Prehospital nursing students' experiences of patient safety culture in emergency medical services-A qualitative study

Abstract

Aims and objectives: To describe prehospital nursing students' experiences of patient safety culture in emergency medical services during their internship.

Background: Patient safety culture in the emergency medical services is a complex phenomenon including more than organisational policies and practices and professionals' technical skills.

Design: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Relevance to clinical practice: 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.

Keywords: ambulance service; emergency medical services; patient safety; prehospital nursing student; safety culture; safety management.