Introduction The inter-healthcare transfer of the critically ill neonate is a critical aspect of larger neonatal intensive care, as it influences the safe transport of neonates from the receiving to the referring hospital. It is crucial then that the transfer process be safe and efficient so as not to compromise the already fragile condition of the neonate. The aim of the study was to understand the challenges advanced life support (ALS) paramedics face during neonatal transfers and to understand how the process could be made safer and more efficient. The objectives related to understanding the transfer process, the challenges linked to the critically ill neonate and the difficulties associated with the ambulance vehicle and equipment. Methods Using a qualitative research approach we sought the views of ALS paramedics at the forefront of transfers nationally. In-depth interviews were held with eight paramedics in KwaZulu-Natal and four focus group discussions with ALS paramedics in KwaZulu-Natal, Gauteng, Free State and the Western Cape in South Africa. A total of 35 ALS paramedics were involved in these group discussions. Results The study uncovered several challenges that paramedics face related to poor organisational preparation for transfer of the critically ill neonate, and other crucial issues that compromise the transfer such as inadequate or defective equipment. Conclusion There is a need for greater scrutiny of the transfer process and a commitment from stakeholders to begin addressing the challenges confronting the safe transfer of critically ill neonates.
{"title":"Towards a Safer and More Efficient Neonatal Transfer System in South Africa: A Qualitative Inquiry with Advanced Life Support Paramedics","authors":"P. Ashokcoomar, R. Bhagwan","doi":"10.33151/ajp.18.951","DOIUrl":"https://doi.org/10.33151/ajp.18.951","url":null,"abstract":"Introduction The inter-healthcare transfer of the critically ill neonate is a critical aspect of larger neonatal intensive care, as it influences the safe transport of neonates from the receiving to the referring hospital. It is crucial then that the transfer process be safe and efficient so as not to compromise the already fragile condition of the neonate. The aim of the study was to understand the challenges advanced life support (ALS) paramedics face during neonatal transfers and to understand how the process could be made safer and more efficient. The objectives related to understanding the transfer process, the challenges linked to the critically ill neonate and the difficulties associated with the ambulance vehicle and equipment. Methods Using a qualitative research approach we sought the views of ALS paramedics at the forefront of transfers nationally. In-depth interviews were held with eight paramedics in KwaZulu-Natal and four focus group discussions with ALS paramedics in KwaZulu-Natal, Gauteng, Free State and the Western Cape in South Africa. A total of 35 ALS paramedics were involved in these group discussions. Results The study uncovered several challenges that paramedics face related to poor organisational preparation for transfer of the critically ill neonate, and other crucial issues that compromise the transfer such as inadequate or defective equipment. Conclusion There is a need for greater scrutiny of the transfer process and a commitment from stakeholders to begin addressing the challenges confronting the safe transfer of critically ill neonates.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114605772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction As registered health professionals, Australian paramedics are required to abide by professional registration standards including the maintenance of continuing professional development (CPD). The broader health literature identifies facilitators, barriers and motivators for engaging in CPD, however the body of knowledge specific to paramedicine is weak. This research seeks to address this gap in the paramedicine body of knowledge. Methods This study adopts a constructivist grounded theory methodology. Data were collected through semi-structured interviews, and analysed using first and second cycle coding techniques. Paramedics from various state-based Australasian ambulance services and private industry (N=10) discussed their experiences specific to their attitudes, perceptions and engagement about CPD. Results Paramedic CPD goes beyond the traditional approach to mandatory training. Paramedics are motivated by factors such as modality of delivery, professional expectations, clinical/professional improvement and, sometimes, fear. Facilitators included organisational support, improved clinical knowledge, practitioner confidence, self-directed learning opportunities and perceived relevance of content. Barriers include cost, workload/fatigue, location, rostering, lack of incentive to engage, lack of employer support and technological problems. Conclusion By understanding what facilitates or motivates engagement in CPD activities, paramedics can navigate their CPD in conjunction with regulatory requirements. Although paramedics report some similar experiences to other health professionals, there are nuances that appear specific to the discipline of paramedicine. Of interest, a unique finding related to fear influencing paramedic CPD engagement. The results of this study informs paramedic employers and paramedic CPD providers with insights to assist in the development of positive CPD experiences and interactions.
{"title":"Facilitators, Barriers and Motivators of Paramedic Continuing Professional Development","authors":"Lisa Hobbs, S. Devenish, D. Long, V. Tippett","doi":"10.33151/ajp.18.857","DOIUrl":"https://doi.org/10.33151/ajp.18.857","url":null,"abstract":"Introduction As registered health professionals, Australian paramedics are required to abide by professional registration standards including the maintenance of continuing professional development (CPD). The broader health literature identifies facilitators, barriers and motivators for engaging in CPD, however the body of knowledge specific to paramedicine is weak. This research seeks to address this gap in the paramedicine body of knowledge. Methods This study adopts a constructivist grounded theory methodology. Data were collected through semi-structured interviews, and analysed using first and second cycle coding techniques. Paramedics from various state-based Australasian ambulance services and private industry (N=10) discussed their experiences specific to their attitudes, perceptions and engagement about CPD. Results Paramedic CPD goes beyond the traditional approach to mandatory training. Paramedics are motivated by factors such as modality of delivery, professional expectations, clinical/professional improvement and, sometimes, fear. Facilitators included organisational support, improved clinical knowledge, practitioner confidence, self-directed learning opportunities and perceived relevance of content. Barriers include cost, workload/fatigue, location, rostering, lack of incentive to engage, lack of employer support and technological problems. Conclusion By understanding what facilitates or motivates engagement in CPD activities, paramedics can navigate their CPD in conjunction with regulatory requirements. Although paramedics report some similar experiences to other health professionals, there are nuances that appear specific to the discipline of paramedicine. Of interest, a unique finding related to fear influencing paramedic CPD engagement. The results of this study informs paramedic employers and paramedic CPD providers with insights to assist in the development of positive CPD experiences and interactions.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114607021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Advanced Paediatric Life Support, Australia Paediatric Life Support course is designed to improve outcomes for critically ill and injured paediatrics treated by healthcare professionals. It is comprised of pre-reading, online learning and a one-day face-to-face session that covers basic life support, airway management, cardiac rhythm recognition and defibrillation, intraosseous access and recognition of the seriously injured and ill child. This paper reviews the course and concludes that it should be considered as part of the continuing professional development requirements for paramedics.
{"title":"Paediatric Life Support by Advanced Paediatric Life Support, Australia: Course Review","authors":"Shannon Macfarlane, James Pearce","doi":"10.33151/AJP.18.947","DOIUrl":"https://doi.org/10.33151/AJP.18.947","url":null,"abstract":"The Advanced Paediatric Life Support, Australia Paediatric Life Support course is designed to improve outcomes for critically ill and injured paediatrics treated by healthcare professionals. It is comprised of pre-reading, online learning and a one-day face-to-face session that covers basic life support, airway management, cardiac rhythm recognition and defibrillation, intraosseous access and recognition of the seriously injured and ill child. This paper reviews the course and concludes that it should be considered as part of the continuing professional development requirements for paramedics.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115779352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction There is ubiquitous belief that right ventricular myocardial infarction (RVMI) patients are pre-load dependent, and that administering nitrates to this cohort may cause adverse events – most notably hypotension. This article charts a narrative history of RVMI and nitrates: from the initial recognition of RVMI and early support of the use of nitrates, through the spread of the view against nitrates, and to the recent publication of evidence once again supporting their use. Methods Four databases were systematically searched (PubMed, Embase, Medline, Web of Science) and results screened by title, then abstract, and finally full text. Results were presented using a chronological narrative structure. Results The view against the use of nitrates during RVMI can be traced back to a single 1989 cohort study of 28 patients, then later being adopted by a series of influential secondary evidence papers, and ultimately by international guidelines. In 2016, 2017 and 2019, new cohort studies totalling 1046 patients were presented, all of which concluded that nitrates are safe to administer during RVMI. Conclusion This article charts how a single retrospective cohort study with low statistical power came to form the dominant narrative on best practice despite complex and conflicting primary evidence.
人们普遍认为，右心室心肌梗死(RVMI)患者是负荷前依赖性的，对这一队列患者使用硝酸盐可能会导致不良事件——最明显的是低血压。本文描绘了RVMI和硝酸盐的叙事历史:从最初认识到RVMI和早期支持使用硝酸盐，通过反对硝酸盐观点的传播，以及最近再次支持使用硝酸盐的证据的发表。方法系统检索PubMed、Embase、Medline、Web of Science 4个数据库，按标题筛选、摘要筛选、全文筛选。结果以时间顺序叙述结构呈现。结果反对在RVMI期间使用硝酸盐的观点可以追溯到1989年对28名患者进行的一项队列研究，后来被一系列有影响力的二手证据论文采纳，并最终被国际指南采纳。在2016年、2017年和2019年，共有1046名患者进行了新的队列研究，所有这些研究都得出结论，在RVMI期间施用硝酸盐是安全的。这篇文章描绘了一个具有低统计能力的单一回顾性队列研究如何在复杂和相互矛盾的主要证据的情况下形成最佳实践的主导叙述。
{"title":"Right Ventricular Myocardial Infarction and Adverse Events from Nitrates: A Narrative Review","authors":"M. Wilkinson-Stokes","doi":"10.33151/ajp.18.897","DOIUrl":"https://doi.org/10.33151/ajp.18.897","url":null,"abstract":"Introduction There is ubiquitous belief that right ventricular myocardial infarction (RVMI) patients are pre-load dependent, and that administering nitrates to this cohort may cause adverse events – most notably hypotension. This article charts a narrative history of RVMI and nitrates: from the initial recognition of RVMI and early support of the use of nitrates, through the spread of the view against nitrates, and to the recent publication of evidence once again supporting their use. Methods Four databases were systematically searched (PubMed, Embase, Medline, Web of Science) and results screened by title, then abstract, and finally full text. Results were presented using a chronological narrative structure. Results The view against the use of nitrates during RVMI can be traced back to a single 1989 cohort study of 28 patients, then later being adopted by a series of influential secondary evidence papers, and ultimately by international guidelines. In 2016, 2017 and 2019, new cohort studies totalling 1046 patients were presented, all of which concluded that nitrates are safe to administer during RVMI. Conclusion This article charts how a single retrospective cohort study with low statistical power came to form the dominant narrative on best practice despite complex and conflicting primary evidence.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121065705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdullah Alabdali, Nawfal Aljerian, Tamara Alrumayyan, Joud Alwasel, Noura Alsayari, Winnie Philip
Introduction Mental healthcare experts worldwide have been calling for increased contributions from medical professionals and organisations to improve the skills of healthcare practitioners and their coordination with mentally ill patients. However, the contributions and roles of paramedics in treating the mentally ill are still considered limited, and few studies have been conducted on paramedics’ judgement and decision-making when caring for patients with mental illness. This study aimed to assess paramedics’ perceptions, knowledge and skills in dealing with psychiatric emergencies. Methods A cross-sectional study was conducted among participants from the Saudi Red Crescent Authority; different hospitals in Riyadh were invited from September to October 2019 to complete a validated structured questionnaire. The Statistical Package for the Social Sciences version 22 (SPSS 22) software was used for data analysis. Results A total of 124 participants were included in this study; their mean age was 29.93 years, 95.2% were male, 78.9% had a bachelor degree and 12.1% had higher education. The majority of participants agreed that it is important for paramedics to know about mental illness (91.1%) and stated that they were comfortable managing a person with mental illness (63.7%). Almost half (49.6%) disagreed with the statement that psychiatric disorders are caused by religious or supernatural factors, whereas 24% were unsure, and 26.4% agreed. On assessing paramedics’ knowledge and skills, 31.4% scored above average, 42% scored average (average defined as answering six to seven out of 10 questions correctly), and 26.6% scored below average. However, when asked if they carry out the mental status examination on mentally ill patients, 66.1% stated ‘no’. Conclusion This study indicated that the majority of paramedics have positive perceptions regarding mental illness; moreover, it was shown that paramedics are knowledgeable and trained in dealing with emergency psychiatric patients. Further investigation regarding the practice and role of paramedics is necessary.
{"title":"Paramedics’ Perceptions, Knowledge and Skills regarding Emergency Psychiatric Patients in Riyadh, Saudi Arabia","authors":"Abdullah Alabdali, Nawfal Aljerian, Tamara Alrumayyan, Joud Alwasel, Noura Alsayari, Winnie Philip","doi":"10.33151/ajp.18.844","DOIUrl":"https://doi.org/10.33151/ajp.18.844","url":null,"abstract":"Introduction Mental healthcare experts worldwide have been calling for increased contributions from medical professionals and organisations to improve the skills of healthcare practitioners and their coordination with mentally ill patients. However, the contributions and roles of paramedics in treating the mentally ill are still considered limited, and few studies have been conducted on paramedics’ judgement and decision-making when caring for patients with mental illness. This study aimed to assess paramedics’ perceptions, knowledge and skills in dealing with psychiatric emergencies. Methods A cross-sectional study was conducted among participants from the Saudi Red Crescent Authority; different hospitals in Riyadh were invited from September to October 2019 to complete a validated structured questionnaire. The Statistical Package for the Social Sciences version 22 (SPSS 22) software was used for data analysis. Results A total of 124 participants were included in this study; their mean age was 29.93 years, 95.2% were male, 78.9% had a bachelor degree and 12.1% had higher education. The majority of participants agreed that it is important for paramedics to know about mental illness (91.1%) and stated that they were comfortable managing a person with mental illness (63.7%). Almost half (49.6%) disagreed with the statement that psychiatric disorders are caused by religious or supernatural factors, whereas 24% were unsure, and 26.4% agreed. On assessing paramedics’ knowledge and skills, 31.4% scored above average, 42% scored average (average defined as answering six to seven out of 10 questions correctly), and 26.6% scored below average. However, when asked if they carry out the mental status examination on mentally ill patients, 66.1% stated ‘no’. Conclusion This study indicated that the majority of paramedics have positive perceptions regarding mental illness; moreover, it was shown that paramedics are knowledgeable and trained in dealing with emergency psychiatric patients. Further investigation regarding the practice and role of paramedics is necessary.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124190845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Traditionally, undergraduate emergency medical care (EMC) training programs have, over the years, typically focussed on developing individuals with proficiency in clinical skills who can perform complex procedures in the act of administering safe and effective emergency care in the pre-hospital setting. A shortcoming of this training relates to the attention given to the soft skills needed to work efficiently in a team-based environment. Crisis resource management (CRM) is a structured, evidence-based approach to training that is designed to enhance teamwork performance in critical circumstances where the absence of coordinated teamwork could lead to undesired outcomes. Methods A narrative review of GOOGLE SCHOLAR, MEDLINE, PUBMED, CINAHL as well as paramedic-specific journals was conducted. Articles were included if they examined the importance of CRM in pre-hospital emergency care; training undergraduate pre-hospital emergency care students on the principles and practices of CRM; and non-technical skills in pre-hospital emergency care. Discussion Researchers found limited articles related to CRM and the pre-hospital emergency care setting. Our findings reveal that CRM focusses on addressing non-technical skills necessary for effective teamwork and that those identified to be relevant for effective teamwork in pre-hospital emergency care setting include situation awareness, decision-making, verbal communication, teamwork as well as leadership and followership skills. Conclusion Effective team management is a core element of expert practice in emergency medicine. When practised in conjunction with medical and technical expertise, CRM can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of a pre-hospital emergency care plan.
{"title":"The Need for Purposeful Teaching, Learning and Assessment of Crisis Resource Management Principles and Practices in the Undergraduate Pre-Hospital Emergency Care Curriculum: A Narrative Literature Review","authors":"M. Rowland, A. Adefuye, C. Vincent-Lambert","doi":"10.33151/ajp.18.820","DOIUrl":"https://doi.org/10.33151/ajp.18.820","url":null,"abstract":"Introduction Traditionally, undergraduate emergency medical care (EMC) training programs have, over the years, typically focussed on developing individuals with proficiency in clinical skills who can perform complex procedures in the act of administering safe and effective emergency care in the pre-hospital setting. A shortcoming of this training relates to the attention given to the soft skills needed to work efficiently in a team-based environment. Crisis resource management (CRM) is a structured, evidence-based approach to training that is designed to enhance teamwork performance in critical circumstances where the absence of coordinated teamwork could lead to undesired outcomes. Methods A narrative review of GOOGLE SCHOLAR, MEDLINE, PUBMED, CINAHL as well as paramedic-specific journals was conducted. Articles were included if they examined the importance of CRM in pre-hospital emergency care; training undergraduate pre-hospital emergency care students on the principles and practices of CRM; and non-technical skills in pre-hospital emergency care. Discussion Researchers found limited articles related to CRM and the pre-hospital emergency care setting. Our findings reveal that CRM focusses on addressing non-technical skills necessary for effective teamwork and that those identified to be relevant for effective teamwork in pre-hospital emergency care setting include situation awareness, decision-making, verbal communication, teamwork as well as leadership and followership skills. Conclusion Effective team management is a core element of expert practice in emergency medicine. When practised in conjunction with medical and technical expertise, CRM can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of a pre-hospital emergency care plan.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130171837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Maths anxiety is defined as feelings of tension that interfere with dealing with numbers and mathematical problems. Self-efficacy, which is related to maths anxiety, can be defined as perceptions of one's abilities to math problems, tasks and math-related course work. This study aimed to investigate the effect of gender, age and year level on maths anxiety and self-efficacy and to study the relationship between self-efficacy and maths anxiety among paramedic students. Methods A cross-sectional study of paramedic students at Monash University in Victoria was conducted. Participants completed a 15-minute paper-based questionnaire which is composed of Maths Anxiety Rating Scale – Revised (MARS-R),) the Maths Self-Efficacy Scale (MSES) and demographic information. Results The questionnaires were completed and returned by 344 students. (81.3% return rate). The mean score for the MARS-R was 25.71 (SD=8.80) and for the MSES was 125.59 (SD=29.55). Females had higher maths anxiety levels (M=26.83, SD=9.00) than males (M=23.67, SD=8.26) and lower self-efficacy (M=119.59, SD=29.30) than males (M=135.73, SD=27.39). There was a significant negative relationship between MARS-R and MSES levels. Multiple linear regression indicated that maths self-efficacy (beta = -0.626, p<0.001) made the strongest contribution to maths anxiety levels. Conclusion There was a significant negative relationship between maths anxiety and self-efficacy levels reported by the paramedic student cohort. Gender plays an integral part in determining maths anxiety and self-efficacy level. To improve maths performance and reduce anxiety during calculation tasks, such as dose determinations, targeted education should be developed to improve maths self-efficacy.
{"title":"The Effect of Self-Efficacy on Maths Anxiety among Paramedic Students","authors":"Eihab A Khasawneh, C. Gosling, B. Williams","doi":"10.33151/ajp.18.814","DOIUrl":"https://doi.org/10.33151/ajp.18.814","url":null,"abstract":"Introduction Maths anxiety is defined as feelings of tension that interfere with dealing with numbers and mathematical problems. Self-efficacy, which is related to maths anxiety, can be defined as perceptions of one's abilities to math problems, tasks and math-related course work. This study aimed to investigate the effect of gender, age and year level on maths anxiety and self-efficacy and to study the relationship between self-efficacy and maths anxiety among paramedic students. Methods A cross-sectional study of paramedic students at Monash University in Victoria was conducted. Participants completed a 15-minute paper-based questionnaire which is composed of Maths Anxiety Rating Scale – Revised (MARS-R),) the Maths Self-Efficacy Scale (MSES) and demographic information. Results The questionnaires were completed and returned by 344 students. (81.3% return rate). The mean score for the MARS-R was 25.71 (SD=8.80) and for the MSES was 125.59 (SD=29.55). Females had higher maths anxiety levels (M=26.83, SD=9.00) than males (M=23.67, SD=8.26) and lower self-efficacy (M=119.59, SD=29.30) than males (M=135.73, SD=27.39). There was a significant negative relationship between MARS-R and MSES levels. Multiple linear regression indicated that maths self-efficacy (beta = -0.626, p<0.001) made the strongest contribution to maths anxiety levels. Conclusion There was a significant negative relationship between maths anxiety and self-efficacy levels reported by the paramedic student cohort. Gender plays an integral part in determining maths anxiety and self-efficacy level. To improve maths performance and reduce anxiety during calculation tasks, such as dose determinations, targeted education should be developed to improve maths self-efficacy.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121924427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The relatively quick evolution of paramedicine and the inevitable ‘growing pains’ associated with an evolving profession has seen mentoring and the role of the mentor become clouded in confusion, ineffective education and a lack of specific research. Paramedicine's recent development as a registered profession has also seen mentoring explicitly outlined as being a capability expected of all registered paramedics. However, the paramedic-mentoring model in Australia seems to have been mostly left up to the individual paramedic to develop in isolation from adequate training and mentoring themselves. If paramedicine is to continue its evolution as a legitimate healthcare profession, the quality of clinical mentoring must be acknowledged as a significant factor by higher education institutions, and the public and private services who employ paramedics, and nurtured accordingly.
{"title":"Mentor or Tormentor? A Commentary on the Fractured Role of Mentoring in Paramedicine","authors":"A. Bell, S. Whitfield","doi":"10.33151/ajp.18.984","DOIUrl":"https://doi.org/10.33151/ajp.18.984","url":null,"abstract":"The relatively quick evolution of paramedicine and the inevitable ‘growing pains’ associated with an evolving profession has seen mentoring and the role of the mentor become clouded in confusion, ineffective education and a lack of specific research. Paramedicine's recent development as a registered profession has also seen mentoring explicitly outlined as being a capability expected of all registered paramedics. However, the paramedic-mentoring model in Australia seems to have been mostly left up to the individual paramedic to develop in isolation from adequate training and mentoring themselves. If paramedicine is to continue its evolution as a legitimate healthcare profession, the quality of clinical mentoring must be acknowledged as a significant factor by higher education institutions, and the public and private services who employ paramedics, and nurtured accordingly.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127089752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Campeau, Maud Huiskamp, Nicole Sykes, Susan Kriening, S. Bourn, Kritine VanAarsen
Introduction Quality improvement (QI) programs have become common in paramedic systems, but they are often limited to individual agencies. Modern paramedicine involves many different agencies and inter-agency QI programs would better reflect their co-operative efforts. Similarly, inter-agency use of clinical outcome measurements can offer system level performance data. This study's intent was to explore the feasibility of planning an inter-agency QI program that uses outcome measures. Methods This study used a modified Delphi methodology. A 49-member panel of inter-agency representatives was convened to identify and prioritise clinical outcome-based topics. Over a 3-month period, two online surveys were conducted followed by a 1-day face-to-face meeting. Results The study demonstrated very high participation rates. Results progressed from an initial wide range of 38 topics to a final consensus of two: infection/sepsis and patient safety/care pathways, complete with outcome measures. Conclusion Inter-agency quality improvement planning is an under investigated area, but this study demonstrates that it is feasible. Additionally, this planning can incorporate clinical outcome measures that inform system level discussions about quality. Other paramedic agencies may draw on the study's processes when planning their own quality improvement programs.
{"title":"An Inter-Agency Expert Panel's Prioritisation of Clinical Quality Improvement Topics in a Paramedic System","authors":"A. Campeau, Maud Huiskamp, Nicole Sykes, Susan Kriening, S. Bourn, Kritine VanAarsen","doi":"10.33151/ajp.18.917","DOIUrl":"https://doi.org/10.33151/ajp.18.917","url":null,"abstract":"Introduction Quality improvement (QI) programs have become common in paramedic systems, but they are often limited to individual agencies. Modern paramedicine involves many different agencies and inter-agency QI programs would better reflect their co-operative efforts. Similarly, inter-agency use of clinical outcome measurements can offer system level performance data. This study's intent was to explore the feasibility of planning an inter-agency QI program that uses outcome measures. Methods This study used a modified Delphi methodology. A 49-member panel of inter-agency representatives was convened to identify and prioritise clinical outcome-based topics. Over a 3-month period, two online surveys were conducted followed by a 1-day face-to-face meeting. Results The study demonstrated very high participation rates. Results progressed from an initial wide range of 38 topics to a final consensus of two: infection/sepsis and patient safety/care pathways, complete with outcome measures. Conclusion Inter-agency quality improvement planning is an under investigated area, but this study demonstrates that it is feasible. Additionally, this planning can incorporate clinical outcome measures that inform system level discussions about quality. Other paramedic agencies may draw on the study's processes when planning their own quality improvement programs.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125474341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Critically ill neonates often require urgent transport to a neonatal care facility shortly after birth. The safe transfer of ill neonates is a critical part of their continuum of care. Methods A review of the empirical work and literature around the safe transfer of ill neonates was undertaken to explore what factors influence a safe transfer. Results What emerged was that a multitude of adverse events influence the clinical deterioration of the neonate, including the physiological condition of the neonate, equipment-related challenges and the unpreparedness of those involved to deal with neonatal clinical emergencies. Conclusion This review highlights the necessary equipment required, the nature of clinical emergencies that may arise, and the need to consider utilising specialised neonatal transfer units to effect the safe transfer of the critically ill neonate.
{"title":"Critical Issues Underpinning the Safe Transfer of Ill Neonates: A Review of the Literature","authors":"R. Bhagwan","doi":"10.33151/ajp.18.874","DOIUrl":"https://doi.org/10.33151/ajp.18.874","url":null,"abstract":"Introduction Critically ill neonates often require urgent transport to a neonatal care facility shortly after birth. The safe transfer of ill neonates is a critical part of their continuum of care. Methods A review of the empirical work and literature around the safe transfer of ill neonates was undertaken to explore what factors influence a safe transfer. Results What emerged was that a multitude of adverse events influence the clinical deterioration of the neonate, including the physiological condition of the neonate, equipment-related challenges and the unpreparedness of those involved to deal with neonatal clinical emergencies. Conclusion This review highlights the necessary equipment required, the nature of clinical emergencies that may arise, and the need to consider utilising specialised neonatal transfer units to effect the safe transfer of the critically ill neonate.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128789712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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