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The opinion of emergency medical service personnel regarding safety in pre-hospital emergency care practice

By Robyn Holgate


A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Emergency Medicine Johannesburg, 2015The pre-hospital setting poses a potential threat to safety as emergency care takes place in a dynamic, uncontrolled and ever-changing environment. In addition Emergency Medical Services (EMS) personnel are generally overworked. All these factors translate to possible errors which may well compromise the health conditions of the patients. This study reflects the opinions of pre-hospital personnel regarding safety and as such the perception of the current state of safety in South African EMS. A prospective, descriptive and cross-sectional online survey was utilised to obtain opinions from respondents regarding pre-hospital safety in their work environment. Results A total of 610 electronic requests to partake in the survey were sent with a yield of 26.9% (n=164). A variety of questions relating to personal safety, patient safety and organisational safety culture were posed to the respondents. The typical respondent was a white (84%, n=134), male (69%, n=109), Advanced Life Support Paramedic (55%, n=86), between the age of 31 and 40 years (44%, n=69), who has between 11 and 15 years of EMS experience and works in in the private sector (62.5%, n=65). Concerns included management support, fatigue, vehicle accidents and interpersonal violence. The majority have been exposed to vehicle accidents (54.2%, n=84) and it is believed that management could do more to ensure vehicle safety. Interpersonal violence should not be considered an anomaly in the EMS. The perceived incidence of violence towards the respondents is 56% (n=88), which is lower than that experienced by their international EMS colleagues. This workplace interpersonal violence was deemed the most important safety concern. Most respondents did not seem to think that medical adverse events were particularly prevalent in their work environment, but appeared more comfortable admitting to having witnessed others making errors. Limitations include a convenience sample which does not represent all EMS, and it is recommended that a representative study be completed. Conclusion Contributing factors towards safety concerns include lack of management support, poor communication from management, fatigue, interpersonal violence and inadequate staffing. There is evidence of a focus on a patient safety culture within the EMS

Year: 2015
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