Relationship between the depressive state of emergency life-saving technicians and near-misses

Katsumi Honno; Tatsuhiko Kubo; Yoshiki Toyokuni; Tomohiro Ishimaru; Shinya Matsuda; Yoshihisa Fujino

doi:10.1002/ams2.463

Relationship between the depressive state of emergency life-saving technicians and near-misses

Acute Med Surg. 2019 Oct 27;7(1):e463. doi: 10.1002/ams2.463. eCollection 2020 Jan-Dec.

Authors

Katsumi Honno¹, Tatsuhiko Kubo², Yoshiki Toyokuni¹, Tomohiro Ishimaru^{3

4}, Shinya Matsuda¹, Yoshihisa Fujino⁵

Affiliations

¹ Department of Public Health School of Medicine University of Occupational and Environmental Health Kitakyushu Japan.
² Department of Public Health and Health Policy Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
³ Department of Health Management Nishinihon Occupational Health Service Center Kitakyushu Japan.
⁴ Department of Occupational Health Practice and Management Institute of Industrial Ecological Sciences University of Occupational and Environmental Health Kitakyushu Japan.
⁵ Department of Environmental Epidemiology Institute of Industrial Ecological Sciences University of Occupational and Environmental Health Kitakyushu Japan.

Abstract

Aim: A depressive state is a key risk factor for medical errors made by emergency life-saving technicians (ELSTs). However, no study has examined the occurrence of near-misses in ELSTs. We investigated the association between a depressive state and near-misses among ELSTs.

Methods: A cross-sectional study was undertaken in 345 ELSTs using an anonymous self-administered questionnaire. The main exposure was a depressive state that was measured using the Quick Inventory of Depressive Symptomatology. For the main outcome, near-miss events, we calculated odds ratios (OR) of depressive states, adjusted for age and work-related factors by multivariable logistic regression. For exploratory purposes, we also undertook secondary analyses to determine whether work-related factors were associated with a depressive state.

Results: We obtained 254 responses. Compared to ELSTs without a depressive state, the adjusted OR for near-misses among ELSTs with a mild depressive state was 3.14 (95% confidence interval [CI], 1.37-7.16; P = 0.007), and that among ELSTs with a moderate or greater depressive state was 5.29 (95% CI, 1.46-19.09; P = 0.011). For a depressive state, in the exploratory analyses, the OR of nap duration while on duty for less than 2 h was 3.34 (95% CI, 1.15-9.67; P = 0.027), that for irregular mealtime while on duty was 3.71 (95% CI, 2.00-6.86; P < 0.001), and that for a duration of desk work of 4 h or longer was 2.21 (95% CI, 1.15-4.25; P = 0.017).

Conclusion: A depressive state was significantly associated with the occurrence of near-misses among ELSTs. That a depressive state among ELSTs was related to nap duration and excessive office work indicates that improved management of the work environment and operations of ELSTs is necessary for the provision of safe emergency medical services.

Keywords: Emergency life‐saving technician; medical error; near‐miss; paramedic; quick inventory of depressive symptomatology.