Abstract
Background: Delivering pre-hospital emergency care has the potential to be hazardous, and the patient could experience an adverse event. Despite these potential, yet known, threats, little is known about patient safety in the pre-hospital care setting, in contrast to in-hospital care. In South Africa, there are no reports on patient safety and human error issues in the pre-hospital care setting. This study investigated the perspectives of emergency care practitioners (ECPs) in South Africa on the types of errors that occur in the pre-hospital emergency care setting, as well as factors that influence patient safety and precipitate errors during pre-hospital care.Methods: This research was designed as an exploratory study that used a questionnaire administered on 2000 ECPs to obtain their perceptions on factors the influence human error and patient safety in the pre-hospital emergency care environment. Results: Of the 2000 questionnaires distributed, 1,510 were returned, giving a response rate of 76%. Analysis of the respondents’ responses in relation to the types of human errors in the pre-hospital environment yielded five dominant themes, namely errors relating to poor judgement, poor skill/knowledge, fatigue, and communication, and human error. According to the participants, inadequate equipment, environmental factors, personal safety concerns, practitioner’s incompetence, and ineffective teamwork are the top five factors that influence patient safety in the pre-hospital emergency care setting. The majority (65.1%; p < 0.001) of public sector ECPs reported that they had not received training on patient safety, nor do they have a protocol for managing medical error at their workplace (65.7%; p < 0.007). Conclusion: In conclusion, this study investigated paramedics’ views on types of errors that occur in the pre-hospital emergency care setting, and factors that influence patient safety and precipitate errors during pre-hospital care. It was found that public-sector emergency medical service (EMS) in South Africa seldom train their staff on patient safety or have a protocol for managing medical error. The study advocates that, to overcome medical errors, EMS in South Africa should establish a culture of safety that focuses on system improvement and personnel training.
Factors That Influence Human Error and Patient Safety in the Pre-hospital Emergency Care Setting: Perspectives of Emergency Care Practitioners in a Middle-income Country
