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Registered nurses’ experiences of near misses in ambulance care: a critical incident technique study
Uppsala University Hospital, Sweden.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Borås, Sweden. (iCARE)ORCID iD: 0000-0001-7865-3480
2019 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 47, no November, article id 100776Article in journal (Refereed) Published
Abstract [en]

Background: In hospitals, potentially harmful near misses occur daily exposing patients to adverse events and safety risks. The same applies to ambulance care, but it is unclear what the risks are and why near misses arise.

Aim: To explore registered nurses’ experiences and behaviours associated with near misses where patient safety in the ambulance service was jeopardized.

Methods: Based on critical incident technique, a retrospective and descriptive design with individual qualitative interviews was used. Ten men and five women from the Swedish ambulance service participated.

Results: Seventy-three critical incidents of near misses constituted four main areas: Drug management; Human-technology interactions; Assessment and care and Patient protection actions. Incidents were found in drug management with incorrect drug mixing and dosage. In human-technology interactions, near misses were found in handling of electrocardiography, mechanical chest compression devices and other equipment. Misjudgement and delayed treatment were found in patient assessments and care measures while patient protection actions failed in transport safety, hygiene and local area knowledge.

Conclusions: Experiencing near misses led to stress, guilt and shame. The typical behaviour in response to near misses was to immediately correct the action. Occasionally, however, the near miss was not discovered until later without causing any harm.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 47, no November, article id 100776
Keywords [en]
Patient safety, Near misses, Ambulance care, Nurses, Emergency medical services, Critical incident technique
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-86937DOI: 10.1016/j.ienj.2019.05.002OAI: oai:DiVA.org:lnu-86937DiVA, id: diva2:1338173
Available from: 2019-07-20 Created: 2019-07-20 Last updated: 2019-11-26

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Bremer, Anders

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CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf