In patient safety, which statement best defines a near miss?

• A. An event that causes patient harm.
• B. A medication error that reaches the patient.
• C. An error that reaches the patient but causes no harm.
• D. An error that could have caused harm but is caught before reaching the patient.

Answer: (D)

A near miss is an event where an error had the potential to cause harm but was prevented before it could reach the patient. The essential idea is safety improvement through interception—the harm never actually occurs because someone or something stops it in time.

This definition fits best because it emphasizes prevention of harm and the missed opportunity for harm, not harm that actually happened. For example, a nurse notices a medication order that would have given the patient the wrong dose and corrects it before administration. No patient is harmed, but a lapse was identified and prevented, which is the hallmark of a near miss.

Other descriptions miss this preventive element. An event that causes harm is an actual adverse event. An error that reaches the patient but causes no harm describes a no-harm incident, which is not the same focus as a near miss.