The effect of ambulance clinicians' well-being on occupational and patient safety in prehospital emergency medical services: A scoping review

Abstract

Working in prehospital emergency medical services (EMS) can be unpredictable and emotionally demanding for ambulance clinicians (ACs). Burnout, stress, poor sleep quality, fatigue, and psychological health issues increase the risk of accidents and adverse events related to occupational and patient safety. This scoping review aimed to identify and map the existing literature on the current state of the effect of ACs’ well-being on occupational or patient safety risks in prehospital emergency medical services settings. The methodologies of the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines were used. The databases searched included CINAHL Plus, PubMed, Scopus, Web of Science, and MedNar on March 8, 2024. Peer-reviewed and nonpeer-reviewed scientific and nonscientific sources were searched. The reference lists of the selected sources were screened for further papers. Participants who were ACs working in prehospital EMS and reported their physical, psychological, and social well-being related to adverse events in occupational or patient safety were eligible for inclusion. Quantitative, qualitative, and mixed-method studies; reviews; text, opinion, and discussion papers; and gray literature were included. Two reviewers independently reviewed the titles, abstracts, and full texts and assessed the quality of the sources. Data were extracted from the 2 reviewers by using an extraction tool. Data were analyzed using numerical and thematic methods. In total, 35 sources were included. Four themes were identified from the heterogeneous data: Deficiencies in psychological well-being, Deficiencies in physical well-being, Deficiencies in psychophysical well-being, and Deficiencies in social well-being. Fatigue and stress experienced by ACs are the most important factors that negatively affect patient and occupational safety. Deficiencies in psychophysical well-being have a clear effect on both patient and occupational safety. There is limited evidence on the effect of ACs’ well-being on patient and occupational safety in prehospital EMS.