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Strandås M, Vizcaya-Moreno MF, Ingstad K, Sepp J, Linnik L, Vaismoradi M. An Integrative Systematic Review of Promoting Patient Safety Within Prehospital Emergency Medical Services by Paramedics: A Role Theory Perspective. J Multidiscip Healthc 2024; 17:1385-1400. [PMID: 38560485 PMCID: PMC10981423 DOI: 10.2147/jmdh.s460194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Timely and effective prehospital care significantly impacts patient outcomes. Paramedics, as the frontline providers of emergency medical services, are entrusted with a range of critical responsibilities aimed at safeguarding the well-being of patients from the moment they initiate contact in the out-of-hospital environment to the time of handover at healthcare facilities. This study aimed to understand the multifaceted roles of paramedics in promoting patient safety within the context of prehospital emergency medical services. A systematic review with an integrative approach using the Whittemore and Knafl's framework was performed examining qualitative, quantitative, and mixed-methods research, then conducting data assessment, quality appraisal, and narrative research synthesis. Literature search encompassed PubMed (including MEDLINE), Scopus, Cinahl, ProQuest, Web of Science, and EMBASE, with the aim of retrieving studies published in English in the last decade from 2013 to 2023. To conceptualize the roles of paramedics in ensuring patient safety, the review findings were reflected to and analyzed through the role theory. The preliminary exploration of the database yielded 2397 studies, ultimately narrowing down to a final selection of 16 studies for in-depth data analysis and research synthesis. The review findings explored facilitators and obstacles faced by paramedics in maintaining patient safety in terms of role ambiguity, role conflict, role overload, role identity, and role insufficiency in the dynamic nature of prehospital care. It also highlighted the diverse roles of paramedics in ensuring patient safety, which encompassed effective communication and decision making for the appropriate management of life-threatening emergencies. The effectiveness of paramedics in playing their roles in promoting patient safety relies on acknowledging the contributions of paramedics to the culture of patient safety; training and educational initiatives focused on enhancing their decision-making abilities and both their non-technical and technical competencies; developing relevant guidelines and protocols; improving collaboration between paramedics and other healthcare peers; optimizing environmental conditions and equipment; fostering a supportive work environment.
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Affiliation(s)
- Maria Strandås
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | | | - Kari Ingstad
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Jaana Sepp
- Tallinn Health Care College, Academic and International Affairs Office, Tallin, Estonia
| | - Ljudmila Linnik
- Tallinn Health Care College, Academic and International Affairs Office, Tallin, Estonia
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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2
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Noble AJ, Lees C, Hughes K, Almond L, Ibrahim H, Broadbent C, Dixon P, Marson AG. Raring to go? A cross-sectional survey of student paramedics on how well they perceive their UK pre-registration course to be preparing them to manage suspected seizures. BMC Emerg Med 2023; 23:119. [PMID: 37807077 PMCID: PMC10561511 DOI: 10.1186/s12873-023-00889-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Paramedics convey a high proportion of seizure patients with no clinical need to emergency departments (EDs). In a landmark study, only 27% of UK paramedics reported being "Very…"/ "Extremely confident" making seizure conveyance decisions. Improved pre-registration education on seizures for paramedics is proposed. Clarity is needed on its potential given recent changes to how UK paramedics train (namely, degree, rather than brief vocational course). This study sought to describe UK student paramedics' perceived readiness to manage seizures and educational needs; compare this to what they report for other presentations; and, explore subgroup differences. METHODS Six hundred thirty-eight students, in year 2 or beyond of their pre-registration programme completed a cross-sectional survey. They rated perceived confidence, knowledge, ability to care for, and educational needs for seizures, breathing problems and, headache. Primary measure was conveyance decision confidence. RESULTS For seizures, 45.3% (95% CI 41.4-49.2) said they were "Very…"/"Extremely confident" to make conveyance decisions. This was similar to breathing problems, but higher than for headache (25.9%, 95% CI 22.6-29.5). Two hundred and thirty-nine participants (37.9%, 95% CI 34.1-41.8) said more seizure education was required - lower than for headache, but higher than for breathing problems. Subgroup differences included students on university-based programmes reporting more confidence for conveyance decisions than those completing degree level apprenticeships. CONCLUSIONS Student paramedics report relatively high perceived readiness for managing seizures. Magnitude of benefit from enhancements to pre-registration education may be more limited than anticipated. Additional factors need attention if a sizeable reduction to unnecessary conveyances for seizures is to happen.
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Affiliation(s)
- Adam J Noble
- Department of Public Health, Policy and Systems, University of Liverpool, Ground Floor, Whelan Building, Liverpool, L69 3GL, UK.
| | - Carolyn Lees
- School of Health Sciences, University of Liverpool, Liverpool, UK
| | - Kay Hughes
- School of Public and Allied Health, Liverpool John Moores University, Liverpool, UK
| | - Lucy Almond
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Hesham Ibrahim
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Cerys Broadbent
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Pete Dixon
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Anthony G Marson
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
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Lorenz-Artz K, Bierbooms J, Bongers I. Unraveling complexity in changing mental health care towards person-centered care. Front Psychiatry 2023; 14:1250856. [PMID: 37779631 PMCID: PMC10536252 DOI: 10.3389/fpsyt.2023.1250856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Background Mental health care (MHC) needs to shift towards person-centered care to better meet people's individual needs. Open Dialogue (OD) is well-aligned with this perspective and brings it into practice. This study focuses on exploring the change process within a pilot project involving three MHC teams as they transition to a person-centered OD practice. Our aim is to identify and reflect on the challenges faced by MHC professionals in adopting person-centered care, and shedding light on the underlying complexity of these challenges. By gaining a better understanding of these obstacles, we hope to contribute to the adoption of the person-centered approach in MHC practice. Methods Our research employed a qualitative design, involving a total of 14 semi-structured interviews with MHC professionals who were either trained in OD, OD trainees, or MHC professionals without OD training. To analyze the data, we utilized a hybrid approach that combined deductive - and inductive thematic analysis. Results We identified four distinctive challenges: (1) understanding and knowledge transfer, (2) (inter)personal process, (3) emotional discomfort, and (4) the need for multi-stakeholder participation and support. In practice, these challenges intersect and the appearance of and relationships between these challenges are not linear or disentangleable. Conclusion Upon careful consideration of these interdependent challenges, it became evident that embedding a person-centered approach like OD brings about systemic change, leading to an unfamiliar situation X. The research findings indicated that understanding and conveying the concept of person-centered care in practical settings poses significant challenges. The field of knowledge management helps to capture the complexity of understanding and transferring this knowledge. The change process necessitates an (inter)personal process and elicits emotional discomfort, as person-centered OD practice confronts a deeply entrenched paradigm in MHC. Achieving a shared understanding of person-centered care requires dedicated time and attention, while introducing this approach prompts broader discussions on underlying values and human rights in MHC. Current implementation efforts may underestimate or overlook these underlying values, but initiating an open dialogue can serve as an initial step in addressing the complexities.
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Affiliation(s)
- Karin Lorenz-Artz
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Mental Health Care Institute, Eindhoven, Netherlands
| | - Joyce Bierbooms
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Inge Bongers
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Mental Health Care Institute, Eindhoven, Netherlands
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Phillips P, Trenoweth S. Crossing the 'flaky bridge' - the initial transitory experiences of qualifying as a paramedic: a mixed-methods study. Br Paramed J 2023; 8:18-27. [PMID: 37284606 PMCID: PMC10240861 DOI: 10.29045/14784726.2023.6.8.1.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Introduction Newly qualified paramedics (NQPs) may experience emotional turbulence as they transition to professional practice. This may negatively affect confidence and have an adverse effect on attrition. This study highlights the initial transitory experiences of NQPs. Methods The study utilised a mixed-methods convergent design. Qualitative and quantitative data were collected simultaneously and triangulated to more fully interpret participants' experiences. A convenience sample of 18 NQPs from one ambulance trust was used. The Connor-Davidson Resilience 25-point Scale questionnaire (CD-RISC25) was administered and analysed using descriptive statistics. Semi-structured interviews were conducted simultaneously and analysed using Charmaz's constructivist grounded theory approach. Data were collected from September to December 2018. Results There was a range of resilience scores, with a mean of 74.7/100 (standard deviation 9.6). Factors relating to social support were scored highly, and factors relating to determinism and spirituality were scored lower. Qualitative data constructed a process whereby participants were navigating a new identity across three spheres simultaneously: professional, social and personal identity. Attending a catalyst event such as a cardiac arrest was a trigger for starting to navigate this process. Participants had different pathways through this transitional period. Participants who found this process particularly turbulent seemed to have lower resilience scores. Conclusion The transition from student to NQP is an emotionally turbulent time. Navigating a changing identity seems to be at the centre of this turbulence, and this is triggered by a catalyst event such as attending a cardiac arrest. Interventions which support the NQP in navigating this change in identity, such as group supervision, may improve resilience and self-efficacy and reduce attrition.
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Affiliation(s)
- Peter Phillips
- Bournemouth University ORCID iD: http://orcid.org/0000-0002-9895-6945
| | - Steve Trenoweth
- Bournemouth University ORCID iD: http://orcid.org/0000-0001-8342-499X
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Emeriau Farges C, Bastille I, Desjardins C, Deschênes AA, Ouellet S, Rioux CA, Trépanier M. L’impact de la reconnaissance organisationnelle sur la santé psychologique au travail des répartiteurs d’urgence. PSYCHOLOGIE DU TRAVAIL ET DES ORGANISATIONS 2022. [DOI: 10.1016/j.pto.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wallin K, Werkander Harstäde C, Bremer A, Hörberg U. Nurse preceptors' experience-based strategies for supporting learning in the ambulance service-A combined focus group and dyadic interview study. J Adv Nurs 2021; 78:1704-1717. [PMID: 34873737 DOI: 10.1111/jan.15127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/07/2021] [Accepted: 11/27/2021] [Indexed: 11/28/2022]
Abstract
Ambulance service organizations worldwide report about an expanding professional role, responsibilities and scope of practice for ambulance clinicians, resulting in discussions concerning educational design and desired professional competencies. To face the contemporary demands in ambulance care, non-technical skills are advocated and clinical practice considered fundamental for the development of these abilities. However, there is very little research concerning educational strategies for supporting the desired competencies for novice registered nurses in the ambulance service. AIM To describe and explore nurse preceptors' experience-based strategies for supporting registered nurses learning in the ambulance service. DESIGN The study had an inductive and data-driven approach, guided by phenomenological epistemology. METHODS Twenty-seven Swedish nurse preceptors were interviewed in three focus groups and four dyadic interviews between October 2019 and April 2020. The data were analysed with reflexive thematic analysis. FINDINGS The nurse preceptors use several learning strategies, focusing on a socialization process and a clinical competence process, intertwined during clinical practice to support the development of a situated professional identity and a clinical decision-making competence. Supportive structures facilitate a progressive learning strategy when addressing desired skills and cognitive abilities in teamwork processes and clinical judgement. CONCLUSION Supporting novice clinicians, prior to and during clinical practice in the ambulance service, should include medical assessment skills, situation awareness and processes for effective teamwork. Further, novice clinicians need to develop complex cognitive abilities to deal with the dynamic nature of decision-making in ambulance care. IMPACT The study findings show contextual strategies, previously not described and desired competencies when supporting learning for registered nurses in the ambulance service. A theoretical grounding in episteme, techne, phronesis and situation awareness may guide educators at universities, managers in the ambulance service, preceptors and novice clinicians worldwide in the planning and performance of teaching and learning in the ambulance service.
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Affiliation(s)
- Kim Wallin
- Specialized RN within Ambulance Care (SAN), Växjö, Sweden.,Centre of Interprofessional Cooperation within Emergency care (CICE), Växjö, Sweden.,Faculty of Health and Life sciences, Linnaeus University, Växjö, Sweden
| | | | - Anders Bremer
- Specialized RN within Ambulance Care (SAN), Växjö, Sweden.,Centre of Interprofessional Cooperation within Emergency care (CICE), Växjö, Sweden.,Faculty of Health and Life sciences, Linnaeus University, Växjö, Sweden
| | - Ulrica Hörberg
- Faculty of Health and Life sciences, Linnaeus University, Växjö, Sweden
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7
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Page D, Brazelton T, Kokx G, Jennings PA, Williams B. Paramedic student encounters with patients during clinical placements: A multi-institutional cohort study. J Am Coll Emerg Physicians Open 2021; 2:e12391. [PMID: 33718925 PMCID: PMC7926011 DOI: 10.1002/emp2.12391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/11/2021] [Accepted: 01/29/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Paramedic students in the US are required to complete clinical placements to gain supervised experience with real patient encounters. Given wide variation in clinical placement practices, an evidence-based approach is needed to guide programs in setting realistic and attainable goals for students. This study's goal was to describe patient encounters and hours logged by paramedic students during clinical placements. METHODS A retrospective review of prospectively collected quality assurance data entered by US paramedic students between 2010 and 2014 was conducted. De-identified electronic records entered in the Field Internship Student Data Acquisition Project (FISDAP) Skill Tracker database were included from consenting paramedic students whose records were audited and approved by instructors. Descriptive statistics were calculated. RESULTS A total of 10,645 students encountered 2,239,027 patients; most encounters occurred in hospital settings (n = 1,311,967, 59%). The median total number of patient encounters per paramedic student was 206 (142-269) and the median total clinical placement hours per student was 626 (504-752). The median number of team leads per student was 56 (30-84). Students encountered a median of 22 (12-31) pediatric patients, ages 0-12 years, and 181 (126-238) adolescent or adult patients. For pediatric patient encounters, the most common clinical impressions were respiratory distress, other medical complaints, and extremity trauma. Among adult patient encounters, the most common clinical impressions included other medical, trauma, and cardiac conditions. CONCLUSIONS US paramedic students experienced a variable range of patient encounter types and volumes. The findings of this study offer an evidence base from which programs can set realistic and attainable clinical placement requirements.
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Affiliation(s)
- David Page
- Prehospital Care Research ForumUniversity of California Los AngelesLos AngelesCaliforniaUSA
- Department of ParamedicineMonash UniversityMelbourneAustralia
| | - Tom Brazelton
- School of Medicine and Public HealthUniversity of Wisconsin MadisonMadisonWisconsinUSA
| | - Gordon Kokx
- Committee on Accreditation of Educational Programs for the EMS ProfessionsRowlettTexasUSA
| | - Paul A Jennings
- Department of ParamedicineMonash UniversityMelbourneAustralia
| | - Brett Williams
- Department of ParamedicineMonash UniversityMelbourneAustralia
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8
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McCloughen A, Levy D, Johnson A, Nguyen H, McKenzie H. Nursing students’ socialisation to emotion management during early clinical placement experiences: A qualitative study. J Clin Nurs 2020; 29:2508-2520. [DOI: 10.1111/jocn.15270] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/27/2020] [Accepted: 03/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Andrea McCloughen
- Susan Wakil School of Nursing and Midwifery Faculty of Medicine and Health The University of Sydney Camperdown NSW Australia
| | - David Levy
- Susan Wakil School of Nursing and Midwifery Faculty of Medicine and Health The University of Sydney Camperdown NSW Australia
- Centre for Medical Psychology and Evidence‐based Decision Making Faculty of Science The University of Sydney Camperdown NSW Australia
| | - Anya Johnson
- Work and Organisational Studies University of Sydney Business School Sydney Australia
| | - Helena Nguyen
- Work and Organisational Studies University of Sydney Business School Sydney Australia
| | - Heather McKenzie
- Susan Wakil School of Nursing and Midwifery Faculty of Medicine and Health The University of Sydney Camperdown NSW Australia
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9
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Graf AC, Jacob E, Twigg D, Nattabi B. Contemporary nursing graduates’ transition to practice: A critical review of transition models. J Clin Nurs 2020; 29:3097-3107. [DOI: 10.1111/jocn.15234] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/16/2019] [Accepted: 02/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Amanda C. Graf
- School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia
| | - Elisabeth Jacob
- School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia
| | - Diane Twigg
- School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia
| | - Barbara Nattabi
- The University of Western Australia Crawley Western Australia Australia
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Wallin K, Hörberg U, Harstäde CW, Elmqvist C, Bremer A. Preceptors´ experiences of student supervision in the emergency medical services: A qualitative interview study. NURSE EDUCATION TODAY 2020; 84:104223. [PMID: 31726285 DOI: 10.1016/j.nedt.2019.104223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/30/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Clinical placements play a central part in the education of future emergency medical services (EMS) staff and their development of clinical skills and competence. A key aspect of students' integration of theory and praxis and development into an independent clinician is a supportive mentorship with the preceptor. However, students report barriers for learning within the EMS, while the preceptors' experiences of their role have received scant attention in research. OBJECTIVES To describe preceptors' experiences of student supervision in the EMS during clinical placements. DESIGN A descriptive qualitative design was used. Twenty specialist nurses were recruited among EMS staff from all parts of Sweden. METHODS Data were collected using individual interviews and analyzed with latent qualitative content analysis. FINDINGS EMS preceptors develop a competence in combining caring and learning adapted to individual student needs when facing students with varying needs in an ever-changing healthcare setting. A trustful relationship between student and preceptor is fundamental when coping with a dual responsibility for student and patient needs. However, several aspects in the EMS setting hinders the preceptors' ability to support the development of the students' independence. Surrounding support structures are important if the preceptors are to feel safe and secure in their role as assessor, teacher and ambulance nurse. CONCLUSIONS Preceptors need to develop a didactic flexibility through preceptor courses adapted to the complex premises found in the EMS. Ambulance services and universities should recognize the importance of preceptors´ colleagues, student continuity, university support and cooperation for improving quality and clarity in supervision during clinical placements.
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Affiliation(s)
- Kim Wallin
- Centre of Interprofessional Cooperation within Emergency care (CICE), Sweden; Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
| | - Ulrica Hörberg
- Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
| | | | - Carina Elmqvist
- Centre of Interprofessional Cooperation within Emergency care (CICE), Sweden; Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
| | - Anders Bremer
- Centre of Interprofessional Cooperation within Emergency care (CICE), Sweden; Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
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11
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Anderson NE, Slark J, Faasse K, Gott M. Paramedic student confidence, concerns, learning and experience with resuscitation decision-making and patient death: A pilot survey. Australas Emerg Care 2019; 22:156-161. [DOI: 10.1016/j.auec.2019.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 11/26/2022]
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12
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Mourh J, Newby B. Barriers and Strategies for Transition from Student to Successful Hospital Pharmacist. Can J Hosp Pharm 2019; 72:219-226. [PMID: 31258167 PMCID: PMC6592656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Many health care professionals experience a process of transition when entering the workforce. Various barriers have been documented in the literature, including a lack of confidence, challenging interactions with patients and colleagues, workload, increased responsibility, and a fear of making mistakes. Strategies to overcome these barriers, such as orientation and support programs, have been proposed. However, evidence for the transition of students into successful hospital pharmacists is limited. OBJECTIVES To identify key barriers to the transition from student to successful hospital pharmacist and to outline strategies to overcome these barriers. METHODS An electronic survey was distributed to Lower Mainland Pharmacy Services (LMPS) pharmacists, and subsequent one-on-one interviews were completed with a subgroup of new pharmacists. RESULTS A total of 137 LMPS pharmacists (about 32% of potential respondents) responded to the survey, and 3 of these also participated in an interview. A performance score (used to quantify the transition experience) was calculated for 113 respondents, and there was a correlation between performance score and role satisfaction (r = 0.550, p < 0.001). Performance score was also correlated with years spent working as a hospital pharmacist (r = 0.333, p < 0.001) and with highest level of pharmacy education (r = 0.210, p = 0.026). Work in a specialty area and presence of an orientation program were additional factors associated with higher average performance scores. The greatest need for transitional support was during the first year of work, with trainers and social supports being identified as the most helpful resources. Various perspectives were offered during the interviews, with multiple barriers and strategies proposed. CONCLUSIONS Among respondents to this survey, the key barriers faced during the transition from student to successful hospital pharmacist were limited time working as a hospital pharmacist, lack of additional pharmacy education, lack of knowledge, rotation among multiple areas, uncertainty about role identity, and limited university preparation. Given that successful transition is associated with subsequent job satisfaction, workplace strategies such as limiting the number of practice areas, developing an orientation program, and providing continued support during the first year of work should be encouraged.
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Affiliation(s)
- Jasminder Mourh
- , BSc(Pharm), ACPR, is a Clinical Pharmacist, Maternal Fetal Medicine, Child and Adolescent Psychiatry, Neonatal and Pediatric Pharmacy, Surrey Memorial Hospital, Surrey, British Columbia
| | - Brandi Newby
- , BSc(Pharm), ACPR, is Coordinator with the Neonatal and Pediatric Pharmacy, Surrey Memorial Hospital, Surrey, British Columbia
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13
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Alrazeeni D. International internship experience for emergency medical service paramedic students. Saudi J Anaesth 2018; 12:540-547. [PMID: 30429734 PMCID: PMC6180675 DOI: 10.4103/sja.sja_146_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction The purpose of this study is to delineate the training activities in the internship program, describe students' clinical and emergency medical service field hours and skills performance, and compare between internship students groups in their skills performance. Methods This is a retrospective, descriptive, and analytical study based on an interpretive observational documentary review of internship reports received on internship students. Results Three groups of internship students participated in various training activities in 3 years. Students in Group A (2015) completed 4610 h and contact 1600 patients. They completed the following clinical skills: 712 medication administrations, 652 intravenous (IV) access, 174 team leads (TLs), 4 live patient endotracheal intubations, and 13 ventilations. Students in Group B (2016) completed 2424 h and contact 797 patients. They completed several clinical skills including 256 medication administrations, 249 IV access, 16 TLs, 1 live patient endotracheal intubation, and 8 ventilations. Students in Group C (2017) completed 5700 h and contact 1200 patients. They completed several skills including 673 medication administrations, 650 IV access, 198 TLs, 11 live patient endotracheal intubations, and 27 ventilations. The study revealed significant differences and superiority in skills performance in Groups A (2015) and C (2017) over Group B (2016). Conclusion Internship students have exposure opportunities to patients and have more opportunities to perform medication administration, IV activities, and serve as TLs. As expected, internship students have few opportunities to perform live tube insertions and ventilation. There are statistical significant differences in skills performance within the group of students in each year and among the three groups of internship students.
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Affiliation(s)
- Daifallah Alrazeeni
- EMS Department, Prince Sultan Bin Abdulaziz College for EMS, King Saud University, Riyadh, Saudi Arabia.,Chair of Saudi Association for Emergency Medical Services, Riyadh, Saudi Arabia
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14
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Hörberg A, Jirwe M, Kalén S, Vicente V, Lindström V. We need support! A Delphi study about desirable support during the first year in the emergency medical service. Scand J Trauma Resusc Emerg Med 2017; 25:89. [PMID: 28877728 PMCID: PMC5588605 DOI: 10.1186/s13049-017-0434-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/30/2017] [Indexed: 11/30/2022] Open
Abstract
Background New and inexperienced emergency medical service (EMS) professionals lack important experience. To prevent medical errors and improve retention there is an urgent need to identify ways to support new professionals during their first year in the EMS. Methods A purposeful sample and snowball technique was used and generated a panel of 32 registered nurses with 12–48 months of EMS experience. A Delphi technique in four rounds was used. Telephone interviews were undertaken in round one to identify what desirable support professionals new to the EMS desire during their first year. Content analysis of the transcribed interviews yielded items which were developed into a questionnaire. The experts graded each item in terms of perceived importance on a 5-graded likert scale. Consensus level was set at 75%. Items which reached consensus were removed from questionnaires used in subsequent rounds. Results Desirable support was categorized into eight areas: Support from practical skills exercises, support from theoretical knowledge, support from experiences based knowledge, theoretical support, support from an introduction period, support from colleagues and work environment, support from management and organization and other support. The experts agree on the level of importance on 64 of a total of 70 items regarding desirable support. One item was considered not important, graded 1 or 2, 63 items were considered important, graded 4 or 5. Conclusion Even with extensive formal competence the EMS context poses challenges where a wide variety of desirable forms of support is needed. Support structures should address both personal and professional levels and be EMS context oriented.
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Affiliation(s)
- Anna Hörberg
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Academic EMS, Stockholm, Sweden.
| | - Maria Jirwe
- Department of Neurobiology Care Sciences and Society, Division of Nursing, Stockholm, Sweden
| | - Susanne Kalén
- Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm City Council, Stockholm, Sweden
| | - Veronica Vicente
- The Ambulance Medical Service in Stockholm (AISAB) Sweden, Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Academic EMS, Stockholm, Sweden
| | - Veronica Lindström
- Department of Neurobiology Care Sciences and Society, Division of Nursing, Academic EMS, Stockholm, Sweden
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Everyday Dangers - The Impact Infectious Disease has on the Health of Paramedics: A Scoping Review. Prehosp Disaster Med 2017; 32:217-223. [PMID: 28134071 DOI: 10.1017/s1049023x16001497] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Paramedics respond to emergency scenes in often uncontrolled settings without being aware of potential risks. This makes paramedicine one of the most dangerous occupations. One of these dangers is the risk of contracting infectious diseases. Research in this area is predominantly focused on compliance in the use of protective equipment, attitudes and perceptions of paramedics, infectious disease policy, and exposure rates to blood and body fluids. The purpose of this scoping review was to determine what is known about the impact of infectious disease on the health of paramedics. METHODS Using the Arskey and O'Malley methodological framework, a scoping review was undertaken, which allows for a broad search of the available evidence. RESULTS The literature search identified eight articles for review that reported on paramedic exposure trends; the lack of reported blood-borne infections contracted, such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV); instances of severe acute respiratory syndrome (SARS) infections; and the higher prevalence of methicillin-resistant staphylococcus aureus (MRSA) nasal infections amongst paramedics. CONCLUSIONS Exposure to infectious diseases is decreasing, yet it remains significant. The decrease is attributed to prevention strategies; however, paramedic knowledge and attitudes as well as the uncontrolled environment paramedics work in can be a barrier. Contraction of infectious diseases is generally low; exceptions to this are MRSA colonization, influenza, and SARS. Paramedics are at greater risk of acquiring these infectious diseases compared to the general public. The effect on the health of paramedics is not well reported. Thomas B , O'Meara P , Spelten E . Everyday dangers - the impact infectious disease has on the health of paramedics: a scoping review. Prehosp Disaster Med. 2017;32(2):217-223.
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