Near-miss Incidents Research Articles

Training for Vessel Collision Prevention: Circumstances and Causes of Near-Miss Incidents

Training for Vessel Collision Prevention: Circumstances and Causes of Near-Miss Incidents

Application of Information Link Control in Surgical Specimen Near-Miss Events in a South China Hospital: Nonrandomized Controlled Study.

Information control is a promising approach for managing surgical specimens. However, there is limited research evidence on surgical near misses. This is particularly true in the closed loop of information control for each link. A new model of surgical specimen process management is further constructed, and a safe operating room nursing practice environment is created by intercepting specimen near-miss events through information safety barriers. In a large hospital in China, 84,289 surgical specimens collected in the conventional information specimen management mode from January to December 2021 were selected as the control group, and 99,998 surgical specimens collected in the information safety barrier control surgical specimen management mode from January to December 2022 were selected as the improvement group. The incidence of near misses, the qualified rate of pathological specimen fixation, and the average time required for specimen fixation were compared under the 2 management modes. The causes of 2 groups of near misses were analyzed and the near misses of information safety barrier control surgical specimens were studied. Under the information-based safety barrier control surgical specimen management model, the incidence of adverse events in surgical specimens was reduced, the reporting of near-miss events in surgical specimens was improved by 100%, the quality control quality management of surgical specimens was effectively improved, the pass rate of surgical pathology specimen fixation was improved, and the meantime for surgical specimen fixation was shortened, with differences considered statistically significant at P<.05. Our research has developed a new mode of managing the surgical specimen process. This mode can prevent errors in approaching specimens by implementing information security barriers, thereby enhancing the quality of specimen management, ensuring the safety of medical procedures, and improving the quality of hospital services.

Predictors of driving risk in patients with obstructive sleep apnea syndrome treated by continuous positive airway pressure: a French multicenter prospective cohort.

To investigate the predictors of persistent driving risk related to sleepiness in patients with obstructive sleep apnea syndrome (OSAS) treated by continuous positive airway pressure (CPAP). Longitudinal analysis of a prospective national database including 5308 patients with OSAS and an indication of CPAP. Near misses related to sleepiness, accidents related to sleepiness, and sleepiness at the wheel (SAW) were assessed before initiation and after ≥90 days of treatment. Multivariable associations with the cumulative incidence of near-misses and accidents under treatment were calculated using Cox models adjusted for age, sex, obesity, sleep duration, SAW, accidents/near-misses history, depressive symptoms, residual apnea-hypopnea index, and adherence to treatment. Residual SAW under treatment was associated with an eight-fold higher incidence of near-misses related to sleepiness (hazard ratios [HR] = 8.63 [6.08-12.2]) and five-fold higher incidence of accidents related to sleepiness (HR = 5.24 [2.81-9.78]). Adherence ≤4 h/night was also a significant predictor of persistent driving risk (HR = 1.74 [1.12-2.71] for near-misses and HR = 3.20 [1.37-7.49] for accidents). Residual SAW and treatment adherence ≤4 h/night are easy-to-assess markers to detect persistent driving risk during the follow-up evaluations of patients under treatment. Health professionals, but also policymakers, should be aware of the crucial importance of systematically evaluating these elements during the follow-up evaluations of the patients with OSAS treated by CPAP to better evaluate their driving risk.

Workplace Hazard Identification through Near-Miss Reports: A Social Network Analysis

Occupational Safety and Health (OHS) is an effort to create a safe and healthy working environment. The company, which is engaged in power generation, experienced many near-miss cases from 2016 to 2023. Near-miss incidents are an early signal of the potential for severe accidents in the future if not resolved immediately. Identifying and addressing potential hazards early is necessary to prevent fatal work accidents. This study aims to analyze the reporting pattern of near-miss incidents by company employees through the IZAT application (Zero et al.) with a social network analysis (SNA) approach. This method identifies relationships and interaction patterns between employees in reporting near-miss incidents, thus revealing objects that need special attention. Data was obtained from September 2020 to July 2023. The analysis showed that 276 employees actively reported various near-miss incidents through IZAT (Zero Accident Assistant Application). This pattern reflects employees' sensitivity to potential hazards in their work environment. The findings of this study make a positive contribution to the improvement of the occupational safety and health management system in the company regarding the mitigation of potential hazards based on incoming report data. The recommendations provided are related to occupational safety aspects that need to be prioritized for management improvement. The implication of this research is to increase employee awareness in identifying and reporting potential hazards so as to prevent work accidents in the future.

Analysing Near-Miss Incidents in Construction: A Systematic Literature Review

The construction sector is notorious for its high rate of fatalities globally. Previous research has established that near-miss incidents act as precursors to accidents. This study aims to identify research gaps in the literature on near-miss events in construction and to define potential directions for future research. The Scopus database serves as the knowledge source for this study. To identify publications on near-miss events, the search field “Article Title, Abstract, Keywords” was utilized with the keywords “construction” and “near miss”. The main research themes were defined based on keyword mapping performed using VOSviewer. Selected publications were assessed for their alignment with the defined research theme. A statistical analysis of the publications and the co-occurrence of keywords was conducted. The authors of the identified publications primarily used statistical analyses, artificial intelligence, employee monitoring, tracking systems, and building information modelling in their research. The conclusions from the literature review indicate a need for further research focused on developing effective predictive models for workplace accidents based on knowledge of near-miss events. This will contribute to a better understanding of the mechanisms leading to accidents and their prevention, ultimately resulting in a significant reduction in accidents in the construction sector.

Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis

BackgroundTriage and clinical consultations increasingly occur remotely. We aimed to learn why safety incidents occur in remote encounters and how to prevent them.Setting and sampleUK primary care. 95 safety incidents...

Lost needles, pads and where to find them.

This study aims to assess the frequency and associated factors of surgical "near-miss" incidents (NMIs) in neurosurgery using an event reporting system, to inform the development of appropriate interventions. This retrospective study collected reports of NMIs in our hospital's neurosurgery operating room (OR) from January 2019 to January 2022 through an adverse event reporting system and anonymous surveys. We conducted intergroup difference analysis using t-tests and investigated factors contributing to NMIs using Pearson correlation coefficients. We further constructed multinomial logistic regression models to explore the important factors affecting the types of lost objects and search times. A total of 195 NMIs were included in this study, with the primary items lost being 62 brain cotton pads and 133 needles. Statistical analysis revealed that smaller pads (48.4%) and size 3.0 needles (49.6%) were the most commonly missed items, with the longest retrieval times. The likelihood of NMIs occurring was higher for nurses with junior and/or non-neurosurgical backgrounds (needles: 82.7%, pads: 83.9%). Furthermore, factors such as extended working hours, nighttime surgeries, larger incisions, and more surgical instruments all increased the incidence of NMIs. The results of the multinomial logistic regression model showed that the type and search time for lost needles in the OR were jointly influenced by multiple factors (p<0.05) compared to cotton pads. The occurrence of NMIs is associated with various factors. Reporting NMIs and their causes helps identify solutions before adverse events occur, thereby enhancing patient safety.

NEAR MISS MATERNAL MORTALITY IN A TERTIARY CARE CENTRE: A RETROSPECTIVE STUDY

Introduction:One of the most important metrics for evaluating the caliber of healthcare provided is maternal mortality. A near-miss register can provide insightful information on maternity care shortcomings, improving our healthcare systems capacity to recognize and resolve difficulties with staff, infrastructure, and detection. Both altered physiological and pathological circumstances that increase the risk of pregnancy set critical maternal patients apart from typical pregnant and puerperal women. Our studys goal was to assess the various near-miss incidents that mothers encountered in connection to maternal mortality. Methods: Retrospective data were collected from March 2020 to April 2023 at Smt. Kashibai NavaleMedicalCollegeandGeneralHospital,Pune, over aspan of three-years.Everypatientwhorequiredintensivecare unit(ICU) admission or became critically ill in Operation theatre (OT) or Causality during pregnancy,childbirthwithinforty-twodaysoftheendof thepregnancy,wereincludedinthisstudy.Duringthisstudyperiod,therewereatotalof 5,950deliveries,outofwhich5,938resultedinlivebirths(LB).Outofatotalof these 5950 pregnancies 58cases had adverse abnormal outcomes, among these 58 cases,50 wereclassifiedasmaternalnearmissand8asmaternalmortality. Results: The maternal mortality ratio (MMR) at our hospital was 134 per one lakh, which is marginallyelevatedduetodelaysinaccessingtimelymaternalhealthcareservices.Therewere 8/1000livebirths(LB),orthematernalnear-missratio(MNMR),whichisthenumberofmaternal near-misses per 1000 LB. Furthermore, 9/1000 LB was the severe maternal outcome rate (SMOR),whichmeasuresthenumberofseverematernaloutcomesforevery1000livebirths. Ourfindingsshowedthathemorrhageandhypertensivedisorderduringpregnancywerethe primary contributors to illness and death, with sepsis and severe anemia serving as the secondary causes. Among organ dysfunctions, cardiac illness was the leading cause of morbidityaswellasmortality,followedbyrespiratorydysfunction. Conclusion:Throughthisresearch,ithasbeenestablishedthatimprovingindividualhealthcare facilitiescanpreventcasesofnearmiss.Moreover,quickreferralafterfirst-linetherapywould be vital in saving the lives of pregnant women. Hence, timeliness when managing cases of maternalnearmissisimportant.Ourexperienceindicatesthatthereshouldbewell-equipped peripheralreferralunitswithtrainedmanpowertohandleobstetricemergenciesforinstance massive obstetrichemorrhages, sepsis and Eclampsia.

Effect of Previous Accidents and Near-Miss Incidents on Risk Perceptions of Construction Workers

ABSTRACT The construction industry suffers from a high number of occupational fatalities and injuries, despite ongoing efforts by practitioners and researchers to improve. Overall, the safety improvement approaches in the industry have been reactive with reliance on historical data. Recently, the focus of safety improvement has shifted to being proactive using leading indicators such as risk perception and safety control. The leading indicators are perception-based and limited empirical investigation has been conducted on the impact of previous accidents on the safety perceptions of the construction workers. This quantitative study used survey questionnaires to collect data from workers of multiple healthcare projects in the Southwestern region of the US. The survey questionnaires were developed based on existing instruments and gathered data was analyzed to test hypotheses related to the impact of previous incident experience on the safety perceptions of the construction workers. Analyses revealed a significant correlation between previous incident experience and workers’ perception of safety risk. The study did not find a significant association between workers’ previous incident experience and their perception of safety control. This suggests that workers’ perception of their capability to control safety risks may not be significantly influenced by their past experiences of accidents or near-miss incidents.

A prospective study of surgeons’ workloads and associated factors in real-world practice

New technologies such as laparoscopic and robotic surgery are spreading, and there is a demand for physicians to keep up with novel methods. In contrast to the recent focus on healthcare professional burnout, the mental and physical costs during surgery are not well-understood. We aimed to quantify surgeons’ workloads in daily urological surgical practice and clarify potential background factors associated with such workloads. Urologists in Hokkaido, Japan, were invited to this study. Between December 2020 and December 2021, participants repeatedly reported workloads, which were assessed using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), after each surgery in conjunction with participants’ names, patients’ backgrounds, their roles (independent operator, operator under supervision, instructor, and 1st or 2nd assistant), and surgical outcomes, via SurveyMonkey®. Because of the heterogeneity among individuals, a linear mixed-effects model was utilized to analyze factors associated with NASA-TLX, calculating the parameter estimates (PE) of regression coefficients for each factor and their 95% confidence interval (CI). Sixty-five urologists (5 women) joined the study, and 2169 data were collected within 7 days after surgeries. A linear mixed-effects model revealed that female surgeons (PE + 15.56, 95% CI 2.36–28.77), urgent/emergency surgery (PE + 6.65, 95% CI 4.59–8.70), intraoperative complications (PE + 9.26, 95% CI 6.76–11.76), and near-miss incidents (PE + 3.81, 95% CI 2.27–5.36) were associated with higher workloads. Regarding the surgeons’ role, operator under supervision (PE + 12.46, 95% CI 9.86–15.06) showed the highest workloads. Surgeons’ workloads decreased as the number of previous cases of the same procedure increased. Surgeons’ workloads were associated with various factors. Given that the highest workloads were for operators under supervision, instructors should be aware of trainees’ high workloads and devise appropriate instructional interventions.

The predictive power of electronic reporting system utilization on voluntary reporting of near-miss incidents among nurses: A PLS-SEM approach.

Patient safety is crucial in healthcare, with incident reporting vital for identifying and addressing errors. Near-miss incidents, common yet underreported, serve as red flags requiring attention. Nurses' underreporting, influenced by views and system usability, inhibits learning opportunities. The Electronic Reporting System (ERS) is a modern solution, but its effectiveness remains unclear. This study aimed to investigate the role of the ERS in enhancing the voluntary reporting of near-miss (VRNM) incidents among nurses. A cross-sectional study was conducted in the Al Dhafra region of the United Arab Emirates, involving 247 nurses from six hospitals. Data were collected using a questionnaire between April 2022 and August 2022. Structural Equation Modelling Partial Least Square (SEM-PLS) was employed for data analysis. The average variance extracted for the ERS construct was 0.754, indicating that the common factor accounted for 75.4% of the variation in the ERS scores. The mean ERS score was 4.093, with a standard deviation of 0.680. For VRNM, the mean was 4.104, and the standard deviation was 0.688. There was a positive correlation between ERS utilization and nurses' willingness to report near-miss incidents. Additionally, our research findings suggest a 66.7% relevance when applied to various hospital settings within the scope of this study. The findings suggest that adopting a user-friendly reporting system and adequate training on the system's features can increase reporting and improve patient safety. Additionally, these systems should be designed to be operated by nursing staff with minimal obstacles.

Assessing the Self-Report Instruments of Younger Versus Older Riders Involved in Near-Miss Motorcycle Incidents

Road accidents pose severe and pervasive consequences, especially in low- and middle-income countries (LMICs), where both the population and fatal accidents among youth and the elderly are steadily increasing. Therefore, this study aims to develop a model for risky behavior in near-miss incidents among motorcycle riders in Thailand. It intends to compare models between younger and older riders utilizing structural equation modeling (SEM) with a multi-group approach. The data were examined employing modified instruments derived from the Motorcycle Rider Behavior Questionnaire (MRBQ). Samples depicting risky riding behavior were obtained from both younger and older rider groups. Parameter invariance testing revealed differences between the two groups. Control errors notably emerged as the predominant factor contributing to near-miss incidents for both age groups. Speeding was identified as the primary concern for the younger group, while adverse weather conditions were deemed crucial for the older group. Based on this study, policy recommendations endorse the creation of targeted training programs for novice riders, emphasizing adherence to legal speed limits and the adoption of safe riding practices. Additionally, the study underscores the importance of preparing riders, especially those in the older age group, for adverse weather conditions. Doi: 10.28991/CEJ-2024-010-02-019 Full Text: PDF

Facility Based Audit of Maternal Near Miss, Maternal and Neonatal Mortality in a Tertiary Hospital, South-West Nigeria: One-Year Review

Background: There is a poor linkage between MPDSR audits on the one hand, and the quality improvement processes proffered by them. This usually leads to varied implementation of recommendations. Buy-in from the community and health facilities are needed for full implementation. To better identify and track causes of maternal and perinatal mortality, it is necessary to combine review of maternal near-miss morbidities with findings at MPDSR meetings. Objectives: A. Evaluate near-miss morbidity and near-miss to mortality ratio. B. To compare the nature of near-miss morbidity with maternal mortality. C. To compare findings of near-miss maternal morbidity with maternal mortality among women who registered for care and those who did not. Design: Retrospective study. Methods: Monthly review of data collected on maternal near-miss morbidity and maternal mortality at MPDSR meetings for all women who delivered at our facility from 1st December 2022 till 31st December 2023. Results: The near-miss incidence ratio was 70 per 1000 live births while the maternal mortality ratio was 1399 per 100000 live births. Hypertensive disorders of pregnancy and sepsis were responsible for 85.8% of maternal mortality. Despite contributing 62.4% to maternal near-miss events, obstetric haemorrhage was responsible for 14.2% of maternal mortality. Unbooked patients were responsible for 83% near-miss morbidity and 95% of mortality occurred in this same group. Conclusion: While we have made some progress in our care of women with Postpartum haemorrhage, hypertensive disorders of pregnancy remains a cause for concern for both maternal near-miss morbidity and maternal mortality. Health workers should be trained to recognise and promptly refer women with hypertensive disorders for expert care pre-delivery, intrapartum and postpartum. Antenatal care and facility delivery for all pregnant women remain the pathways towards reducing near-miss morbidity and maternal mortality ratio.

Obstetric Near Miss Events at a Tertiary Care Centre, Birgunj

Introduction: Near miss cases are the ones who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. Near-miss is recognized as the predictor of the level of care and maternal deathand thereforea review of near-miss obstetric eventsis useful to investigate maternal mortality. The study was meant to determine the ratio and nature of near-miss obstetric cases and associated factors.Materials and Methods: This was a prospective observational study done in the Department of Obstetrics and Gynaecology at National Medical College and Teaching Hospital from 1st February 2022 to 31st January 2023. Ethical approval was obtained from IRC (Ref. F-NMC/537/077-078).The near-miss cases were identified among the admitted obstetric cases using the five-factor scoring system and followed till their discharge or death.The assessment of the causes of near-miss cases was done.Results: During the study period, 1163 live births, 33 near-miss cases, and5 maternal mortalities were recorded. The incidence of near-miss was 28.37 per 1000 live births, the mortality index was 13.16% and the near-miss to maternal mortality ratio was 6.6: 1. Haemorrhage (39.39%) was the most common event responsible for near-miss, followed by hypertensive disorders (24.24%). Similarly, cardiovascular (78.79%) was the most common organ dysfunction recorded, followed by hepatic (33.33%).Conclusion: Haemorrhage and hypertensive disorders are the major causes of near-miss events. Identification and evaluation of the factors of near-miss cases can reduce maternal morbidity and mortality, as special preventive actions for the management of its complications can be planned. It is also worth presenting near-miss cases in national indices.

Comparison Using Intelligent Systems for Data Prediction and Near Miss Detection Techniques

Malaysia ranks third among ASEAN countries in terms of deaths due to accidents, with an alarming increase in the number of fatalities each year. Road conditions contribute significantly to near-miss incidents, while the inefficiency of installed CCTVs and the lack of monitoring system algorithms worsen the situation. The objective of this research is to address the issue of increasing accidents and fatalities on Malaysian roads. Specifically, the study aims to investigate the use of video technology and machine learning algorithms for the car detection and analysis of near-miss accidents. To achieve this goal, the researchers focused on Penang, where the MBPP has deployed 1841 CCTV cameras to monitor traffic and document near-miss accidents. The study utilised the YOLOv3, YOLOv4, and Faster RCNN algorithms for vehicle detection. Additionally, the study employed image processing techniques such as Bird’s Eye View and Social Distancing Monitoring to detect and analyse how near misses occur. Various video lengths (20s, 40s, 60s and 80s) were tested to compare the algorithms’ error detection percentage and test duration. The results indicate that Faster RCNN beats YOLOv3 and YOLOV4 in car detection with low error detection, whereas YOLOv3 and YOLOv4 outperform near-miss detection, while Faster RCNN does not perform it. Overall, this study demonstrates the potential of video technology and machine learning algorithms in near-miss accident detection and analysis. Transportation authorities can better understand the causes of accidents and take appropriate measures to improve road safety using these models. This research can be a foundation for further traffic safety and accident prevention studies.

Analyzing Near-Miss Incidents and Risky Riding Behavior in Thailand: A Comparative Study of Urban and Rural Areas

Preventing near-miss incidents is considered a proactive measure, as it aims to prevent events that have a risk of resulting in accidents. This is regarded as a vital component of building a sustainable and secure society within communities. In the present day, low- and middle-income countries (LMICs) often experience the highest fatality rates from motorcycle accidents, which frequently involve mixed traffic scenarios with other vehicles. The distinct physical characteristics and environmental conditions of roads in urban and rural areas significantly contribute to different riding behaviors. Therefore, the objective of this study is to develop a behavioral model related to near-miss incidents among motorcycle riders in both urban and rural regions using multi-group structural equation modeling (SEM). Data collected from six Thai regions via adapted MRBQ assessed control errors, violations, and safety equipment use in a sample of 2002 riders (1066 urban, 936 rural). Through parameter invariance testing, differences in factor loadings, intercepts, and structural paths were identified between urban and rural areas. All three of these factors significantly influenced near-miss incidents among motorcycle riders in both urban and rural areas. The policy recommendations resulting from this study can contribute to enhancing safety measures for motorcycle riders.

Research on Near-Miss Incidents Monitoring and Early Warning System for Building Construction Sites Based on Blockchain Technology

Research on Near-Miss Incidents Monitoring and Early Warning System for Building Construction Sites Based on Blockchain Technology

Exploring near miss errors associated with split-pack robotic dispensing

Abstract Introduction Pharmacy automation using dispensing robots for the supply of medicines is not new. Improved dispensing efficiencies, maximised storage capacity and reduced dispensing errors are cited as key benefits.1 Published articles describe the impact of automation on dispensing error rates and types for original-pack dispensing2 with a paucity of literature on split-packs. Split-pack dispensing cannot be entirely eradicated: the ability to barcode and return to the robot facilitates the storage of medicines locally where dispensary footprint is limited; a manual process and one that is subject to human error. With anecdotal reports of split-pack robotic dispensing errors, there is an opportunity to explore near-miss errors as part of routine monitoring undertaken. Aim To establish the incidence and type of near-miss dispensing errors associated with split-pack robotic dispensing. Methods Approval was obtained from the Trust Pharmacy Research Committee. The need for ethical submission was waived. Near-miss dispensing errors were recorded in real-time via direct observations using a standardised data collection tool adapted from the Royal Pharmaceutical Society Near Miss Error Log3; with additional data collected on whether prescription requests were for original or split-pack quantities and storage location. All drugs dispensed/ checked in the dispensary between 09:00-17:00 were included (4 days in January 2023). All prescription types for individual patient medication orders were included. Stock drugs and outpatient prescriptions were excluded. A manual count of all items dispensed/ checked was undertaken each day to provide the denominator. Data was entered into Microsoft excel and analysed. Results Overall near-miss dispensing error incidence of 3.5% (72 near-misses/ 2035 items dispensed). Fourteen of fifty-eight (24.1%) erroneously dispensed items had two near-misses identified. Near-miss incidence associated with original-pack dispensing of 3.1% (50 near-misses/ 1590 items dispensed) compared with split-pack dispensing of 4.9% (22 near-misses/ 445 items dispensed). Chi square (with Yate’s correction) did not identify a statistical significant difference between the overall near-miss error rate between the two (p&amp;gt; 0.06). Most common original-pack dispensing error types were ‘wrong instructions on label’ (n=29/50), ‘wrong quantity on label and dispensed’ (n= 6/50), and ‘missing label’ on item (n=5/50). For split-pack dispensing, ‘wrong instructions on label’ (n=9/22), ‘wrong quantity dispensed’ (n=8/22), and ‘wrong quantity labelled’ (n=5/22) were most common. Discussion/Conclusion Local prevalence of near-misses is higher than in reported published literature1. Whilst direct comparisons are difficult to make due to differences in research methods, definitions, and operating systems; the incidence of near-miss errors associated with split-packs was notably higher than original-pack dispensing despite no statistical difference. Similar near-miss error types were identified for original/ split-pack dispensing with ‘wrong instructions on the label’ being the most common. This is consistent with published literature1 on errors with pharmacy automation. With split-pack robotic dispensing, it was noted that the quantity were not always as identified on the barcode label due to the manual returns process. Direct observations have indicated that missing patient information leaflets are a common problem for split-pack dispensing, although not recorded in this study. Further work should focus on causes/ contributory factors to split-pack robotic dispensing errors.

Contributing factors to near-miss experiences of motorcyclists in Thailand: A random parameter probit model approach

Road accidents cause a large number of deaths, especially in Thailand. When considered in depth, motorcycles account for the highest percentage of fatalities. According to Heinrich's Safety Triangle Model, a decrease in near misses will reduce the number of road accidents. There is still a lack of studies on risky behaviors contributing to near misses involving motorcycles. This study aims to comprehend the various factors that influence the frequency of near-miss experiences using a questionnaire on near-miss incidents. The contributing factors include road factors (e.g., road surface, number of traffic lanes, speed limit), environmental factors (e.g., driving at night), and driver factors (e.g., using a phone while driving). Of the 2002 respondents, a total of 1547 people have occasionally experienced a near-miss incident. A random parameter probit model (RPOP) was used for analyzing the relationship between the contributing factors and the near-miss frequency, and model statistics clearly confirm that RPOPs that import only significant variables are the most suitable models. The study found 14 factors that affect near-miss frequency, and there are 5 variables that are random parameters. Variables that increase the chance of a near-miss incident include driving at night (both with and without lights), roads with concrete road surfaces, and roads with unclear lane markings. This study provides policy recommendations for relevant agencies that were identified to reduce near-miss motorcycle accidents.

Nature and type of patient-reported safety incidents at a tertiary hospital in South Africa during the COVID-19 period (2018-2021)- A retrospective review.

The healthcare sector in South Africa has seen a rise in medical errors and negligence adversely affecting healthcare delivery. This study aimed to determine the nature and magnitude of Patient Safety Incidents at a tertiary hospital between April 2018 to March 2021 (the COVID-19 era). A retrospective review of Patient Safety Incidents forms and clinical records of inpatients above 12 years with a reported incident were included. The overall incidence of patient safety incidents was 4.40 PSIs per 10 000 patient-days. The majority of PSIs were harmful incidents (An incident that results in harm to a patient that is related to medical management, in contrast to disease complications or underlying disease) at 72.50% [145/200], followed by no harm incidents at 18.00% [36/200] and 9.50% [19/200] near-miss incidents. The five highest incident types were clinical process/procedure [83/200; 41.50%], behaviour [49/200; 24.50%], falls [28/200; 14%], complications [20/200; 10%], and pressure sores [11/200; 5.50%]. Incidents occurred more frequently within the week (83.50%) and during day shift (67.50%). Overall, the study showed low PSI reporting rates which is an inherent challenge with voluntary reporting. Notably, there has been an increasing trend in reporting. The results reflect a reporting culture more inclined to bring awareness to incidents that have negative outcomes.