Australasian Emergency Care最新文献_第3页

Examining emergency departments practices on advance care directives and medical treatment decision making using the victorian emergency minimum dataset 利用维多利亚州急诊最低数据集研究急诊科在预先护理指示和医疗决策方面的做法。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-01-22 DOI: 10.1016/j.auec.2024.01.001

Introduction

Existence of Advance Care Planning (ACP) documents including contact details of Medical Treatment Decision Makers (MTDM), are essential patient care records that support Emergency Department (ED) clinicians in implementing treatment concordant with patients’ expressed wishes. Based upon previous findings, we conducted a statewide study to evaluate the performance of Victorian public hospital emergency departments on reporting of availability of records for ACP.

Method

The study is a quantitative retrospective observational comparative design based upon ED tier levels as defined by the Australasian College for Emergency Medicine (ACEM) for the calendar year 2021.

Results

Of 1.8 million total Victorian ED attendances, 15,222 patients had an ACP alert status recorded. Of these, 7296 were aged ≥ 65 years (study group). Of the thirty-one public EDs that submitted data, 65 % were accredited and assigned a level of service tier. The presence of ACP alerts positively correlated to location, tier level, age and gender (MANOVA wilk’s; p < 0.001, value=.981, F = (12, 15,300), partial ƞ² = .006, observed power = 1.0 = 95.919).

Conclusion

The identified rate of ACP reporting is low. Strategies to improve the result include synchronising ACP (generated at different points) electronically, staff education, training and further validation of the data at the sending and receiving agencies.

导言：预先护理计划（ACP）文件（包括医疗决策者（MTDM）的详细联系方式）是重要的患者护理记录，可帮助急诊科（ED）临床医生按照患者表达的意愿实施治疗。基于之前的研究结果，我们在全州范围内开展了一项研究，以评估维多利亚州公立医院急诊科在报告 ACP 记录可用性方面的表现：该研究是一项定量回顾性观察比较设计，基于澳大利亚急诊医学学院（ACEM）对 2021 日历年急诊室级别的定义：在维多利亚州总计 180 万的急诊室就诊人次中，152222 名患者记录了 ACP 警报状态。其中，7296 名患者的年龄≥ 65 岁（研究组）。在提交数据的 31 家公立急诊室中，65% 的急诊室获得了认证并被划分了服务等级。ACP警报的存在与地点、级别、年龄和性别呈正相关（MANOVA wilk's；P 2 = .006，观察功率 = 1.0 = 95.919）：结论：ACP 报告的确认率较低。提高这一结果的策略包括以电子方式同步 ACP（在不同地点生成）、员工教育、培训以及在发送和接收机构进一步验证数据。

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引用次数: 0

“Mind the gap”: An exploratory qualitative study of paramedics’ experiences attending older adults who fall in Western Australia "注意差距对西澳大利亚州护理人员护理跌倒老年人的经验进行探索性定性研究

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-01-17 DOI: 10.1016/j.auec.2024.01.004

Purpose

To explore paramedics’ experiences and perspectives about attending and managing older adults who had fallen.

Procedures

This qualitative, exploratory study used a purposive sample of paramedics in Western Australia. Participants had at least one year of clinical experience. Semi-structured interviews were undertaken. Data were analysed via an inductive thematic approach.

Findings

Fourteen paramedics were interviewed (Median age: 38 years, n = 5 females). The main theme identified that experiences were positive when attending patients with high-acuity medical problems or injuries following falls because binary decision-making (transport vs non-transport) was appropriate. Themes highlighted that decision-making for low-acuity falls attendances was a complex balance between 1) patient context, 2) risk management, 3) paramedic reactions, and 4) the lack of alternate referral pathways available. Experiences could be stressful and frustrating when attending falls call-outs for older adults with no injuries or medical problems. Participants concurred that when transport to hospital was not required there were no available, alternative pathways to refer onwards for appropriate health or social care.

Conclusion

Attending low-acuity call-outs for falls was often frustrating and required complex decision-making, with gaps in services identified. Further exploration of alternative referral pathways for health care for pre-hospital management of adults who fall is required.

目的探讨护理人员在护理和管理跌倒的老年人方面的经验和观点。程序这项定性探索性研究采用了西澳大利亚州护理人员的目的性样本。参与者至少有一年的临床经验。研究人员进行了半结构化访谈。研究结果 14 名辅助医务人员接受了访谈（年龄中位数：38 岁，n = 5 名女性）。主要主题表明，在救治高危医疗问题患者或跌倒后受伤的患者时，经验是积极的，因为二元决策（转运与非转运）是适当的。这些主题强调，低危急性跌倒患者的就诊决策需要在 1) 患者背景、2) 风险管理、3) 辅助医务人员的反应以及 4) 缺乏替代转诊途径之间进行复杂的平衡。在接诊没有受伤或医疗问题的老年人时，可能会感到紧张和沮丧。参加者一致认为，在不需要送往医院的情况下，没有其他可供选择的转诊途径来转诊到适当的医疗或社会护理机构。需要进一步探索为成人跌倒者提供院前管理的其他医疗转诊途径。

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引用次数: 0

Informing Utstein-style reporting guidelines for prehospital thrombolysis: A scoping review 院前溶栓的乌特斯坦式报告指南：范围审查

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2024-01-16 DOI: 10.1016/j.auec.2023.12.001

Louis Jenkins , Tania Johnston , Richard Armour , Sonja Maria

Background

Rural Australians with acute myocardial infarction (AMI) face higher mortality rates due to limited access to specialised cardiac services. Paramedic-administered prehospital thrombolysis (PHT) has emerged as an alternative to primary percutaneous intervention (pPCI) for patients facing barriers or delays to cardiac care. There is variability in PHT practices among Australian ambulance services, lacking standardised definitions and outcome measures. The aim of this scoping review was to identify quality indicators and influencing factors associated with outcomes for patients receiving PHT.

Methods

A systematic search of literature in SCOPUS and Academic Search Complete, CINAHL and Health Source: Nursing/Academic Edition databases via EBSCO (Health) was conducted following the Joanna Briggs Institute methodology. Peer-reviewed studies from the past decade were screened using search criteria relevant to prehospital thrombolysis and quality indicators. Data extraction was performed and themed using five domains from the Utstein-style template commonly known for standardised prehospital cardiac arrest reporting.

Results

After removing duplicates, the search yielded 3596 articles with 28 empirical studies meeting inclusion criteria for the review. These were primarily retrospective cohort studies performed in Australia, Canada and the United States. The scoping review identified 24 clinical quality indicators and factors related to Emergency Medical Service (EMS) systems, AMI recognition and ambulance dispatch, patient variables, PHT processes and patient outcomes. These findings correlate to the Donabedian structure-process-outcome quality of care model and have utility to inform future PHT reporting guidelines for jurisdictional ambulance services.

Conclusions

Given the variability in prehospital practice across Australian ambulance services, standardised reporting on quality indicators for PHT is needed. The Utstein-style template used to report data on pre-hospital cardiac arrest, trauma and airway management could be used for quality improvement in PHT. This review presents 24 quality indicators representing system, recognition and response, patient, process, and outcomes related to PHT. These results could be used to inform a future Delphi study and Utstein-like reporting guideline for prehospital thrombolysis.

背景澳大利亚农村地区的急性心肌梗塞（AMI）患者由于难以获得专业的心脏医疗服务而面临较高的死亡率。辅助医务人员进行的院前溶栓治疗（PHT）已成为面临心脏护理障碍或延误的患者经皮介入治疗（pPCI）的替代方案。澳大利亚救护服务机构的 PHT 实践存在差异，缺乏标准化的定义和结果衡量标准。方法在 SCOPUS 和 Academic Search Complete、CINAHL 和 Health Source 中对文献进行系统检索：按照乔安娜-布里格斯研究所（Joanna Briggs Institute）的方法，通过 EBSCO（健康）对护理/学术版数据库进行了系统检索。使用与院前溶栓和质量指标相关的检索标准筛选了过去十年中经过同行评审的研究。在去除重复内容后，共检索到 3596 篇文章，其中有 28 项经验性研究符合综述的纳入标准。这些研究主要是在澳大利亚、加拿大和美国进行的回顾性队列研究。范围界定审查确定了 24 项临床质量指标以及与急救医疗服务 (EMS) 系统、急性心肌梗死识别和救护车调度、患者变量、PHT 流程和患者预后相关的因素。这些研究结果与多纳比德结构-过程-结果护理质量模型相关联，有助于为辖区内救护车服务机构未来的 PHT 报告指南提供信息。结论鉴于澳大利亚各救护车服务机构的院前实践存在差异，因此需要对 PHT 质量指标进行标准化报告。用于报告院前心脏骤停、创伤和气道管理数据的乌特斯坦式模板可用于改善院前急救质量。本综述介绍了 24 项质量指标，分别代表与 PHT 相关的系统、识别和响应、患者、流程和结果。这些结果可用于未来的德尔菲研究和类似于 Utstein 的院前溶栓报告指南。

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引用次数: 0

Seizure or syncope: Is the history-based scale feasible to use in an emergency department setting? 癫痫或晕厥:基于病史的量表是否适用于急诊科?

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2023-12-05 DOI: 10.1016/j.auec.2023.11.002

Stevo Lukić , Aleksandar Stojanov

Background

This study aimed to assess the efficacy of a screening questionnaire, based on historical criteria, in distinguishing between seizures and syncope in patients experiencing their first episode of transient loss of consciousness (TLOC) in a neurology emergency department.

Methods

A prospective cohort of 159 patients with initial TLOC episodes underwent clinical observation and answered a nine-question screening questionnaire. The questionnaire's predictive ability was compared to final diagnoses determined through detailed neurology, electrophysiology, and cardiology assessments during a minimum 12-month follow-up. Logistic regression (LR) analysis was performed with final diagnosis as the outcome variable. The calibration and discrimination of the models were assessed.

Results

revealed that the screening score accurately classified 72.33% of patients. Among those with positive screening scores, 65 (67.71%) had seizures compared to 31 (32.29%) with syncope. Introducing a novel risk-scoring model incorporating age and gender, in addition to the screening score, significantly improved performance achieving an accurate classification rate of 81.48%. Among patients with a positive prediction, 63 (80.77%) had seizure, whereas 15 (19.23%) had syncope.

Conclusions

Employing a structured questionnaire based on common historical criteria is a valuable tool for distinguishing between seizure and syncope in the dynamic setting of the emergency department.

背景:本研究旨在评估基于历史标准的筛查问卷在神经内科急诊科首次经历短暂性意识丧失(TLOC)的患者中区分癫痫发作和晕厥的功效。方法:对159例首次TLOC发作的患者进行临床观察，并回答9个问题的筛查问卷。在至少12个月的随访中，问卷的预测能力与通过详细的神经学、电生理学和心脏病学评估确定的最终诊断进行了比较。以最终诊断为结局变量进行Logistic回归分析。对模型的标定和判别进行了评价。结果:筛查评分准确分类患者72.33%。筛查评分阳性的患者中，癫痫发作65例(67.71%)，晕厥31例(32.29%)。在筛选评分的基础上，引入了一种结合年龄和性别的新型风险评分模型，显著提高了绩效，准确率达到81.48%。阳性预测患者中癫痫发作63例(80.77%)，晕厥15例(19.23%)。结论:在急诊科的动态环境中，采用基于共同历史标准的结构化问卷是区分癫痫发作和晕厥的一个有价值的工具。

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引用次数: 0

Editorial: Resuscitation science for emergency care clinicians 社论:急救临床医生的复苏科学。

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2023-11-25 DOI: 10.1016/j.auec.2023.11.001

Julie Considine

引用次数: 0

Education interventions and emergency nurses’ clinical practice behaviours: A scoping review 教育干预与急诊护士临床实践行为:范围综述。

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2023-11-18 DOI: 10.1016/j.auec.2023.10.004

Julie Considine , Ramon Z. Shaban , Margaret Fry , Kate Curtis

Background

Many education interventions in emergency nursing are aimed at changing nurse behaviours. This scoping review describes and synthesises the published research education interventions and emergency nurses’ clinical practice behaviours.

Methods

Arksey and O’Malley’s methodological framework guided this review, which is reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). CINAHL, MEDLINE complete, ERIC, and Psycinfo were searched on 3 August 2023. Two pairs of researchers independently conducted all screening. Synthesis was guided by the Behaviour Change Wheel and Bloom’s Taxonomy of Educational Objectives.

Results

Twenty-five studies were included. Educational interventions had largely positive effects on emergency nurses’ clinical practice behaviours. Ten different interventions were identified, the most common was education sessions (n = 24). Seven studies reported underpinning theoretical frameworks. Of the essential elements of behaviour change, seven interventions addressed capability, four addressed motivation and one addressed opportunity. Mapping against Bloom’s taxonomy, thirteen studies addressed analysis, eleven studies addressed synthesis and two studies addressed evaluation.

Conclusion

Few studies addressed elements of behaviour change theory or targeted cognitive domains. Future studies should focus on controlled designs, and more rigorous reporting of the education intervention(s) tested, and theoretical underpinning for intervention(s) selected.

背景:急诊护理的许多教育干预旨在改变护士的行为。本综述描述并综合了已发表的研究、教育干预和急诊护士的临床实践行为。方法:Arksey和O'Malley的方法框架指导了本综述，根据系统评价和荟萃分析扩展范围评价的首选报告项目(PRISMA-ScR)进行报告。检索时间为2023年8月3日，检索时间为CINAHL、MEDLINE complete、ERIC和Psycinfo。两对研究人员独立进行了所有的筛选。综合是由行为改变轮和布鲁姆的教育目标分类学指导的。结果:纳入25项研究。教育干预对急诊护士临床实践行为有显著的正向影响。确定了10种不同的干预措施，最常见的是教育课程(n = 24)。七项研究报告了基本的理论框架。在行为改变的基本要素中，7项干预涉及能力，4项涉及动机，1项涉及机会。根据Bloom的分类法，13项研究涉及分析，11项研究涉及综合，2项研究涉及评价。结论:很少有研究涉及行为改变理论或目标认知领域的要素。未来的研究应侧重于控制设计，更严格地报告所测试的教育干预措施，以及所选择的干预措施的理论基础。

{"title":"Education interventions and emergency nurses’ clinical practice behaviours: A scoping review","authors":"Julie Considine , Ramon Z. Shaban , Margaret Fry , Kate Curtis","doi":"10.1016/j.auec.2023.10.004","DOIUrl":"10.1016/j.auec.2023.10.004","url":null,"abstract":"<div><h3>Background</h3><p>Many education interventions in emergency nursing are aimed at changing nurse behaviours. This scoping review describes and synthesises the published research education interventions and emergency nurses’ clinical practice behaviours.</p></div><div><h3>Methods</h3><p>Arksey and O’Malley’s methodological framework guided this review, which is reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). CINAHL, MEDLINE complete, ERIC, and Psycinfo were searched on 3 August 2023. Two pairs of researchers independently conducted all screening. Synthesis was guided by the Behaviour Change Wheel and Bloom’s Taxonomy of Educational Objectives.</p></div><div><h3>Results</h3><p>Twenty-five studies were included. Educational interventions had largely positive effects on emergency nurses’ clinical practice behaviours. Ten different interventions were identified, the most common was education sessions (n = 24). Seven studies reported underpinning theoretical frameworks. Of the essential elements of behaviour change, seven interventions addressed capability, four addressed motivation and one addressed opportunity. Mapping against Bloom’s taxonomy, thirteen studies addressed analysis, eleven studies addressed synthesis and two studies addressed evaluation.</p></div><div><h3>Conclusion</h3><p>Few studies addressed elements of behaviour change theory or targeted cognitive domains. Future studies should focus on controlled designs, and more rigorous reporting of the education intervention(s) tested, and theoretical underpinning for intervention(s) selected.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X23000866/pdfft?md5=ed8acfa38951748d5c065fd6b2e96372&pid=1-s2.0-S2588994X23000866-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of inter-rater reliability of screening tools to identify patients at risk of medication-related problems across the emergency department continuum of care 评估筛查工具在急诊科持续护理过程中识别有用药相关问题风险的患者的相互可靠性

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2023-11-14 DOI: 10.1016/j.auec.2023.10.005

Jessica D’lima , Simone E. Taylor , Elise Mitri , Andrew Harding , Jerry Lai , Elizabeth Manias

Background

Following a national multicentre study, two emergency department (ED) screening tools were developed to determine risk of medication-related problems; one for use at ED presentation and another at ED discharge to the community. This study aimed to determine the inter-rater reliability amongst ED health professionals when applying these screening tools to a series of case scenarios.

Methods

A prospective, cross-sectional study was undertaken in the ED of a major metropolitan hospital. Twelve case scenarios were developed following ED observation of a range of patients, which were incorporated into a questionnaire and distributed to 50 health professionals. Inter-rater reliabilities of each explanatory variable of the screening tools and overall assessment were calculated using Fleiss’ multi-rater kappa.

Results

The questionnaire was completed by 15 doctors, 19 nurses and 16 pharmacists. Fleiss’ kappa showed an overall inter-rater reliability for the ED presentation tool of 0.83 (95% CI 0.83–0.84), indicating near perfect agreement. Fleiss’ kappa for the ED discharge tool was 0.83 (95% CI 0.83–0.85), which also showed near perfect agreement.

Conclusions

The screening tools produced favourable inter-rater reliability amongst ED health professionals. These results have important implications for ensuring consistency of ED decision-making in screening patients at risk of developing medication-related problems.

背景在一项全国性多中心研究之后，我们开发了两种急诊科（ED）筛查工具来确定药物相关问题的风险；一种在急诊科就诊时使用，另一种在急诊科出院返回社区时使用。本研究旨在确定急诊科医护人员在将这些筛查工具应用于一系列病例情景时的相互评分可靠性。方法在一家大型都市医院的急诊科开展了一项前瞻性横断面研究。在对一系列患者进行急诊室观察后，研究人员设计了 12 个病例情景，并将其纳入问卷调查，分发给 50 名医疗专业人员。结果15名医生、19名护士和16名药剂师填写了问卷。Fleiss'kappa显示，急诊室表现工具的总体评分者间可靠性为0.83（95% CI 0.83-0.84），表明评分者间的一致性接近完美。ED 出院工具的弗莱斯卡帕值为 0.83（95% CI 0.83-0.85），也显示出近乎完美的一致性。这些结果对于确保急诊科在筛查有用药相关问题风险的患者时决策的一致性具有重要意义。

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引用次数: 0

Examining management plans for patients who frequently presented to the emergency department 检查经常到急诊科就诊的患者的管理计划。

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2023-11-01 DOI: 10.1016/j.auec.2023.10.003

Felicity Moon , Jonathan Knott , Siobhan Feely

Background

Patients who frequently present to Emergency Department (ED) experience complex health and social needs. While research has examined interventions that aim to decrease frequent ED attendances, there is a need to understand the types of interventions provided to patients by hospital clinicians during presentations.

Methods

Using qualitative content analysis, 82 management plans were evaluated to understand the scope and type of interventions provided by clinicians for patients frequently presenting to the ED at the Royal Melbourne Hospital, Australia.

Results

Patients often presented to the ED due to mental and psychological distress, substance use and physical health concerns alongside psychosocial vulnerabilities. The goals of care documented in plans focussed on management of health issues, aggression within the ED, and coordinating care with community services. Recommended interventions addressed presenting needs with multi-disciplinary approach to respond to distress and aggression. Finally, the plans provided insight into service coordination dynamics between the ED and community-based health and social care services.

Conclusions

The plans recommended interventions that sought to provide holistic care for patients in collaboration with relevant community-based services. The findings suggest that clinicians in the ED can provide appropriate and meaningful care for patients who experience frequent presentations.

背景：经常到急诊科就诊的患者经历了复杂的健康和社会需求。虽然研究已经检查了旨在减少急诊就诊频率的干预措施，但有必要了解医院临床医生在就诊期间为患者提供的干预措施类型。方法：采用定性内容分析法，对82项管理计划进行评估，以了解临床医生为澳大利亚皇家墨尔本医院经常就诊的患者提供的干预措施的范围和类型，物质使用和身体健康问题以及心理社会脆弱性。计划中记录的护理目标侧重于健康问题的管理、ED内的攻击性以及与社区服务协调护理。建议的干预措施以多学科方法应对痛苦和攻击，满足提出的需求。最后，这些计划深入了解了ED与社区卫生和社会护理服务之间的服务协调动态。结论：该计划建议采取干预措施，寻求与相关的社区服务合作，为患者提供全面护理。研究结果表明，急诊科的临床医生可以为频繁就诊的患者提供适当和有意义的护理。

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引用次数: 0

Virtual emergency care in Victoria: Stakeholder perspectives of strengths, weaknesses, and barriers and facilitators of service scale-up 维多利亚州的虚拟急救：利益相关者对优势、劣势、障碍的看法以及扩大服务的推动者。

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2023-10-16 DOI: 10.1016/j.auec.2023.10.001

Dai Pu , Peter Cameron , Wendy Chapman , Louise Greenstock , Lena Sanci , Michele L. Callisaya , Terry Haines

Background

Virtual emergency services have been proposed as an alternative service model to conventional in-person emergency department attendance.

Methods

Twenty participants were interviewed: 10 emergency medicine physicians, 4 health care consumers, and 6 other health care professionals. Conventional content analysis was performed on the interview transcriptions to identify perceived strengths and weaknesses of the VED, and barriers and facilitators to scaling-up the VED.

Results

VEDs are perceived as a convenient approach to provide and receive emergency care while ensuring safety and quality of care, however some patients may still need to attend the ED in person for physical assessments. There is currently a lack of evidence, guidelines, and resources to support their implementation. Most of the potential and existing barriers and facilitators for scaling-up the VED were related to their effectiveness, reach and adoption. Broader public health contextual factors were viewed as barriers, while potential actions to address resources and costs could be facilitators.

Conclusions

VEDs were viewed as a convenient service model to provide care, can not replace all in-person visits. Current policies and guidelines are insufficient for wider implementation. Most of the barriers and facilitators for its scaling-up were related to VED effectiveness and delivery.

背景：虚拟急诊服务已被提议作为传统的面对面急诊科就诊的替代服务模式。方法：20名参与者接受了访谈：10名急诊医生、4名医疗保健消费者和6名其他医疗保健专业人员。对访谈记录进行了传统的内容分析，以确定VED的优势和劣势，以及扩大VED的障碍和促进因素。结果：VED被认为是提供和接受紧急护理的方便方法，同时确保护理的安全和质量，然而，一些患者可能仍然需要亲自去急诊室进行身体评估。目前缺乏支持其实施的证据、指导方针和资源。扩大VED的大多数潜在和现有障碍和促进者与它们的有效性、覆盖范围和采用有关。更广泛的公共卫生背景因素被视为障碍，而解决资源和成本问题的潜在行动可能是促进因素。结论：VED被视为一种提供护理的便捷服务模式，不能取代所有的亲自就诊。目前的政策和指导方针不足以更广泛地执行。扩大其规模的大多数障碍和促进者都与VED的有效性和交付有关。

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引用次数: 0

The time-course of visual scanning behaviour of paramedicine students upon arrival at a simulated emergency call 护理专业学生在接到模拟紧急呼叫时的视觉扫描行为的时间过程。

IF 1.8 4区医学 Q1 Nursing

Australasian Emergency Care

Pub Date : 2023-10-13 DOI: 10.1016/j.auec.2023.10.002

Matthew J. Stainer , Alex J. MacQuarrie , Sean O’Loughlin , Andy Bell , Nick Abussi , Steve Whitfield , Elizabeth Cardell

Background

Limited knowledge exists regarding how paramedics acquire an understanding of the scene they encounter upon arrival, despite their need to quickly gather information for effective clinical decision-making. This study examined visual scanning behaviour during the early stages of simulated emergency calls.

Methods

Eye movements of 10 paramedicine students were recorded during simulated calls conducted in both a high-fidelity classroom setting and a full sensory immersion setting.

Results

Students focused on similar areas in both settings, with most time spent looking at the patient rather than distractors such as room features or other people. Analysis of gaze behaviour across the first five minutes revealed a more nuanced pattern: attention initially gravitated towards distractors but decreased as students became familiar with their surroundings and focused on the task at hand. This pattern was consistent across both simulation settings, indicating that information-seeking strategies may be independent of scene complexity.

Conclusions

Expertise relies on the ability to differentiate between relevant and irrelevant information. Given the unpredictable nature of their work, paramedics must continuously adapt their understanding of a scene from the moment they enter it. Understanding how this skill develops may help identify expert strategies to inform training of novice paramedics.

背景：尽管医护人员需要快速收集信息以进行有效的临床决策，但关于医护人员如何在抵达时了解他们遇到的场景的知识有限。这项研究考察了模拟紧急呼叫早期阶段的视觉扫描行为。方法：在高保真课堂环境和全感官沉浸环境中进行的模拟通话中，记录了10名护理专业学生的眼动。结果：在这两种情况下，学生们关注的领域相似，大部分时间都花在看病人上，而不是房间特征或其他人等干扰因素上。对前五分钟的凝视行为的分析揭示了一种更微妙的模式：注意力最初被分心者吸引，但随着学生熟悉周围环境并专注于手头的任务，注意力会减少。这种模式在两种模拟设置中都是一致的，这表明信息搜索策略可能与场景复杂性无关。结论：专业知识依赖于区分相关信息和不相关信息的能力。鉴于其工作的不可预测性，护理人员必须从进入现场的那一刻起就不断调整他们对现场的理解。了解这种技能的发展可能有助于确定专家策略，为新手护理人员的培训提供信息。

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引用次数: 0