used in-home observations and chart review to monitor 131 pediatric patients with leukemia or lymphoma for six months and found that 10% experienced adverse drug events due to medication errors in the home and 42% experienced a medication error with the potential for harm. Failures in communication was the most common contributing factor. Findings underscored a critical need for interventions to support safe medication use at home. Researchers concluded that improvements addressing communication with and among caregivers should be co-developed with families and based on human-factors engineering.

Nurse-sensitive outcomes are important indicators of nursing safety. In this retrospective study of 600 patient records from ten Swedish home healthcare organizations, researchers found that 74% of patient safety incidents were classified as nursing-sensitive and that the majority of those events were preventable. The most common types of nursing-sensitive events were falls, pressure injuries, healthcare-associated infections, and incidents related to medication management.

Children with complex care needs present unique challenges for both parents and clinical teams. This commentary offers a physician-parent’s perspective on weaknesses in the care system that decreased medication safety for her child and also decreased patient-centeredness, including lack of a respect for the family as care team members.

Natural disasters and other public health emergencies (PHE), such as the COVID-19 pandemic, can dramatically change the delivery of healthcare. This scoping review identified considerable research examining the relationship between public health emergencies and disruptions to personal medication practices (e.g., self-altering medication regimens, access barriers, changing prescribing providers) and subsequent medication-related harm.

Home healthcare is common among older adults, who are often vulnerable to patient safety events due to factors such as medical complexity. This cross-sectional study of 4,296 Medicare patients examined the relationship between receipt of home healthcare services, perceived gaps in care coordination, and preventable adverse outcomes. The researchers found that home healthcare was not associated with self-reported gaps in care coordination, but was associated with increases in self-reported preventable drug-drug interactions (but not ED visits or hospital admissions).

Patients with medical complexities who are receiving palliative care may be at increased risk for patient safety events. This cross-sectional survey found that patient safety concerns were common among patients receiving specialist community palliative care in Germany. Patients reported that physical disability, physical and psychological symptoms, and side effects or complications from medication therapy were the most common causes of impaired safety, as well as the COVID-19 pandemic.

Insulin-related errors result in nearly 100,000 emergency department visits annually in the United States, with 30% resulting in hospitalization. It is unclear if published guidelines and strategies for reducing these errors have been effective; therefore, this review sought to identify interventions to reduce insulin errors in home and hospital settings. Three themes emerged: technology, education, and policy. Understanding these findings may help clinicians and patients to decrease insulin administration errors and help researchers develop and evaluate future studies targeting insulin-related errors.

People taking medications at home may have difficulty opening packaging which can result in improper, dangerous storage practices. This review includes 12 studies where participants were observed opening a variety of medication packages (e.g., blister packs, child-resistant containers). While all studies reported participant difficulty, no consistent contributory factors were identified, and the methodological quality of all studies was typically low. Additional research is required to encourage improvement in medication packaging.

Hospital-level care at home can reduce cost and hospital readmissions, but adverse events still occur at levels similar to hospitals. This study explored adverse events related to home mechanical ventilation (HMV), in order to categorize causes and recommend solutions. Interventions for nurses (e.g., checklists) and manufacturers (e.g., alarm design) may improve HMV.

Medication errors and other adverse events are thought to occur in 10% of home care patients. This Delphi study identified 27 high-risk medications (e.g., oral chemotherapy, anticoagulants) in home care nursing that require a specific procedure and an additional 28 that warrant additional monitoring. Home care agencies and researchers should focus on developing and evaluating policies to improve safety of high-risk medications.

Children with complex medical needs are vulnerable to patient safety threats. This qualitative study explored the perspectives of parents with children living at home with a central venous access device (CVAD). Parents highlight the persistent fear of central line-associated blood stream infections as well as the importance of maintaining a sense of normalcy for their children.

Patient use of digital and online symptom checkers is increasing, but formal validation of these tools is lacking. This systematic review identified ten studies assessing symptom checkers evaluating a variety of conditions, including infectious diseases and ophthalmic conditions. The authors concluded that the diagnostic and triage accuracy of symptom checkers varies and has low accuracy.