Pa ien and S a Sa e y Inciden s and Nea Misses in Ou -O -Hospi al
Eme gency Ca e
Ma i Salminen-Tuomaala1*, Päi i Leikkola2 and Eija Paa ilainen3
1Seinäjoki Uni e si y o Applied Sciences, School o Heal h Ca e and Social Wo k, Finland
2Nu sing Di ec o , Seinäjoki Cen al Hospi al, Finland
3P o esso (Resea ch Collegium 2011-2012). School o Heal h Sciences (Nu sing Science) Uni e si y o Tampe e, Finland; Sou h Os obo hnia Hospi al Dis ic ,
Seinäjoki, Finland
*Co esponding au ho : Ma i Salminen-Tuomaala, PhD, Senio Lec u e , Seinäjoki Uni e si y o Applied Sciences, School o Heal h Ca e and Social Wo k,
Koskenalan ie 17 Seinäjoki, Finland Tel: +350505739568; E-mail: [email p o ec ed]
Recei ed da e: June 25, 2014, Accep ed da e: Sep embe 09, 2014, Published da e: Sep embe 16, 2014
Copy igh : © 2014 Tuomaala MS, e al. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e Commons A ibu ion License, which pe mi s
un es ic ed use, dis ibu ion, and ep oduc ion in any medium, p o ided he o iginal au ho and sou ce a e c edi ed.
Abs ac
Objec i es: The pu pose o his quali a i e s udy is o desc ibe pa ien and s a sa e y inciden s and nea misses
in ou -o -hospi al eme gency ca e wi h he aim o p o iding new knowledge ha can be use ul in p e en ing and
dec easing isks in eme gency ca e. Resea ch Me hodology and se ing: The da a consis ed o olun a y,
anonymous epo s collec ed online om eme gency ca e s a in 2013 in one hospi al dis ic ha se es a
popula ion o 200,000 in Finland. A o al o 45 inciden desc ip ions o ad e se inciden s, isks and nea misses we e
acc ued, all o which we e analyzed using induc i e con en analysis.
Resul s: The esul s e eal ha h ea s o pa ien sa e y a e associa ed wi h he pa ien ’s psychological and
physical s a us, medica ion, ca e equipmen and con ex . In occupa ional sa e y o eme gency ca e p o ide s, he
pa ien ’s men al ill-being and agg ession, he con ex , ca e equipmen and eme gency d i ing cons i u e po en ial
sou ces o isks.
Conclusion: As only a limi ed numbe o inciden s we e epo ed, s a should be encou aged o use he epo ing
sys em as an essen ial pa o quali y managemen in eme gency se ices. Mo e a en ion needs o be paid o
assessing he o e all eme gency si ua ion om he iewpoin o sa e y and he le el and eliabili y o in o ma ion
be o e s a ing diagnos ic p ocedu es and ea men . Educa ion and s udy o ea lie sa e y inciden s can help
p e en isks.
In oduc ion
Pa ien and s a sa e y ha e in e na ionally become an inc easing
conce n in a ious heal hca e sec o s [1-4]. Fo example,
app oxima ely en pe cen o pa ien s in Eu ope a e subjec o some
ad e se e en du ing hei hospi al ca e [3]. Up un il oday, li le
esea ch has been conduc ed on pa ien and occupa ional sa e y in
eme gency ca e speci ically. The knowledge gap is e en wide as
ega ds ou -o -hospi al eme gency ca e. Much o eme gency ca e is
s a ed in p e-hospi al se ings and no all pa ien s e en need o be
aken o hospi al. Ve y o en, eme gency ca e can be compe en ly
deli e ed in he pa ien ’s home [5,6] o o he loca ion, using a “s ay
and play” app oach.
To summa ize some o he exis ing esea ch: A s udy conduc ed on
ad e se e en s and nea misses in he Uni ed Kingdom e ealed ha
pa ien sa e y e en s had mos o en in ol ed medica ion e o s, poo
communica ion and equipmen mal unc ion, de ec o misuse [7].
S udies on medica ion e o s ha e shown ha isks we e caused by
o e dosing o adminis e ing a w ong d ug [8,9]. Fu he s udies e eal
ha pa ien sa e y is associa ed wi h s a compe ence [10-12]. Besides
clinical compe ence, eme gency ca e p o ide s need si ua ional
sensi i i y and p oblem-sol ing skills. They need o be able o
an icipa e isks and sa e y inciden s and o iden i y nea miss
si ua ions [13-15]. E en deciding whe he o ea a pa ien a home
can in ol e a isk [6,16-19]. The pa ien ’s physical condi ion is usually
ca e ully assessed and well documen ed, bu mo e a en ion needs o
be paid o documen ing he pa ien ’s psychological s a us and e ec s o
in e en ions aken [20]. Inexpe ienced ecen g adua es equi e
suppo om mo e expe ienced colleagues, especially in unan icipa ed
si ua ions ha call o b isk decision-making and ac ion. Young s a
membe s may eel p essu ed o ac as , while simul aneously eeling
insecu e abou hei assessmen and decision-making compe ence.
No ye able o assess he o e all si ua ion, hey end o ocus on de ail
[8,21].
In occupa ional sa e y, ad e se e en s and nea misses ha e been
shown o be associa ed wi h equipmen mal unc ion and wi h isks
caused by ci cums ances o iolence [7]. Unan icipa ed, apidly
changing si ua ions and lacking in o ma ion o pa ien s’ medical
his o y inc ease he isk o sa e y inciden s [8]. Misunde s andings and
o he dis up ions in he low o in o ma ion ha e o en been ound o
con ibu e o ad e se e en s [22-24]. All ele an backg ound
in o ma ion should he e o e be eadily a ailable elec onically [25].
I is clea ha sys ema ic ac ion is equi ed o ecognize isks and o
p e en human e o [26,27]. I may be added in his con ex ha a
concep ual model has been p oposed [28], sugges ing ha he sa e y
and quali y o pa ien ca e, as well as he occupa ional sa e y o ca e
p o ide s, can be assessed in e ms o s uc u e, p ocess o ou come o
ca e. This pe spec i e could be applied o ou -o -hospi al eme gency
ca e as well.
Eme gency Medicine: Open
Access
Salminen-Tuomaala e al., Eme gency Med 2014,
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h p://dx.doi.o g/10.4172/2165-7548.1000219
Resea ch A icle Open Access
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ISSN:2165-7548 EGM, an open access jou nal Volume 4 • Issue 6 • 1000219
A wo d on e minology: This s udy uses he e m sa e y inciden o
e e o unin ended o unexpec ed (ad e se) e en s which led o could
ha e led o some ha m o ei he pa ien s o eme gency ca e p o ide s.
The e m nea miss is used o e en s ha came e y close o ha ming
pa ien s o p o essionals.
Objec i es
In an a emp o dec ease he knowledge gap ega ding pa ien and
occupa ional sa e y in ou -o -hospi al eme gency ca e, his pape
desc ibes pa ien and s a sa e y inciden s and nea misses in ou -o -
hospi al se ings in one hospi al dis ic in Finland. The s udy aims a
p o iding new knowledge ha can be use ul in p e en ing and
dec easing isks in eme gency ca e.
The esea ch ques ions a e:
Wha kind o si ua ions occu s in eme gency ca e ha jeopa dizes
pa ien sa e y?
Wha kind o si ua ions occu s in eme gency ca e ha jeopa dizes
he ac ion and sa e y o eme gency ca e s a ?
Me hods
3.1 Da a collec ion
Da a o his quali a i e esea ch we e collec ed in he i s en
mon hs o he yea 2013 in one hospi al dis ic ha se es
app oxima ely 200,000 inhabi an s in Finland. The ma e ial was
ob ained om a Web-based Repo ing Sys em called HaiP o. This
na ionwide epo ing sys em, launched in 2005, was designed o collec
heal h ca e p o ide s’ olun a y, anonymous desc ip ions o isks,
sa e y inciden s and nea misses in heal h se ices. The sys em is based
on olun a y, anonymous s a epo ing o nea misses and ad e se
e en s in bo h pa ien ca e and occupa ional sa e y. The sys em
con ains a single ques ion, eques ing po en ial esponden s o
desc ibe a sa e y inciden and i s h ea ening elemen s in hei own
wo ds. The idea is o encou age heal h p o essionals o s udy he
causes and onse mechanisms o ad e se e en s and nea misses and o
look o p e en i e ac ion [29]. Lea ning o iden i y nea misses can
help s a o a oid po en ially isky si ua ions and change hei ac ion
and beha io [30]. Volun a y, anonymous epo ing allows dealing
wi h sa e y issues wi hou public guil and shame [22-24,31].
The numbe o inciden desc ip ions ob ained in he a ge
popula ion (one hospi al dis ic wi h 200,000 inhabi an s) be ween
Janua y and No embe in 2013 was 45. All hese desc ip ions we e
included in his s udy e ospec i ely.
3.2 Da a analysis
Da a we e analyzed using induc i e con en analysis. A s a emen –
exp essed in a wo d, cause o sen ence - was selec ed as he uni o be
analyzed. Da a we e educed by coding hem by esea ch ask.
Simila i ies and di e ences we e iden i ied and s a emen s combined
o p oduce sub-ca ego ies. Sub-ca ego ies wi h simila con en s we e
combined o yield main ca ego ies. Reliabili y o he analysis was
imp o ed by including au hen ic ex ac s om he HaiP o Repo ing
Sys em [32].
Resul s
The esul s sec ion is based on a quali a i e analysis o he all he
inciden desc ip ions ob ained du ing 10 mon hs in 2013 h ough he
olun a y online HaiP o Repo ing Sys em in a hospi al dis ic ha
se es a popula ion o 200,000. The esul s sec ion in has been di ided
in o wo pa s, he i s o which deals wi h pa ien sa e y. The second
pa desc ibes ad e se inciden s and isk ac o s in he wo k o
eme gency ca e s a .
4.1 Risks o pa ien sa e y
In his s udy, isks o pa ien sa e y in ou -o -hospi al eme gency
ca e we e associa ed wi h he pa ien ’s psychological and physical
condi ion, medica ion, equipmen and con ex , as shown in igu e 1. I
was also e ealed ha pa ien sa e y can be comp omised by poo
communica ion o epo ing. None o he ac o s p edomina ed.
Figu e 1: Risks o pa ien sa e y in eme gency ca e
Risk ac o s ela ed o he pa ien ’s psychological and physical
condi ion:Sa e y inciden s and nea misses in eme gency can be
associa ed wi h pa ien s’ memo y diso de s, con usion, physical ail y
o men al heal h p oblems. In he ollowing example, he combined
poo physical condi ion o a s oke pa ien and s a negligence
esul ed in an ad e se inciden .
A pa ien had been aken o he wa d by ambulance. They had le
him si ing alone on he edge o he bed. The wa d s a had no been
p ope ly in o med o he pa ien ’s condi ion. The pa ien ell and hi
his head on he loo .
Risk ac o s ela ed o medica ion: E en when immedia e
medica ion is equi ed, calcula ing he co ec dose should no be
comp omised. This s udy showed ha medica ion e o s we e a
po en ial sou ce o isk in eme gency ca e. As in he example below,
e o s may be caused by lack o expe ience. No ice s a membe s do
no always ha e a concep ion o wha cons i u es a no mal dose.
Unclea di ision o du ies was ano he ac o ha esul ed in p oblems
in he ca e p o ide s’ desc ip ions, o example when ambulance c ew
s ayed in heal h cen e o assis s a he e.
My colleague ga e a pa ien 10 mg o Diazepam IV, ins ead o 2 mg.
She mus ha e mishea d he doc o ’s o de s du ing consul a ion, and
Ci a ion: Salminen-Tuomaala, Leikkola P, Paa ilainen E (2014) Pa ien and S a Sa e y Inciden s and Nea Misses in Ou -O -Hospi al
Eme gency Ca e . Eme gency Med 4: 219. doi:10.4172/2165-7548.1000219
Page 2 o 5
Eme gency Med
ISSN:2165-7548 EGM, an open access jou nal Volume 4 • Issue 6 • 1000219
she had no idea o a no mal dosage ye . The pa ien s opped b ea hing
and we had o bag him.
We we e in he heal h cen e helping ou and he e was a pa ien
su e ing om ches pain. Because o his gene al condi ion, we ook an
ECG and pu him on a d ip. The doc o o de ed him Ni o in usion
and I hough ha he heal h cen e nu se would go and dilu e i . This
did no happen o some eason and he doc o s a ed o demand i
om me a ull oice. So I made a hinking e o in a hu y and
wi hd ew h ee ampoules in o a sy inge. We did no no ice he mis ake
immedia ely, bu I s a ed o wonde as he pa ien ’s blood p essu e
wen down. The pa ien ’s li e was no a isk, bu i was a nea miss.
The di ision o du ies was no clea , who should do wha . The
medica ion a ea was es less and he doc o in e e ed by shou ing and
ushing us.
Risk ac o s ela ed o ca e equipmen : Equipmen mal unc ion,
whe he i conce ns communica ion ools o de ices used o measu e
i al signs, is ano he po en ial sou ce o isk, as shown in his s udy,
oo. Fo example, de ices used o measu e blood suga o blood
p essu e may occasionally gi e w ong eadings. Expe ienced s a
knows how o educe isks by combining and compa ing eadings and
pa ien obse a ion, as in he ollowing desc ip ion w i en by a ca e
p o ide :
We we e aking a pa ien ’s blood suga . Fi s , i was 32.5. A e a
minu e, howe e , we measu ed i again and i was 7.2. We ied once
mo e wi h he pa ien ’s own de ice and go he esul 12.0. The pa ien
was poo ly, ain and i ed. Had we no measu ed again, he pa ien
would ha e been a isk, because we would ha e gi en him a la ge
dosage o No o apid.
The mobile o ou uni go ou o whack. We we e unable o con ac
anyone by elephone. We needed o call and consul a doc o in he
cen al hospi al, bu we could no each any numbe . The phone asked
o an upda e o he so wa e, which we could no pe o m, no being
able o con ac he se e .
Risk ac o s ela ed o he con ex : Ou -o -hospi al ca e can ake
place in any con ex . Risks may be caused by he en i onmen , wea he
condi ions o people p esen in he si ua ion. The pa ien may be
wai ing o help in di icul access loca ions; on a oo , in he s ee , in
wa e o on a scene wi h a g ea numbe o people. Access o he scene
may be complica ed by wea he o a ic condi ions. In cold wea he ,
pa ien s wai ing ou doo s a e subjec o he isk o hypo he mia.
A pa ien had allen in o an AIV odde silo. We had o wai o
assis ance o be able o li him up. The pa ien was conscious bu
unable o mo e his limbs.
Dis essed people on he scene may a ec he eme gency ca e
eam’s possibili ies o help he pa ien . Those p esen may ha e hei
own, di e en iews o how he pa ien should be ea ed.
I was di icul o in e iew he pa ien , because he amily membe s
kep p essing us o ake him o hospi al. They we e anxious and did
no unde s and when we said ha he si ua ion needed o be assessed
i s . They kep shou ing and jumping abou a ound us.
4.2 Risks o occupa ional sa e y in eme gency ca e
Figu e 2 shows ha isk ac o s in he occupa ional sa e y o
eme gency ca e s a we e ound o be associa ed wi h pa ien s’
psychological ill-being and agg ession, he con ex , equipmen and
eme gency d i ing. The i s ac o men ioned, pa ien s’ psychological
ill-being and agg ession s ood ou as he mos p ominen ac o .
Figu e 2: Risks o occupa ional sa e y in eme gency ca e
Risk ac o s ela ed o he pa ien ’s psychological ill-being and
agg ession: The ollowing examples illus a e how he pa ien ’s
psychological ill-being and agg ession may pu he s a ’s occupa ional
sa e y a isk. In mos epo s wi hin he HaiP o sys em such inciden s
we e associa ed wi h pa ien s’ hea y use o alcohol o men al heal h
p oblems. Combined use o alcohol and d ugs may lead o e bal o
physical agg ession. Acu ely changing si ua ions and pa ien s’
unexpec ed beha io endange s he occupa ional sa e y o eme gency
ca e s a .
A pa ien had called he eme gency cen e complaining o back
pain. He had consumed a g ea deal o alcohol du ing he day. When
he ambulance go he e, he pa ien e used o answe any ques ions
abou he ca e. They ied e e y hing o ge him in o he ehicle, bu
he would no co-ope a e. The pa ien ’s beha io became agg essi e.
His speech was agg essi e, oo. He ied o hi one s a membe . He
h ew a lo o s ones, hi ing he on o he ambulance, while he
pa amedics had o ake e uge in he ambulance.
I was abou o emo e he blood p essu e cu om a d unken man,
when he hi me in he nose.
Pa ien s’ es lessness and agg ession may also be due o side e ec s
o d ugs. Some imes pa ien s exp ess discon en wi h ea men
al e na i es o ake i o g an ed ha he ambulance will ake hem o
hospi al. The pa ien in he ollowing desc ip ion ound i di icul o
accep ha his condi ion did no equi e ambulance anspo .
A pa ien called he eme gency cen e because o leg pain. He old
ha he had a se e e pain in he hip and ha his own pain medica ion
was no su icien a all. The pain in he leg and he inju y we e an old
complain , he pa ien was s ill able o ake b isk s eps. The pa ien
demanded ha he ambulance c ew should ake him o hospi al and
ha hey should come and ell he doc o how o ea he leg. He was
old ha he e was no need o ambulance anspo bu ha a axi
migh be called o ake him o see a doc o . The pa ien go ang y,
ushed in o he ki chen o ge a big kni e, using i o h ea en he ca e
p o ide s and saying ha he would cu o his leg i he was no aken o
hospi al. He h ew o he kni e in o he wall and con inued e bal
agg essi e beha io . The pa ien had decided o ge in o hospi al by
ambulance and he did no ag ee wi h he ac s conce ning his
Ci a ion: Salminen-Tuomaala, Leikkola P, Paa ilainen E (2014) Pa ien and S a Sa e y Inciden s and Nea Misses in Ou -O -Hospi al
Eme gency Ca e . Eme gency Med 4: 219. doi:10.4172/2165-7548.1000219
Page 3 o 5
Eme gency Med
ISSN:2165-7548 EGM, an open access jou nal Volume 4 • Issue 6 • 1000219
admission. He may ha e had wi hd awal symp oms a e
discon inua ion o T amal ha may ha e caused his ou bu s .
Use o illici d ugs can esul in agg essi e beha io . Se e al d ug
use s may be ga he ed in a loca ion when he ambulance a i es,
which adds o he isk. I is o en necessa y o seek assis ance om he
police.
A pa ien had called an ambulance because he was unable o s and.
The ambulance a i ed and hey ound he house doo locked. The
wo pa amedics wen a ound he house o he back doo . The back
doo was open, and as hey emo ed he cu ain ha hung om he
doo , hey ound he pa ien wi h an ai i le poin ing a hem. The
pa ien did, howe e , lowe he weapon and one o he pa amedics
placed i a he away. The pa ien was easily exci able all he ime, bu
he s ayed a home and p omised o ake a axi o he heal h cen e.
Some imes a pa ien ’s agg ession may be associa ed wi h ea and he
may be unable o unde s and why he is being app oached by he
eme gency ca e s a . Pa ien s, who su e om delusions, con usion o
demen ia, may expe ience he s a as h ea ening and eso o
physical agg ession. A bi e om a iolen pa ien , o example, can
lead o dange ous and pe sis en in ec ions. The manne in which
pa ien s a e app oached and he si ua ion managed is o g ea
consequence.
The man was wa ing a s ick and ied o a ack us when we wen o
see him. The spec acles o one o he pa amedics ell on he loo , bu
he e we e no se ious inju ies o b uises. The pa ien had demen ia
and he hough we we e he e o ake him o p ison.
An aged man s a ed o hi and lail his a ms abou and ied o kick
me when I ook his i als and lis ened o his b ea hing. He bi me in
my igh a m.
Risk ac o s ela ed o he con ex : Eme gency ca e p o essionals
wo k in a a ie y o con ex s, in and ou doo s.
Limi ed space can inc ease isks, o example when ca e mus be
p o ided in con ined spaces, such as oile s. Lack o exi pa hs can
escala e he isk in iolen si ua ions. In addi ion, and impo an ly,
e y o en ca e is p o ided in a mo ing ambulance. Each si ua ion is
unique and i may be di icul o an icipa e he isks. The examples
below demons a e isks caused by wea he condi ions and pe s.
The pa ien was lying on his back on ice. I ied o ge o him as as
as possible and slipped. I hi my head on he ice bu was able o
con inue immedia ely owa ds o pa ien .
I was abou o en e a pa ien ’s home wi h my colleague. The e was
an ang y dog in he ya d. The dog bi my colleague’s ouse s’ legs bu
did no cause any physical inju y. We asked a amily membe o
emo e he dog. When I had he pa ien on a s e che and was li ing
him in o he ehicle, he dog eached ou om he amily membe ’s
a ms and bi me in my igh a m. I go a wound.
Risk ac o s ela ed o equipmen : In eme gency ca e p o ide s’
wo k, mal unc ioning equipmen and lack o expe ience can esul in
physical ha m. A deg ee o echnical skills and concen a ion a e
equi ed o use he equipmen sa ely. The p o essional’s dis ess o
anxie y will jeopa dize bo h s a and pa ien sa e y.
While aking a pa ien ou o he ambulance, he on legs o he
s e che did no ca ch no mally. I had o make a sudden mo ion down
and o wa d. A e he e en , my lowe back became pain ul and I had
di icul y mo ing.
My colleague somehow li ed he s e che ca elessly and he pa ien
il ed and nea ly ell o he s e che . I made a sudden mo ion and
caugh he pa ien in my a ms. I pulled my back and go a pain in my
hip.
Risk ac o s ela ed o eme gency d i ing: I may p o e challenging
o p o ide e ec i e ca e in a as mo ing ambulance ha has o
o e ake o he ehicles. O he d i e s’ unexpec ed eac ions may lead
o sudden b aking, as in he ollowing example.
I was wi h my colleague, a ending o a pa ien in he ca e
compa men . The d i e was a i s esponde . The d i e suddenly
slowed down om 140 kph. We ha e o emo e ou sea bel s e e y
once in a while o ca e o he pa ien . Now I had s ood up o ca e o
he pa ien . I was holding on o he secu i y ail, bu s ill los my g ip
because o he sudden b aking. I olled o e , alling on my knees on an
open eme gency bag.
Discussion
Sa e y is an essen ial quali y ac o in eme gency ca e [4,33,34].
Sa e y inciden s and nea misses in pa ien and occupa ional sa e y can
be assessed in ela ion o he s uc u e and p ocess o he ca e [28]. In
eme gency ca e, s uc u al ac o s in ol e he s a ’s compe ence
s uc u e and he con ex in which hey wo k. P ocess ac o s, on he
o he hand, ep esen mo e indi idual ac o s p esen du ing he ime
con inuum ha s a s wi h he i s con ac o he pa ien and ends
wi h u ning him o e o ollow-up ca e.
In his s udy, isks o pa ien sa e y we e associa ed wi h he
pa ien ’s psychological and physical s a us, medica ion, ca e
equipmen and con ex . Some o hese ac o s can be an icipa ed and
p e en ed by making use o ele an esea ch esul s, whe eas o he s
a e si ua ion-speci ic and appea mo e andomly and unexpec edly. As
hey a e di icul o p edic , he isk o human e o is inc eased. One
can disce n a chain o isks unde pinning a ious sa e y inciden s,
which o en has i s onse in a ela i ely mino mis ake in he
assessmen o in e p e a ion o a si ua ion. Fo una ely, si ua ion
sensi i i y is a skill ha can be de eloped [14,18].
One way o dec ease medica ion e o s, sa e y inciden s and nea
misses is o p o ide con inuing educa ion, o example on
pha macology. P e ious s udies, oo, s ess he impo ance o u he
aining and educa ion o de elop s a skills and knowledge [6,8].
Ca e equipmen mus be o high quali y and i should be es ed a he
beginning o each shi . The impo ance o main aining high quali y in
eme gency ca e equipmen has been obse ed be o e [10,11].
In his s udy, isks o occupa ional sa e y we e associa ed wi h he
pa ien ’s men al ill-being and agg ession and wi h he con ex , ca e
equipmen and eme gency d i ing. Sa e and high quali y equipmen
can dec ease isks [11], as can con inuing educa ion.
Conclusions
This s udy analysed 45 inciden desc ip ions acc ued du ing 10
mon hs in a hospi al dis ic ha se es 200,000 inhabi an s. The
limi ed numbe o he desc ip ions can ega ded as a limi a ion o he
s udy, and longe da a collec ion pe iods a e indica ed in simila
s udies in he u u e. On he o he hand, his was a quali a i e s udy,
whose pu pose was no o each any quan i a i e gene aliza ions. The
c edibili y o he s udy, as one o he eliabili y c i e ia o quali a i e
esea ch [34], is enhanced by he use o au hen ic ex ac s om he
HaiP o Sys em desc ip ions w i en by eme gency ca e s a .
Ci a ion: Salminen-Tuomaala, Leikkola P, Paa ilainen E (2014) Pa ien and S a Sa e y Inciden s and Nea Misses in Ou -O -Hospi al
Eme gency Ca e . Eme gency Med 4: 219. doi:10.4172/2165-7548.1000219
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ISSN:2165-7548 EGM, an open access jou nal Volume 4 • Issue 6 • 1000219
The ac ha only 45 inciden s we e epo ed in he anonymous
online sys em can be conside ed a posi i e phenomenon, al hough i is
mos likely ha many inciden s, especially mino ones, a e ne e
epo ed. This poin o an impo an conclusion: S a should be
encou aged o use he epo ing sys em as an essen ial pa o quali y
managemen in eme gency se ices. Secondly, i can be in e ed ha
mo e a en ion needs o be paid o assessing he o e all eme gency
si ua ion om he iewpoin o sa e y and o looking in o he le el and
eliabili y o in o ma ion be o e s a ing any diagnos ic p ocedu es
and ea men .
The esul s a e use ul om he pe spec i es o pa ien and
occupa ional sa e y. The knowledge can be applied in heal h ca e
educa ion, bo h du ing oca ional quali ica ion s udies o eme gency
ca e s a o du ing i s -cycle nu sing s udies and la e , in a ious
con inuing educa ion p og ams. S udying desc ip ions o s a
expe iences and nea misses can make s uden s be e p epa ed o
demanding acu e si ua ions.
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Eme gency Ca e . Eme gency Med 4: 219. doi:10.4172/2165-7548.1000219
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ISSN:2165-7548 EGM, an open access jou nal Volume 4 • Issue 6 • 1000219