Risk perception among healthcare professionals working in emergency care in remote locations: a scoping review

Risk management in emergency services in remote or rural areas is vital for ensuring safety and effective care. These settings present complex challenges that demand well-planned, efficient, and swift approaches. Remote locations are defined here as geographically isolated places, with limited, difficult or slow access to services, infrastructures and/or communications. The perception of risk by healthcare professionals in these areas is crucial for informed decision-making and improved service management. This work presents the first study of existing scientific evidence concerning healthcare professionals' perceptions of risks in remote emergency settings.

A scoping review was conducted in accordance with a previously published protocol, using the Scopus, PubMed, LILACS, Cochrane, CINAHL, and Web of Science databases. The review followed the Population, Concept, and Context framework, focusing on healthcare professionals (population), risk perception (concept), and emergency care in remote settings (context). Studies published in English or Portuguese were considered, with no restrictions on publication date. Eligible study designs included observational, quantitative studies, qualitative studies, and systematic reviews. Data extraction and validation were performed independently by two reviewers.

Based on the inclusion criteria, 26 articles were selected for analysis. The review focused on study objectives, methodological approaches, key hazards examined, primary risk perceptions reported by emergency healthcare professionals in remote settings, perceived challenges, and identified coping strategies.

The analysis revealed that studies predominantly focus on individual risks or fragmented understandings of hazards. Risk assessments are typically based on ad-hoc methods, with an emphasis on clinical judgment and decision-making processes. None of the reviewed articles approached risk assessment using a consequence-probability framework as recommended by internationally accepted standards.