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McGuire SS, Lampman MA, Smith OA, Clements CM. Impact of Workplace Violence Against Emergency Medical Services (EMS). PREHOSP EMERG CARE 2024:1-9. [PMID: 39042823 DOI: 10.1080/10903127.2024.2381218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/21/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVES The objectives of this study were to: (1) understand the personal impact of workplace violence (WPV) on staff within a large multistate emergency medical services (EMS) agency, (2) describe the impact of WPV on subsequent patient interactions, examining how experiences of violence affect the quality of care provided by EMS clinicians, (3) examine the influence of WPV on perceived workplace safety among prehospital personnel and its correlation with retention in the EMS field, and (4) solicit recommendations from staff for the prevention and mitigation of WPV in the future. METHODS We conducted virtual focus groups and individual interviews with 22 prehospital personnel using a descriptive qualitative design within a large multistate Midwest EMS agency between 4/5/2023-6/20/2023. Data were analyzed using Thematic Analysis to identify common perceptions among and across participants. RESULTS Major themes of personal impact; impact on patient interactions; influence of WPV on career longevity/sustainability; and relationship between EMS culture and WPV were identified. Overall, participants shared the perception that WPV is "part of the job", and that verbal abuse was so common that they hadn't previously considered it as violence. Participants provided several examples of WPV and described how these experiences impacted them personally (e.g., hypervigilance) and impacted their subsequent interaction with patients (e.g., quicker to use restraints, loss of empathy). Participants shared the perception that EMS is no longer valued or respected by patients or communities. Several voiced concerns for the next generation of colleagues and nearly all participants reported the need for education and training in situational awareness, de-escalation, and self-defense tactics. Participants referenced desire for more coordination and communication with law enforcement, change in culture of abuse from patients without repercussions, and improved agency mental health support and peer support/mentoring following a violent event. Despite experiences with WPV, the majority reported plans to remain in EMS. CONCLUSIONS Emergency Medical Services personnel are commonly traumatized by violence in their work and nonphysical violence is underappreciated. Despite its impact on staff and subsequent patient interactions, most participants reported plans to remain within EMS. Multi-faceted system-focused efforts are needed to shift toward and support a zero-tolerance culture for WPV.
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Affiliation(s)
- Sarayna S McGuire
- Division of Prehospital Medicine, Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michelle A Lampman
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Olivia A Smith
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Casey M Clements
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
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Zhang Z, Li Y, Wang S, Wang J, Huang Y, Wang X, Guo H, Zhou J. Exploring the Impact of Workplace Violence on the Mental Health of Chinese Correctional Officers: A JD-R Model Approach. Psychol Res Behav Manag 2024; 17:2865-2874. [PMID: 39104767 PMCID: PMC11298411 DOI: 10.2147/prbm.s468370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024] Open
Abstract
Background Correctional officers face widespread workplace violence and the resulting overwork that can profoundly damage their physical and mental health. Purpose This study aims to investigate the mediating role of overwork in the relationship between workplace violence and the manifestation of physical and mental health issues among correctional officers. Methods This study enlisted 472 eligible participants. Cross-sectional data were obtained using the Chinese version of the Workplace Violence Scale (WVS), while the physical and mental health of correctional officers was evaluated through relevant scales. Analysis involved descriptive statistics, correlation analyses, and tests for mediation models. Results The study found significant correlations between workplace violence, overwork, and various mental health variables (depression, anxiety, stress, suicidal ideation, and insomnia), with correlations ranging from 0.135 to 0.822 (p < 0.01). Mediation analysis revealed that workplace violence directly impacts correctional officers' physical and mental health (p < 0.001) and also has an indirect effect through overwork (p < 0.023). These findings underscore the substantial impact of workplace violence on the health of correctional officers, both directly and indirectly. Conclusion Workplace violence and overwork significantly contribute to the physical and mental health challenges faced by correctional officers. Overwork acts as a mediator in the relationship between workplace violence and these health issues. The study suggests addressing workplace violence and mental health issues among correctional officers by increasing their numbers, improving the work environment, and implementing enhanced welfare policies.
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Affiliation(s)
- Zheng Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
| | - Yan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
| | - Siyuan Wang
- Pingtang Compulsory Isolation Detoxification Institute in Hunan Province, Changsha, People’s Republic of China
| | - Jizhi Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
| | - Ying Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
| | - Huijuan Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
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Abdo M, Schlösser A. A systematic review of post-traumatic growth in ambulance personnel: facilitators and prevalence rates. Br Paramed J 2024; 9:34-46. [PMID: 38946734 PMCID: PMC11210585 DOI: 10.29045/14784726.2024.6.9.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Introduction Ambulance personnel are exposed to traumatic and stressful situations, which can increase the risk of mental health conditions, such as post-traumatic stress disorder (PTSD). High rates of PTSD have been found in ambulance personnel (Petrie et al., 2018), but no review is available to examine post-traumatic growth (PTG - positive psychological change following a trauma) in this population. This literature review provides an overview of the prevalence rates and facilitators that may contribute to PTG in ambulance personnel. Methods A systematic search was conducted on EBSCOhost in January 2024 across the following six databases: Academic Search Ultimate, PsycINFO, PsycARTICLES, MEDLINE, ERIC and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ultimate. Results Eleven papers were identified for this review. Pooled prevalence of PTG was moderate (52%), and facilitators for PTG were grouped into five categories: coping style/strategies, resilience, personality traits, gender and incident characteristics. Conclusions Numerous facilitators contributed to the development of PTG, although these did not arise in all papers. The quality of research ranged from satisfactory to excellent. Evidence suggested that adaptive coping style, high levels of resilience, the absence of a personality trait (neuroticism) and being female may facilitate PTG. Further research is needed to support the reliability of findings.
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Affiliation(s)
- Molly Abdo
- Humber Teaching NHS Foundation Trust ORCID iD: https://orcid.org/0009-0004-7662-9363
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Kamaja V, Nordquist H. The recovery processes among paramedics who encountered violence during work-a narrative interview study. J Occup Med Toxicol 2024; 19:17. [PMID: 38750485 PMCID: PMC11097420 DOI: 10.1186/s12995-024-00417-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Almost all paramedics encounter workplace violence (WPV) during their careers. The most common form of WPV is verbal, and the perpetrator is usually the patient. It is known that paramedics suffer from post-traumatic stress disorder and other mental health problems, and WPV is one of the reasons behind that. Nevertheless, little is known about the recovery processes paramedics have had after encountering WPV. The research question was: What kind of recovery processes have paramedics had after encountering WPV? METHODS A qualitative, narrative interview study was done. Data was collected in individual interviews with Finnish paramedics (n = 18). Paramedics were from different parts of Finland, and their ages varied from 24 to 49 years. They had been working in EMS for an average of 10.5 years (range 1.5 to 25 years). Interviews were conducted with a narrative approach, which enabled paramedics to narrate their experiences and speak on their own terms about the subject to the extent of their choosing. The data was analyzed using thematic analysis. RESULTS Ten recovery process themes were identified: Strong psychological and physical reactions in a short time frame, Questioning one's profession and actions, Various support structures aided in recovery, Dysfunctional processes hindered recovery, Personal resources provided support, The support of the workcommunity as a lifeline, Left to cope alone, Permanent changes to work routines, Resulting in professional growth and Eternal crack in the shell. CONCLUSIONS Many internal and external factors affect paramedics' recovery processes. While some receive adequate help, others struggle to get appropriate support, especially from their organization and supervisors. The findings of this study suggest that clear protocols should be established to help paramedics recover after encountering WPV and that an individual aspect should be kept in mind, as not everybody reacts in the same way.
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Affiliation(s)
- Veera Kamaja
- Jokilaakson Terveys Oy, Sairaalantie 11, Jämsä, 42100, Finland
| | - Hilla Nordquist
- Department of Healthcare and Emergency Care, South-Eastern Finland University of Applied Sciences, Pääskysentie 1, Kotka, 48220, Finland.
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Mausz J, Piquette D, Bradford R, Johnston M, Batt AM, Donnelly EA. Hazard Flagging as a Risk Mitigation Strategy for Violence against Emergency Medical Services. Healthcare (Basel) 2024; 12:909. [PMID: 38727466 PMCID: PMC11083417 DOI: 10.3390/healthcare12090909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags-applied either to the individual, their residential address, or phone number-can alert paramedics to the possibility of violence, potentially reducing the risk of injury. Leveraging a novel violence reporting process embedded in the electronic patient care record, we reviewed violence reports filed over a thirteen-month period since its inception in February 2021 to assess the effectiveness of hazard flagging as a potential risk mitigation strategy. Upon reviewing a report, paramedic supervisors can generate a hazard flag if recurrent violent behavior from the patient is anticipated. In all, 502 violence reports were filed, for which paramedic supervisors generated hazard flags in 20% of cases (n = 99). In general, cases were not flagged either because the incident occurred at a location not amenable to flagging or because the supervisors felt that a hazard flag was not warranted based on the details in the report. Hazard flagging was associated with an increased risk of violence during subsequent paramedic attendance (Odds Ratio [OR] 6.21, p < 0.001). Nevertheless, the process appears to reliably identify persons who may be violent towards paramedics.
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Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (D.P.); (M.J.)
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Dan Piquette
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (D.P.); (M.J.)
| | - Robert Bradford
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5C1, Canada;
| | - Mandy Johnston
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (D.P.); (M.J.)
| | - Alan M. Batt
- Faculty of Health Sciences, Queen’s University, 99 University Avenue, Kingston, ON K7L 3N6, Canada;
- Department of Paramedicine, Monash University, Building H, Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Elizabeth A. Donnelly
- School of Social Work, University of Windsor, 167 Ferry Street, Room 213, Windsor, ON N9A 0C5, Canada;
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Mausz J, D’Eath J, Jackson NA, Johnston M, Batt AM, Donnelly EA. Sexist, Racist, and Homophobic Violence against Paramedics in a Single Canadian Site. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:505. [PMID: 38673416 PMCID: PMC11050378 DOI: 10.3390/ijerph21040505] [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: 01/23/2024] [Revised: 03/12/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between 1 February 2021 and 28 February 2022, two paramedic supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high inter-rater agreement across the dimensions (k = 0.73-0.83), and after resolving discrepant cases, we found that one in four violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience over the course of their work and its potential for psychological harm.
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Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Joel D’Eath
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
| | - Nicholas A. Jackson
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
| | - Mandy Johnston
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
| | - Alan M. Batt
- Faculty of Health Sciences, Queen’s University, 99 University Avenue, Kingston, ON K7L 3N6, Canada;
- Department of Paramedicine, Monash University, Peninsula Campus, Building H, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Elizabeth A. Donnelly
- School of Social Work, University of Windsor, 167 Ferry Street, Room 213, Windsor, ON N9A 0C5, Canada;
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Shah KA, Ng CKC. Workplace violence in medical radiation science: A systematic review. Radiography (Lond) 2024; 30:440-447. [PMID: 38199160 DOI: 10.1016/j.radi.2023.12.018] [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: 08/18/2023] [Revised: 12/07/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION According to World Health Organization (WHO), workplace violence (WPV) is a significant issue in healthcare. However, no systematic review on WPV in medical radiation science (MRS) has been published yet. The purpose of this paper is to systematically review prevalence of WPV in MRS and its risk factors. METHODS Electronic scholarly publication databases, namely EBSCOhost/Cumulative Index of Nursing and Allied Health Literature Ultimate, PubMed/Medline, ScienceDirect, Scopus, and Wiley Online Library were used for literature search to identify articles about WPV in MRS published over last 10 years as per preferred reporting items for systematic reviews and meta-analyses guidelines. To facilitate comparisons of the WPV prevalence and relative importance of individual risk factors across the included studies, their reported absolute figures of findings were used to synthesize respective percentages (if not stated). RESULTS Twelve papers met the selection criteria and were included. This review shows that the WPV prevalence were 69.2-100 % (whole career) and 46.1-83.0 % (last 12 months) in diagnostic radiography, 63.0-84.0 % (whole career) in radiation therapy, 57.6 % in medical sonography (last 12 months), and 46.8 % (last 6 months) in nuclear medicine. The identified WPV risk factors included intoxicated patients, staff stress, feeling of inadequacy resulting in self-protection, more vulnerable practitioners (female, <40 years old and <5-year experience), working in radiation therapy treatment room, emergency department, examination room, general radiography, public hospital, and non-examination and waiting areas, long patient waiting time, night shift, overcrowding environment, unable to meet patients'/family members' expectations, miscommunication, patient handling, inadequate staff and security measures, interaction with colleagues, and lone working. CONCLUSION The WPV risk in diagnostic radiography and radiation therapy appears extremely high as a result of the aforementioned risk factors. Nevertheless, these study findings should be used with caution due to potential non-response bias. IMPLICATIONS FOR PRACTICE A WPV policy should be developed in every clinical workplace. Even if such policy is available, its enforcement including policy awareness boosting, and encouraging incident reporting and support seeking will be essential for reducing WPV. More survey studies based on WHO WPV questionnaire should be conducted for strengthening evidence base.
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Affiliation(s)
- K A Shah
- Curtin Medical School, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - C K C Ng
- Curtin Medical School, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia; Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
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Jones R, Jackson D, Usher K. First responder mental health, traumatic events and rural and remote experience. J Adv Nurs 2024; 80:835-837. [PMID: 37675883 DOI: 10.1111/jan.15856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/20/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Rikki Jones
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Debra Jackson
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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Thomas B, Jacob A, McCann D, Buykx P, Schultz R, Kinsman L, O’Meara P, Edvardsson K, Spelten E. Analysis of Violent Incidents at Five Regional and Remote Australian Emergency Departments: A Retrospective Descriptive Study. SAGE Open Nurs 2024; 10:23779608241261597. [PMID: 39049851 PMCID: PMC11268014 DOI: 10.1177/23779608241261597] [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: 09/18/2023] [Revised: 03/25/2024] [Accepted: 05/08/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction Workplace violence is endemic, destructive, and escalating in frequency and severity in healthcare. There is a paucity of research on workplace violence in regional and remote hospital emergency departments (EDs). Objective The aim of this study was to identify the perpetrator and situational characteristics associated with violent incidents in the ED across five regional and remote Australian sites. Method This study audited hospital summary data, incident reports, and medical records for a 12-month period in 2018 to examine the perpetrator and situational characteristics of workplace violence incidents in five regional and remote Australian EDs. Results Violent incidents were evenly spread throughout the week and across shifts. Most incidents were triaged as urgent, occurred within the first 4 hr, and had multidisciplinary involvement. Almost one in every six incidents resulted in an injury. Perpetrators of violence were predominantly young and middle-aged males and almost always patients, with most presenting with mental and behavioral disorders, or psychoactive substance use. Conclusions Understanding the characteristics of perpetrators of violence can help in seeking to tailor interventions to reduce further violent behaviors. These findings carry implications for optimizing patient care, staff safety and resource management.
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Affiliation(s)
- Brodie Thomas
- La Trobe Rural Health School, La Trobe University, Mildura, Australia
| | - Alycia Jacob
- La Trobe Rural Health School, La Trobe University, Mildura, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia
| | - Damhnat McCann
- School of Nursing, University of Tasmania, Launceston, Australia
| | - Penny Buykx
- School of Humanities, Creative Industries and Social Sciences, The University of Newcastle, Callaghan, Australia
| | | | - Leigh Kinsman
- Mid North Coast Local Health District, Port Macquarie, Australia
- Violet Vines Marshman Centre for Rural Health Research, La Trobe University, Australia
| | - Peter O’Meara
- Department of Paramedicine, Monash University, Frankston, Australia
| | | | - Evelien Spelten
- La Trobe Rural Health School, La Trobe University, Mildura, Australia
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Khoza TL, Sibiya MN, Mshunqane N. Factors Predisposing Emergency Medical Technicians to Workplace Violence: A Cross Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241233452. [PMID: 38491932 PMCID: PMC10944587 DOI: 10.1177/00469580241233452] [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: 06/29/2022] [Revised: 12/04/2023] [Accepted: 01/31/2024] [Indexed: 03/18/2024]
Abstract
Emergency medical technicians (EMT) are at high risk of workplace violence as they often care for patients in uncontrolled and often hostile emergency settings. Gauteng Province, the most populous province in South Africa, caters for 75% of the total population which is dependant on state funded health care. Public sector EMTs' have been robbed with aggravated circumstances, assaulted with intent to do grievous bodily harm, raped and even murdered whilst on duty. Despite this, comprehensive studies investigating the factors that predispose public sector EMTs' to workplace violence in Gauteng Province are lacking. Thus, the aim of this study was to investigate the factors that predispose public service EMTs' to workplace violence in Gauteng Province. Data were collected using questionnaires. A total of 413 questionnaires were returned by community members of Gauteng who met the inclusion criteria. Descriptive statistics and binomial tests were used to analyze data. The results of this study revealed that workplace violence toward public service EMTs' in Gauteng is attributed to the high rates of crime, the widening gap of inequality, economic deprivation of basic rights to previously disadvantaged communities by government, vulnerability of EMTs' when responding to the ill and injured within low- and middle-income communities and a lack of consequence for disorderly behavior within the communities. An understanding of the community factors that predispose EMTs' to workplace violence may improve the understanding of the phenomenon of workplace violence and developing prevention programs within the communities.
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Campos ICM, Souza MS, Alves M. Violence in the daily work of healthcare professionals in an emergency care unit. Rev Gaucha Enferm 2023; 44:e20230001. [PMID: 37971106 DOI: 10.1590/1983-1447.2023.20230001.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/25/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To analyze the daily work of an Emergency Care Unit (ECU), with emphasis on the violence experienced by the multiprofessional healthcare team. METHOD Case study with a qualitative approach, conducted in na ECU in Minas Gerais, Brazil. The collection took place between August 2020 and January 2021, through observations, interviews and document review. Data were organized in MAXQDA 2020® and subjected to Content Analysis, based on Michel de Certeau's theoretical framework of everyday life. RESULTS A total of 31 healthcare professionals participated. Violence against professionals was associated with the waiting time, the lack of beds for transfer and the restrictionson the entry of companions. The main aggressions were verbal, followed by physical aggression. FINAL CONSIDERATIONS The daily life of the ECU was permeated by labor violence. Although it was governed by strategies aimed at organizing the assistance provided, professionals adopted tactics to cope with the adversity.
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Affiliation(s)
- Isabella Cristina Moraes Campos
- Instituto Federal Sudeste de Minas Gerais (IF Sudeste MG), Campus São João del-Rei. Núcleo de Ambiente, Saúde e Segurança. São João del-Rei, Minas Gerais, Brasil
| | - Moema Santos Souza
- Universidade Estadual de Minas Gerais (UEMG). Departamento de Enfermagem. Passos, Minas Gerais, Brasil
| | - Marília Alves
- Universidade Federal de Minas Gerais (UFMG). Escola de Enfermagem. Departamento de Enfermagem Aplicada. Belo Horizonte, Minas Gerais, Brasil
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Ipek M, Özlük B. Patients' opinion on violence against healthcare workers and their level of satisfaction in emergency department in Turkey: A cross-sectional study. Int Emerg Nurs 2023; 71:101350. [PMID: 37708667 DOI: 10.1016/j.ienj.2023.101350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/07/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Violence, with an increasing rate of cases in the health care system which adversely affects the quality of provision of services, has become a social health issue that also has negative impacts both on healthcare workers and patients. This study was conducted to determine the opinion of patients, who had been admitted to the emergency department, towards violence against healthcare workers, and their level of satisfaction with health services. METHODS The study employed a cross-sectional design and was conducted with 348 patients who had received healthcare services in the adult emergency department in Turkey. The Emergency Department Patient Satisfaction Survey and An eight-item questionnaire prepared by the researchers consisting of the patient's characteristics and their statements on violence were used to collect the data. RESULTS Among the patients, 26.7% stated that they had been violent toward healthcare workers. It was determined that 91.4% of the cases were verbal and 8.6% were physical. Among the patients, 82.2% had not known about the legal sanctions for violence against healthcare workers. The low level of propensity for violence in patients who were satisfied with the emergency department service was statistically significant (p < 0.05). CONCLUSIONS As a result of the study, it was found that one in four patients had been violent to healthcare workers, and the vast majority had a lack of information about legal sanctions. Policymakers should take deterrent measures to prevent the occurrence of violence and develop more critical sanctions.
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Affiliation(s)
- Muhammet Ipek
- Emergency Unit Nurse, Konya Numune Hospital, Konya, Turkey
| | - Bilgen Özlük
- Necmettin Erbakan University, Faculty of Nursing, Department of Nursing Management, Konya, Turkey.
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Persaud E, Parker GB, Mitchell AH. Blood and Body Fluid Exposure Among Healthcare Workers and Personal Protective Equipment Usage in the United States. Workplace Health Saf 2023; 71:429-435. [PMID: 37232173 DOI: 10.1177/21650799231163132] [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] [Indexed: 05/27/2023]
Abstract
BACKGROUND The International Safety Center disseminates the Exposure Prevention Information Network (EPINet) surveillance system to standardize a system for healthcare facilities to track mucocutaneous blood and body fluid exposures. METHODS Occupational exposure incidents to blood and body fluids were recorded within the participant health systems and hospitals (N = 41), using the EPINet Blood and Body Fluid Exposure Report Form. Forms include detailed questions about the circumstances surrounding the exposure, including the type of exposure, body part(s) involved, and if the employee reporting the incident was wearing personal protective equipment (PPE). RESULTS There were statistically significant differences between participants who wore PPE at time of exposure versus those who did not. Differences were noted by job category (χ2 =32.91, p-value = <.001); where the exposure occurred (χ2 = 32.31, p-value = <.001); what the exposure was a result of (χ2 = 50.19, p-value = <.001); and day versus night shift (χ2 = 11.47, p-value = .001). CONCLUSION/APPLICATIONS TO PRACTICE The study found that occupational exposure to blood and body fluids in 2021 remain high risk given the frequency with which they happen, the exposure site (face) and lack of PPE use. The pandemic seemed to matter little in changing frequencies despite high awareness and growing PPE availability and supply. The findings provide robust information about how exposures occur, why they remain high risk, and how important it is to improve reporting and surveillance to prevent occupational exposures and disease in healthcare in future.
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Taylor J, Murray R, Binzer M, Robert Borse C, Davis A, Gallogly V, Ghanbari R, Diane McKinsey L, Chief David Picone B, Gary Wingrove P. EMERG-ing data: Multi-city surveillance of workplace violence against EMS responders. JOURNAL OF SAFETY RESEARCH 2023; 86:62-79. [PMID: 37718071 PMCID: PMC10621673 DOI: 10.1016/j.jsr.2023.06.008] [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: 11/14/2022] [Revised: 05/22/2023] [Accepted: 06/13/2023] [Indexed: 09/19/2023]
Abstract
PROBLEM Between 1980 and 2021, emergency medical services (EMS) calls experienced a 421% increase, while calls for fires declined by 55%. The more exposure, the more the opportunity for workplace violence (WPV). Due to the non- existence of a reporting system that captures physical and verbal violence, it has been difficult to quantify the degree of WPV experienced by the U.S. fire and rescue service. METHODS To describe WPV in three large metropolitan fire departments, an existing data system was modified. The EMERG platform was selected because it is one of the most confidential data systems available to collect exposures. RESULTS In a one-year pilot of EMERG, 126 events were reported. Verbal violence was present in 81% of all reports, with physical violence only at 19%. Patients were the most frequently reported assailant (73%).The most frequently reported injury was emotional stress (70%). Six percent of all injuries reported moderate-to-major physical injury severity, and 30% reported moderate-to-major mental injury severity. DISCUSSION Verbal violence as a contributor to first responder stress is often underestimated. This pilot shows that it can and should be captured. That mental injury severity was consistently rated higher than physical injury severity across all injuries is not surprising given the prevalence of verbal violence reported and because physical violence has emotional sequela. SUMMARY Data from the EMERG reporting system give us evidence, on a larger scale than has ever existed for the fire and rescue service, that verbal and physical violence, and the resultant emotional stress and mental injury severity, is an issue that needs further attention and resources. PRACTICAL APPLICATIONS In order to ensure robust surveillance, it remains likely that triangulation of multiple data sources will still be required to approximate the true burden.
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Affiliation(s)
- Jennifer Taylor
- Dornsife School of Public Health at Drexel University, United States.
| | - Regan Murray
- University of Arkansas Fayetteville, United States
| | | | | | - Andrea Davis
- Dornsife School of Public Health at Drexel University, United States
| | - Victoria Gallogly
- Dornsife School of Public Health at Drexel University, United States
| | - Rozhan Ghanbari
- Dornsife School of Public Health at Drexel University, United States; California Department of Public Health
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Mausz J, Johnston M, Arseneau-Bruneau D, Batt AM, Donnelly EA. Prevalence and Characteristics of Violence against Paramedics in a Single Canadian Site. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6644. [PMID: 37681784 PMCID: PMC10487157 DOI: 10.3390/ijerph20176644] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/24/2023] [Accepted: 08/11/2023] [Indexed: 09/09/2023]
Abstract
Violence against paramedics has been described as a 'serious public health problem' but one that remains 'vastly underreported', owing to an organizational culture that stigmatizes reporting-hindering efforts at risk mitigation in addition to creating a gap in research. Leveraging a novel reporting process developed after extensive stakeholder consultation and embedded within the electronic patient care record, our objective was to provide a descriptive profile of violence against paramedics in a single paramedic service in Ontario, Canada. Between 1 February 2021 and 31 January 2023, a total of 374 paramedics in Peel Region (48% of the workforce) generated 941 violence reports, of which 40% documented physical (n = 364) or sexual (n = 19) assault. The violence was typically perpetrated by patients (78%) and primarily took place at the scene of the 9-1-1 call (47%); however, violent behavior frequently persisted or recurred while in transit to hospital and after arrival. Collectively, mental health, alcohol, or drug use were listed as contributing circumstances in 83% of the violence reports. In all, 81 paramedics were physically harmed because of an assault. On average, our data correspond to a paramedic filing a violence report every 18 h, being physically assaulted every 46 h, and injured every 9 days.
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Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, Fernforest Division, 1600 Bovaird Drive East, Brampton, ON L6R 4R5, Canada;
- Department of Family and Community Medicine, Temerty Faculty of Medicine, The University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Mandy Johnston
- Peel Regional Paramedic Services, Tomken Division, 6825 Tomken Road, Mississauga, ON L5T 1N4, Canada;
| | - Dominique Arseneau-Bruneau
- Peel Regional Paramedic Services, Fernforest Division, 1600 Bovaird Drive East, Brampton, ON L6R 4R5, Canada;
| | - Alan M. Batt
- Faculty of Health Sciences, Queen’s University, 99 University Avenue, Kingston, ON K7L 3N6, Canada;
- Department of Paramedicine, Monash University, Building H, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Elizabeth A. Donnelly
- School of Social Work, The University of Windsor, 167 Ferry Street, Windsor, ON N9A 0C5, Canada;
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16
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Mausz J, Donnelly EA. Violence Against Paramedics: Protocol for Evaluating 2 Years of Reports Through a Novel, Point-of-Event Reporting Process. JMIR Res Protoc 2023; 12:e37636. [PMID: 36928257 PMCID: PMC10131719 DOI: 10.2196/37636] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Violence against paramedics has been described as a serious public health problem with the potential for significant physical and psychological harm, but the organizational culture within the profession encourages paramedics to consider violence as just "part of the job." Therefore, most incidents of violence are never formally documented. This limits the ability of researchers and policy makers to develop strategies that mitigate the risk and enhance paramedic safety. OBJECTIVE Following the development and implementation of a novel, point-of-event violence reporting process in February 2021, our objectives are to (1) estimate the prevalence of violence and generate a descriptive profile for incidents of reported violence; (2) identify potentially high-risk service calls based on characteristics of calls that are generally known to the responding paramedics at the point of dispatch; and (3) explore underpinning themes, including intolerance based on gender, race, and sexual orientation, that contribute to incidents of violence. METHODS Our work is situated in a single paramedic service in Ontario, Canada. Using a convergent parallel mixed methods approach, we will retrospectively review 2 years of quantitative and qualitative data gathered from the External Violence Incident Report (EVIR) system from February 1 2021 through February 28, 2023. The EVIR is a point-of-event reporting mechanism embedded in the electronic patient care record (ePCR) developed through an extensive stakeholder engagement process. When completing an ePCR, paramedics are prompted to file an EVIR if they experienced violence on the call. Our methods include using descriptive statistics to estimate the prevalence of violence and describe the characteristics of reported incidents (Objective 1), logistic regression modeling to identify high-risk service calls (Objective 2), and qualitative content analysis of incident report narratives to identify underpinning themes that contribute to violence (Objective 3). RESULTS As of January 1, 2023, 377 paramedics-approximately 1 in 5 active-duty paramedics in the service-have filed a total of 975 violence reports. Early analysis suggests 40% of reports involved a physical assault on the reporting paramedic. Our team is continuing to collect data with more fulsome analyses beginning in March 2023. Our findings will provide much-needed epidemiological data on the prevalence of violence against paramedics in a single paramedic service, its contributing themes, and potential risk factors. CONCLUSIONS Our findings will contribute to a growing body of literature demonstrating that violence against paramedics is a complex problem that requires a nuanced understanding of its scope, risk factors, and contributing circumstances. Collectively, our research will inform larger, multisite prospective studies already in the planning stage and inform organizational strategies to mitigate the risk of harm from violence. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/37636.
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Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, Brampton, ON, Canada
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Reducing Violence in Riyadh’s Emergency Departments: The Critical Role of Healthcare Providers. Healthcare (Basel) 2023; 11:healthcare11060823. [PMID: 36981480 PMCID: PMC10048218 DOI: 10.3390/healthcare11060823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Emergency department staff are at high risk of experiencing violence and aggression from patients and visitors, which can have negative impacts on healthcare providers in the ED. The aim of this study was to explore the role of healthcare providers in addressing local violence in Riyadh EDs and investigate their preparedness for managing violent incidents. We used a descriptive, correlational design with survey methodology to collect data from a convenience sample of nurses, ED technicians, physicians, and advanced practice providers in Riyadh city’s EDs. To examine the associations, we used an analysis of variance (ANOVA) for unadjusted relationships and an analysis of covariance (ANCOVA) for adjusted associations. Measures included a demographic survey, and clinicians responded to an online survey. A total of 206 ED staff participated in the questionnaire, and 59% reported experiencing physical violence during an ED shift, with 61% of incidents being caused by relatives. Additionally, 32% of the participants witnessed workplace violence. Our findings revealed that male healthcare workers, physicians, and those working in the governmental sector were at the highest risk of experiencing violence. We also found a statistically significant association between the rate of patients seen in the ED and the frequency of assault (physical or verbal) in the ED. Our results suggest that the rate of workplace violence in Riyadh EDs is high, and more efforts are needed to protect the health and well-being of healthcare providers. Senior management should take a position against ED domestic violence and reinforce managerial and healthcare provider resources by adopting policies and procedures that protect healthcare workers’ safety. This study provides valuable insights into the nature and prevalence of violence in Riyadh EDs and highlights the critical role of healthcare providers in reducing violence in EDs.
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Colin R, Wild P, Paris C, Boini S. Facteurs psychosociaux et accidents du travail, que dit la littérature ? ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Hou Y, Corbally M, Timmins F. Violence against nurses by patients and visitors in the emergency department: A concept analysis. J Nurs Manag 2022; 30:1688-1699. [PMID: 35700325 PMCID: PMC9795924 DOI: 10.1111/jonm.13721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 12/30/2022]
Abstract
AIM This analysis investigates the concept of violence against nurses by patients and visitors in the emergency department. It aims to differentiate, clarify, and clearly identify this specific concept, which will facilitate more apt measurement and reporting, ultimately to contribute violence reduction measures. BACKGROUND Due to contextual factors, occupational risk and patient characteristics, violence against nurses by patients and visitors in the emergency department varies from other types of violence against other health care staff. METHODS This study employed Walker and Avant's concept analysis technique. RESULTS The analysis found that violence against nurses by patients and visitors in the emergency department is primarily an occurrence of interpersonal violence based on the working relationship, whereby the patient and/or visitor becomes an assailant, and a nurse becomes a target in the absence of capable guardianship. There is also an intentional use of physical force or power, which results in or has a high chance of causing harm. CONCLUSION A clearer understanding of the antecedents, attributes, and consequences of violence against nurses by patients and visitors arising from this concept analysis provides a framework that will assist in the understanding, measurement, reporting, and prevention of violence and inform future research. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers are encouraged to adopt strategies that act on the factors related to attributes and antecedents that will serve to reduce the occurrence of intentional violent acts.
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Affiliation(s)
- Yongchao Hou
- Emergency DepartmentShanXi Provincial People's HospitalTaiyuanShanXiChina
| | - Melissa Corbally
- School of Nursing and MidwiferyTrinity College DublinDublinIreland
| | - Fiona Timmins
- School of Nursing, Midwifery & Health SystemsUniversity College DublinDublinIreland
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20
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Taylor JA, Murray RM, Davis AL, Brandt-Rauf S, Allen JA, Borse R, Pellechia D, Picone D. Model Policies to Protect U.S. Fire-Based EMS Responders From Workplace Stress and Violence. New Solut 2022; 32:119-131. [PMID: 35322702 PMCID: PMC9280702 DOI: 10.1177/10482911221085728] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The stress and violence to fire-based emergency medical service responders (SAVER) Systems-Level Checklist is an organizational-level intervention to address stress and violence in emergency medical service (EMS), focused on the development of policy and training. Fire and EMS leadership, first responders, dispatchers, and labor union representatives participated in the SAVER Model Policy Collaborative to develop model policies that resulted from the most feasible checklist items. ThinkLets technology was employed to achieve consensus on the model policies, and an Action SWOT analysis was then conducted to assess facilitators and barriers to policy implementation. The resultant model policies are a systems-level workplace violence intervention for the U.S. fire and rescue service that is ready for implementation. Expected improvements to organizational outcomes such as burnout, job engagement, and job satisfaction are anticipated, as are decreasing assaults and injuries. The SAVER Model Policies have the potential to inform national standards and regulations on workplace violence in EMS.
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Affiliation(s)
- Jennifer A. Taylor
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Regan M. Murray
- Health, Human Performance and Recreation, University of Arkansas College of Education and Health Professions, Fayetteville, AR, USA
| | - Andrea L. Davis
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Sherry Brandt-Rauf
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | | | | | | | - David Picone
- San Diego Fire-Rescue Department, San Diego, CA, USA
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21
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Srikanth P, Monsey LM, Meischke HW, Baker MG. Determinants of Stress, Depression, Quality of Life, and Intent to Leave in Washington State Emergency Medical Technicians During COVID-19. J Occup Environ Med 2022; 64:642-648. [PMID: 35673703 PMCID: PMC9377359 DOI: 10.1097/jom.0000000000002587] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study characterizes determinants of stress, depression, quality of life, and intent to leave among emergency medical technicians (EMTs) in the Puget Sound region, Washington, during the COVID-19 pandemic and identifies areas for intervention on these outcomes. METHODS A cross-sectional survey measured stress, depression, quality of life, and intent to leave among EMTs ( N = 123). Regression models were developed for these outcomes. RESULTS A total of 23.8% of respondents were very likely to leave their position in the next 6 months. Job demands predicted stress and depression, and financial security predicted stress and quality of life. Intent to leave was predicted by stress, manager support, and length of employment. CONCLUSIONS Increased exposure to hazards has impacted EMT mental health. Emergency medical technicians are vital to healthcare, so improving EMT health and well-being is important, as attrition during a pandemic could impact public health.
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22
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Jones R, Jackson D, Woods C, Usher K. Complexity, safety and challenges: Emergency responders’ experience of people affected by methamphetamines. Nurs Health Sci 2022; 24:535-544. [PMID: 35869590 PMCID: PMC9544434 DOI: 10.1111/nhs.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022]
Abstract
Providing care to methamphetamine‐related callout events in the prehospital environment is often complex and resource‐intensive, requiring staff to manage agitation and violence‐related side effects of methamphetamines. In Australia, emergency responders are increasingly required to attend events related to methamphetamines, even though reports suggest methamphetamine use across Australia has declined. The aim of the study was to explore Australian police and paramedic experiences attending methamphetamine‐related events. A qualitative descriptive phenomenology design was employed using semi‐structured interviews with employed police (10) and paramedics (8) from Australia. Data were analyzed using thematic analysis. Participants described the complexities associated with providing prehospital care to people affected by methamphetamines. Participants described associated domestic/family violence, increased levels of violence, challenges with communication, and responder emotional and psychological distress and physical injury. Violence associated with methamphetamine use is a critical factor in prehospital care. Workplace violence and family/domestic violence are important issues that require further research to ensure families and staff are well supported and have the services they need to continue responding to people affected by methamphetamine use.
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Affiliation(s)
- Rikki Jones
- School of Health University of New England Armidale NSW Australia
| | - Debra Jackson
- Faculty of Medicine and Health University of Sydney NSW
| | | | - Kim Usher
- School of Health University of New England NSW
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23
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Alshahrani KM, Johnson J, Hill L, Alghunaim TA, Sattar R, O’Connor DB. A qualitative, cross-cultural investigation into the impact of potentially traumatic work events on Saudi and UK ambulance personnel and how they cope. BMC Emerg Med 2022; 22:116. [PMID: 35761202 PMCID: PMC9235175 DOI: 10.1186/s12873-022-00666-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is common among ambulance personnel, but its prevalence varies between developed and developing countries. This study aimed to investigate the lived experience of potentially traumatic work events between Saudi and UK ambulance personnel. Methods Semi-structured interviews with 16 ambulance workers from Saudi Arabia and the United Kingdom (8 participants from each country) were conducted to explore their lived experiences of potentially traumatic events at work. Data were analyzed using thematic analysis. Results Four key themes were identified from interviews: (1) some events are inherently more stressful than others; (2) pressure of organizational and interpersonal stressors; (3) convergence and divergence in cross-cultural coping strategies; and (4) preferring formal and confidential support. Conclusions There were differences in the nature of traumatic events and the ways of coping between the two cultures, but paramedics in both cultures had an agreement about their preference for individual and formal support. The results of this study may help inform the development of interventions and PTSD prevention programs for ambulance personnel. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-022-00666-w.
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Spelten E, van Vuuren J, O'Meara P, Thomas B, Grenier M, Ferron R, Helmer J, Agarwal G. Workplace violence against emergency health care workers: What Strategies do Workers use? BMC Emerg Med 2022; 22:78. [PMID: 35524175 PMCID: PMC9074314 DOI: 10.1186/s12873-022-00621-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/28/2022] [Indexed: 12/01/2022] Open
Abstract
Background Workplace violence by patients and bystanders against health care workers, is a major problem, for workers, organizations, patients, and society. It is estimated to affect up to 95% of health care workers. Emergency health care workers experience very high levels of workplace violence, with one study finding that paramedics had nearly triple the odds of experiencing physical and verbal violence. Many interventions have been developed, ranging from zero-tolerance approaches to engaging with the violent perpetrator. Unfortunately, as a recent Cochrane review showed, there is no evidence that any of these interventions work in reducing or minimizing violence. To design better interventions to prevent and minimize workplace violence, more information is needed on those strategies emergency health care workers currently use to prevent or minimize violence. The objective of the study was to identify and discuss strategies used by prehospital emergency health care workers, in response to violence and aggression from patients and bystanders. Mapping the strategies used and their perceived usefulness will inform the development of tailored interventions to reduce the risk of serious harm to health care workers. In this study the following research questions were addressed: (1) What strategies do prehospital emergency health care workers utilize against workplace violence from patients or bystanders? (2) What is their experience with these strategies? Methods Five focus groups with paramedics and dispatchers were held at different urban and rural locations in Canada. The focus group responses were transcribed verbatim and analyzed using thematic analysis. Results It became apparent that emergency healthcare workers use a variety of strategies when dealing with violent patients or bystanders. Most strategies, other than generic de-escalation techniques, reflect a reliance on the systems the workers work with and within. Conclusion The study results support the move away from focusing on the individual worker, who is the victim, to a systems-based approach to help reduce and minimize violence against health care workers. For this to be effective, system-based strategies need to be implemented and supported in healthcare organizations and legitimized through professional bodies, unions, public policies, and regulations.
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Affiliation(s)
- Evelien Spelten
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia.
| | - Julia van Vuuren
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia
| | - Peter O'Meara
- Department of Paramedicine, Monash University, Melbourne, Australia
| | - Brodie Thomas
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia
| | | | - Richard Ferron
- Niagara Emergency Medical Services, Niagara Region, Niagara, Canada
| | - Jennie Helmer
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,British Columbia Emergency Health Services, Vancouver, Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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Garner DG, DeLuca MB, Crowe RP, Cash RE, Rivard MK, Williams JG, Panchal AR, Cabanas JG. Emergency medical services professional behaviors with violent encounters: A prospective study using standardized simulated scenarios. J Am Coll Emerg Physicians Open 2022; 3:e12727. [PMID: 35475121 PMCID: PMC9023872 DOI: 10.1002/emp2.12727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/07/2022] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction To evaluate emergency medical services (EMS) professional response to escalating threats of violence during simulated patient encounters and describe differences in behaviors by characteristics. Methods EMS professionals of a large county‐based system participated in 1 of 4 standardized patient care scenarios. Each 8‐minute scenario included escalated threats of violence such that EMS personnel should escape the scene for safety. Trained evaluators recorded EMS professionals' performance using standardized data elements. Outcomes included EMS personnel escape and verbal de‐escalation attempts. Descriptive statistics and univariable odds ratios (OR) with 95% confidence intervals (95% CI) are reported. Results There were 270 EMS professionals evaluated as individual members of 2‐person crews. Overall, 54% escaped the unsafe scene and 54% made an adequate de‐escalation attempt; 20% did not make an adequate de‐escalation attempt nor escape the unsafe scene. Paramedics demonstrated lower odds of escaping compared to emergency medical technicians (OR: 0.40; 95% CI: 0.17–0.94), yet greater odds of adequate de‐escalation (OR: 3.17, 95% CI: 1.38–7.31). EMS professionals with more than 20 years of experience (OR: 0.32, 95% CI: 0.13–0.79, ref:2 years or less) and those with military experience (OR: 0.37; 95% CI: 0.17–0.81) demonstrated reduced odds of escaping. Crisis intervention team (CIT) training was associated with reduced odds of escape (OR: 0.38; 95% CI: 0.21–0.69), but increased odds of adequate de‐escalation (OR: 2.19; 95% CI: 1.19–4.04). Conclusions Nearly half of EMS professionals did not remove themselves from a simulated patient care scenario with an escalating threat of physical violence. EMS‐specific training for de‐escalation as a first‐line technique, recognizing imminent violence, and leaving a dangerous environment is needed.
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Affiliation(s)
- Donald G. Garner
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
| | - Mallory B. DeLuca
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
| | | | - Rebecca E. Cash
- Massachusetts General Hospital Department of Emergency Medicine Boston Massachusetts USA
| | | | - Jefferson G. Williams
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
- University of North Carolina Department of Emergency Medicine Chapel Hill North Carolina USA
| | - Ashish R. Panchal
- National Registry of Emergency Medical Technicians Columbus Ohio USA
- Wexner Medical Center, Department of Emergency Medicine The Ohio State University Columbus Ohio USA
| | - Jose G. Cabanas
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
- University of North Carolina Department of Emergency Medicine Chapel Hill North Carolina USA
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Schablon A, Kersten JF, Nienhaus A, Kottkamp HW, Schnieder W, Ullrich G, Schäfer K, Ritzenhöfer L, Peters C, Wirth T. Risk of Burnout among Emergency Department Staff as a Result of Violence and Aggression from Patients and Their Relatives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094945. [PMID: 35564338 PMCID: PMC9105776 DOI: 10.3390/ijerph19094945] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/11/2022] [Accepted: 04/16/2022] [Indexed: 02/06/2023]
Abstract
Emergency department staff are often affected by incidents of violence. The aim of the study was to generate data on the frequency of violence by patients and accompanying relatives and the correlation between experienced aggression, a possible risk of burnout and a high sense of stress. Additionally, the buffering effect of good preventive preparation of care staff by the facility on aggressive visitors and patients was examined. In this cross-sectional study, members of the German Society for Interdisciplinary Emergency and Acute Medicine were surveyed. The investigation of risk factors, particularly experiences of verbal and physical violence, as well as exhaustion and stress, was carried out using ordinal regression models. A total of 349 staff from German emergency departments took part in the survey, 87% of whom had experienced physical violence by patients and 64% by relatives. 97% had been confronted with verbal violence by patients and 94% by relatives. Violence by relatives had a negative effect on perceived stress. High resilience or effective preparation of employees for potential attacks was shown to have a protective effect with regard to the burnout risk and perceived stress. Therefore, management staff play a major role in preventing violence and its impact on employees.
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Affiliation(s)
- Anja Schablon
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (J.F.K.); (A.N.); (C.P.)
- Correspondence:
| | - Jan Felix Kersten
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (J.F.K.); (A.N.); (C.P.)
| | - Albert Nienhaus
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (J.F.K.); (A.N.); (C.P.)
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Healthcare and Welfare Services, 22089 Hamburg, Germany
| | | | - Wilfried Schnieder
- Klinikum Herford, Emergency Department, Medizin Campus OWL of the Ruhr University Bochum, 32049 Herford, Germany;
| | - Greta Ullrich
- Zentrale Notaufnahme, Paracelsus-Klinik Henstedt-Ulzburg, 24558 Henstedt-Ulzburg, Germany;
| | - Karin Schäfer
- Prevention Service, Institution for Statutory Accident Insurance and Prevention in the Healthcare and Welfare Services, Helmholtzstrasse 2, 80636 Munich, Germany;
| | - Lisa Ritzenhöfer
- Prevention Department, Accident Insurance Institution Hessen, Leonardo-da-Vinci-Allee 20, 60486 Frankfurt am Main, Germany;
| | - Claudia Peters
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (J.F.K.); (A.N.); (C.P.)
| | - Tanja Wirth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany;
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Xu J, Cao Y, Wang Y, Qiao Q. Judicial judgment and media sensation of violence against medical staff in China: A fuzzy set qualitative comparative analysis (fsQCA). PLoS One 2021; 16:e0259014. [PMID: 34679107 PMCID: PMC8535389 DOI: 10.1371/journal.pone.0259014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/11/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Violence against medical staff has been prevalent in China over the past two decades. Although Chinese authorities have released many laws and regulations to protect medical staff from violence since 2011, the legal approach alone is unlikely to resolve this complex issue. In particular, several cases of violence against medical staff in China have caused great media sensation. METHOD This paper proposes an integrated model that combines the environmental stimuli theory, broken windows theory, and rational choice theory. It adopts the fuzzy set qualitative comparative analysis (fsQCA) to untangle the causal relationship between violence against medical staff, media sensation, and judicial judgment. We examined reports of medical violence on media and news websites from January 1, 2010, to January 31, 2020, and selected 50 cases with detailed information for this study. RESULTS The results show that each condition is not sufficient for the absence of judicial judgment, but when combined, they are conducive to the outcome. The conditions of hospital level, medical cost, and media sensation play important roles. The providers, patients, and environmental factors are indicators of inadequate or lack of judicial judgment, which corresponds to previous expectations. CONCLUSIONS The integrated model greatly enriches the extant theories and literature, and also yields implications for preventing violence against medical staff in China. We suggest that sustainable and innovative healthcare reform should be initiated. For example, public hospitals should remain the cornerstone of national public health security. Medical staff in public hospitals must be regarded as "civil servants". Therefore, the current legal system should be improved. The media should objectively report events concerning medical staff and improve public healthcare knowledge.
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Affiliation(s)
- Jian Xu
- School of Media and Communication and China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Yongrong Cao
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Yangyang Wang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Qingquan Qiao
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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Ericsson CR, Nordquist H, Lindström V, Rudman A. Finnish paramedics' professional quality of life and associations with assignment experiences and defusing use - a cross-sectional study. BMC Public Health 2021; 21:1789. [PMID: 34610798 PMCID: PMC8490964 DOI: 10.1186/s12889-021-11851-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/22/2021] [Indexed: 12/04/2022] Open
Abstract
Background Paramedics experience traumatic events and social emergencies during assignments while also being subjected to verbal and physical threats. Consequently, they are at risk for burnout and secondary traumatic stress, factors inherent to professional quality of life. Defusing and peer-support potentially decrease such symptoms; however, perceived defusing needs and use are not always balanced. Our aim was to explore Finnish paramedics’ professional quality of life, using the Professional Quality of Life Scale, with associations to EMS assignment experiences as well as formal and informal defusing need and use over a 12-month period. Methods A quantitative study of 257 Finnish paramedics using a cross-sectional design. Study outcomes were secondary traumatic stress (STS), compassion satisfaction (CS), and burnout (BO) scores using the modified 9-item Short Professional Quality of Life scale (ProQOL). Likert-type scales were used to collect participants’ recollections of assignment experiences and defusing from a 12-month period. Associations were explored using Spearman’s correlation coefficients. Results Short ProQOL score medians were STS 4.00 (IQR 3), BO 6.00 (IQR 3) and CS 13.00 (IQR 3). STS and BO correlated to experiences of social emergencies and traumatic events while BO correlated to experiences of threat situations (r = 0.206, p = .001). Paramedics perceived a need for defusing in general associated with STS (r = 0.178, p < .001) and participated in informal defusing. Participation in defusing of any form did not associate with ProQOL scores. Conclusions Finnish paramedics’ more frequent experiences of social emergencies, traumatic events, and paramedic-directed threat situations were associated with higher levels of STS and BO. STS was also associated with paramedics’ increased need for defusing and use of informal peer defusing, although neither STS, BO or CS scores associated to any defusing form. Managing paramedics STS and BO, while fostering CS, could therefore be a future research focus. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11851-0.
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Affiliation(s)
- Christoffer R Ericsson
- Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Department of Healthcare, Arcada University of Applied Sciences, Jan Magnus Janssons plats 1, 00560, Helsinki, Finland.
| | - Hilla Nordquist
- South-Eastern Finland University of Applied Sciences, Kotka, Finland
| | - Veronica Lindström
- Department of Neurobiology, Care Sciences and Society, Section of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Ann Rudman
- Department of Health and Welfare, Dalarna University, Falun, Sweden
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Lourens A, Parker R, Hodkinson P. Emergency care providers' perspectives of acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A qualitative study. Int Emerg Nurs 2021; 58:101042. [PMID: 34333334 DOI: 10.1016/j.ienj.2021.101042] [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: 04/11/2021] [Accepted: 06/10/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION A growing body of evidence suggests that pain knowledge and management are poor, perhaps more so in the prehospital setting. The daily challenges that emergency care providers face in dealing with prehospital pain remain unclear. This study aimed to gain a deeper understanding of acute prehospital pain assessment and management in the Western Cape, South Africa. METHODS A series of focus group discussions, using a constructivist paradigm and qualitative content analysis were conducted. RESULTS The key themes emerging from six focus groups (total 25 emergency care providers) related to the difficulties of assessing pain in this setting, factors affecting clinical reasoning in this (hostile) setting, the realities of prehospital pain care for non-advanced life support practitioners, along with emergency departments' lack of understanding and appreciation of the prehospital environment, and participants' suggestions to improve pain practice. CONCLUSION Several barriers and enablers, some novel, to pain assessment and management in the South African prehospital setting were identified. Our findings provide valuable insight and understanding of the challenges related to pain care prehospital providers face, in other similar prehospital settings, but also to the global body of knowledge on prehospital barriers and enablers of pain assessment and management.
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Affiliation(s)
- Andrit Lourens
- Division of Emergency Medicine, University of Cape Town (UCT), Cape Town, Western Cape, South Africa.
| | - Romy Parker
- Department of Anaesthesia and Perioperative Medicine, University of Cape Town (UCT), Cape Town, Western Cape, South Africa.
| | - Peter Hodkinson
- Division of Emergency Medicine, University of Cape Town (UCT), Cape Town, Western Cape, South Africa.
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Du XL, Zhao XR, Gao H, Shen WW, Liao JZ. Analysis of Monitoring, Early Warning and Emergency Response System for New Major Infectious Diseases in China and Overseas. Curr Med Sci 2021; 41:62-68. [PMID: 33582907 PMCID: PMC7881914 DOI: 10.1007/s11596-021-2319-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/25/2020] [Indexed: 01/30/2023]
Abstract
In recent years, the impact of new major infectious diseases on people's normal life is becoming more and more frequent, which has brought great impact on people's life safety and social economy, especially the corona virus disease 2019, which has been sweeping the globe. Public health and disease prevention and control systems in different countries have different performances in response to the pandemic, but they all have exposed many shortcomings. Countries around the world urgently need to improve the monitoring, early warning and emergency response systems for new major infectious diseases. As the outpost and main part of medical rescue, the hospital urgently needs to establish a set of scientifically advanced emergency response mechanism that is suitable for the business process of the medical system and unified standards in order to improve the response efficiency and quality of emergency treatment.
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Affiliation(s)
- Xing-Li Du
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xin-Rui Zhao
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huan Gao
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wan-Wan Shen
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jia-Zhi Liao
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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