Marcellus, Lenora

There is a common expectation among health care professionals to "do no harm" and, while this is the ideal, it is not the reality. Despite the best intentions of health care professionals, errors do occur. The objectives of this review were to explore how health care professionals were affected by their involvement in adverse events and to determine the types of support health care professionals required after making an error. An integrative literature review of eleven research articles was conducted to explore common themes. These eleven studies included four quantitative studies, six qualitative studies, and one mixed-methods study. The results of this literature review indicate that following an error, health care professionals experience emotional distress on both a personal and a professional level. Health care professionals require individual as well as organizational support to help them cope with the error. The findings of the integrative literature review have important implications for nursing practice, nursing leaders and advanced practice nursing.

The changing epidemiology of child health means that an increasing number of children with chronic and complex health issues live well into adulthood, most of whom will require life-long care coordination. The needs of these children cross multiple disciplines and involve many subsystems. The current economic climate places heavy demands on health care systems to exercise cost containing measures. Services are fragmented, hospital discharges are expedited, and patients are expected to assume a greater degree of responsibility for their own care. Coordination of the care of pediatric patients is left predominantly in the hands of parents with little knowledge of health care system functioning or awareness of available resources. In order to ensure comprehensive patient care specific to patient needs it is necessary to identify gaps in service provision and advocate for the development of programs to address the fragmentation in care. Existing models of care coordination and chronic care management have focused predominantly on the adult population. This paper will focus on meeting the needs of children with complex and chronic medical conditions by exploring the various models for care and theory underpinning nursing children and families experiencing transitions. Suggestions for application of theory in practice will be achieved through the presentation of a case example.