Patients' Perceptions of Safety in Emergency Medical Services: an Interview Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2020 Oct 22

PMID 33087370

Citations 4

Authors

Anu Venesoja

Maaret Castren

Susanna Tella

Veronica Lindstrom

Affiliations

Soon will be listed here.

Abstract

Background: Research on patient safety in emergency medical services (EMS) has mainly focused on the organisation's and/or the EMS personnel's perspective. Little is known about how patients perceive safety in EMS. This study aims to describe the patients' experiences of their sense of safety in EMS.

Methods: A qualitative design with individual interviews of EMS patients (n=21) and an inductive qualitative content analysis were used.

Results: Patients' experiences of EMS personnel's ability or inability to show or use their medical, technical and driving skills affected the patients' sense of safety. When they perceived a lack of professionalism and knowledge among EMS personnel, they felt unsafe. Patients highlighted equality in the encounter, the quality of the information given by EMS personnel and the opportunity to participate in their care as important factors creating a sense of safety during the EMS encounter. Altogether, patients' perceptions of safety in EMS were connected to their confidence in the EMS personnel.

Conclusions: Overall, patients felt safe during their EMS encounter, but the EMS personnel's professional competence alone is not enough for them to feel safe. Lack of communication or professionalism may compromise their sense of safety. Further work is needed to explore how patients' perceptions of safety can be used in improving safety in EMS.

Citing Articles

Root causes behind patient safety incidents in the emergency department and suggestions for improving patient safety - an analysis in a Finnish teaching hospital.

Halinen M, Tiirinki H, Rauhala A, Kiili S, Ikonen T BMC Emerg Med. 2024; 24(1):209.

PMID: 39506678 PMC: 11542263. DOI: 10.1186/s12873-024-01120-9.

Finnish emergency medical services managers' and medical directors' perceptions of collaborating with patients concerning patient safety issues: a qualitative study.

Venesoja A, Tella S, Castren M, Lindstrom V BMJ Open. 2023; 13(4):e067754.

PMID: 37037618 PMC: 10111928. DOI: 10.1136/bmjopen-2022-067754.

Prehospital nursing students' experiences of patient safety culture in emergency medical services-A qualitative study.

Venesoja A, Lindstrom V, Castren M, Tella S J Clin Nurs. 2022; 32(5-6):847-858.

PMID: 35672936 PMC: 10083998. DOI: 10.1111/jocn.16396.

Driving the ambulance: an essential component of emergency medical services: an integrative review.

Becker J, Hugelius K BMC Emerg Med. 2021; 21(1):160.

PMID: 34922453 PMC: 8684175. DOI: 10.1186/s12873-021-00554-9.

References

Elo S, Kyngas H . The qualitative content analysis process. J Adv Nurs. 2008; 62(1):107-15. DOI: 10.1111/j.1365-2648.2007.04569.x. View

Bishop A, Macdonald M . Patient Involvement in Patient Safety: A Qualitative Study of Nursing Staff and Patient Perceptions. J Patient Saf. 2014; 13(2):82-87. DOI: 10.1097/PTS.0000000000000123. View

Ahlenius M, Lindstrom V, Vicente V . Patients' experience of being badly treated in the ambulance service: A qualitative study of deviation reports in Sweden. Int Emerg Nurs. 2016; 30:25-30. DOI: 10.1016/j.ienj.2016.07.004. View

Bell S, Roche S, Mueller A, Dente E, OReilly K, Sarnoff Lee B . Speaking up about care concerns in the ICU: patient and family experiences, attitudes and perceived barriers. BMJ Qual Saf. 2018; 27(11):928-936. PMC: 6225795. DOI: 10.1136/bmjqs-2017-007525. View

Reiman T, Pietikainen E, Oedewald P . Multilayered approach to patient safety culture. Qual Saf Health Care. 2010; 19(5):e20. DOI: 10.1136/qshc.2008.029793. View

McTier L, Botti M, Duke M . Patient participation in medication safety during an acute care admission. Health Expect. 2013; 18(5):1744-56. PMC: 5060834. DOI: 10.1111/hex.12167. View

Fairbanks R, Crittenden C, OGara K, Wilson M, Pennington E, Chin N . Emergency medical services provider perceptions of the nature of adverse events and near-misses in out-of-hospital care: an ethnographic view. Acad Emerg Med. 2008; 15(7):633-40. DOI: 10.1111/j.1553-2712.2008.00147.x. View

Coster J, Irving A, Turner J, Phung V, Siriwardena A . Prioritizing novel and existing ambulance performance measures through expert and lay consensus: A three-stage multimethod consensus study. Health Expect. 2017; 21(1):249-260. PMC: 5750751. DOI: 10.1111/hex.12610. View

Sahlstrom M, Partanen P, Azimirad M, Selander T, Turunen H . Patient participation in patient safety-An exploration of promoting factors. J Nurs Manag. 2018; 27(1):84-92. DOI: 10.1111/jonm.12651. View

10.

Reis C, Paiva S, Sousa P . The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions. Int J Qual Health Care. 2018; 30(9):660-677. DOI: 10.1093/intqhc/mzy080. View

11.

Doyle C, Lennox L, Bell D . A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013; 3(1). PMC: 3549241. DOI: 10.1136/bmjopen-2012-001570. View

12.

Bigham B, Buick J, Brooks S, Morrison M, Shojania K, Morrison L . Patient safety in emergency medical services: a systematic review of the literature. Prehosp Emerg Care. 2011; 16(1):20-35. DOI: 10.3109/10903127.2011.621045. View

13.

Brice J, Studnek J, Bigham B, Martin-Gill C, Custalow C, Hawkins E . EMS Provider and Patient Safety during Response and Transport: Proceedings of an Ambulance Safety Conference. Prehosp Emerg Care. 2011; 16(1):3-19. DOI: 10.3109/10903127.2011.626106. View

14.

Sahlstrom M, Partanen P, Rathert C, Turunen H . Patient participation in patient safety still missing: Patient safety experts' views. Int J Nurs Pract. 2016; 22(5):461-469. DOI: 10.1111/ijn.12476. View

15.

Sammer C, Lykens K, Singh K, Mains D, Lackan N . What is patient safety culture? A review of the literature. J Nurs Scholarsh. 2010; 42(2):156-65. DOI: 10.1111/j.1547-5069.2009.01330.x. View

16.

Vincent C, Burnett S, Carthey J . Safety measurement and monitoring in healthcare: a framework to guide clinical teams and healthcare organisations in maintaining safety. BMJ Qual Saf. 2014; 23(8):670-7. PMC: 4112428. DOI: 10.1136/bmjqs-2013-002757. View

17.

Rainey H, Ehrich K, Mackintosh N, Sandall J . The role of patients and their relatives in 'speaking up' about their own safety - a qualitative study of acute illness. Health Expect. 2013; 18(3):392-405. PMC: 5060780. DOI: 10.1111/hex.12044. View

18.

Togher F, OCathain A, Phung V, Turner J, Siriwardena A . Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study. Health Expect. 2014; 18(6):2951-61. PMC: 5810705. DOI: 10.1111/hex.12279. View

19.

Weaver M, Wang H, Fairbanks R, Patterson D . The association between EMS workplace safety culture and safety outcomes. Prehosp Emerg Care. 2011; 16(1):43-52. PMC: 3533489. DOI: 10.3109/10903127.2011.614048. View

20.

Sjolin H, Lindstrom V, Hult H, Ringsted C, Kurland L . What an ambulance nurse needs to know: a content analysis of curricula in the specialist nursing programme in prehospital emergency care. Int Emerg Nurs. 2014; 23(2):127-32. DOI: 10.1016/j.ienj.2014.09.002. View