The implementation of the integrated approach to mental health care at primary health care (PHC) clinics could pose a challenge to PHC nurses. The study explored the perceptions of the professional nurses on the challenges affecting the implementation of the integrated approach to mental health care.  A qualitative, descriptive, and exploratory design was used. The population is comprised of PHC nurses working in the Mutale sub-district PHC facilities in Limpopo Province, South Africa. Probability systematic random sampling and purposive sampling were used to obtain a sample of six PHC clinics and 45 PHC nurses respectively. Ethical principles were taken into account. Focus groups and individual interviews were used to collect data. Data analysis was done using Tesch’s open coding method.  Poor management of PHC resources and difficulties in managing psychotic patients were found to affect the implementation of the integrated approach to mental health care at PHC clinics. The study suggests that staff development programs are instituted and staff trained to acquire skills to handle aggressive mentally ill patients.

Transitioning to a new hospital facility represents a significant challenge to clinicians and institutional leadership, and represents a risk to patient safety if the planned systems, models of care, and physical environment are not tested prior to the transition. The challenge is complex - involving workers, the workplace (including technology, equipment, and physical environment), work processes, and the patients who benefit from the work. Healthcare simulation offers a range of methodologies to examine this complex system, identify latent safety threats, and engage clinicians in a shared problem-solving approach. Latent safety threats (LST)s, can be defined as “system-based threats to patient safety that can materialize at any time,” and often go unrecognized by health care professionals, unit directors, or hospital administration. These errors in design, organization, training, or maintenance may have a significant impact on patient safety and, if not recognized and mitigated, could potentially delay management in an emergency situation and/or possibly result in patient harm. Immersive, full-environment (‘‘in situ’’) simulation exercises make it possible to prospectively determine whether newly built clinical facilities allow workflow patterns that foster safe and well-coordinated patient care.