The term Patient Safety Incident refers to any event or circumstance which could have resulted or did result in unnecessary harm to a patient. Patient Safety Incidents consist of near miss events, no-harm incidents, and harmful incidents.
Near Misses are patient safety incidents that do not reach the patient and, therefore, no harm resulted. Example: the physiotherapist realizes that the acupuncture needles they were about to use have become contaminated. The physiotherapist discards the needles in an appropriate sharps container.
No-harm Incidents are patient safety incidents that reach the patient, but no discernible harm resulted. Example: a patient reports that their hot pack is too warm and requests additional padding. Extra towelling is provided to address the concern. After the incident, the physiotherapist discovers that the temperature on the hydrocollator was set too high and adjusts it to the appropriate temperature.
Harmful Incidents are patient safety incidents that result in harm to the patient. Sometimes referred to as adverse events, sentinel events, or critical incidents.
Example: the physiotherapist attends a patient to perform post-operative mobilization. The patient experiences a sudden decrease in blood pressure and faints, falling to the floor and sustaining a laceration to their head and a fractured hip on their non-operative side.
Harmful incidents may include adverse reactions (unexpected harms arising from a justified treatment applied correctly and appropriately) and side effects (known effects other than the primary, intended effect, which may be negative in nature).
Figure 1: Patient Safety Incidents
Harm classification system
Asymptomatic or mild symptoms, self-care only (e.g., ice/heat, over-the-counter analgesic)
Limiting age-appropriate activities of daily living (e.g., work, school) OR sought care from a medical doctor
Medically significant but not immediately life-threatening; temporarily limits self-care (e.g., bathing, dressing, eating) OR urgent or ER assessment sought
Results in death OR a life-threatening harm OR a harm resulting in inpatient hospitalization or prolongation of existing hospitalization for more than 24 hours; a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions; a congenital anomaly/birth defect