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Emergency medical and health providers' perceptions of key issues in prehospital patient safety.

机译：急诊医疗人员对院前患者安全关键问题的看法。

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OBJECTIVES: To date, most patient safety studies have been conducted in relation to the hospital rather than the prehospital setting and data regarding emergency medical services (EMS)-related errors are limited. To address this gap, a study was conducted to gain an in-depth understanding of the views of highly experienced EMS practitioners, educators, administrators, and physicians on major issues pertaining to EMS patient safety. The intent of the study was to identify key issues to give direction to the development of best practices in education, policy, and fieldwork. METHODS: A qualitative study was conducted using processes described by Lincoln and Guba (1985) to enhance the quality and credibility of data and analysis. Purposive sampling was used to identify informants with knowledge and expertise regarding policy, practice, and research who could speak to the issue of patient safety. Sixteen participants, the majority of whom were Canadian, participated in in-depth interviews. RESULTS: Two major themes were identified under the category of key issues: clinical decision making and EMS's focus and relationship with health care. An education gap has developed in EMS, and there is tension between the traditional stabilize-and-transport role and the increasingly complex role that has come about through "scope creep." If, as expected, EMS aligns increasingly with the health sector, then change is needed in the EMS educational structure and process to develop stronger clinical decision-making skills. CONCLUSION: The results of this study indicate that many individual organizations and health regions are addressing issues related to patient safety in EMS, and there are important lessons to be learned from these groups. The broader issues identified, however, are system-wide and best addressed through policy change from health regions and government.
机译：目标：迄今为止，大多数患者安全性研究都是针对医院进行的，而不是院前设置，有关急诊医疗服务（EMS）相关错误的数据有限。为了弥补这一差距，进行了一项研究，以深入了解经验丰富的EMS从业人员，教育者，管理人员和医师在与EMS患者安全有关的重大问题上的观点。该研究的目的是确定关键问题，以指导发展教育，政策和实地工作的最佳实践。方法：使用Lincoln和Guba（1985）描述的过程进行了定性研究，以提高数据和分析的质量和可信度。目的抽样被用来识别对政策，实践和研究具有知识和专业知识的举报人，这些举报人可以谈论患者安全问题。 16名参与者（其中大多数是加拿大人）参加了深入采访。结果：在关键问题类别下确定了两个主要主题：临床决策和EMS的重点以及与医疗保健的关系。 EMS中的教育差距已经扩大，传统的稳定和运输角色与通过“范围蠕变”而变得越来越复杂的角色之间存在紧张关系。如果如预期的那样，EMS与卫生部门的接轨越来越紧密，那么就需要改变EMS的教育结构和过程，以发展更强的临床决策技能。结论：这项研究的结果表明，许多个体组织和健康地区正在解决与EMS患者安全有关的问题，并且从这些群体中可以吸取重要的教训。但是，确定的更广泛的问题是整个系统的，最好通过卫生区域和政府的政策变更来解决。

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