'please describe from your point of view a typical case of an error in palliative care': Qualitative data from an exploratory cross-sectional survey study among palliative care professionals

摘要

Context: Patient safety is a concern in medicine, and the prevention of medical errors remains a challenge. The definition and understanding of an error is particularly difficult in palliative care, with scarce empirical evidence about the nature and causes of medical errors in that discipline. Objectives: This study explored incidents palliative care professionals perceive as typical errors in their practice, and descriptions of such events. Methods: In the context of an exploratory, cross-sectional survey on errors in palliative care among professionals of palliative care institutions in Bavaria, Germany (n=168), participants described a typical case in which an error occurred. Data from free-text answers was qualitatively analyzed, and categories for areas and causes of errors were extracted. Results: The questionnaire was returned by 42% (n=70) of the sample. Two-thirds of respondents (n=46, 66%) gave a free-text answer describing a typical error in palliative care. Seven potential areas for errors were identified in the qualitative analysis: drug treatment, palliative sedation, communication, care organization, treatment plan, end-of-life care, and history taking. Six categories emerged as causes of errors: miscommunication, system failure, dysfunctional attitudes, lack of knowledge, wrong use of technology, and misjudgement. Conclusion: Data showed that medical errors in palliative care, as seen by professionals in the field, primarily affect medication and communication, and miscommunication and system failures are perceived as the leading causes of errors. A better understanding of the characteristics of errors within palliative care and further qualitative research are warranted to prevent errors and enhance patient safety.