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Development of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care

Packendorff, Niclas (författare)
Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden,PreHospen
Magnusson, Carl (författare)
Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
Wibring, Kristoffer (författare)
Department of Ambulance and Prehospital Care, Region Halland, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Axelsson, Christer (författare)
Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden,PreHospen
Andersson Hagiwara, Magnus (författare)
Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen
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 (creator_code:org_t)
2024
2024
Engelska.
Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - 1757-7241. ; 32:1
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BackgroundEmergency Medical Services (EMS) are a unique setting because care for the chief complaint is given across all ages in a complex and high-risk environment that may pose a threat to patient safety. Traditionally, a reporting system is commonly used to raise awareness of adverse events (AEs); however, it could fail to detect an AE. Several methods are needed to evaluate patient safety in EMS. In this light, this study was conducted to (1) develop a national ambulance trigger tool (ATT) with a guide containing descriptions of triggers, examples of use, and categorization of near misses (NMs), no harm incidents (NHIs), and harmful incidents (HIs) and (2) use the ATT on randomly selected ambulance records.MethodsThe ambulance trigger tool was developed in a stepwise manner through (1) a literature review; (2) three sessions of structured group discussions with an expert panel having knowledge of emergency medical service, patient safety, and development of trigger tools; (3) a retrospective record review of 900 randomly selected journals with three review teams from different geographical locations; and (4) inter-rater reliability testing between reviewers.ResultsFrom the literature review, 34 triggers were derived. After removing clinically irrelevant ones and combining others through three sessions of structured discussions, 19 remained. The most common triggers identified in the 900 randomly selected records were deviation from treatment guidelines (30.4%), the patient is non conveyed after EMS assessment (20.8%), and incomplete documentation (14.4%). The positive triggers were categorized as a near miss (40.9%), no harm (3.7%), and harmful incident (0.2%). Inter-rater reliability testing showed good agreement in both sessions.ConclusionThis study shows that a trigger tool together with a retrospective record review can be used as a method to measure the frequency of harmful incidents, no harm incidents, and near misses in the EMS, thus complementing the traditional reporting system to realize increased patient safety.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

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The Human Perspective in Care

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