The trend of change in the role of pre-hospital emergency medical services in Iran's healthcare system: a situational analysis

Design and assessment of a web-based educational electronic system for non-practical nursing skills development among nursing students

BACKGROUND

Despite the importance of non-practical nursing activities, there is currently a lack of a suitable framework for their use among nurses and nursing students in Iran. This study aimed to design, implement, and evaluate a web-based educational electronic system for developing non-practical nursing skills (ESNPNSD).

METHODS

This sequential methodological study was conducted in three phases: (1) identifying the Minimum Data Set (MDS) elements, (2) designing, developing, and implementing the system, and (3) evaluating the ESNPNSD. The system was assessed by 72 nursing students from two academic semesters, selected through convenience sampling. Following validation by experts during a Delphi phase, the ESNPNSD was developed and evaluated using the User Experience Questionnaire (UEQ). The UEQ scores ranged from - 3 to + 3 and included categories of normal, positive, and negative evaluations. Data were analyzed using SPSS version 18. Ethical considerations were fully observed.

RESULTS

In the first phase, 136 items were identified across 12 categories. After formal and content validity checks, 68% and 55% of the items achieved content validity coefficients of 1 and 0.87, respectively, qualifying them for inclusion in the system. The Cronbach's alpha score for all items in the system was 0.95. The ESNPNSD system scored averages of 1.75 for attractiveness, 1.46 for dependability, 1.58 for efficiency, 1.74 for novelty, and 1.23 for stimulation.

CONCLUSION

The ESNPNSD has the potential to support the development of non-practical nursing skills and facilitate patient safety by providing structured educational resources and interactive learning experiences. However, further studies with objective assessments of learning outcomes are needed to validate its impact comprehensively.

CLINICAL TRIAL NUMBER

not applicable.

Exploring Saudi paramedics' experiences in managing adult trauma cases: a qualitative study

BACKGROUND

Saudi paramedics face numerous challenges while providing care for adult trauma patients affecting their care but little is known about these specific challenges.

METHODS

A qualitative study was conducted using a purposive sample of Saudi paramedics from the Saudi Red Crescent Authority (SRCA) across various cities. Data were collected through online semi-structured interviews and analyzed using the framework method.

RESULTS

A total of 20 paramedics were recruited and interviewed. They identified challenges in trauma response, including coordinating care, ensuring the accuracy and accessibility of patient information, and maintaining confidence and readiness. Participants emphasized the need for independent knowledge acquisition through courses, simulations, and peer discussions. They also highlighted the need for more paramedics, strategies to reduce burnout, and the importance of accurately assessing patient conditions. Additionally, they also stressed the importance of raising public awareness to enhance trauma care.

CONCLUSION

This study explored Saudi paramedics' experiences in managing adult trauma patients. standardized handovers, more staff, and greater public awareness are the main key needs to improve daily practice.

Examining Emergency Medical Services: Delay Time, Response Time, On-Scene Time In Six Peaks of the COVID-19 Pandemic in Eastern Iran

BACKGROUND

Time indices are key elements in prehospital medical emergencies. The number of calls to Emergency Medical Services (EMS) and the number of missions they have undertaken have been impacted by the COVID-19 epidemic.

OBJECTIVES

This study's goal was to evaluate prehospital EMS time indices at the apex of the COVID-19 outbreak.

METHODS

Data were extracted retrospectively from the Asayar Automation System, which records details on all emergency medical calls resulting in patient transport. The study period was from March 2018 to March 2021, covering the pre-COVID period and the first through sixth peaks of the pandemic in Iran. Standardized data extraction procedures were used to minimize bias in this retrospective review.

RESULTS

In this study, most transport missions occurred during the fifth peak (n = 2811). In addition, the most missions were related to the age group above 60 years (31.1%), and the highest rate of patient transport (65.9%) was observed in male patients. Traumatic events, cardiac emergencies, impaired consciousness, and psychiatric disorders were, respectively, the main causes of patient transport. Moreover, a significant difference was observed between time indices of various COVID-19 peaks (p < 0.001).

CONCLUSIONS

Even though the structure of Iran's emergency system is based on the American-Anglo model, and rapid patient transfers to medical facilities are prioritized, the COVID-19 epidemic resulted in increased calls and missions and affected time indices. Therefore, it is suggested that the method and type of service provision be modified during similar crises.

Investigating the relationship between aging perception and self-efficacy in the older adults: a cross-sectional study in Eastern Iran

BACKGROUND

With the global increase in the older adults population, understanding factors that impact their quality of life is crucial. The perception of aging and self-efficacy are significant factors affecting older adults health outcomes. This descriptive cross-sectional study investigates the relationship between Aging Perception and self-efficacyamong older adults individuals in Birjand city, a demographic that is rapidly increasing but under-research.

METHODS

This cross-sectional study was conducted from September 2022 to September 2023 on 400 older adults individuals in Birjand city. Participants were selected using a random sampling method from four regions, ensuring a representative sample. Data were collected through two main questionnaires: the Shortened Perceived Aging Questionnaire (SPAQ) and the General Self-Efficacy Questionnaire (GSE), both validated for the Persian-speaking population. Statistical analysis was performed using SPSS SOFTWARE.

ARMONK, NY

IBM CORP. version 26, employing nonparametric tests due to the non-normal distribution of data.

RESULTS

The study found a strong positive correlation between Aging Perception and self-efficacy (Spearman's R = 0.79, p < 0.001), indicating that a more positive perception of aging is associated with higher self-efficacy. The analysis also revealed that men generally reported a more positive perception of aging and higher self-efficacy compared to women. However, underlying diseases and marital status did not significantly affect the Aging Perception or self-efficacy scores.

CONCLUSIONS

The findings suggest that enhancing self-efficacy among the older adults could improve their perception of aging, potentially leading to better health outcomes and quality of life. This study underscores the need for targeted interventions that consider cultural and gender-specific factors. Further research using longitudinal designs is recommended to explore the causality between Aging Perception and self-efficacy and to confirm these findings across different regions and cultural backgrounds in Iran.

Comparative study on the impact of 'Infographic versus video feedback' on enhancing students' clinical skills in basic life support

BACKGROUND

Effective cardiopulmonary resuscitation (CPR) training for nursing students is crucial for improving patient outcomes in cardiac arrest scenarios. This study assesses the impact of infographic versus video feedback on enhancing nursing students' clinical skills in Basic Life Support (BLS).

METHODS

In a randomized controlled setting, 76 nursing students at Torbat Heydariyeh University of Medical Sciences were divided into two groups: one received infographic-based education and the other video feedback training. Pre- and post-intervention assessments measured knowledge and skill retention using validated questionnaires.

RESULTS

Post-training, the infographic group showed significantly higher knowledge scores, while the video feedback group exhibited greater improvement in CPR skill performance. No significant differences were noted in pre-training assessment scores between the groups.

CONCLUSION

Infographic-based education enhances BLS knowledge retention, and video feedback improves practical CPR skills. This suggests potential benefits of a combined infographic and video feedback approach for optimizing CPR training outcomes, addressing a critical need in medical education.

Comparison of pre-hospital management of out-of-hospital cardiac arrest and its outcomes between the COVID-19 and pre-COVID-19 periods

Out-of-hospital cardiac arrest (OHCA) is a time-sensitive medical emergency that needs immediate interventions. COVID-19 affected the performance of the emergency medical service (EMS) system in pre-hospital care, including the management of cardiac arrest. This study aimed to identify the impact of the COVID-19 pandemic on pre-hospital management of out-of-hospital cardiac arrest and its outcome in Qom City, Iran. In this descriptive-analytical study, the data were collected from the electronic registration system of the EMS center in Qom, Iran. All OHCA patients who received resuscitation during COVID-19 and before COVID-19 were enrolled in the study. Data consisted of the characteristics of OHCA patients, EMS interventions and response times, and the outcome of OHCA. A P-value of <0.05 was deemed statistically significant. 630 OHCA patients in the COVID-19 period and 524 OHCA patients in the pre-COVID-19 period were included in the study. Endotracheal intubation and defibrillation were done more in the COVID-19 period than in the pre-COVID-19 period (50.2 % vs. 17 %, p<0.001 %, and 40.1 % vs. 22.5 %, p < 0.001, respectively). The EMS response time was longer during the COVID-19 pandemic (9.1 ± 3.9 min vs. 7.6 ± 1.4 min, p < 0.001). The rate of pre-hospital return of spontaneous circulation (ROSC) was lower in the COVID-19 period (15.6 % vs. 8.4 %, p < 0.001). According to univariate analysis, ROSC was predicted by COVID-19 (p < 0.001). However, COVID-19 was not the statistically significant independent predictor after multivariate analysis (p < 0.67). The COVID-19 pandemic period influenced OHCA and ROSC. Also, it affected pre-hospital management in the OHCA situation. The negative impact of COVID-19 on the EMS response reflected the need to know and remove barriers to managing crises such as COVID-19.

Identifying mitigation strategies of comprehensive health centers against dust hazard: a qualitative study in Iran

BACKGROUND

Exposure to dust can disrupt healthcare services and severely affect all activity domains of the health system. The aim of this study was to explore mitigation strategies for comprehensive health centers against dust hazard.

METHOD

The present study was conducted using a qualitative design with a conventional content analysis approach in 2023. The participants in this study were managers and staff of comprehensive health centers and experts in health in disasters and emergencies in Kerman, Bam, Regan, and Ahvaz. Data were collected through interviews. Data collection continued until data saturation. The collected data were analyzed based on the steps proposed by Graneheim and Lundman. Participants' statements, after recording and transcribing, were categorized into semantic units. Data were analyzed by using MAXQDA software version 2020.

RESULTS

The analysis of the data with 23 participants revealed 106 Codes, 13 sub- categories and 5 main categories including: (A) reducing the impact of dust hazards, (B) management functions, (C) empowerment and performance improvement, (D) maintaining and promoting safety, and (E) Inter-sectoral coordination to implement mitigation strategies.

CONCLUSION

The findings showed that the mitigation strategies and solutions can be used by health policymakers and planners to reduce the impact of dust hazard, empower and motivate healthcare staff, develop training protocols to enhance risk perception of the staff and members of the community, create the necessary infrastructure for adoption of effective mitigation strategies in healthcare centers to create resilience and continue service delivery.

The impact of the education program based on dimensions of quality of work life among emergency medical services providers

BACKGROUND

Quality of work life is a vital factor for health care providers. This study aimed to determine the impact of the education program based on dimensions of quality of work life among emergency medical services employees.

METHODS

The quasi-experimental study was conducted on 100 emergency medical services employees in Tehran, Iran, who were chosen using a convenience sampling method (50 in the intervention group and 50 in the control group). The information was gathered using a Demographic Questionnaire and a Walton Quality of Work Life Questionnaire with eight dimensions. The research was carried out in three stages: design, implementation, and evaluation of the education program. During the design phase, the educational needs of the participants were determined in terms of the dimensions of the quality of work life and work and total living space. The education program on work-life quality was implemented in four virtual group sessions, emphasizing the educational needs identified through uploading educational content to the WhatsApp application. The evaluation was conducted in two stages: before the education program and three months after the program. With a significance level of 0.05, the data was analyzed using SPSS version 24 software.

RESULTS

The results revealed that an education program on the quality of work life and its dimensions, emphasizing strategies to improve work and total living space, can improve the score of this dimension in the intra-group comparison of both the intervention and control groups (p = 0.046), as well as in the inter-group comparison, at the three-month post-intervention stage, there is a significant difference and a significant increase (p = 0.030), but it does not have a significant effect on the quality of work life and its other dimensions.

CONCLUSION

It is recommended that emergency medical services managers plan to improve the quality of working life of their employees, particularly in terms of work and total living space.

Emergency Medical Service in the Elderly Population in Iran: A Cross-sectional Study Before and During the COVID-19 Pandemic

This research examines the impact of an aging population in Eastern Iran on prehospital emergency medical services (EMS), with a focus on changes before and during the COVID-19 pandemic. A descriptive cross-sectional analysis was performed on data from 10,264 elderly individuals using EMS in Torbat-e Heydarieh County from March 2019 to March 2022. Statistical analyses, including t-tests and Chi-square tests, were conducted using SPSS software. Findings indicate that 30% of the 33,847 EMS calls received were from older adults. The nature of emergencies evolved from cardiovascular issues pre-pandemic to predominantly impaired consciousness during COVID-19, a statistically significant shift (p < .001). The study concludes with a call for research targeted at this demographic and suggests setting up dedicated EMS response units to cater to the elderly, responding to the increase in elderly-related EMS needs.