South Carelia Social and Healthcare District, Lappeenranta, Finland.
Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
J Clin Nurs. 2023 Mar;32(5-6):847-858. doi: 10.1111/jocn.16396. Epub 2022 Jun 7.
To describe prehospital nursing students' experiences of patient safety culture in emergency medical services during their internship.
Patient safety culture in the emergency medical services is a complex phenomenon including more than organisational policies and practices and professionals' technical skills.
The descriptive qualitative approach used the Sharing Learning from Practice to improve Patient Safety Learning Event Recording Tool, which includes both open-ended and structured questions.
Purposeful sampling was used, and data were collected from graduating prehospital nursing students (n = 17) from three Finnish Universities of Applied Sciences. Open-ended questions were reviewed using thematic analysis, and frequencies and percentages were derived from structured questions. COREQ guidelines were used to guide this study.
Four themes were identified during the thematic analysis: environmental and other unexpected factors in emergency medical services, working practices and professionalism in emergency medical services, teamwork in emergency medical services and feelings related to patient safety events in emergency medical services. Patient safety events described by students were seldom reported in the healthcare system or patient files. According to the students, such events were most likely related to communication, checking/verification and/or teamwork.
This study shows that prehospital nursing students can produce important information about patient safety events and the reasons that contributed to those events. Therefore, emergency medical services organisations and managers should use students' observations to develop a patient safety culture in emergency medical services.
Understanding how prehospital nursing students have experienced patient safety culture during their internships on ambulances can support educational institutions, together with emergency medical services organisations and managers, to improve policies for students to express patient safety concerns as well as patient safety successes.
描述在实习期间，急诊医学专业的护理专业学生在院前环境中对患者安全文化的体验。
急诊医疗服务中的患者安全文化是一种复杂的现象，包括组织政策和实践以及专业人员的技术技能。
本研究采用描述性定性方法，使用从实践中学习以提高患者安全学习事件记录工具，该工具包括开放式和结构化问题。
采用目的性抽样，从三所芬兰应用科学大学的即将毕业的院前护理学生（n=17）中收集数据。使用主题分析对开放式问题进行了审查，并从结构化问题中得出了频率和百分比。使用 COREQ 指南来指导这项研究。
在主题分析中确定了四个主题：急诊医疗服务中的环境和其他意外因素、急诊医疗服务中的工作实践和专业精神、急诊医疗服务中的团队合作以及急诊医疗服务中与患者安全事件相关的感受。学生描述的患者安全事件很少在医疗保健系统或患者档案中报告。根据学生的说法，此类事件最可能与沟通、检查/验证和/或团队合作有关。
本研究表明，院前护理学生可以提供有关患者安全事件及其促成因素的重要信息。因此，急诊医疗服务组织和管理人员应该利用学生的观察结果来发展急诊医疗服务中的患者安全文化。
了解护理专业学生在实习期间在救护车上对患者安全文化的体验，可以支持教育机构、急诊医疗服务组织和管理人员共同制定政策，让学生表达对患者安全问题的关注以及患者安全方面的成功经验。
