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Niyonsaba M, Nkeshimana M, Uwitonze JM, Davies J, Maine R, Nyinawankusi JD, Hunt M, Rickard R, Jayaraman S, Watt MH. Challenges and opportunities to improve efficiency and quality of prehospital emergency care using an mHealth platform: Qualitative study in Rwanda. Afr J Emerg Med 2023; 13:250-257. [PMID: 37767314 PMCID: PMC10520315 DOI: 10.1016/j.afjem.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Prompt, high-quality pre-hospital emergency medical services (EMS) can significantly reduce morbidity and mortality. The goal of this study was to identify factors that compromise efficiency and quality of pre-hospital emergency care in Rwanda, and explore the opportunities for a mobile health (mHealth) tool to address these challenges. Methods In-depth interviews were conducted with 21 individuals representing four stakeholder groups: EMS dispatch staff, ambulance staff, hospital staff, and policymakers. A semi-structured interview guide explored participants' perspectives on all aspects of the pre-hospital emergency care continuum, from receiving a call at dispatch to hospital handover. Participants were asked how the current system could be improved, and the potential utility of an mHealth tool to address existing challenges. Interviews were audio-recorded, and transcripts were thematically analyzed using NVivo. Results Stakeholders identified factors that compromise the efficiency and quality of care across the prehospital emergency care continuum: triage at dispatch, dispatching the ambulance, locating the emergency, coordinating patient care at scene, preparing the receiving hospital, and patient handover to the hospital. They identified four areas where an mHealth tool could improve care: efficient location of the emergency, streamline communication for decision making, documentation with real-time communication, and routine data for quality improvement. While stakeholders identified advantages of an mHealth tool, they also mentioned challenges that would need to be addressed, namely: limited internet bandwidth, capacity to maintain and update software, and risks of data security breaches that could lead to stolen or lost data. Conclusion Despite the success of Rwanda's EMS system, this study highlights factors across the care continuum that could compromise quality and efficiency of prehospital emergency care. Mobile health tools hold great promise to address these challenges, but contextual issues need to be considered to ensure sustainability of use.
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Affiliation(s)
| | - Menelas Nkeshimana
- University Teaching Hospital of Kigali (Centre Hospitalier Universitaire de Kigali), Rwanda
| | | | - Justine Davies
- University of Birmingham, Institute of Applied Health Research, United Kingdom
- Stellenbosch University, Centre for Global Surgery, Department of Global Health, South Africa
- University of the Witwatersrand, Faculty of Health Sciences, School of Public Health, South Africa
| | - Rebecca Maine
- University of Washington, Department of Surgery, United States
| | | | - McKenna Hunt
- University of Utah, Honors College, United States
| | - Rob Rickard
- Rwanda Build Program, Common World Inc., Rwanda
| | | | - Melissa H. Watt
- University of Utah, Department of Population Health Sciences, United States
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Babaei HA, Ferdosi M, Masoumi G, Rezaei F. A comparative study on specialized services in pre-hospital emergencies in Iran and selected countries. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:414. [PMID: 38333162 PMCID: PMC10852191 DOI: 10.4103/jehp.jehp_232_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/01/2023] [Indexed: 02/10/2024]
Abstract
The quality of emergency services is one of the indicators describing the health status of countries. Moreover, the specialization of services and targeted response to any accident or disease has been the priority of pre-hospital emergency operations in some leading countries. This study aimed to compare the special services provided in the emergency department of several selected countries. This was a comparative study that was done in Isfahan in 2022. Data were collected by reviewing the literature provided by libraries and emergency websites of selected countries. We selected countries based on the accessibility of information in two groups of developed countries and countries with the same income and population as Iran including Germany, France, The United States, Australia, Britain, Malaysia, and Turkey. Data were classified and compared based on staff, vehicles, and specialized services. Emergency staffs in most countries were of different skill and training levels. Ambulances varied in equipment types in various land, air, and sea forms and dimensions. Developed countries had more modern ambulances and equipment. France and Germany were operating more especially. Specialized teams are dispatched only in the United States and Germany. Existing studies have shown the adequacy and effectiveness of these teams in reducing complications and mortality and improving the prognosis of patients. The use of specialized teams appropriate to each emergency based on the specific and targeted response is effective in improving the prognosis of patients. The results of this study are suggested to beneficiaries to improve the quality of emergency care and reduce complications and potential causalities.
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Affiliation(s)
- Habib Allah Babaei
- Department of Health in Disasters and Emergencies, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Ferdosi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamraza Masoumi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rezaei
- Department of Health in Disasters and Emergencies, Health Management and Economics Research Centers, Isfahan University of Medical Sciences, Isfahan, Iran
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Karmelić E, Lindlöf H, Luckhaus JL, Castillo MM, Vicente V, Härenstam KP, Savage C. Decision-making on the fly: a qualitative study of physicians in out-of-hospital emergency medical services. BMC Emerg Med 2023; 23:65. [PMID: 37286931 DOI: 10.1186/s12873-023-00830-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/23/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Out-of-hospital Emergency Medical Services (OHEMS) require fast and accurate assessment of patients and efficient clinical judgment in the face of uncertainty and ambiguity. Guidelines and protocols can support staff in these situations, but there is significant variability in their use. Therefore, the aim of this study was to increase our understanding of physician decision-making in OHEMS, in particular, to characterize the types of decisions made and to explore potential facilitating and hindering factors. METHODS Qualitative interview study of 21 physicians in a large, publicly-owned and operated OHEMS in Croatia. Data was subjected to an inductive content analysis. RESULTS Physicians (mostly young, female, and early in their career), made three decisions (transport, treat, and if yes on either, how) after an initial patient assessment. Decisions were influenced by patient needs, but to a greater extent by factors related to themselves and patients (microsystem), their organization (mesosystem), and the larger health system (macrosystem). This generated a high variability in quality and outcomes. Participants desired support through further training, improved guidelines, formalized feedback, supportive management, and health system process redesign to better coordinate and align care across organizational boundaries. CONCLUSIONS The three decisions were made complex by contextual factors that largely lay outside physician control at the mesosystem level. However, physicians still took personal responsibility for concerns more suitably addressed at the organizational level. This negatively impacted care quality and staff well-being. If managers instead adopt a learning orientation, the path from novice to expert physician could be more ably supported through organizational demands and practices aligned with real-world practice. Questions remain on how managers can better support the learning needed to improve quality, safety, and physicians' journey from novice to expert.
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Affiliation(s)
- Ema Karmelić
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen, Stockholm, 18A 171 77, Sweden
| | - Henrik Lindlöf
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- The ambulance medical service of Region Västmanland, Västerås, Sweden
| | - Jamie Linnea Luckhaus
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen, Stockholm, 18A 171 77, Sweden
| | - Moa Malmqvist Castillo
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen, Stockholm, 18A 171 77, Sweden
| | - Veronica Vicente
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- The ambulance medical service in Stockholm (AISAB), Stockholm, Sweden
- Academic EMS, Stockholm, Sweden
| | - Karin Pukk Härenstam
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen, Stockholm, 18A 171 77, Sweden
- Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden
| | - Carl Savage
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen, Stockholm, 18A 171 77, Sweden.
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.
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Gage CH, Stander C, Gwyther L, Stassen W. Emergency medical services and palliative care: a scoping review. BMJ Open 2023; 13:e071116. [PMID: 36927584 PMCID: PMC10030966 DOI: 10.1136/bmjopen-2022-071116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to map existing emergency medical services (EMS) and palliative care literature by answering the question, what literature exists concerning EMS and palliative care? The sub-questions regarding this literature were, (1) what types of literature exist?, (2) what are the key findings? and (3) what knowledge gaps are present? DESIGN A scoping review of literature was performed with an a priori search strategy. DATA SOURCES MEDLINE via Pubmed, Web of Science, CINAHL, Embase via Scopus, PsycINFO, the University of Cape Town Thesis Repository and Google Scholar were searched. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Empirical, English studies involving human populations published between 1 January 2000 and 24 November 2022 concerning EMS and palliative care were included. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened titles, abstracts and full texts for inclusion. Extracted data underwent descriptive content analysis and were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. RESULTS In total, 10 725 articles were identified. Following title and abstract screening, 10 634 studies were excluded. A further 35 studies were excluded on full-text screening. The remaining 56 articles were included for review. Four predominant domains arose from included studies: (1) EMS' palliative care role, (2) challenges faced by EMS in palliative situations, (3) EMS and palliative care integration benefits and (4) proposed recommendations for EMS and palliative care integration. CONCLUSION EMS have a role to play in out-of-hospital palliative care, however, many challenges must be overcome. EMS provider education, collaboration between EMS and palliative systems, creation of EMS palliative care guidelines/protocols, creation of specialised out-of-hospital palliative care teams and further research have been recommended as solutions. Future research should focus on the prioritisation, implementation and effectiveness of these solutions in various contexts.
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Affiliation(s)
- Caleb Hanson Gage
- Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Charnelle Stander
- Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Liz Gwyther
- Division of Interdisciplinary Palliative Care and Medicine, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Willem Stassen
- Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
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Juhrmann ML, Grindrod AE, Gage CH. Emergency medical services: the next linking asset for public health approaches to palliative care? Palliat Care Soc Pract 2023; 17:26323524231163195. [PMID: 37063113 PMCID: PMC10102939 DOI: 10.1177/26323524231163195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/20/2023] [Indexed: 04/18/2023] Open
Abstract
Emergency medical services (EMS) are a unique workforce providing 24/7 emergency care across high-income countries (HICs) and low- and middle-income countries (LMICs). Although traditionally perceived as first responders to traumatic and medical emergencies, EMS scope of practice has evolved to respond to the changing needs of communities, including a growing demand for community-based palliative care. Public health provides a useful framework to conceptualise palliative and end-of-life care in community-based settings. However, countries lack public policy frameworks recognising the role EMS can play in initiating palliative approaches in the community, facilitating goals of care at end of life and transporting patients to preferred care settings. This article aims to explore the potential role of EMS in a public health palliative care approach in a critical discussion essay format by (1) discussing the utility of EMS within a public health palliative care approach, (2) identifying the current barriers preventing public health approaches to EMS palliative care provision and (3) outlining a way forward through priorities for future research, policy, education and practice. EMS facilitate equitable access, early provision, expert care and efficacious integration of community-based palliative care. However, numerous structural, cultural and practice barriers exist, appearing ubiquitous across both HICs and LMICs. A Public Health Palliative Care approach to EMS Framework highlights the opportunity for EMS to work as a linking asset to build capacity and capability to support palliative care in place; connect patients to health and community supports; integrate alternative pathways by engaging multidisciplinary teams of care; and reduce avoidable hospital admissions by facilitating home-based deaths. This article articulates a public health approach to EMS palliative and end-of-life care provision and offers a preliminary framework to illustrate the components of a potential implementation and policy strategy.
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Affiliation(s)
| | - Andrea E. Grindrod
- Public Health Palliative Care Unit, School of
Psychology and Public Health, La Trobe University, Melbourne, VIC,
Australia
| | - Caleb H. Gage
- Division of Emergency Medicine, University of
Cape Town, Cape Town, South Africa
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Goodrich J, Tutt L, Firth AM, Evans CJ, Murtagh FE, Harding R. The most important components of out-of-hours community care for patients at the end of life: A Delphi study of healthcare professionals' and patient and family carers' perspectives. Palliat Med 2022; 36:1296-1304. [PMID: 35766525 PMCID: PMC9446430 DOI: 10.1177/02692163221106284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Community services for palliative patients outside normal working hours are variable and the best evidence-based models of care have not been determined. AIM To establish expert consensus on the most important components of out-of-hours community palliative care services. DESIGN Delphi study. The first round listed 68 components generated from systematic literature reviewing, focus groups with healthcare professionals and input from the project's patient and public involvement advisory group. The components deemed 'essential' by over 70% of participants in the first round were refined and carried forward to a second round, asking participants to rank each on a five-point Likert scale (5 highest to 1 lowest). The consensus threshold was median of 4 to 5 and interquartile range of ⩽1. PARTICIPANTS Community specialist palliative care health professionals, generalist community health professionals and patients and family carers with experience of receiving care out-of-hours at home. RESULTS Fifty-four participants completed round 1, and 44 round 2. Forty-five components met the threshold as most important for providing out-of-hours care, with highest consensus for: prescription, delivery and administration of medicines; district and community nurse visits; and shared electronic patient records and advance care plans. CONCLUSIONS The Delphi method identified the most important components to provide community palliative care for patients out-of-hours, which are often provided by non-specialist palliative care professionals. The importance placed on the integration and co-ordination with specialist palliative care through shared electronic records and advance care plans demonstrates the reassurance for patients and families of being known to out-of-hours services.
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Affiliation(s)
- Joanna Goodrich
- Florence Nightingale Faculty of Nursing Midwifery a Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Lydia Tutt
- Florence Nightingale Faculty of Nursing Midwifery a Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Alice M Firth
- Florence Nightingale Faculty of Nursing Midwifery a Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Catherine J Evans
- Florence Nightingale Faculty of Nursing Midwifery a Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Fliss Em Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Richard Harding
- Florence Nightingale Faculty of Nursing Midwifery a Palliative Care, Cicely Saunders Institute, King's College London, London, UK
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Bowers B, Pollock K, Barclay S. Unwelcome memento mori or best clinical practice? Community end of life anticipatory medication prescribing practice: A mixed methods observational study. Palliat Med 2022; 36:95-104. [PMID: 34493122 PMCID: PMC8796157 DOI: 10.1177/02692163211043382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Anticipatory medications are injectable drugs prescribed ahead of possible need for administration if distressing symptoms arise in the final days of life. Little is known about how they are prescribed in primary care. AIM To investigate the frequency, timing and recorded circumstances of anticipatory medications prescribing for patients living at home and in residential care. DESIGN Retrospective mixed methods observational study using General Practitioner and community nursing clinical records. SETTING/PARTICIPANTS 329 deceased adult patients registered with Eleven General Practitioner practices and two associated community nursing services in two English counties (30 most recent deaths per practice). Patients died from any cause except trauma, sudden death or suicide, between 4 March 2017 and 25 September 2019. RESULTS Anticipatory medications were prescribed for 167/329 (50.8%) of the deceased patients, between 0 and 1212 days before death (median 17 days). The likelihood of prescribing was significantly higher for patients with a recorded preferred place of death (odds ratio [OR] 34; 95% CI 15-77; p < 0.001) and specialist palliative care involvement (OR 7; 95% CI 3-19; p < 0.001). For 66.5% of patients (111/167) anticipatory medications were recorded as being prescribed as part of a single end-of-life planning intervention. CONCLUSION The variability in the timing of prescriptions highlights the challenges in diagnosing the end-of-life phase and the potential risks of prescribing far in advance of possible need. Patient and family views and experiences of anticipatory medication care, and their preferences for involvement in prescribing decision-making, warrant urgent investigation.
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Affiliation(s)
- Ben Bowers
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kristian Pollock
- Nottingham Centre for the Advancement of Research into Supportive, Palliative and End of Life Care, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Stephen Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Azizi M, Ebadi A, Ostadtaghizadeh A, Dehghani Tafti A, Roudini J, Barati M, Khankeh HR, Bidaki R. Psychological Distress Model Among Iranian Pre-Hospital Personnel in Disasters: A Grounded Theory Study. Front Psychol 2021; 12:689226. [PMID: 34858247 PMCID: PMC8631713 DOI: 10.3389/fpsyg.2021.689226] [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: 03/31/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents and mental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective. Methods: A grounded theory methodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020. Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approach Conclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.
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Affiliation(s)
- Maryam Azizi
- Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran.,School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ostadtaghizadeh
- Department of Disaster and Emergency Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Dehghani Tafti
- School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Juliet Roudini
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Leipzig, Leipzig, Germany
| | - Mohammad Barati
- Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Khankeh
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Reza Bidaki
- Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Parvaresh-Masoud M, Cheraghi MA, Imanipour* M. Workplace interpersonal conflict in prehospital emergency: Concept analysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:347. [PMID: 34761033 PMCID: PMC8552288 DOI: 10.4103/jehp.jehp_213_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/15/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND In the turbulent and stressful work environment of prehospital emergencies, the conflict among emergency medical technicians (EMT) and other health-care providers is inevitable. This study aims to examine the concept of workplace interpersonal conflict (WIC) in prehospital emergencies. MATERIALS AND METHODS The eight-step Walker and Avant's concept analysis approach was adopted to define the concept. Iranmedex, SID, Magiran, ISC, PubMed, Scopus, Embase, and Web of Science searched with keywords such as WIC and hospital emergencies. After an extensive review of online national and international databases, one dictionary, nine books, and 25 articles in English and Persian were retrieved for the purposes of the study. RESULTS The antecedents, attributes, and consequences of the concept identified. EMT must learn how to eliminate their destructive effects while enhancing constructive effects. CONCLUSION Conflict is an inevitable part of life, and EMT must learn how to reduce their destructive effects while increasing constructive results.
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Affiliation(s)
- Mohammad Parvaresh-Masoud
- Department of Critical Care and Nursing Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Cheraghi
- Department of Critical Care and Nursing Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Imanipour*
- Department of Critical Care and Nursing Management, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abate H, Mekonnen C. Knowledge, Practice, and Associated Factors of Nurses in Pre-Hospital Emergency Care at a Tertiary Care Teaching Hospital. Open Access Emerg Med 2020; 12:459-469. [PMID: 33408536 PMCID: PMC7781023 DOI: 10.2147/oaem.s290074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Pre-hospital emergency care is a medical care given to patients before arrival in the hospital after activation of the emergency team. Poor knowledge and practice about pre-hospital emergency care hurt the health outcomes of the patients. OBJECTIVE This study aimed to assess knowledge and practice nurses at the University of Gondar Compressive Specialized Hospital, Northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted from March 20 to April 10, 2020. A stratified sampling technique was used to select the study participants. Data were collected using a pretested structured self-administered questionnaire. Data were analyzed using SPSS version 20. To explain study variables, frequency tables and percentages were used. Logistic regression analysis was used to see the association between independent and dependent variables. RESULTS Out of the total 378 respondents, less than half (42.9%) had good knowledge; similarly, 49.5% of them had good practice about pre-hospital emergency care. Male sex and attend formal training were significant associations with both knowledge and practice of pre-hospital emergency nursing care. Male participants (adjusted odds ratio (AOR) = 6.57, 95% confidence interval (CI) (3.79-11.36)) and having training (AOR=1.74, 95% CI (1.83-3.66)) were significantly associated with knowledge of pre-hospital emergency care, whereas male sex (AOR=1.73, 95% CI (1.09-2.73)) and having training (AOR=6.16, 95% CI (2.69-14.10)) were significantly associated with the practice of pre-hospital emergency care. CONCLUSION Knowledge and practice of nurses regarding pre-hospital emergency care was found to be inadequate as compared to previous studies. Male sex and attend formal training showed a positive and significant association with both knowledge and practice of pre-hospital emergency nursing care. The responsible body ought to allow professional development and attending formal training for nurses.
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Affiliation(s)
- Hailemichael Abate
- Department of Medical Nursing, College of Health Science, Gondar, Ethiopia
| | - Chilot Mekonnen
- Department of Medical Nursing, College of Health Science, Gondar, Ethiopia
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