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de Paula BAC, Haberland DF, Guilherme FJDA, Barbosa BL, de Oliveira AB, da Silva TASM. Aerospace nurses' competencies in disaster situations: a scoping review. Rev Lat Am Enfermagem 2024; 32:e4326. [PMID: 39319890 PMCID: PMC11421517 DOI: 10.1590/1518-8345.7421.4326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/21/2024] [Indexed: 09/26/2024] Open
Abstract
OBJECTIVE to map the competencies of aerospace nurses in disaster situations. METHOD a scoping review following the steps recommended by the JBI and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The review was conducted in three phases by two independent reviewers, with blinding, and supported by a third reviewer to resolve disagreements. Selection was based on the analysis of titles, descriptors, and abstracts, with specific eligibility criteria, followed by the full-text reading. At the end of the selection phase, 37 publications were included. RESULTS the results highlighted the need for the development of technical skills, knowledge of flight physiology, familiarity with aeronautical emergency procedures, communication skills, leadership, and responsibilities in aircraft preparation. During transport, nurses perform patient history taking (anamnesis), physical examinations, patient monitoring, clinical procedures, and manage in-flight complications. After the flight, they conduct documentation, develop procedures, sanitize clinical equipment, and replenish consumable materials. CONCLUSION given the complexity of aerospace nursing practices in disaster situations, it is essential for professionals to develop competencies to ensure safe and effective care. There is a need to develop technologies, regulatory frameworks, and legal provisions for legal support, as well as future studies to validate and deepen the mapped competencies.
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Affiliation(s)
| | | | | | - Bruno Leal Barbosa
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Rio de Janeiro, RJ, Brazil
| | | | - Thiago Augusto Soares Monteiro da Silva
- Universidade de Vassouras, Curso de Enfermagem, Vassouras, RJ, Brazil
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Rio de Janeiro, RJ, Brazil
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Olive P, Hives L, Ashton A, O’Brien MC, Taylor A, Mercer G, Horsfield C, Carey R, Jassat R, Spencer J, Wilson N. Psychological and psychosocial aspects of major trauma care: A survey of current practice across UK and Ireland. TRAUMA-ENGLAND 2023. [DOI: 10.1177/14604086221145529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction Psychological and psychosocial impacts of major trauma, defined as any injury that has the potential to be life-threatening and/or life changing, are common, far-reaching and often enduring. There is evidence that these aspects of major trauma care are often underserved. The aim of this research was to gain insight into the current provision and operationalisation of psychological and psychosocial aspects of major trauma care across the UK and Ireland. Methods A cross-sectional online survey, open to health professionals working in major trauma network hospitals was undertaken. The survey had 69 questions across six sections: Participant Demographics, Psychological First Aid, Psychosocial Assessment and Care, Assessing and Responding to Distress, Clinical Psychology Services, and Major Trauma Keyworker (Coordinator) Role. Results There were 102 respondents from across the regions and from a range of professional groups. Survey findings indicate a lack of formalised systems to assess, respond and evaluate psychological and psychosocial aspects of major trauma care, most notably for patients with lower-level distress and psychosocial support needs, and for trauma populations that don't reach threshold for serious injury or complex health need. The findings highlight the role of major trauma keyworkers (coordinators) in psychosocial aspects of care and that although major trauma clinical psychology services are increasingly embedded, many lack the capacity to meet demand. Conclusion Neglecting psychological and psychosocial aspects of major trauma care may extend peritraumatic distress, result in preventable Years Lived with Disability and widen post-trauma health inequalities. A stepped psychological and psychosocial care pathway for major trauma patients and their families from the point of injury and continuing as they move through services towards recovery is needed. Research to fulfil knowledge gaps to develop and implement such a model for major trauma populations should be prioritised along with the development of corresponding service specifications for providers.
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Affiliation(s)
- P Olive
- School of Nursing, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - L Hives
- Research Facilitation and Delivery Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - A Ashton
- Psychology Service, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - MC O’Brien
- Neuropsychology Department, Kings College Hospital NHS Foundation Trust, London, UK
| | - A Taylor
- Trauma Orthopaedics, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - G Mercer
- Acute Rehabilitation Trauma Unit, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - C Horsfield
- West Yorkshire Critical Care & Major Trauma Operational Delivery Networks and South Yorkshire & Bassetlaw Critical Care ODN, Leeds, UK
| | - R Carey
- School of Nursing, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - R Jassat
- School of Medicine, University of Central Lancashire, Preston, UK
| | - J Spencer
- Research Facilitation and Delivery Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - N Wilson
- Research Facilitation and Delivery Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
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Altruism in Paramedicine: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10091731. [PMID: 36141343 PMCID: PMC9498595 DOI: 10.3390/healthcare10091731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
While altruism has been studied in healthcare professions such as nursing and medicine, the exploration of the characteristics of altruism, as related to paramedicine and emergency care in Australia, is limited. This scoping review explores altruism in paramedicine from the perspective of the paramedic as practitioner, learner, and educator as seen through the lens of the paramedic and the patient. Also discussed is the positive impact of altruism on the patient experience of care. A scoping review was used to assess the availability of data related to altruism in paramedicine. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used to guide the process. Search categories were orientated around the subject (altruism) and discipline (paramedicine). A total of 27 articles are included in this scoping review. Initial searching identified 742 articles; after duplicate removal, 396 articles were screened with 346 excluded. Fifty articles were full-text reviewed and 23 excluded. The final 27 were extracted following full-text screening. None of the articles are specific to altruism in paramedicine. The data related to the practice of altruism in paramedicine are extremely limited. The preponderance of data arise from Europe and North America which, due to crewing and service differences, may impact the practice of altruism in different regions. Recent changes to the scope of paramedic practice, workload, education, and case acuity may influence behaviour regarding altruism, compassion, caring, and associated caring behaviours. The practice and education of paramedics including altruism, compassion, caring and caring behaviours in the Australasian setting warrants further research.
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Ibsen S, Laursen BS, Christensen EF, Weinreich UM, Mikkelsen S, Lindskou TA. How Patients Who Are Transported by Ambulance Experience Dyspnea and the Use of a Dyspnea Scale: A Qualitative Study. Healthcare (Basel) 2022; 10:healthcare10071208. [PMID: 35885735 PMCID: PMC9319940 DOI: 10.3390/healthcare10071208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 12/03/2022] Open
Abstract
Approximately 7% of all dispatched ambulances in Denmark are for patients for whom breathing difficulties are the main cause for using ambulance services. Objective measurements are routinely carried out in the ambulances, but little is known of the patients’ subjective experience of dyspnea. The purpose of this study was to investigate how patients with acute dyspnea, transported to hospital by ambulance, experience their situation, along with their experience of the use of a dyspnea scale. The study was carried out in the North Denmark Region. Transcribed patient interviews and field notes were analyzed and interpreted with inspiration from Paul Ricoeur. For interviews, we included 12 patients with dyspnea who were transported to the hospital by ambulance: six women and six men all aged 60 years or above. Observations were made over six ambulance transports related to dyspnea. Three themes emerged: “anxiety”, “reassurance in the ambulance” and “acceptance of the dyspnea measurements in the ambulance”. Several patients expressed anxiety due to their dyspnea, which was substantiated by observations in the ambulance. The patients expressed different perspectives on what improved the situation (treatment, reassurance by ambulance professionals). The patients and the ambulance personnel were, in general, in favor of the dyspnea scale.
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Affiliation(s)
- Stine Ibsen
- Centre for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, 9000 Aalborg, Denmark; (E.F.C.); (T.A.L.)
- Department of Physiotherapy, University College of Northern Denmark, 9000 Aalborg, Denmark
- Correspondence:
| | - Birgitte Schantz Laursen
- Clinical Nursing Research Unit, Aalborg University Hospital, 9000 Aalborg, Denmark;
- Sexology Research Centre, Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Erika Frischknecht Christensen
- Centre for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, 9000 Aalborg, Denmark; (E.F.C.); (T.A.L.)
- Clinic of Internal and Emergency Medicine, Department of Emergency and Trauma Care, 9000 Aalborg, Denmark
| | - Ulla Møller Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, 9000 Aalborg, Denmark;
- The Clinical Institute, Aalborg University, 9000 Aalborg, Denmark
| | - Søren Mikkelsen
- The Prehospital Research Unit, Region of Southern Denmark, 5000 Odense, Denmark;
| | - Tim Alex Lindskou
- Centre for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, 9000 Aalborg, Denmark; (E.F.C.); (T.A.L.)
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Olive P, Hives L, Wilson N, Ashton A, O’Brien MC, Mercer G, Jassat R, Harris C. Psychological and psychosocial aspects of major trauma care in the United Kingdom: A scoping review of primary research. TRAUMA-ENGLAND 2022. [DOI: 10.1177/14604086221104934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction More people are surviving major trauma, often with life changing injuries. Alongside physical injury, many survivors of major trauma experience psychological and psychosocial impacts. Presently, there is little guidance at the UK national level for psychological and psychosocial aspects of major trauma care. Set in the context of the regional model of major trauma care implemented in the UK in 2012, the purpose of this review was to identify and bring together primary research about psychological and psychosocial aspects of major trauma care in the UK to produce an overview of the field to date, identify knowledge gaps and set research priorities. Methods A scoping review was undertaken. Seven electronic databases (MEDLINE, Cochrane Library, CINAHL, Embase, PsycINFO, SocINDEX with Full Text and PROSPERO) were searched alongside a targeted grey literature search. Data from included studies were extracted using a predefined extraction form and underwent bibliometric analysis. Included studies were then grouped by type of research, summarised, and synthesised to produce a descriptive summary and overview of the field. Results The searches identified 5,975 articles. Following screening, 43 primary research studies were included in the scoping review. The scoping review, along with previous research, illustrates that psychological and psychosocial impacts are to be expected following major trauma. However, it also found that these aspects of care are commonly underserved and that there are inherent inequities across major trauma care pathways in the UK. Conclusion Though the scoping review identified a growing body of research investigating psychological and psychosocial aspects of major trauma care pathways in the UK, significant gaps in the evidence base remain. Research is needed to establish clinically effective psychological and psychosocial assessment tools, corresponding interventions, and patient-centred outcome measures so that survivors of major trauma (and family members or carers) receive the most appropriate care and intervention.
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Affiliation(s)
- Philippa Olive
- School of Nursing, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Lucy Hives
- Research Facilitation and Delivery Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - Neil Wilson
- Research Facilitation and Delivery Unit, Applied Health Research Hub, University of Central Lancashire, Preston, UK
| | - Amy Ashton
- Clinical Health Psychology Service, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Marie Claire O’Brien
- Neuropsychology Department, Kings College Hospital NHS Foundation Trust, London, UK
| | - Gemma Mercer
- Acute Rehabilitation Trauma Unit, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Raeesa Jassat
- School of Medicine, University of Central Lancashire, Preston, UK
| | - Catherine Harris
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, Applied Health Research Hub, University of Central Lancashire, Preston, UK
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Ejderlöf J, Engström Å. The Helicopter Transports of Patients Critically ill with COVID-19. SAGE Open Nurs 2022; 8:23779608221094108. [PMID: 35493543 PMCID: PMC9039442 DOI: 10.1177/23779608221094108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/06/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of our study was to describe specialist nurses’ experiences with the helicopter transport of patients critically ill with COVID-19. Method Our study followed a descriptive qualitative design anchored in the naturalistic paradigm and was based on qualitative content analysis. The study followed the consolidated criteria for reporting qualitative research. Results Six semi-structured interviews were conducted with specialist nurses who have cared for patients critically ill with COVID-19 during helicopter transport. The analysis of the interviews resulted in three themes—designing new routines before transport, working under new conditions and post-transport and reflections—with 11 categories. The goal of the intensive care transport of patients with COVID-19 was twofold: to prevent the spread of infection by using personal protective equipment and to prevent the contamination of the helicopter. Conclusion For the nurses, working in personal protective equipment created a feeling of distance from patients that compromised patient–nurse intimacy. Our results suggest that ensuring the sufficiency of equipment required in the event of major accidents and pandemics is critical.
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Affiliation(s)
| | - Åsa Engström
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden
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Bergman L, Pettersson M, Chaboyer W, Carlström E, Ringdal M. In safe hands: Patients' experiences of intrahospital transport during intensive care. Intensive Crit Care Nurs 2020; 59:102853. [PMID: 32223920 DOI: 10.1016/j.iccn.2020.102853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Intrahospital transports are associated with complications and adverse events in intensive care patients. Yet, little is known about how patients' percive these tranfers. Thus, this study aimed to explore patients' experiences of the intrahospital transport process. RESEARCH DESIGN An exploratory qualitative study compromising interviews with twelve patients. Data were analysed using thematic analysis. SETTING Two intensive care units in a university hospital setting. MAIN OUTCOME An understanding of patients' experiences of the intrahospital transport process. FINDINGS The main finding was patients' description of "being in safe hands" during the transport. Patients' experience of transports as feasible and safe was reflected in the first main theme, "feeling prepared and safeguarded". The second theme, "being on the move", described patients' perceptions of the transport; although they were aware of movement, the transport was viewed as a minor event during their stay. The third theme, "entrusting myself to others", revealed how patients handed over control and decision making to the staff, confident that they would look after their best interest. CONCLUSIONS Patients perceived intrahospital transports as an acceptable and safe process. Findings suggest that patients' experience could be improved by being provided with accurate and timely information and preparedness for transport-related events.
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Affiliation(s)
- Lina Bergman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, PO Box 457, SE-405 30 Gothenburg, Sweden.
| | - Monica Pettersson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, PO Box 457, SE-405 30 Gothenburg, Sweden.
| | - Wendy Chaboyer
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, PO Box 457, SE-405 30 Gothenburg, Sweden.
| | - Eric Carlström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, PO Box 457, SE-405 30 Gothenburg, Sweden.
| | - Mona Ringdal
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, PO Box 457, SE-405 30 Gothenburg, Sweden.
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Sandström L, Engström Å, Nilsson C, Juuso P. Experiences of suffering multiple trauma: A qualitative study. Intensive Crit Care Nurs 2019; 54:1-6. [PMID: 31351691 DOI: 10.1016/j.iccn.2019.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 06/11/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES In an effort to strengthen health care professionals' ability to anticipate and address multiple trauma patients' needs, this study aims to explore the experience of suffering from multiple trauma. DESIGN This is a qualitative descriptive study. Nine interviews were analysed using content analysis. SETTING The study included patients who had been registered in the Swedish Intensive Care registry [SIR] due to suffering multiple trauma. FINDINGS The analysis revealed one theme, A detour in life, based on three sub-themes: (a) Feeling lost and not knowing what to expect, (b) Striving to get life back on track and (c) Dealing with 'dead ends' during rehabilitation. The theme showed that those who suffered multiple trauma did not know what to expect of their recovery and they expressed experiencing a lack of understanding and guidance from healthcare professionals. As it was important to focus on the present and find ways to move on in life, they sought for other ways to find direction in matters of rehabilitation and care. CONCLUSIONS A shared understanding is essential in order to define a person's needs. By setting short-term goals and improving documentation, healthcare professionals across the trauma recovery continuum could more easily gain insight of their patients' needs and address them with supportive guidance.
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Affiliation(s)
- Linda Sandström
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden.
| | - Åsa Engström
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Carina Nilsson
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Päivi Juuso
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Granström A, Strömmer L, Falk AC, Schandl A. Patient experiences of initial trauma care. Int Emerg Nurs 2018; 42:25-29. [PMID: 30274901 DOI: 10.1016/j.ienj.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/21/2018] [Accepted: 08/29/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Correct initial treatment of trauma patients reduces mortality and morbidity. However, the initial examination may be perceived as traumatic because of the stressful situation, the unfamiliar setting and the shock of being seriously injured. To date, little is known about patient's experiences of initial trauma management. The aim of this study was to explore trauma patients' experiences of being exposed to initial full trauma team assessment at a Level 1 trauma centre. METHODS Interviews with 16 patients who had been exposed to initial trauma care were conducted at a Level 1 trauma centre, at a Swedish University Hospital. The interviews were transcribed verbatim and analysed with qualitative content analysis. RESULTS Patients' experiences of initial trauma care can be summarized as: feeling safe in a frightening situation. The trauma team members were mostly perceived as professional, well-organised, and efficient. Yet, the patients described an emotional response to the trauma, physical discomfort during the examination, and feeling prioritised or being ignored in the encounter with the trauma team members. CONCLUSION The initial trauma care may be improved if the trauma team members keep the patient's physical and emotional wellbeing in focus and maintain an informative dialogue with the patient during the whole process.
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Affiliation(s)
- Anna Granström
- Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Insitutet, Stockholm, Sweden.
| | - Lovisa Strömmer
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Insitutet, Stockholm, Sweden
| | - Ann-Charlotte Falk
- Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Insitutet, Stockholm, Sweden
| | - Anna Schandl
- Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden; Surgical Care Sciences, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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