P. Watkins, P. Buzzacott, D. Brink, Stacey Masters, A. M. Hill
Introduction Falls are a globally prevalent health issue, with 37.3 million falls severe enough to require medical attention each year. Falls can result in major trauma and are the second leading cause of unintentional injury deaths worldwide. The role of emergency medical services (EMS) in the pre-hospital emergency treatment of falls is critical, however the sources describing this phase of care has not previously been synthesised. The aim of this scoping review is to identify and map the published literature on the characteristics and injuries of adults who fall, are attended by EMS, EMS interventions and patient disposition. Methods The methods for scoping reviews outlined by the JBI Manual for Evidence Synthesis will be used. Databases including Medline, Scopus, CINAHL Plus, Cochrane, EMBASE and ProQuest will be searched from inception. Reference lists of included sources will also be searched. Two reviewers will independently complete title, abstract and full text screening. Included sources will be summarised using narrative synthesis and conceptual categories including patient characteristics, injuries, EMS intervention and patient disposition will be mapped. Discussion This protocol describes the framework to identify the scope, comprehensiveness and concepts surrounding pre-hospital falls to identify gaps in knowledge regarding the role of EMS in attending patients who sustain a fall.
{"title":"Pre-Hospital Management, Injuries and Disposition of Ambulance Attended Adults who Fall: A Scoping Review Protocol","authors":"P. Watkins, P. Buzzacott, D. Brink, Stacey Masters, A. M. Hill","doi":"10.33151/ajp.18.876","DOIUrl":"https://doi.org/10.33151/ajp.18.876","url":null,"abstract":"Introduction Falls are a globally prevalent health issue, with 37.3 million falls severe enough to require medical attention each year. Falls can result in major trauma and are the second leading cause of unintentional injury deaths worldwide. The role of emergency medical services (EMS) in the pre-hospital emergency treatment of falls is critical, however the sources describing this phase of care has not previously been synthesised. The aim of this scoping review is to identify and map the published literature on the characteristics and injuries of adults who fall, are attended by EMS, EMS interventions and patient disposition. Methods The methods for scoping reviews outlined by the JBI Manual for Evidence Synthesis will be used. Databases including Medline, Scopus, CINAHL Plus, Cochrane, EMBASE and ProQuest will be searched from inception. Reference lists of included sources will also be searched. Two reviewers will independently complete title, abstract and full text screening. Included sources will be summarised using narrative synthesis and conceptual categories including patient characteristics, injuries, EMS intervention and patient disposition will be mapped. Discussion This protocol describes the framework to identify the scope, comprehensiveness and concepts surrounding pre-hospital falls to identify gaps in knowledge regarding the role of EMS in attending patients who sustain a fall.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"18 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":"129281207","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}
James Pearce, R. Pap, D. Moher, Julia Williams, P. Simpson
Introduction Case reports make important contributions to evidence-based practice. As with research of any methodological design, the quality and completeness in how the evidence is reported influences the strength of the evidence. Quality in reporting is best achieved through the use of a consensus-based reporting guideline. ‘Case Reports’ (CARE) is a 13-item reporting guideline for case reports. To make CARE more applicable, several discipline specific ‘extensions’ have been developed. Pre-hospital care is an emerging clinical discipline rich in its own specific context and character. Therefore, the aim of this project is to develop and disseminate a pre-hospital extension of the CARE reporting guideline (PREHOSPITAL-CARE). Methods This project will consist of four phases and will be undertaken in accordance with the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network's guidance for developers of health research reporting guidelines. Phase 1 will comprise a systematic review aimed at identifying features commonly reported in pre-hospital case reports. In phase 2, two consensus-based processes will be conducted, including a Delphi method and an interactive consensus meeting, to produce a list of items that will form the draft guideline items for PREHOSPITAL-CARE. Phase 3 will see this draft being piloted among a selected group of pre-hospital clinicians, academics and students. In the fourth and final phase, an extensive dissemination strategy will be executed, including publication of the PREHOSPITAL-CARE reporting guideline and an ‘elaboration and explanation’ (E&E) companion paper to advocate for the standardised, high-quality reporting of pre-hospital case reports. Outcomes The final outcome will be the publication of the PREHOSPITAL-CARE reporting guideline with an associated E&E paper. Discussion The reporting of health research, including pre-hospital case reports, has been criticised for a lack of completeness and consistency. The development of PREHOSPITAL-CARE will enable the improvement and standardised reporting of pre-hospital case reports.
{"title":"Protocol for Development of a Consensus-Based Reporting Guideline Extension for Pre-Hospital Case Reports (Prehospital-Care)","authors":"James Pearce, R. Pap, D. Moher, Julia Williams, P. Simpson","doi":"10.33151/ajp.18.885","DOIUrl":"https://doi.org/10.33151/ajp.18.885","url":null,"abstract":"Introduction Case reports make important contributions to evidence-based practice. As with research of any methodological design, the quality and completeness in how the evidence is reported influences the strength of the evidence. Quality in reporting is best achieved through the use of a consensus-based reporting guideline. ‘Case Reports’ (CARE) is a 13-item reporting guideline for case reports. To make CARE more applicable, several discipline specific ‘extensions’ have been developed. Pre-hospital care is an emerging clinical discipline rich in its own specific context and character. Therefore, the aim of this project is to develop and disseminate a pre-hospital extension of the CARE reporting guideline (PREHOSPITAL-CARE). Methods This project will consist of four phases and will be undertaken in accordance with the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network's guidance for developers of health research reporting guidelines. Phase 1 will comprise a systematic review aimed at identifying features commonly reported in pre-hospital case reports. In phase 2, two consensus-based processes will be conducted, including a Delphi method and an interactive consensus meeting, to produce a list of items that will form the draft guideline items for PREHOSPITAL-CARE. Phase 3 will see this draft being piloted among a selected group of pre-hospital clinicians, academics and students. In the fourth and final phase, an extensive dissemination strategy will be executed, including publication of the PREHOSPITAL-CARE reporting guideline and an ‘elaboration and explanation’ (E&E) companion paper to advocate for the standardised, high-quality reporting of pre-hospital case reports. Outcomes The final outcome will be the publication of the PREHOSPITAL-CARE reporting guideline with an associated E&E paper. Discussion The reporting of health research, including pre-hospital case reports, has been criticised for a lack of completeness and consistency. The development of PREHOSPITAL-CARE will enable the improvement and standardised reporting of pre-hospital case reports.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"32 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":"115845765","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}
Timothy Makrides, L. Baranowski, Lucas Hawkes-Frost, J. Helmer
The field of paramedicine has undergone significant change and modernisation over the past 50 years. Presently there are no consistent terms or lexicon used across the profession to describe different levels of advanced practice. This inconsistency risks creating confusion as the professionalisation of paramedic practice continues. As well, many empirical studies support the claim that communication and the importance of managing language actively plays a crucial role in supporting change and in shaping the new paradigm. Therefore, the way one uses communication, and the deliberate choice of words to describe advance practice, will support change in the desired direction. This article explores these terms and their attendant influences on perceptions of practice to argue for change towards the standardised use of the term ‘advanced care paramedic’ across the Anglo-American paramedic system.
{"title":"Advanced Care or Advanced Life Support – What are we Providing?","authors":"Timothy Makrides, L. Baranowski, Lucas Hawkes-Frost, J. Helmer","doi":"10.33151/AJP.18.950","DOIUrl":"https://doi.org/10.33151/AJP.18.950","url":null,"abstract":"The field of paramedicine has undergone significant change and modernisation over the past 50 years. Presently there are no consistent terms or lexicon used across the profession to describe different levels of advanced practice. This inconsistency risks creating confusion as the professionalisation of paramedic practice continues. As well, many empirical studies support the claim that communication and the importance of managing language actively plays a crucial role in supporting change and in shaping the new paradigm. Therefore, the way one uses communication, and the deliberate choice of words to describe advance practice, will support change in the desired direction. This article explores these terms and their attendant influences on perceptions of practice to argue for change towards the standardised use of the term ‘advanced care paramedic’ across the Anglo-American paramedic system.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"102 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":"114386183","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 A one-size-fits-all approach to adrenaline dosing is likely to be sub-optimal for out-of-hospital cardiac arrest given the diverse nature of patient age, bodyweight, frailty and intra-arrest coronary perfusion pressure. An individualised adrenaline dosing approach to cardiac arrest using invasive blood pressure monitoring has been shown to increase rates of return of spontaneous circulation in the hospital setting, but evidence for this approach has not yet been reviewed in the pre-hospital setting. Methods A scoping review was undertaken using Science Direct, ProQuest, PubMed, CINAHL Complete and GALE Health and Wellness databases with the search terms ‘arterial line’, ‘pre-hospital’, ‘cardiac arrest’ and similar derivatives. Subject matter experts and authors of articles meeting inclusion criteria were also consulted to help identify further relevant studies. Articles were included if they pertained to the use of arterial lines in cardiac arrest in the pre-hospital field, and excluded if they related to traumatic cardiac arrest, in a language other than English, Dutch or French, or not retrievable as a full text. Results A total of 1408 articles were identified using the search method, of which three remained after de-duplication, use of inclusion and exclusion criteria, and full text appraisal. The current pre-hospital literature is lacking and avenues for further research to improve the evidence for hemodynamic guided resuscitation were identified. Conclusion Paramedic-initiated invasive arterial monitoring presents a new, but as yet unproven, intervention for improving cardiac arrest outcomes.
考虑到患者年龄、体重、虚弱程度和停搏时冠状动脉灌注压的不同性质，采用一刀切的肾上腺素给药方法可能不是院外心脏骤停的最佳选择。使用有创血压监测的个体化肾上腺素剂量治疗心脏骤停的方法已被证明可以增加医院环境中自发循环的恢复率，但这种方法的证据尚未在院前环境中进行审查。方法使用Science Direct、ProQuest、PubMed、CINAHL Complete和GALE Health and Wellness数据库进行范围综述，检索词为“动脉线”、“院前”、“心脏骤停”和类似衍生词。还咨询了主题专家和符合纳入标准的文章作者，以帮助确定进一步的相关研究。涉及院前领域心脏骤停中动脉导管使用的文章被纳入，涉及创伤性心脏骤停的文章被排除，且采用英语、荷兰语或法语以外的语言，或无法作为全文检索。结果采用检索方法共检索到文献1408篇，经去重复、纳入标准、排除标准及全文鉴定后，仅剩3篇。目前院前文献缺乏，进一步研究的途径，以提高血液动力学引导复苏的证据被确定。结论护理人员发起的有创动脉监测是一种新的但尚未证实的改善心脏骤停结果的干预措施。
{"title":"Goldilocks in Cardiac Arrest: A Scoping Review of Invasive Hemodynamic Monitoring in the Pre-Hospital Setting for Getting Adrenaline Dosing Just Right","authors":"Youri Wijland","doi":"10.33151/ajp.18.890","DOIUrl":"https://doi.org/10.33151/ajp.18.890","url":null,"abstract":"Introduction A one-size-fits-all approach to adrenaline dosing is likely to be sub-optimal for out-of-hospital cardiac arrest given the diverse nature of patient age, bodyweight, frailty and intra-arrest coronary perfusion pressure. An individualised adrenaline dosing approach to cardiac arrest using invasive blood pressure monitoring has been shown to increase rates of return of spontaneous circulation in the hospital setting, but evidence for this approach has not yet been reviewed in the pre-hospital setting. Methods A scoping review was undertaken using Science Direct, ProQuest, PubMed, CINAHL Complete and GALE Health and Wellness databases with the search terms ‘arterial line’, ‘pre-hospital’, ‘cardiac arrest’ and similar derivatives. Subject matter experts and authors of articles meeting inclusion criteria were also consulted to help identify further relevant studies. Articles were included if they pertained to the use of arterial lines in cardiac arrest in the pre-hospital field, and excluded if they related to traumatic cardiac arrest, in a language other than English, Dutch or French, or not retrievable as a full text. Results A total of 1408 articles were identified using the search method, of which three remained after de-duplication, use of inclusion and exclusion criteria, and full text appraisal. The current pre-hospital literature is lacking and avenues for further research to improve the evidence for hemodynamic guided resuscitation were identified. Conclusion Paramedic-initiated invasive arterial monitoring presents a new, but as yet unproven, intervention for improving cardiac arrest outcomes.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"88 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":"127160017","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 Physical injury is a major cause of premature death and/or disability worldwide. South African mortality statistics indicate approximately half of all injury-related deaths were intentional, often from sharp-force injuries. Injury surveillance data for victims of penetrating injury is scarce in low- to middle-income countries with a reliance on mortality data. The aim was to provide an epidemiological description of penetrating injury and the related haemorrhagic shock resuscitation practice in a South African emergency medical service. Methods A prospective, observational, descriptive study was conducted in urban Cape Town. ‘R’ statistical computing was used. Emergency care providers voluntarily documented parameters for mechanism of injury, vital signs, intravenous fluid resuscitation and demographic information for patients with penetrating injury. Results Of 2884 (N) penetrating trauma cases, 143 (n) cases were sampled from providers. The chest (35.7%) and upper-limbs (31.5%) were the most common anatomy for penetrating injuries. The estimated mean crystalloid fluid volume administered for penetrating abdominal and chest injuries was 1010.6 mL and 925.3 mL respectively. A statistically significant association was observed between fluid administration and clinical indications such as systolic and diastolic blood pressure, heart rate, capillary refill time, level of consciousness estimation from the scene of the incident to the hospital after intravenous fluid administration. Most emergency medical service call outs (56%) were likely to occur between 20:00 and 02:00. Conclusion The intravenous fluid management by pre-hospital emergency care providers for patients with penetrating traumatic injuries, do not cohere with hypotensive resuscitative recommendations. Future research must include clinical practice guideline implementation efficacy and pre-hospital surveillance mechanisms. This study informs hospital clinician expectations for penetrating trauma care by pre-hospital providers.
{"title":"Penetrating Injury from Interpersonal Violence and Related Haemorrhagic Shock Resuscitation Practices in An Urban South African Emergency Medical Service","authors":"M. Zalgaonker, N. Naidoo, L. Christopher","doi":"10.33151/ajp.18.873","DOIUrl":"https://doi.org/10.33151/ajp.18.873","url":null,"abstract":"Introduction Physical injury is a major cause of premature death and/or disability worldwide. South African mortality statistics indicate approximately half of all injury-related deaths were intentional, often from sharp-force injuries. Injury surveillance data for victims of penetrating injury is scarce in low- to middle-income countries with a reliance on mortality data. The aim was to provide an epidemiological description of penetrating injury and the related haemorrhagic shock resuscitation practice in a South African emergency medical service. Methods A prospective, observational, descriptive study was conducted in urban Cape Town. ‘R’ statistical computing was used. Emergency care providers voluntarily documented parameters for mechanism of injury, vital signs, intravenous fluid resuscitation and demographic information for patients with penetrating injury. Results Of 2884 (N) penetrating trauma cases, 143 (n) cases were sampled from providers. The chest (35.7%) and upper-limbs (31.5%) were the most common anatomy for penetrating injuries. The estimated mean crystalloid fluid volume administered for penetrating abdominal and chest injuries was 1010.6 mL and 925.3 mL respectively. A statistically significant association was observed between fluid administration and clinical indications such as systolic and diastolic blood pressure, heart rate, capillary refill time, level of consciousness estimation from the scene of the incident to the hospital after intravenous fluid administration. Most emergency medical service call outs (56%) were likely to occur between 20:00 and 02:00. Conclusion The intravenous fluid management by pre-hospital emergency care providers for patients with penetrating traumatic injuries, do not cohere with hypotensive resuscitative recommendations. Future research must include clinical practice guideline implementation efficacy and pre-hospital surveillance mechanisms. This study informs hospital clinician expectations for penetrating trauma care by pre-hospital providers.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"25 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":"127241631","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 This study sought to investigate how prepared emergency care providers are to deal with death, dying and bereavement in the pre-hospital setting in Dubai, and to make recommendations related to such events. Methods A quantitative descriptive prospective design was utilised. Data was collected using an online self-report questionnaire sent to all operational emergency care providers in the Dubai Corporation of Ambulance Services. The data was analysed using the IBM Statistical Package for Social Sciences version 25.0. Results Nearly 65% of participants (n=316) reported that they had not received any formal education or training on death, dying and bereavement. Those that did, reported that the training was conducted mainly by nursing (25.9%; n=124) and paramedic (13.6%; n=65) instructors. One-quarter of participants (25.4%; n=126) reported experiencing intrusive symptoms such as sleep loss, nightmares and missing work as a result of a work-related death or dying incident, but only 4.1% (n=20) had received professional counselling. Conclusion This study found that emergency care providers are underprepared to deal with death, dying and bereavement. A comprehensive death education program encompassing the unique challenges that emergency and pre-hospital setting presents should be implemented to reduce emotional anxiety and help emergency care providers cope better with death, and decrease abnormal grief reactions of the bereft. Abnormal grief reactions can include restlessness, searching for the lost person and disrupted autonomic nervous system functions.
{"title":"The Preparedness of Emergency Care Providers to Deal with Death, Dying and Bereavement in the Pre-Hospital Setting in Dubai","authors":"R. Conning, R. Naidoo, R. Bhagwan","doi":"10.33151/ajp.18.944","DOIUrl":"https://doi.org/10.33151/ajp.18.944","url":null,"abstract":"Introduction This study sought to investigate how prepared emergency care providers are to deal with death, dying and bereavement in the pre-hospital setting in Dubai, and to make recommendations related to such events. Methods A quantitative descriptive prospective design was utilised. Data was collected using an online self-report questionnaire sent to all operational emergency care providers in the Dubai Corporation of Ambulance Services. The data was analysed using the IBM Statistical Package for Social Sciences version 25.0. Results Nearly 65% of participants (n=316) reported that they had not received any formal education or training on death, dying and bereavement. Those that did, reported that the training was conducted mainly by nursing (25.9%; n=124) and paramedic (13.6%; n=65) instructors. One-quarter of participants (25.4%; n=126) reported experiencing intrusive symptoms such as sleep loss, nightmares and missing work as a result of a work-related death or dying incident, but only 4.1% (n=20) had received professional counselling. Conclusion This study found that emergency care providers are underprepared to deal with death, dying and bereavement. A comprehensive death education program encompassing the unique challenges that emergency and pre-hospital setting presents should be implemented to reduce emotional anxiety and help emergency care providers cope better with death, and decrease abnormal grief reactions of the bereft. Abnormal grief reactions can include restlessness, searching for the lost person and disrupted autonomic nervous system functions.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"6 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132463399","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 Previous studies have shown teaching public health in medical courses improves students’ analytical, problem-solving and communication skills. However, little research to date has shown if public health teaching is helpful to paramedic students. The aim of this study was to examine if having paramedic tutors teach public health had a positive effect on students’ learning and interest in public health. Methods 184 second-year paramedic students at an Australian university completed a printed survey and provided feedback about their learning experience. Students answered multiple choice and open-ended questions about whether their understanding of a public health subject was improved by having a paramedic tutor, and if having different tutors each week affected students’ learning. Results Most students reported their understanding of public health improved when the subject was taught by a paramedic tutor and when paramedic scenario examples were included in teaching. Nearly half felt having different tutors each week made learning difficult. The following themes emerged from student narratives: the relevance of public health to their career; an improved understanding of public health; a realisation about the importance of public health; difficulties presented by an inconsistent teaching style; and poor follow-up and conflicting advice. Conclusion Teaching public health from a paramedic perspective enabled students to understand the relevance of paramedic practice and the role paramedics play in the public health system. Having the same paramedic tutor teaching each week helped students understand the relationship between public health and paramedic practice.
{"title":"Undergraduate Paramedic Students’ Experience of Paramedic Tutors Teaching Public Health","authors":"M. Sendall, Athena Ng, L. Mccosker","doi":"10.33151/ajp.18.765","DOIUrl":"https://doi.org/10.33151/ajp.18.765","url":null,"abstract":"Introduction Previous studies have shown teaching public health in medical courses improves students’ analytical, problem-solving and communication skills. However, little research to date has shown if public health teaching is helpful to paramedic students. The aim of this study was to examine if having paramedic tutors teach public health had a positive effect on students’ learning and interest in public health. Methods 184 second-year paramedic students at an Australian university completed a printed survey and provided feedback about their learning experience. Students answered multiple choice and open-ended questions about whether their understanding of a public health subject was improved by having a paramedic tutor, and if having different tutors each week affected students’ learning. Results Most students reported their understanding of public health improved when the subject was taught by a paramedic tutor and when paramedic scenario examples were included in teaching. Nearly half felt having different tutors each week made learning difficult. The following themes emerged from student narratives: the relevance of public health to their career; an improved understanding of public health; a realisation about the importance of public health; difficulties presented by an inconsistent teaching style; and poor follow-up and conflicting advice. Conclusion Teaching public health from a paramedic perspective enabled students to understand the relevance of paramedic practice and the role paramedics play in the public health system. Having the same paramedic tutor teaching each week helped students understand the relationship between public health and paramedic practice.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"18 1 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":"130916373","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 The handover of a patient in the pre-hospital setting is different to other handover settings and therefore requires a different definition and description to that of other patient handover environments. Identifying those factors that affect the efficacy of handover could provide useful for formulating improvement strategies. Aim This research set out to describe the negative experiences of pre-hospital emergency care personnel handing over in the emergency centre in Johannesburg, South Africa, with a view to identifying potential areas for improvement. This paper reports on responses to an open-ended question that formed part of a purpose-designed, paper-based questionnaire that formed part of a mixed-methods study. Methods Data were collected from pre-hospital emergency care personnel within Johannesburg, South Africa. Responses from 140 participants were captured verbatim into Atlas.ti® for coding, analysis and interpretation using a qualitative descriptive methodology. Two themes were generated from a qualitative descriptive analysis of the data: communication barriers, and process barriers to emergency centre handover. These were confirmed by the categories and codes that made up these themes. Conclusion This study identifies some of the factors perceived by pre-hospital emergency care personnel to negatively affect emergency centre handover. It provides insights into how communication and process within the emergency centre have the potential to negatively impact emergency centre handover efficacy.
{"title":"The Identification of Factors Contributing to Negative Handover Experiences of Pre-Hospital Emergency Care Personnel in Johannesburg, South Africa","authors":"A. Makkink, Christopher Stein, S. Bruijns","doi":"10.33151/ajp.18.829","DOIUrl":"https://doi.org/10.33151/ajp.18.829","url":null,"abstract":"Introduction The handover of a patient in the pre-hospital setting is different to other handover settings and therefore requires a different definition and description to that of other patient handover environments. Identifying those factors that affect the efficacy of handover could provide useful for formulating improvement strategies. Aim This research set out to describe the negative experiences of pre-hospital emergency care personnel handing over in the emergency centre in Johannesburg, South Africa, with a view to identifying potential areas for improvement. This paper reports on responses to an open-ended question that formed part of a purpose-designed, paper-based questionnaire that formed part of a mixed-methods study. Methods Data were collected from pre-hospital emergency care personnel within Johannesburg, South Africa. Responses from 140 participants were captured verbatim into Atlas.ti® for coding, analysis and interpretation using a qualitative descriptive methodology. Two themes were generated from a qualitative descriptive analysis of the data: communication barriers, and process barriers to emergency centre handover. These were confirmed by the categories and codes that made up these themes. Conclusion This study identifies some of the factors perceived by pre-hospital emergency care personnel to negatively affect emergency centre handover. It provides insights into how communication and process within the emergency centre have the potential to negatively impact emergency centre handover efficacy.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"1 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":"130871228","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}
M. Nasr Isfahani, Mohammad Hatami, Donya Sheibani Tehrani
Introduction Quality of life (QoL) is an important index of general and mental health. Several studies have demonstrated healthcare staff can provide higher quality services to patients when they have a better QoL. Working in emergency care services has a heavy workload therefore poor QoL can lead to poor quality of service to patients. We aimed to assess the QoL in pre-hospital and hospital emergency healthcare workers in Isfahan province in Iran via the WHOQOL-BREF (World Health Organization Quality of Life) questionnaire. Methods A total of 891 pre-hospital and hospital emergency personnel were selected via the census method. The WHOQOL-BREF questionnaire was filled out by the participants over a period of 1 year. Results A total of 891 subjects participated. About 33.7% of the participants were pre-hospital emergency staff, 59.1% emergency department nurses, 5.3% emergency department physicians, and 1.6% emergency medicine specialists. Approximately 412 participants (48.8%) were women and 469 (53.2%) were men (mean age 37.72 ± 11.02 years). QoL in pre-hospital and hospital emergency personnel had the highest mean score in the general health domain (61.43 ± 21.38) and the lowest mean score in the environmental health domain (48.54 ± 17.62). Social relationships with a mean score of 53.30 ± 23.56 were not significantly different to the average (p>0.05). Workplace and work experience had a significant effect on all domains of QoL. Conclusion Pre-hospital and hospital emergency personnel in Isfahan province had an optimal QoL, except in environmental health. Therefore, to increase the QoL in this area the periodical evaluation of environmental health is recommended. Appropriate training to create workplace adjustment and work experience can also improve QoL.
生活质量(Quality of life, QoL)是综合健康和心理健康的重要指标。几项研究表明，当医护人员的生活质量较好时，他们可以为患者提供更高质量的服务。急诊护理工作工作量大，因此生活质量差会导致对患者的服务质量差。我们旨在通过WHOQOL-BREF(世界卫生组织生活质量)问卷评估伊朗伊斯法罕省院前和医院急诊医护人员的生活质量。方法采用普查方法，抽取891名院前和医院急救人员。WHOQOL-BREF问卷由参与者在1年的时间内填写。结果共纳入891名受试者。约33.7%的参与者为院前急救人员，59.1%为急诊科护士，5.3%为急诊科医生，1.6%为急诊医学专家。其中女性412人(48.8%)，男性469人(53.2%)，平均年龄37.72±11.02岁。院前和院内急救人员的生活质量平均得分最高的是一般健康领域(61.43±21.38)，最低的是环境健康领域(48.54±17.62)。社会关系得分为53.30±23.56分，与平均值无显著差异(p>0.05)。工作场所和工作经历对生活质量的各方面均有显著影响。结论除环境健康外，伊斯法罕省院前和医院急救人员的生活质量最佳。因此，为了提高该地区的生活质量，建议定期进行环境健康评价。适当的培训，以创造工作场所的适应和工作经验，也可以提高生活质量。
{"title":"Quality of Life Assessment in Pre-Hospital and Hospital Emergency Healthcare Workers: A Pilot Study","authors":"M. Nasr Isfahani, Mohammad Hatami, Donya Sheibani Tehrani","doi":"10.33151/ajp.18.807","DOIUrl":"https://doi.org/10.33151/ajp.18.807","url":null,"abstract":"Introduction Quality of life (QoL) is an important index of general and mental health. Several studies have demonstrated healthcare staff can provide higher quality services to patients when they have a better QoL. Working in emergency care services has a heavy workload therefore poor QoL can lead to poor quality of service to patients. We aimed to assess the QoL in pre-hospital and hospital emergency healthcare workers in Isfahan province in Iran via the WHOQOL-BREF (World Health Organization Quality of Life) questionnaire. Methods A total of 891 pre-hospital and hospital emergency personnel were selected via the census method. The WHOQOL-BREF questionnaire was filled out by the participants over a period of 1 year. Results A total of 891 subjects participated. About 33.7% of the participants were pre-hospital emergency staff, 59.1% emergency department nurses, 5.3% emergency department physicians, and 1.6% emergency medicine specialists. Approximately 412 participants (48.8%) were women and 469 (53.2%) were men (mean age 37.72 ± 11.02 years). QoL in pre-hospital and hospital emergency personnel had the highest mean score in the general health domain (61.43 ± 21.38) and the lowest mean score in the environmental health domain (48.54 ± 17.62). Social relationships with a mean score of 53.30 ± 23.56 were not significantly different to the average (p>0.05). Workplace and work experience had a significant effect on all domains of QoL. Conclusion Pre-hospital and hospital emergency personnel in Isfahan province had an optimal QoL, except in environmental health. Therefore, to increase the QoL in this area the periodical evaluation of environmental health is recommended. Appropriate training to create workplace adjustment and work experience can also improve QoL.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"8 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":"123787584","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}
Background Emergency centre handover usually takes place between the pre-hospital emergency care personnel who deliver the handover and the emergency centre personnel who receive the handover. Handover that is not effective may present risks to patient safety. One factor that may affect handover delivery is the process of handover within a busy emergency centre. Methods The data reported on in this study formed the qualitative component of a sequential explanatory mixed methods study. It used face-to-face, semi-structured interviews to gather data. Fifteen interviews were conducted with pre-hospital emergency care personnel from a range of qualification and scopes in South Africa. Interviews were transcribed verbatim and imported into Atlas.ti® for coding and analysis using a qualitative descriptive methodology. Results Pre-hospital emergency care participants identified a lack of emergency centre staff available to receive handover as a barrier to effective handover and attributed this to emergency centres being overworked and understaffed. This potentiated interruptions to handover and having to deliver multiple handovers for the same patient. Pre-hospital emergency care participants indicated a preference for handing over directly to a doctor. Conclusion Several potential process barriers to effective emergency centre handover were identified, including lack of personnel to receive handover, interruptions and the need to perform multiple handovers for the same patient. Generally, these barriers were attributed to the busy understaffed and overworked nature of emergency centres. We would encourage future research in emergency centre handover, specifically from the perspective of the personnel who receive handovers.
{"title":"The Process of Handover in the Busy Emergency Centre: A Pre-Hospital Perspective from Johannesburg, South Africa","authors":"A. Makkink, Christopher Stein, S. Bruijns","doi":"10.33151/ajp.18.913","DOIUrl":"https://doi.org/10.33151/ajp.18.913","url":null,"abstract":"Background Emergency centre handover usually takes place between the pre-hospital emergency care personnel who deliver the handover and the emergency centre personnel who receive the handover. Handover that is not effective may present risks to patient safety. One factor that may affect handover delivery is the process of handover within a busy emergency centre. Methods The data reported on in this study formed the qualitative component of a sequential explanatory mixed methods study. It used face-to-face, semi-structured interviews to gather data. Fifteen interviews were conducted with pre-hospital emergency care personnel from a range of qualification and scopes in South Africa. Interviews were transcribed verbatim and imported into Atlas.ti® for coding and analysis using a qualitative descriptive methodology. Results Pre-hospital emergency care participants identified a lack of emergency centre staff available to receive handover as a barrier to effective handover and attributed this to emergency centres being overworked and understaffed. This potentiated interruptions to handover and having to deliver multiple handovers for the same patient. Pre-hospital emergency care participants indicated a preference for handing over directly to a doctor. Conclusion Several potential process barriers to effective emergency centre handover were identified, including lack of personnel to receive handover, interruptions and the need to perform multiple handovers for the same patient. Generally, these barriers were attributed to the busy understaffed and overworked nature of emergency centres. We would encourage future research in emergency centre handover, specifically from the perspective of the personnel who receive handovers.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"184 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":"124677702","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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