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Adverse events in prehospital emergency care: a trigger tool study
Univ Boras, Fac Caring Sci Work Life & Social Welf, SE-50190 Boras, Sweden..
Univ Gothenburg, Dept Mol & Clin Med, SE-40530 Gothenburg, Sweden.;Sahlgrens Univ Hosp, SE-40530 Gothenburg, Sweden..
Univ Boras, Fac Caring Sci Work Life & Social Welf, SE-50190 Boras, Sweden..
Sodra Alvsborg Hosp SAS, Dept Ambulance Care, SE-50182 Boras, Sweden..
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2019 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 19, article id 14Article in journal (Refereed) Published
Abstract [en]

Background: Prehospital emergency care has developed rapidly during the past decades. The care is given in a complex context which makes prehospital care a potential high-risk activity when it comes to patient safety. Patient safety in the prehospital setting has been only sparsely investigated. The aims of the present study were 1) To investigate the incidence of adverse events (AEs) in prehospital care and 2) To investigate the factors contributing to AEs in prehospital care. Methods: We used a retrospective study design where 30 randomly selected prehospital medical records were screened for AEs each month in three prehospital organizations in Sweden during a period of one year. A total of 1080 prehospital medical records were included. The record review was based on the use of 11 screening criteria. Results: The reviewers identified 46 AEs in 46 of 1080 (4.3%) prehospital medical records. Of the 46 AEs, 43 were classified as potential for harm (AE1) (4.0, 95% CI = 2.9-5.4) and three as harm identified (AE2) (0.3, 95% CI = 0.1-0.9). However, among patients with a life-threatening condition (priority 1), the risk of AE was higher (16.5%). The most common factors contributing to AEs were deviations from standard of care and missing, incomplete, or unclear documentation. The most common cause of AEs was the result of action(s) or inaction(s) by the emergency medical service (EMS) crew. Conclusions: There were 4.3 AEs per 100 ambulance missions in Swedish prehospital care. The majority of AEs originated from deviations from standard of care and incomplete documentation. There was an increase in the risk of AE among patients who the EMS team assessed as having a life-threatening condition. Most AEs were possible to avoid.

Place, publisher, year, edition, pages
BMC , 2019. Vol. 19, article id 14
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Health Sciences
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URN: urn:nbn:se:mdh:diva-43023DOI: 10.1186/s12873-019-0228-3ISI: 000462228100001PubMedID: 30678636Scopus ID: 2-s2.0-85060553010OAI: oai:DiVA.org:mdh-43023DiVA, id: diva2:1302347
Available from: 2019-04-04 Created: 2019-04-04 Last updated: 2019-04-10Bibliographically approved

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Strömsöe, Anneli

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