TY  - JOUR
PY  - 2018//
TI  - Barriers to self-reporting patient safety incidents by paramedics: a mixed methods study
JO  - Prehospital emergency care
A1  - Sinclair, Julie E.
A1  - Austin, Michael A.
A1  - Bourque, Christopher
A1  - Kortko, Jennifer
A1  - Maloney, Justin
A1  - Dionne, Richard
A1  - Reed, Andrew
A1  - Price, Penny
A1  - Calder, Lisa A.
SP  - 762
EP  - 772
VL  - 22
IS  - 6
N2  - BACKGROUND: A minimal amount of research exists examining the extent to which patient safety events occur within paramedicine and even fewer studies investigating patient safety systems for self-reporting by paramedics. The purpose of this study was to identify barriers to paramedic self-reporting of patient safety incidents (PSIs). <br><br>METHODS: We randomly distributed paper-based surveys among 1,153 paramedics in an Ontario region in Canada. The survey described one of 5 different PSI clinical scenarios (near miss, adverse event, and minor, major or critical patient care variances) and listed 18 potential barriers to self-reporting PSIs as statements presented for rating on a 5-point Likert scale (very significant = 1 - very insignificant = 5). We invited comments on PSI self-reporting with 2 open-ended questions. We analyzed data with descriptive statistics, chi-square tests and Kruskal-Wallis H test. We used an inductive approach to qualitatively analyze emerging themes. <br><br>RESULTS: We received responses from 1,133 paramedics (98.3%). Almost one third (28.4%) were Advanced Care Paramedics and 45.1% had >10 years' experience. The top 5 barriers to PSI self-reporting (very significant or significant, %) were the fear of being: punished (81.4%), suspended (79.6%), terminated (79.1%), investigated by Ministry of Health and Long-Term Care (78.4%), and decertified (78.0%). Overall, 64.1% responded they would self-report a given PSI. Intention to self-report a PSI varied according to scenario (22.8% near miss, 46.6% adverse event, 74.4% minor, 92.6% major, 95.6% critical). No association was found between level of training (p = 0.55) or years of experience (p = 0.10) and intention to self-report a PSI. Seven themes to improve PSI self-reporting by paramedics emerged from the qualitative data. <br><br>CONCLUSIONS: A high proportion of fear-based barriers to self-reporting of PSIs exist among this study population. This suggests that a culture change is needed to facilitate the identification of future patient safety threats.<p />  <p>Language: en</p>
LA  - en
SN  - 1090-3127
UR  - http://dx.doi.org/10.1080/10903127.2018.1469703
ID  - ref1
ER  -