To prevent medication errors in home care, up-to-date information and communication between healthcare workers is important when patients are transferred from specialist to home care. It is also important to ensure adequate competence with regard to medication, and that there should be openness when medication errors occur, as well as in setting routines for the preparation, alteration and administration of medications.

Summary This study focused on work-related stress among nurses working with critically ill patients. The aim of the study was to examine the effects of workrelated stress with regard to patient safety. The study uses a qualitative design based on focus group interviews with nurses who work with acute, critically ill patients in hospitals. Two regional hospitals were chosen. Inclusion criteria for the focus group panels included the following: nurses with advanced training in anesthesiology, intensive care, or operating-room nursing. Twenty-three nurses were chosen and they were divided into four groups. This study shows that a demanding work environment together with minimal control and social support from colleagues results in increased stress that can often have an effect on patient safety.

Aim To explore home‐care nurses' experiences of patient safety in their delivery of home care to older clients. Background High‐risk organisations, such as the airline industry and the petroleum industry, have long been preoccupied with safety. Only recently has this also become a central theme in health care. Method Four focus group interviews with 20 nurses who work in home care. A qualitative thematic analysis was performed. Results One main theme was identified: struggling with responsibility in different situations. It comprises five subthemes: poor work morale and work ethic; documentation; lack of functional leadership; competence; and lack of updated routines and guidelines. Conclusions Patient safety culture is compromised by a lack of leadership, lack of responsibility among leadership, lack of routines, failure to update procedures, and a lack of knowledge and education among health‐care workers. Implications for nursing management Nurse managers need to be made more aware of the dilemmas faced by nurses, how they struggle with their responsibilities, how they experience powerlessness in certain situations, and the lack of support they receive in decision‐making.

This paper examines the prevalence of multiple symptoms and the relationships between future expectations and multiple symptoms in a cross-sectional study of 100 patients with chronic obstructive pulmonary disease. A questionnaire was used to examine the patients' symptoms of breathlessness, anxiety, depression, sleeplessness, fatigue, and pain, and their outlook for the future. All patients reported breathlessness, 64% anxiety, 69% depression, 28% sleeplessness, 72% fatigue, and 45% pain. Those with anxiety reported significant depression (P < 0.001), and those with fatigue reported significant depression (P = 0.004). Patients who reported pain also reported significant sleeplessness (P = 0.022). A negative outlook for the future was reported by 42% of patients who also reported significantly more anxiety, depression, sleeplessness, fatigue, and pain (P ≤ 0.049). Multiple symptoms are common in chronic obstructive pulmonary disease, and patients with a pessimistic view of the future reported more symptoms. Those with multiple symptoms and a negative outlook toward the future may benefit from interventions to help them achieve a more positive outlook for the future, which may relieve symptom burden.

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