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Haruna J, Uemura S, Hayasaka N, Taguchi Y, Muranaka S, Niiyama S, Inamura H, Sawamoto K, Mizuno H, Himuro N, Narimatsu E. Prehospital emergency care family satisfaction scale for care provided by emergency medical technicians: Scale development and validation. J Eval Clin Pract 2024. [PMID: 38978398 DOI: 10.1111/jep.14090] [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: 02/12/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024]
Abstract
RATIONALE To date, family satisfaction with emergency medical technicians (EMTs) has only been reported through narrative statements in subjective evaluations. Although a quantitative assessment of healthcare professional satisfaction is desirable, no specific measures have been devised to assess family satisfaction with the healthcare and care provided by EMTs. AIMS AND OBJECTIVES This study aimed to develop and validate an EMT care family satisfaction scale to measure patient satisfaction with prehospital emergency care. METHODS The study population comprised 216 family members (N = 216) of patients who used ambulances between November 2020 and May 2021 in a single region in Japan. Questionnaires were distributed to the participants who provided informed consent. An exploratory factor analysis of construct validity was performed to validate the Family Satisfaction Scale. The Cronbach's alpha was used to validate the internal consistency reliability of the scale. RESULTS The exploratory factor analysis results revealed a four-factor structure: 'explanation and communication,' 'physical treatment,' 'psychological support,' and 'environment in the ambulance.' The Cronbach's range (0.80-0.93) for the total score for each of these four factors and the overall total score confirmed favorable internal reliability of this study. CONCLUSIONS The family satisfaction scale developed in this study was constructed and validated to highlight the role of EMTs and needs of the families in the prehospital care settings. Moreover, this scale can be applied in the evaluation and consideration of interventions to improve family satisfaction with EMTs.
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Affiliation(s)
- Junpei Haruna
- Department of Intensive Care Medicine, School of Medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
| | - Shuji Uemura
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | | | - Yukiko Taguchi
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Nursing, School of Health Sciences, Sapporo Medical University, Hokkaido, Japan
| | - Saori Muranaka
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Hokkaido, Japan
| | - Sachi Niiyama
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Hokkaido, Japan
| | - Hirotoshi Inamura
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Pharmacy, Sapporo Medical University Hospital, Hokkaido, Japan
| | - Keigo Sawamoto
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Hirotoshi Mizuno
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Nobuaki Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Eichi Narimatsu
- Department of Emergency Medical Services, Life Flight and Disaster medicine, Sapporo Medical University, Hokkaido, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan
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Tikkanen V, Sundberg K. Care relationship and interaction between patients and ambulance clinicians: A qualitative meta-synthesis from a person-centred perspective. Scand J Caring Sci 2024; 38:24-34. [PMID: 37997183 DOI: 10.1111/scs.13225] [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: 06/13/2023] [Revised: 10/30/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Ambulance care is characterised by disaster medicine, traumatology and care for acute illnesses and accidents. The focus of ambulance care is clearly on medical care, whereas interpersonal interaction between patients and ambulance clinicians appears less prioritised. A patient within ambulance care needs to be listened to, be taken seriously, be treated with empathy and be seen as a unique person. These are fundamental to delivering Person-centred care. AIM The purpose is to describe how the care relationship and interaction between patients and ambulance clinicians in prehospital emergency care are described in the literature and how they can be interpreted from a person-centred perspective. DATA SOURCES AND REVIEW METHODS A qualitative meta-synthesis was used. Data collection was carried out with PubMed, CINAHL Plus and Web of Science in September-October 2022 and in August-September 2023. The first article searching applied a timeline 1990-2022 and the second applied a timeline 2022-2023. A total of 13 studies employing a qualitative approach were evaluated and included in the interpretive analysis. RESULTS Three themes were identified: A good care relationship, Decision-making and Hindrances to practising person-centred care in ambulance care. Trust, good communication and respect for patients' dignity were the most important parts of the good care relationship between patients and ambulance clinicians. Decision-making regarding the examination of patients, medical treatment and transport to the receiving care unit was one of the tasks that ambulance clinicians do independently but in cooperation with patients and family members. Person-centred care within ambulance care may be hindered due to environmental factors, attitudes and behaviour of ambulance clinicians and patient-related factors. CONCLUSION Many ambulance clinicians have already adopted Person-centred care, but several factors can hinder Person-centred care in interactions with patients. Although the results build on a limited number of studies, they indicate that person-centred care needs to be further developed and studied for high-quality ambulance care.
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Affiliation(s)
- Viivi Tikkanen
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
- FALCK Ambulance Stockholm, Hägersten, Sweden
| | - Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Jepsen K, Lindström V, Wihlborg J, HÖrberg A. Newly employed nurses' transition into their new role in the ambulance service- a qualitative study. BMC Nurs 2024; 23:93. [PMID: 38311770 PMCID: PMC10838444 DOI: 10.1186/s12912-024-01745-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/18/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Nurses are essential to ensure safe and high-quality care worldwide. The World Health Organization (WHO) forecasts a shortfall of 5.9 million nurses by the year 2030, and in the ambulance service, the turnover rate ranges between 20% and 30%. With this study, we seek to increase knowledge by exploring the transition of newly employed experienced nurses into their roles in the ambulance service using the Meleis theory of transition. Through understanding transition, support for newly employed nurses can be developed, turnover rates can decrease, and in the long term, patient safety may increase. DESIGN The study employed a qualitative approach. METHODS Eighteen newly employed experienced nurses were individually interviewed four times during their first six months of employment. Deductive qualitative content analysis was used to analyse the data. The reporting of this research adheres to the COREQ checklist. RESULTS The results show that the transition process for newly employed nurses in the ambulance service encompassed all five aspects of Meleis' transition theory: Awareness, Engagement, Change and Difference, Time Span, and Critical Points. The transition period varied among the participants, and it was also observed that not all nurses went through a transition in line with Meleis' theory. Additionally, there were findings that nurses highlighted the impact of the ambulance service culture on their transition. CONCLUSIONS The findings provide a more profound insight into how newly employed nurses with previous experience as nurses navigate their roles and transition into a new profession in a new context. An ambulance service where the organisation is aware of the newly employed nurses' transition processes and what the transition entails can develop and promote a supportive and permissive culture within the ambulance service. For newly employed nurses who are adequately supported, health transitions are more likely to occur, which may increase retention and in the long term increase patient safety. The insights gained from the study can empower ambulance organisations to improve their introduction programmes and offer enhanced support for newly employed experienced nurses entering the ambulance service.
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Affiliation(s)
- Klara Jepsen
- Department of Neurobiology, Care Sciences and Societ, Karolinska Institutet, Stockholm, Sweden.
- Samariten ambulance AB, Stockholm, Sweden.
| | - Veronica Lindström
- Department of Neurobiology, Care Sciences and Societ, Karolinska Institutet, Stockholm, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Ambulance Service, Region Västerbotten, Umeå, Sweden
| | - Jonas Wihlborg
- School of health and welfare, Dalarna University, Dalarna, Sweden
| | - Anna HÖrberg
- School of health and welfare, Dalarna University, Dalarna, Sweden
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Glawing C, Karlsson I, Kylin C, Nilsson J. Work-related stress, stress reactions and coping strategies in ambulance nurses: A qualitative interview study. J Adv Nurs 2024; 80:538-549. [PMID: 37530409 DOI: 10.1111/jan.15819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/07/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
AIM To describe experiences of work-related stress, stress reactions and coping strategies among registered nurses (RNs) in the ambulance service (AS). DESIGN A descriptive and qualitative design. METHODS Participants were recruited from eight different ambulance stations from different geographical locations in central Sweden. Data were collected from 14 RNs during the period from January 2022 to May 2022 using a semi-structured interview guide. Qualitative content analysis was used to analyse data using an abductive approach. RESULTS Three categories describe the RNs' experiences; (1) Situations that cause work-related stress, (2) Reactions and feelings that occur and (3) Management of work-related stress. These three main categories included a total of 12 subcategories. Work-related stress was experienced when participants were a part of traumatic events or experienced insufficient cooperation or a disturbing event in the work environment. The different causes lead to different kinds of reactions with feelings of frustration, fear and loneliness being prominent. To manage the work-related stress, RNs used different kinds of strategies and support from colleagues or lack thereof seemed to have a major impact. CONCLUSIONS Findings revealed the importance of having competent colleagues in the AS. Working with a competent colleague can reduce experiences of stress and prevent feelings of loneliness. It is important for the AS to provide stress-reduction support, to promote cooperation and to maintain and develop RNs' professional competence to ensure quality care and patient safety in the AS.
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Affiliation(s)
- Carina Glawing
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Ingela Karlsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Camilla Kylin
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Jan Nilsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Rantala A, Sterner A, Frank C, Heinrich E, Holmberg B. Older patients' perceptions of the Swedish ambulance service: A qualitative exploratory study. Australas Emerg Care 2023; 26:249-253. [PMID: 36764911 DOI: 10.1016/j.auec.2023.01.005] [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: 11/06/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND As worldwide life expectancy increases, the Swedish Ambulance Service is likely to be affected by the demographic shift towards a larger proportion of older persons. An older population tends to increase the demand for ambulances, indicating a need to illuminate older patients' perspective. Thus, the aim of this study was to explore older patients' perceptions of the Swedish Ambulance Service. METHODS This interview study employed a descriptive qualitative design with a phenomenographic approach in accordance with Dahlgren and Fallsberg. RESULTS Three main descriptive categories emerged to describe the underlying conceptions in the interviews; A double-edged encounter, Trust is created by perceived competence, and Safety through accessibility in vulnerable situations. CONCLUSION Older patients described trust in ambulance clinicians as a prerequisite for feeling safe enough to share their feelings and allow a bodily examination. However, they also criticized the care provided because they questioned the need for certain actions.
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Affiliation(s)
- Andreas Rantala
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Department of Ambulance Service, Region Skåne, Helsingborg, Sweden; Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
| | - Anders Sterner
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Catharina Frank
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Elsa Heinrich
- Department of Ambulance Service, Region Skåne, Malmö, Sweden
| | - Bodil Holmberg
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
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Anderson NE, Robinson J, Goodwin H, Gott M. 'Mum, I think we might ring the ambulance, okay?' A qualitative exploration of bereaved family members' experiences of emergency ambulance care at the end of life. Palliat Med 2022; 36:1389-1395. [PMID: 36154525 DOI: 10.1177/02692163221118204] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In the context of a sudden or unexpected event, people with a life-limiting illness and their family caregivers may be dependent on emergency ambulance services. AIM To explore bereaved family members' experiences of emergency ambulance care at the end of life. DESIGN A qualitative study using reflexive thematic analysis of data collected from semi-structured phone interviews. SETTING/PARTICIPANTS A purposive sample of 38 family caregivers identified from a database of deaths in Aotearoa, New Zealand. RESULTS Emergency ambulance personnel assist, inform and reassure patients and family caregivers managing distressing symptoms, falls, infections, unexpected events and death itself. Family members and patients are aware of the pressure on emergency services and sometimes hesitate to call an ambulance. Associating ambulances with unwanted transport to hospital is also a source of reluctance. CONCLUSIONS The generalist palliative care provided by emergency ambulance personnel is a vital service for patients in the last year of life, and their caregivers. This must be acknowledged in palliative care policy and supported with training, specialist consultation and adequate resources.
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Affiliation(s)
- Natalie Elizabeth Anderson
- Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.,Te Whatu Ora Te Toka Tumai Auckland, Auckland, New Zealand
| | - Jackie Robinson
- Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Hetty Goodwin
- Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.,Te Whatu Ora Te Toka Tumai Auckland, Auckland, New Zealand
| | - Merryn Gott
- Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
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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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Tolossa W, Bala ET, Mekuria M, Ifa M, Deriba BS, Dufera A. Magnitude and Factors Associated with Ambulance Service Utilization Among Women Who Gave Birth at Public Health Institutions in Central Ethiopia. Open Access Emerg Med 2022; 14:457-471. [PMID: 35990044 PMCID: PMC9384968 DOI: 10.2147/oaem.s373700] [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: 06/01/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Effective and well-organized ambulance services system forms the link between household and health facility for providing basic or comprehensive emergency obstetric care. Therefore, the establishment of a strong ambulance services network across the country based on evidences from local study is necessary for the improvement of ambulance service utilization among mothers who gave birth. This study aimed to assess magnitude and factors associated with ambulance service utilization among women who gave birth at public health institutions in central Ethiopia. Methods A community-based cross-sectional study supplemented by a qualitative method was employed. Data were collected via face-to-face interview. A simple random sampling and purposive sampling techniques were used to select study participants. Bivariate and multivariable logistic regression analyses were done to identify factors associated with ambulance services utilization, and variables with a p-value <0.25 were entered in the multivariable logistic regression analysis. Adjusted odds ratio (AOR) with 95% CI and a P-value <0.05 were used to declare statistically significant associations. Results Among study participants, only 214 (46%) utilized ambulance service. Mother who had no formal education (AOR=0.03, 95% CI [0.01, 0.07]), husband who completed primary school and above (AOR=7.03, 95% CI [1.83, 27.16]), rural residence (AOR=2.27, 95% CI [1.11, 4.65]), decision maker to get ambulance service (AOR=0.03, 95% CI [0.01, 0.07]), multigravida (AOR=4.8, 95% CI [2.48, 9.34]), having ambulance phone number (AOR=0.36, 95% CI [0.19, 0.68]), antenatal care attendance (AOR=0.07, 95% CI [0.04, 0.16]), and having discussion with health extension worker (AOR=0.14, 95% CI [0.084, 0.24]) were significantly associated with ambulance service utilization. Conclusion The magnitude of ambulance service utilization was low. Hence, health sector should improve the awareness of pregnant mothers on benefit of ambulance utilization through provision of information. Health care providers should provide antenatal services for pregnant mothers as early as possible.
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Affiliation(s)
- Wondwosen Tolossa
- Department of Public Health, Oromia Regional Health Bureau Chalia District Health Office, Gedo, Ethiopia
| | - Elias Teferi Bala
- Department of Public Health, College of Medicine and Health Sciences Ambo University, Ambo, Ethiopia
| | - Mulugeta Mekuria
- Department of Public Health, College of Medicine and Health Sciences Ambo University, Ambo, Ethiopia
| | - Meseret Ifa
- Department of Public Health, College of Medicine and Health Sciences Ambo University, Ambo, Ethiopia
| | - Berhanu Senbeta Deriba
- Department of Public Health, Salale University College of Medicine and Health Sciences, Fitche, Ethiopia
| | - Adugna Dufera
- Department of Public Health, Oromia Regional Health Bureau Chalia District Health Office, Gedo, Ethiopia
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Larsson G, Dagerhem A, Wihlborg J, Rantala A. Satisfaction among non-conveyed patients and significant others when discharged at the scene by the ambulance service: an exploratory cross-sectional survey. BMC Emerg Med 2022; 22:100. [PMID: 35672702 PMCID: PMC9171931 DOI: 10.1186/s12873-022-00659-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background The ambulance service is facing an increased number of calls and ambulance assignments. Between 12 and 42% of all assignments result in non-conveyance to the Accident and Emergency Department. However, there is limited knowledge regarding satisfaction among patients and significant others when patients are assessed as non-urgent and discharged at the scene. Therefore, the aim of the study was to explore and compare satisfaction with the ambulance service among patients and significant others when the patient was discharged at the scene. Methods The present study was designed as a cross-sectional exploratory survey with a consecutive sample employing the Consumer Emergency Care Satisfaction Scale questionnaire on patients and significant others. Results A total of 162 questionnaires were analysed, 87 patients and 75 significant others. Overall, satisfaction was high with no significant difference between patients and significant others, although 17-19% were dissatisfied with the discharge information. Conclusions Generally, patients and significant others are satisfied with the care provided by the Ambulance Service when discharged at the scene and thus not conveyed the Accident and Emergency Department. The participants were especially satisfied with Specialist Ambulance Nurses’ interpersonal skills, e.g., making time and providing thorough information. Guidelines for assignments involving non-conveyance, as well as information, instructions and what to expect when discharged at the scene can be improved.
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Affiliation(s)
- Glenn Larsson
- PreHospen-Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alma Dagerhem
- Emergency Department, Halland Hospital, Halmstad, Sweden
| | - Jonas Wihlborg
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Andreas Rantala
- Emergency Department, Helsingborg General Hospital, Helsingborg, Sweden. .,Department of Health Sciences, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden. .,Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
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Do we need a pandemic to improve hygiene routines in the ambulance service? A cross-sectional study. Int Emerg Nurs 2022; 62:101171. [PMID: 35487042 PMCID: PMC9042148 DOI: 10.1016/j.ienj.2022.101171] [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: 11/21/2021] [Revised: 02/14/2022] [Accepted: 03/23/2022] [Indexed: 11/20/2022]
Abstract
Background We know that ambulance staff may have sparse knowledge on how to comply with care approaches that ensure appropriate hygiene in the ambulance, but we do not know if and how the COVID-19 pandemic has affected ambulance staff’s perceived compliance with hygiene routines. Aim To investigate ambulance staff’s self-reported hand hygiene (HH) perceptions and compliance; and to explore if and how the COVID-19 pandemic has affected ambulance staff’s perceived compliance with hygiene routines. Methods A cross-sectional study design using the WHO-validated Perception Survey for Healthcare Workers regarding hygiene. Thematic analysis and descriptive statistics were used for analysis. Results 204 surveys were analysed, 92% of participants stated that their hygiene routine compliance had improved during the COVID-19 pandemic, and some participants also described that their colleagues’ practice had improved. These improvements were reportedly driven by the need to acquire new knowledge to deal with the pandemic and sometimes with fear. Conclusions Experience acquired during the pandemic needs to be sustainable if we are to increase HH and hygiene routine compliance in ambulance services. Interventions aimed at changing ambulance staff’s perceived behaviour are warranted, and stakeholders should try and identify the personal motivations that lead these staff to seek self-betterment regarding HH and hygiene routine compliance. Otherwise, the risk of patients suffering from healthcare-associated infection may not decrease as wished.
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Conte H, Wihlborg J, Lindström V. Developing new possibilities for interprofessional learning- students' experience of learning together in the ambulance service. BMC MEDICAL EDUCATION 2022; 22:192. [PMID: 35307011 PMCID: PMC8935834 DOI: 10.1186/s12909-022-03251-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND It is known that setting and context matters, and contextual factors influence interprofessional education (IPE). Activities developed in a new setting should therefore be evaluated to determine students' experiences and learning. IPE in the ambulance service may present a new setting for interprofessional learning (IPL). AIM The aim of this study was to explore undergraduate students' experiences of collaboration and learning together during their clinical rotation in the ambulance service. STUDY DESIGN AND METHOD A mixed convergent parallel design was used to describe nursing and medical students' experiences of collaboration and learning together during their clinical rotation in the ambulance service during autumn 2019. Two group interviews with nursing students (n = 20; response rate 80%) were conducted and the medical students (n = 40; response rate 72.5%) answered a self-assessment questionnaire regarding their IPE. The group discussions were analysed using an inductive thematic analysis and descriptive statistics were used to describe the medical students' self-assessed experiences and competencies in interprofessional collaboration. RESULTS In the context of the ambulance service, some of the challenges included, the team vary daily, a context that can be unpredictable, and the team being required to make decisions in various situations with limited support. The context presented good opportunities to learn together, since they faced a broad variety of situations and had opportunities to follow patients through the chain of care. CONCLUSION The students' experiences show that the ambulance service offers possibilities for IPL. The ambulance service enhanced the students' learning in an unfamiliar environment, encouraging them to develop collaborative learning strategies and situational leadership regardless of established hierarchical structures and stereotypes that are sometimes present in other parts of the health care service. ETHICAL APPROVAL By the Swedish Ethical Review Authority. No: 2019-03595.
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Affiliation(s)
- Helen Conte
- Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet, Stockholm, Sweden
| | - Jonas Wihlborg
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Veronica Lindström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet, Stockholm, Sweden.
- Department of Health Promotion, Sophiahemmet University, Stockholm, Sweden.
- Samariten Ambulance Stockholm, Stockholm, Sweden.
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Becker J, Hugelius K. Driving the ambulance: an essential component of emergency medical services: an integrative review. BMC Emerg Med 2021; 21:160. [PMID: 34922453 PMCID: PMC8684175 DOI: 10.1186/s12873-021-00554-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/06/2021] [Indexed: 04/28/2023] Open
Abstract
Background The transport of patients from one location to another is a fundamental part of emergency medical services. However, little interest has been shown in the actual driving of the ambulance. Therefore, this review aimed to investigate how the driving of the ambulance affects the patient and the medical care provided in an emergency medical situation. Methods A systematic integrative review using both quantitative and qualitative designs based on 17 scientific papers published between 2011 and 2020 was conducted. Results Ambulance driving, both the actual speed, driving pattern, navigation, and communication between the driver and the patient, influenced both the patient’s medical condition and the possibility of providing adequate care during the transport. The driving itself had an impact on prehospital time spent on the road, safety, comfort, and medical issues. The driver’s health and ability to manage stress caused by traffic, time pressure, sirens, and disturbing moments also significantly influenced ambulance transport safety. Conclusions The driving of the ambulance had a potential effect on patient health, wellbeing, and safety. Therefore, driving should be considered an essential part of the medical care offered within emergency medical services, requiring specific skills and competence in both medicine, stress management, and risk approaches in addition to the technical skills of driving a vehicle. Further studies on the driving, environmental, and safety aspects of being transported in an ambulance are needed from a patient’s perspective.
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Affiliation(s)
- Julia Becker
- Institute for Disaster and Emergency Management, 141 69, Berlin, Germany
| | - Karin Hugelius
- Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden.
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13
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Carnesten H, Asp M, Holmberg M. Caring approach for patients with chest pain - Swedish registered nurses' lived experiences in Emergency Medical Services. Int J Qual Stud Health Well-being 2021; 16:1901449. [PMID: 33779530 PMCID: PMC8009108 DOI: 10.1080/17482631.2021.1901449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose: Encountering patients with chest pain iscommon for Registered Nurses (RNs) in Emergency Medical Services (EMS) who are responsible for the patient’s medical and nursing care . From a lifeworld perspective, bodily illness is related to existential suffering, requiring knowledge to asses the situation from a holistic perspective . The aim of this study is to describe the caring approach when RNs encounter patients with chest pain. Methods: A phenomenological methodology to capture RNs’ lived experiences was chosen. Seven qualitative in-depth interviews were conducted at three ambulance stations in Sweden. Results: The essence of the caring approach while encountering patients with chest pain comprises two constituents; “trust based on confidence and competence” and “the collegial striving towards the best possible care”. Trust is two-parted; trust in oneself, and striving towards gaining the patient’s trust . Competence and experience when combined, develop into confidence especially in stressful situations. The caring approach is nurtured in a well-functioning collegial team. Conclusions: This study contributes to understanding the caring approach based on the specific patient’s lifeworld in holistic EMS care. By trusting oneself, the patient, and one’s colleague, RNs in EMS shift focus from medical-orientated care to a holistic lifeworld caring approach. . More research is needed on trust as a phenomenon in EMS, both from caregivers’ and patients’ perspectives.
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Affiliation(s)
- Hillewi Carnesten
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Margareta Asp
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Mats Holmberg
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.,Department of Ambulance Service, Region of Sörmland, Eskilstuna, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
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14
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Kaminsky E, Lindberg Y, Spangler D, Winblad U, K Holmström I. Registered nurses' understandings of emergency medical dispatch center work: A qualitative phenomenographic interview study. Nurs Health Sci 2021; 23:430-438. [PMID: 33665977 DOI: 10.1111/nhs.12824] [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: 10/31/2020] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
Non-urgent and urgent telephone nursing services are increasing globally, and phenomenographic research has shown that how work is understood may influence work performance. This descriptive study makes a qualitative inductive investigation of understandings of emergency medical dispatch center work among registered nurses. Twenty-four registered nurses at three mid Swedish emergency medical dispatch centers were interviewed. Analysis based on phenomenographic principles identified five categories in the interviews: (i) Assess, prioritize, direct, or refer; (ii) Facilitate ambulance nursing work; (iii) Perform nursing care; (iv) Always be available for the public; and (v) Have the person behind the patient in mind. The first constitutes the basis of the work. The second emphasizes cooperation with and support for the ambulance staff. The third entails remotely providing nursing care, whilst the fourth stresses serving the entire population. The fifth and most comprehensive way of understanding work involves having a holistic view of the person in need, including person-centered care. Provision of high-quality emergency medical dispatch center work involves all categories. Combined, they constitute a "work map," valuable for reflection, competence development, and introduction of new staff.
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Affiliation(s)
- Elenor Kaminsky
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ylva Lindberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Douglas Spangler
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Uppsala Center for Prehospital Research, Department of Surgical Sciences - Anesthesia and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Ulrika Winblad
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Inger K Holmström
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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15
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Mulet M, Vuillemin Q, Lachaux J, Trousselard M, Ferrer MH. Perceived Stress, Personality Traits, and State of Victim's Consciousness: Impact on Tourniquet Application Time and Effectiveness. Mil Med 2021; 187:e1216-e1224. [PMID: 33751051 DOI: 10.1093/milmed/usab092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/01/2021] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION One of the main avoidable causes of combat-related injury death is extremity hemorrhage. Even with regular training, failure to properly apply a tourniquet is common. In this study, we sought to assess if rescuer's stress and personality traits, along with victim's state of consciousness, had a role to explain tourniquet application failure. MATERIALS AND METHODS Eighty-seven soldiers completed a sociodemographic and personality questionnaire (perceived stress, active altruism, mindfulness, and empathy) during a forward combat casualty care course. Then, they underwent a leg hemorrhage simulation on a randomly conscious or unconscious victim. Tourniquet application time and effectiveness (using popliteal artery Doppler) were recorded. RESULTS Tourniquet application effective rate was 37% and soldiers with higher levels of perceived stress were at greater risk of failure, especially on a conscious victim. Participants who deployed overseas and those who have undergone combat rescue training were significantly quicker to apply a tourniquet. Altruist and empathetic caregivers were slower to apply the tourniquet while mindful ones were faster. CONCLUSIONS Combat-related injuries, even simulated, not only involve the rescuer's technical skills but also their ability to deal with stressful external stimuli. Tourniquet application speed seems to be influenced by perceived stress and personality traits of the rescuers. Frequent failures justify repeated training, and one way to pursue improvement could be to develop a personalized pedagogy adapting to the needs of the students according to their current skillset but also their perceived stress and personality determinants. In the pedagogical process (planning, goal setting, teaching, and evaluating), the state of consciousness of the victim seems to be a parameter that needs to be accounted for, but further studies are required to accurately describe its influence.
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Affiliation(s)
- Marin Mulet
- Legouest Military Hospital, Metz 57077, France
| | - Quentin Vuillemin
- 60th Medical Ward, 6th Military Medical Center, Valdahon 25800, France
| | - Jordan Lachaux
- 60th Medical Ward, 6th Military Medical Center, Valdahon 25800, France
| | - Marion Trousselard
- Neurophysiology of Stress Unit, Neuroscience and Cognitive Science Department, French Armed Forces Biomedical Research Institute-IRBA, Brétigny-sur-Orge 91223, France
| | - Marie-Hélène Ferrer
- Neurophysiology of Stress Unit, Neuroscience and Cognitive Science Department, French Armed Forces Biomedical Research Institute-IRBA, Brétigny-sur-Orge 91223, France
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16
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Forsell L, Forsberg A, Kisch A, Rantala A. Specialist Ambulance Nurses' Perceptions of Nursing: A Phenomenographic Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5018. [PMID: 32668619 PMCID: PMC7400022 DOI: 10.3390/ijerph17145018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 01/10/2023]
Abstract
Although nursing is the main area of interest in the curriculum of the specialist ambulance nursing program in the advanced level of education, there has been reported a lack of knowledge about nursing in within the ambulance service. The aim was to explore specialist ambulance nurses' perceptions of nursing, which were explored by employing a phenomenographic approach. The study comprises individual interviews with 19 strategically selected specialist ambulance nurses. The results showed seven descriptive categories emerged detailing the variations in how the specialist ambulance nurses perceive, understand, and conceptualize the phenomenon of nursing in the Swedish Ambulance Service. Four categories revealed the specialist ambulance nurses' qualitatively different perceptions of nursing, i.e., their role and responsibility, while three showed perceived barriers to assuming their role and responsibility, comprising culture and leadership, conditions, and framework. The seven categories are outlined in the outcome space. In conclusion, there is a very wide variety of perceptions of ambulance nursing within the Swedish Ambulance Service. There is a need for implement the nursing process both in the Specialist Nursing Pre-hospital Emergency Care education curriculum and within clinical practice. Further, there is a necessity to develop and implement nursing guidelines in the ambulance.
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Affiliation(s)
- Lena Forsell
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden; (A.F.); (A.K.); (A.R.)
- Emergency Department, Helsingborg General Hospital, SE-205 01 Helsingborg, Sweden
| | - Anna Forsberg
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden; (A.F.); (A.K.); (A.R.)
- Department of Cardiothoracic Surgery, Skåne University Hospital, SE-224 42 Lund, Sweden
| | - Annika Kisch
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden; (A.F.); (A.K.); (A.R.)
- Department of Haematology, Skåne University Hospital, SE-224 42 Lund, Sweden
| | - Andreas Rantala
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden; (A.F.); (A.K.); (A.R.)
- Emergency Department, Helsingborg General Hospital, SE-205 01 Helsingborg, Sweden
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17
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Sedlár M. Cognitive skills of emergency medical services crew members: a literature review. BMC Emerg Med 2020; 20:44. [PMID: 32471352 PMCID: PMC7257132 DOI: 10.1186/s12873-020-00330-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background Situation awareness and decision making, listed in non-technical skills taxonomies, are critical for effective and safe performance in high-risk professions. These cognitive skills and their behavioral markers have been studied less in emergency medical services (EMS) crew members. This paper aims to review the existing literature and identify important aspects and behavioral markers of situation awareness and decision making in EMS crew members – those who work in the role of prehospital emergency care providers – and to synthesize findings as a basis for developing a rating and training tool. Method The search for relevant articles was conducted using electronic databases, reference lists of relevant reviews and included articles and personal collection of articles. The selection process based on the PRISMA statement yielded a total of 30 articles that met the eligibility criteria. Their findings were qualitatively synthesized using the structured approach, informed by the already known structure: situation awareness and its elements (gathering information, interpreting information, anticipating future states), decision making and its elements (generating and considering options, selecting and implementing an option, reviewing outcome/decision). Moreover, the element of maintaining standards also emerged as highly relevant for cognitive skills. Results This review found an increased research interest in the non-technical cognitive skills of EMS crew members. The majority of included articles’ research designs were qualitative, then mixed, Delphi, and quantitative. It revealed several specifics of cognitive skills, such as EMS crew members need to holistically assess a wide range of cues and information, to make various health- and safety-related decisions and take EMS standards into account. However, there was only a limited number of observable markers of cognitive skills, such as acts and verbalizations, that could be considered as examples of good behavior. In addition, findings indicate a lack of articles focused on mass-casualty incidents and the interconnection of cognitive skills with other non-technical and medical skills. Conclusion Further research is needed to get a more comprehensive view of behavioral markers of cognitive skills and to develop a rating and training tool to improve EMS crew members’ cognitive performance.
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Affiliation(s)
- Martin Sedlár
- Institute of Experimental Psychology, Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Dúbravská cesta 9, 841 04, Bratislava, Slovak Republic.
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18
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Reay G, Norris JM, Nowell L, Hayden KA, Yokom K, Lang ES, Lazarenko GC, Abraham J. Transition in Care from EMS Providers to Emergency Department Nurses: A Systematic Review. PREHOSP EMERG CARE 2020; 24:421-433. [PMID: 31210572 DOI: 10.1080/10903127.2019.1632999] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Transitions in care between emergency medical services (EMS) providers and emergency department (ED) nurses are critical to patient care and safety. However, interactions between EMS providers and ED nurses can be problematic with communication gaps and have not been extensively studied. The aim of this review was to examine (1) factors that influence transitions in care from EMS providers to ED nurses and (2) the effectiveness of interventional strategies to improve these transitions. Methods: We conducted a mixed-methods systematic review that included searches of electronic databases (DARE, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Joanna Briggs Institute EBP), gray literature databases, organization websites, querying experts in emergency medicine, and the reference lists cited in included studies. All English-language studies of any design were eligible for inclusion. Two reviewers independently screened titles/abstracts and full-texts for inclusion and methodological quality, as well as extracted data from included studies. We used narrative and thematic synthesis to integrate and explore relationships within the data. Results: In total, 8,348 studies were screened and 130 selected for full text review. The final synthesis included 20 studies. Across 15 studies of moderate-to-high methodological quality, 6 factors influenced transitions: different professional lenses, operational constraints, professional relationships, information shared between the professions, components of the transition process, and patient presentation and involvement. Three interventions were identified in 6 methodologically weak studies: (1) transition guideline (DeMIST, Identification, Mechanism/Medical complaint, Injuries/Information related to the complaint, Signs, Treatment and Trends - Allergies, Medication, Background history, Other information [IMIST-AMBO]) with training, (2) mobile web-based technology (EMS smartphone and geographic information system location data), and (3) a new clinical role (ED ambulance off-load nurse dedicated to triaging and assessing EMS patients). There were mixed findings for the effectiveness of transition guidelines and the new clinical role. Mobile technology was seen positively by both EMS providers and ED nurses as helpful for better describing the pre-hospital context and for planning flow in the ED. Conclusion: While multimedia applications may potentially improve the handoff process, future intervention studies need to be rigorously designed. We recommend interdisciplinary training of EMS and ED staff in the use of flexible structured protocols, especially given review findings that interdisciplinary communication and relationships can be challenging.
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Lindström V, Sturesson L, Carlborg A. Patients' experiences of the caring encounter with the psychiatric emergency response team in the emergency medical service-A qualitative interview study. Health Expect 2020; 23:442-449. [PMID: 31967699 PMCID: PMC7104631 DOI: 10.1111/hex.13024] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/22/2019] [Accepted: 12/17/2019] [Indexed: 11/29/2022] Open
Abstract
Background Mental illnesses are increasing in the population; consequently, the number of psychiatric emergencies handled by the emergency medical services (EMS) has also increased. Alternative response systems have been developed and evaluated, but there is still a lack of knowledge concerning the patients' experiences of being cared for in the EMS by a psychiatric emergency response unit (In Swedish: Psykiatrisk Akut Mobilitet [PAM]). Objective The aim of this study was to explore patients' experiences of the caring encounter with the PAM team. Design A qualitative study design with 14 patients' interviews and content analysis was used. Results The patients expressed that the PAM team created a safe environment and actively involved the patient in their care by creating an open and safe place for dialogue. In this safe environment, the patients described how they participated in the decision making and received care without fear of being dismissed, ignored or judged. Discussion and Conclusion The patients' experiences of being cared for by the PAM team show that person‐centred care was achieved by involving the patients in their own care. This participation was possible because mutual trust and confidence existed, and the patients acknowledged the specialist response unit to be a valuable part of the EMS. However, further studies are needed to explore whether the PAM as a response unit in the EMS decreases the risk of suicide and to examine different health economic aspects of using PAM in the EMS.
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Affiliation(s)
- Veronica Lindström
- Academic EMS, Stockholm, Sweden.,Department of Neurobiology, Karolinska Institutet, Care Sciences, and Society Division of Nursing Stockholm, Stockholm, Sweden
| | - Lars Sturesson
- Department of Neurobiology, Karolinska Institutet, Care Sciences, and Society Division of Nursing Stockholm, Stockholm, Sweden
| | - Andreas Carlborg
- Department of Clinical Neuroscience, Centre for psychiatric research, Karolinska Institutet, Stockholm, Sweden
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20
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Wireklint Sundström B, Bremer A, Lindström V, Vicente V. Caring science research in the ambulance services: an integrative systematic review. Scand J Caring Sci 2019; 33:3-33. [PMID: 30252151 PMCID: PMC7432173 DOI: 10.1111/scs.12607] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/04/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The ambulance services are associated with emergency medicine, traumatology and disaster medicine, which is also reflected in previous research. Caring science research is limited and, since no systematic reviews have yet been produced, its focus is unclear. This makes it difficult for researchers to identify current knowledge gaps and clinicians to implement research findings. AIM This integrative systematic review aims to describe caring science research content and scope in the ambulance services. DATA SOURCES Databases included were MEDLINE (PubMed), CINAHL, Web of Science, ProQDiss, LibrisDiss and The Cochrane Library. The electronic search strategy was carried out between March and April 2015. The review was conducted in line with the standards of the PRISMA statement, registration number: PROSPERO 2016:CRD42016034156. REVIEW METHODS The review process involved problem identification, literature search, data evaluation, data analysis and reporting. Thematic data analysis was undertaken using a five-stage method. Studies included were evaluated with methodological and/or theoretical rigour on a 3-level scale, and data relevance was evaluated on a 2-level scale. RESULTS After the screening process, a total of 78 studies were included. The majority of these were conducted in Sweden (n = 42), fourteen in the United States and eleven in the United Kingdom. The number of study participants varied, from a case study with one participant to a survey with 2420 participants, and 28 (36%) of the studies were directly related to patients. The findings were identified under the themes: Caregiving in unpredictable situations; Independent and shared decision-making; Public environment and patient safety; Life-changing situations; and Ethics and values. CONCLUSION Caring science research with an explicit patient perspective is limited. Areas of particular interest for future research are the impact of unpredictable encounters on openness and sensitivity in the professional-patient relation, with special focus on value conflicts in emergency situations.
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Affiliation(s)
- Birgitta Wireklint Sundström
- PreHospen – Centre for Prehospital ResearchUniversity of BoråsBoråsSweden
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Anders Bremer
- PreHospen – Centre for Prehospital ResearchUniversity of BoråsBoråsSweden
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
- Faculty of Health and Life SciencesLinnaeus UniversityVäxjöSweden
- Division of Emergency Medical ServicesKalmar County HospitalKalmarSweden
| | - Veronica Lindström
- Division of NursingDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
- Academic EMSStockholmSweden
| | - Veronica Vicente
- Academic EMSStockholmSweden
- The Ambulance Medical Service in Stockholm (AISAB)StockholmSweden
- Department of Clinical Science and EducationKarolinska InstitutetSödersjukhusetStockholmSweden
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