Knowledge and Practices of Medical Officers on Medical Near Misses in a Tertiary Care Hospital, Sri Lanka

Background: Near misses are the most crucial and valuable elements in the prevention of potentially unintentional harm in patients service provision. Reporting incidents is an essential component in inculcating patient safety culture. In developed countries medical services are now focused on vigilance on such near misses. This paradigm shift of medical service provision paved the way for patient safety domain in medical service design. Patient safety has now become one of the six constituents of service quality. Continuous vigilance for possible near misses will disclose them beforehand. This will avoid triggering the chain reaction that bring about disastrous patient outcomes. Favorability of existing practices and knowledge on near misses are two key determinants of the successful safety culture initiatives. Methods: Cross sectional descriptive study carried out at the Colombo South Teaching Hospital. A stratified sample of medical officers was selected out of those involved in the patient care services. Stratification was done according to the service categories such as specialist grade, grade medical officers and intern officers. Most reason salary sheet used as the sampling frame to select medical officers randomly from each stream. A pretested self-administered questionnaire was used, as the study instrument. The questionnaire contained two main sections as knowledge and practices. Data analysis done using PSSP software. Results: Over all response rate was 90%. Over 94% of respondents had satisfactory or good level of knowledge. 88% did not report near misses. Overall, a considerable percentage (n=168 ,53%) had poor level of practices. Only 5.9% (n=19) had good level of practices. In the specialist grade medical officers 41.1% had poor practices despite none of the specialists having a poor knowledge. Highest level of poor practices (n=128,70.8%) was seen in grade II medical officers. Conclusions: The study reveals that majority of medical officers at CSTH have a satisfactory knowledge on the near misses as predecessors of the of patient harm. continuous engagement in near misses’ surveillance in an organization is an integral component in a patient safety culture. However, the practices are not satisfactory in a majority