Irish Journal of Paramedicine最新文献

英文中文

Rote learning: the ugly duckling of student paramedic education? 死记硬背:学生护理教育的丑小鸭?

Irish Journal of Paramedicine

Pub Date : 2018-09-26 DOI: 10.32378/IJP.V3I2.97

D. Long, Lisa Hobbs, S. Devenish

The intent of this commentary is to ask questions and stimulate discussion amongst academics and paramedic educators as to whether the inherent value of rote learning has simply been lost in the shadow of more recent learning and teaching practices.

这篇评论的目的是提出问题，并激发学者和护理教育工作者之间的讨论，即死记硬背的内在价值是否已经在最近的学习和教学实践的阴影下消失了。

引用次数: 1

A scoping study and qualitative assessment of care planning and case management in community paramedicine 社区护理医学中护理计划和病例管理的范围研究和定性评估

Irish Journal of Paramedicine

Pub Date : 2018-07-26 DOI: 10.32378/IJP.V3I1.76

M. Leyenaar, B. McLeod, Joyce Chan, W. Tavares, Andrew P. Costa, G. Agarwal

Introduction: Community paramedicine (CP) establishes an ongoing patient relationship beyond short emergency care episodes. How care planning and case management have been adapted from the isolated incidents of traditional practice is unclear. The objective of this study is to contribute to paramedic practice by examining broad areas of care planning in CP, identifying gaps in the evidence, clarifying key concepts, and reporting on the types of evidence that address and inform practice. A qualitative analysis of included literature outlines program capacities and identifies comprehensive models of care that can inform clinical practice in CP. Methods: A scoping study was completed that included conducting a systematic search of the literature (in MEDLINE and CINAHL) and selecting relevant studies, followed by data extraction, summarizing, and reporting. The authors of included studies were contacted to confirm the aspects of care planning that were extracted from their respective studies. Aspects of care planning were compared between studies and used to generate a comprehensive list of existing practices. Results: Ten of 1648 studies met inclusion criteria. Qualitative analysis identified 22 aspects of care planning along four themes; enrollment (n=3), assessment and management (n=6), intervention and care (n=5), and collaboration (n=8). No study included all 22 aspects of care planning. One aspect of care planning was present in all 10 studies; collaboration with primary care providers. Conclusion: The aspects of care planning identified through this study provide a framework that can guide service providers in the delivery of care and researchers in defined outcome measures to be assessed. Future program development should be guided by the finding that all articles included in this study included collaboration with primary care providers. By summarizing care planning within CP programs, ongoing program development can embrace collaboration with other care providers to help insure that patients receive the appropriate care.

简介:社区辅助医学(CP)建立了一种持续的病人关系，超越了短期的紧急护理事件。护理计划和病例管理如何从传统实践的孤立事件中进行调整尚不清楚。本研究的目的是通过检查CP中护理计划的广泛领域，确定证据中的差距，澄清关键概念，并报告解决和告知实践的证据类型，从而为护理人员实践做出贡献。对纳入的文献进行定性分析，概述了项目能力，并确定了可以为CP临床实践提供信息的综合护理模式。方法:完成了一项范围界定研究，包括对文献(MEDLINE和CINAHL)进行系统检索，选择相关研究，然后进行数据提取、总结和报告。与纳入研究的作者联系，以确认从各自研究中提取的护理计划方面。护理计划的各个方面在研究之间进行比较，并用于生成现有实践的综合列表。结果:1648项研究中有10项符合纳入标准。定性分析确定了护理计划的22个方面，涉及四个主题;入组(n=3)、评估与管理(n=6)、干预与护理(n=5)、协作(n=8)。没有研究包括所有22个方面的护理计划。护理计划的一个方面在所有10项研究中都存在;与初级保健提供者合作。结论:通过本研究确定的护理计划方面提供了一个框架，可以指导服务提供者提供护理和研究人员确定要评估的结果措施。未来的项目开发应以本研究中所有文章都包括与初级保健提供者的合作这一发现为指导。通过总结CP项目中的护理计划，正在进行的项目开发可以与其他护理提供者合作，以帮助确保患者得到适当的护理。

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引用次数: 14

Paramedic assessment of frailty: An exploratory study of perceptions of frailty assessment tools 护理人员虚弱评估:虚弱评估工具认知的探索性研究

Irish Journal of Paramedicine

Pub Date : 2018-07-26 DOI: 10.32378/IJP.V3I1.80

Wayne Harris, Peter Lucas, H. Eyles, L. Parker

Introduction: Frailty is recognised as a significant variable in the health of older adults. Early identification by paramedics of those at risk of frailty may assist in timely entry to an appropriate clinical care pathway. Early referral to such pathways has been shown to improve patient outcomes and quality of life, as well as deliver economic benefits. To date, little research has been completed regarding assessment of frailty by paramedic professionals using validated assessment tools. The objective of this study was to determine paramedicine students’ perceptions of screening tools to facilitate assessment and knowledge of frailty of older adults. The Edmonton Frail Scale (EFS) and the Groningen Frailty Index (GFI) were determined suitable for this purpose.Methods: The research adopted a mixed methods approach using a survey tool developed to gather both qualitative and quantitative data from students at the completion of a structured aged care clinical placement. Thematic analysis of the qualitative data identified key features of the tools, while a Likert-type scale was used to measure perspectives about the suitability of the tools for use in paramedic practice.Results: Thirty-seven paramedicine students were invited to participate in the study. Thirteen were able to use both tools to conduct frailty assessments and submitted survey responses. Student perspectives indicated both the EFS and GFI are potentially suitable for paramedicine and as clinical learning tools regarding geriatric assessments. Median time to administer the tools was eight minutes for the EFS and ten minutes for the GFI.Conclusion: Paramedicine students support a frailty assessment tool to assist clinical decision making regarding older adults. Further appraisal of validated frailty assessment tools by operational paramedics in a pre-hospital environment is warranted to determine absolute utility for Australian paramedics.

简介:虚弱被认为是老年人健康的一个重要变量。护理人员对那些有虚弱风险的人的早期识别可能有助于及时进入适当的临床护理途径。早期转诊到这些途径已被证明可以改善患者的预后和生活质量，并带来经济效益。到目前为止，很少有研究已经完成关于评估脆弱的护理专业人员使用有效的评估工具。本研究的目的是确定医学生对筛查工具的认知，以促进老年人虚弱的评估和知识。埃德蒙顿脆弱量表(EFS)和格罗宁根脆弱指数(GFI)被确定为适合于这一目的。方法:本研究采用混合方法，使用调查工具收集学生在完成结构化老年护理临床实习时的定性和定量数据。定性数据的专题分析确定了工具的关键特征，而李克特型量表被用来衡量关于工具在护理实践中使用的适用性的观点。结果:共邀请37名医学生参与本研究。13个国家能够使用这两种工具进行脆弱性评估并提交调查答复。学生的观点表明，EFS和GFI都可能适用于医疗辅助和作为老年评估的临床学习工具。使用这些工具的中位时间，EFS为8分钟，GFI为10分钟。结论:辅助医学学生支持虚弱评估工具，以协助临床决策有关老年人。在院前环境中，由操作护理人员对经过验证的虚弱评估工具进行进一步评估，以确定澳大利亚护理人员的绝对效用。

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引用次数: 6

The Elephant in the Room (Clinical Image) 房间里的大象(临床影像)

Irish Journal of Paramedicine

Pub Date : 2018-06-27 DOI: 10.32378/IJP.V3I1.78

Dhari Alrashed, E. Fogarty

Packaging is an important part of transfer medicine. Appropriate packaging in a “layered” manner is widely accepted as a safer way to move patients who may have various cables or tubes attached.In our practise we use modified ventilator airway tubing, approximately 0.5 metres in length with a slit down the longitudinal axis to contain these cables and/or tubes. This tubing has become colloquially known as “Elephant tubing”This tubing is typically used to contain ECG wires and medication giving sets. The Oxygen saturation probe wires and one intravenous access is typically left out during the transfer process in order to be able to access same.

包装是传递药品的重要环节。以“分层”的方式适当包装是被广泛接受的一种更安全的方式，可以移动可能有各种电缆或管道连接的患者。在我们的实践中，我们使用改良的呼吸机气管管，长度约0.5米，纵轴上有一个狭缝，以容纳这些电缆和/或管道。这种管子俗称“象管”，这种管子通常用于容纳心电图线和给药装置。在转移过程中，氧饱和度探头导线和一个静脉通道通常被省略，以便能够访问它们。

引用次数: 0

Moving towards the next level... 迈向下一个阶段……

Irish Journal of Paramedicine

Pub Date : 2018-06-27 DOI: 10.32378/IJP.V3I1.93

C. O'Connor

Since the turn of the century, significant progressive changes have taken place in the provision of prehospital emergency care in Ireland. Few would have dared to imagine the scale of advancement both in terms of education and scope of practice that has taken place since the bells tolled to herald the arrival of the new millennium. Academically, paramedics in Ireland who for over 20 years have been qualified at diploma level now have the opportunity to qualify with an honours bachelor of science degree, and the possibility of progression to masters and doctoral degrees should they feel so inclined. From a clinical perspective, the Advanced Life Support service that is available nationwide today has evolved from an emergency service provided by EMTs just a few short years ago.In order to make the step up to the next level in our development as a bona fide recognised profession, it is essential that we embark on the journey of the development of our own body of knowledge in relation to our education, our practice and our profession as a whole. This editorial will explore some issues related to this.

自世纪之交以来，爱尔兰在提供院前紧急护理方面发生了重大的进步变化。很少有人敢想象，自从钟声敲响预示着新千年的到来以来，在教育和实践方面所发生的进步的规模。在学术上，20多年来一直获得文凭水平资格的爱尔兰护理人员现在有机会获得荣誉理学学士学位，如果他们觉得有兴趣的话，还有可能升读硕士和博士学位。从临床的角度来看，目前在全国范围内提供的高级生命支持服务已经从几年前emt提供的紧急服务发展而来。为了使我们的发展更上一层楼，成为一个真正被认可的专业，我们必须开始发展我们自己的知识体系，将我们的教育、实践和专业作为一个整体。这篇社论将探讨与此相关的一些问题。

引用次数: 0

Physical fitness of paramedic students during vocational training - a follow-up study 护理专业学生职业训练期间体能状况的追踪研究

Irish Journal of Paramedicine

Pub Date : 2018-06-27 DOI: 10.32378/IJP.V3I1.49

H. Paakkonen, J. Ring, J. Kettunen

Introduction: Paramedics’ work includes periods of physically light activity, but also involves short periods of relatively intense physical activity. Even during their studies paramedic students’ days involve a lot of sitting, i.e. physically sedentary behaviour. We initiated a programme to motivate paramedic students to be physically active during their studies. In this study we report physical fitness among paramedic students who for one year participated in brief physical activity counselling consisting of both verbal and a written individually tailored exercise programMethods: A total of 40 paramedic students (26 female, 14 male) had participated voluntarily in a physical activity programme alongside their studies. Subjects’ maximal oxygen consumption and muscle strength were measured at baseline and at one-year follow-up. According to the results of the baseline tests all students were given an individual exercise programme, which included aerobic and muscle strength training.Results: Sixty-five percent (26/40) of the students participated in the follow-up examinations. At baseline male students had higher mean maximal oxygen consumption (VO2Max) and, as expected, greater absolute muscle strength than their female counterparts (all p-values <0.05). During the follow-up females had improved their VO2Max on average by 2.4 ml/kg/min. Furthermore, females on average improved the number of squats by 4.2 [95% Confidence Interval (CI) 0.01 to 8.33] repetitions, and males improved the number of push-ups (mean improvement 4.8, 95% CI 1.93 to 7.57), and left arm grip strength (mean improvement 4.0 kg, 95% CI 1.39 to 6.53).Conclusions: It seems to be possible to maintain, and even slightly improve paramedic students’ physical fitness with a self-directed, guided, home exercise programme. This approach could enhance prospective paramedics’ willingness to develop the necessary physical qualities long-term throughout their clinical careers.

导读:护理人员的工作包括短时间的轻体力活动，但也包括短时间的相对剧烈的体力活动。即使在学习期间，护理专业的学生也要坐着，即身体上久坐不动的行为。我们发起了一项计划，鼓励护理专业的学生在学习期间进行体育锻炼。在这项研究中，我们报告了参加为期一年的简短体育活动咨询的护理学生的身体健康状况，包括口头和书面的个人量身定制的锻炼计划。方法:总共40名护理学生(26名女性，14名男性)在学习期间自愿参加了体育活动计划。在基线和一年随访时测量受试者的最大耗氧量和肌肉力量。根据基线测试的结果，所有学生都进行了个人锻炼计划，其中包括有氧和肌肉力量训练。结果:65%(26/40)的学生参加了随访检查。在基线时，男学生的平均最大耗氧量(VO2Max)高于女学生，正如预期的那样，绝对肌肉力量高于女学生(所有p值<0.05)。在随访期间，雌性的VO2Max平均提高了2.4 ml/kg/min。此外，女性平均增加了4.2次深蹲次数[95%可信区间(CI) 0.01至8.33]，男性增加了俯卧撑次数(平均增加4.8次，95% CI 1.93至7.57)，左臂握力(平均增加4.0公斤，95% CI 1.39至6.53)。结论:通过自主指导的家庭锻炼计划，似乎可以维持甚至略微改善护理学生的身体素质。这种方法可以提高未来护理人员在其临床职业生涯中长期发展必要的身体素质的意愿。

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引用次数: 2

International Examination and Synthesis of the Primary and Secondary Surveys in Paramedicine 辅助医学初级和二级调查的国际审查与综合

Irish Journal of Paramedicine

Pub Date : 2018-03-12 DOI: 10.32378/IJP.V3I2.91

Marc Colbeck, Sonja Maria, Georgette Eaton, C. Campbell, A. Batt, Matthew R Caffey

Background

To guide their care paramedics routinely rely upon two assessment and treatment algorithms, known as the primary survey and the secondary survey. No clear consensus of the concepts (assessments and interventions) that are, or should be, included in these algorithms exist internationally.

Methods

This paper evaluated Australasian paramedic clinical practice guidelines (CPGs), as well as six other international paramedic CPGs (USA, Ireland, UK, South Africa, Qatar, and the United Arab Emirates) in order to identify which concepts are currently described in best-practice recommendations for paramedics. The authors also contributed concepts that they felt were important additions based on their experience as veteran paramedics and paramedic educators.

Results

The resulting amalgamation of concepts identified in each term was then formed into two mnemonics which, together sequentially list approximately 100 specific clinical concepts that paramedics routinely consider in their care of patients. We describe these as the “International Paramedic Primary and Secondary Surveys”.

Conclusion

The primary and secondary surveys presented in this paper represent an evidence-based guide to the best practice in conducting a primary and secondary survey in the paramedic context. Findings will be of use to paramedics, paramedic students, and other clinicians working in remote or isolated practices.

背景:为了指导他们的护理，护理人员通常依靠两种评估和治疗算法，即主要调查和次要调查。国际上对这些算法应包括或应包括的概念(评估和干预)没有明确的共识。方法本文评估了澳大利亚护理人员临床实践指南(cpg)，以及其他六个国际护理人员cpg(美国、爱尔兰、英国、南非、卡塔尔和阿拉伯联合酋长国)，以确定哪些概念目前在护理人员最佳实践建议中被描述。作者还根据他们作为资深护理人员和护理教育者的经验，提供了他们认为重要的补充概念。结果在每个术语中确定的概念合并后形成了两个助记符，它们依次列出了护理人员在护理患者时通常考虑的大约100个特定临床概念。我们将这些称为“国际护理人员初级和二级调查”。结论本文提出的初级和二级调查为护理人员开展初级和二级调查的最佳实践提供了循证指南。研究结果将用于护理人员，护理学生，和其他临床医生在远程或孤立的做法工作。

{"title":"International Examination and Synthesis of the Primary and Secondary Surveys in Paramedicine","authors":"Marc Colbeck, Sonja Maria, Georgette Eaton, C. Campbell, A. Batt, Matthew R Caffey","doi":"10.32378/IJP.V3I2.91","DOIUrl":"https://doi.org/10.32378/IJP.V3I2.91","url":null,"abstract":"BackgroundTo guide their care paramedics routinely rely upon two assessment and treatment algorithms, known as the primary survey and the secondary survey. No clear consensus of the concepts (assessments and interventions) that are, or should be, included in these algorithms exist internationally. Methods This paper evaluated Australasian paramedic clinical practice guidelines (CPGs), as well as six other international paramedic CPGs (USA, Ireland, UK, South Africa, Qatar, and the United Arab Emirates) in order to identify which concepts are currently described in best-practice recommendations for paramedics. The authors also contributed concepts that they felt were important additions based on their experience as veteran paramedics and paramedic educators.Results The resulting amalgamation of concepts identified in each term was then formed into two mnemonics which, together sequentially list approximately 100 specific clinical concepts that paramedics routinely consider in their care of patients. We describe these as the “International Paramedic Primary and Secondary Surveys”.Conclusion The primary and secondary surveys presented in this paper represent an evidence-based guide to the best practice in conducting a primary and secondary survey in the paramedic context. Findings will be of use to paramedics, paramedic students, and other clinicians working in remote or isolated practices.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133342886","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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