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Charlton K, Rees J, Burrow E. Identifying high cholesterol in the ambulance setting: a mixed-methods cohort study to tackle health inequality. J Public Health (Oxf) 2024:fdae009. [PMID: 38291949 DOI: 10.1093/pubmed/fdae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Individuals with low socio-economic status (SES) have disproportionate rates of cardio- vascular disease (CVD) but poorer engagement with preventative health. This study aimed to compare characteristics of individuals with and without hyperlipidaemia and describe their health behaviours. METHODS A mixed-methods study between January and December 2022. Patients aged ≥40 years using the ambulance service with blood pressure of ≥140/90 had their total cholesterol measured using a point of care device. Data including blood pressure, smoking status, National Early Warning Score 2 and clinical frailty scale (CFS) were analysed. RESULTS Of 203 patients (59% female, mean age 65.7 years), 115 (56.7%) had total cholesterol ≥5.1 mmol/L. Thirty patients (14.8%) sought treatment and received either statins (n = 9; 4.4%), dietary modification (n = 7; 3.4%) or no further intervention (n = 14; 6.9%), whilst 85 patients (41.9%) took no further action. Lower CFS (OR 0.53 [0.31-0.93]) and higher total cholesterol (OR 2.07 [1.03-2.76]) predicted seeking further management. SES was not associated with hyperlipidaemia or likelihood of seeking further management, rather this was dictated by competing co-morbidity, poor health literacy and digital divide. CONCLUSIONS Undiagnosed hyperlipidaemia exists in patients using the ambulance service, irrespective of SES. Individual and healthcare system factors prevent engagement in cholesterol lowering behaviours.
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Affiliation(s)
- Karl Charlton
- Research & Development, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne NE15 8NY, UK
| | - Jon Rees
- Helen McArdle Research Institute and Sunderland City Council, School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
| | - Emma Burrow
- Research & Development, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne NE15 8NY, UK
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Romero-Sánchez JM, Sánchez-Almagro CP, White-Ríos M, Paloma-Castro O. Prevalence and clustering of NANDA-I nursing diagnoses in the pre-hospital emergency care setting: A retrospective records review study. J Clin Nurs 2024. [PMID: 38235516 DOI: 10.1111/jocn.16996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/21/2023] [Accepted: 01/07/2024] [Indexed: 01/19/2024]
Abstract
AIM To determine the prevalence and clustering of NANDA-International nursing diagnoses in patients assisted by pre-hospital emergency teams. DESIGN Retrospective descriptive study of electronic record review. METHODS Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two-step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020. RESULTS Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six-cluster solution (n = 26.788) was found. Five clusters had a single high-prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co-occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051). CONCLUSION Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre-hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre-hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre-hospital clinical setting. IMPACT What problem did the study address? There are different models of pre-hospital emergency care services. The use of standardized nursing languages in the pre-hospital setting is not homogeneous. Studies on NANDA-I nursing diagnoses in the pre-hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA-I nursing diagnoses in the pre-hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance. Patients attended by pre-hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre-hospital setting, increasing the evidence of individualized and standardized care plans for pre-hospital care. REPORTING METHOD STROBE checklist has been used as a reporting method. NO PATIENT OR PUBLIC CONTRIBUTION Only patients' records were reviewed without further involvement.
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Affiliation(s)
- José Manuel Romero-Sánchez
- Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
| | - César Pedro Sánchez-Almagro
- Medical Emergency Center 061 (CES 061), Andalusian Health Service, Provincial Service 061 in Cádiz, Regional Government of Andalusia, Cádiz, Spain
| | - Melanie White-Ríos
- Hospital Punta de Europa, Andalusian Health Service, Algeciras, Cádiz, Spain
| | - Olga Paloma-Castro
- Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
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Senda DM, de Souza MP, Castilho Pelloso F, Bocchi Pedroso R, Carvalho MDDB, Pelloso SM. Women Abused: Analysis of Assistance Provided by Urgency Mobile Service. Int J Environ Res Public Health 2024; 21:87. [PMID: 38248550 PMCID: PMC10815712 DOI: 10.3390/ijerph21010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/11/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Considering that reports of violence against women must come after a victim seeks help, the subject matter transcends health-related issues. In Brazil, mobile urgency services (SAMU/SIATE) frequently provide first aid to these women and, to the best of our knowledge, no other research has specifically examined the first reaction given to these women. The present study aimed to analyze SAMU/SIATE assistance to abused women in a cross-sectional study of the assistance to assaulted women provided by SIATE and SAMU Maringá/Norte Novo between 2011 and 2020. Women between 20 and 39 years old, non-pregnant, were the main victims, and 19.52% of them have used drugs of some kind. The (ex) partner figured as the perpetrator in 17.35%, but there was no information about this variable in 73.75% of the records. The Chi-square test shows a mortality rate superior to 70% among the severely traumatized victims. This is the first research work to examine the kind of care that SAMU/SIATE offers, and it identifies several weaknesses in its "modus operandi" that may prevent the results from being applied to larger contexts. In addition, further studies on mobile urgent care services in other provinces are required in order to suggest ways to lessen this epidemic.
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Affiliation(s)
- Dalton Makoto Senda
- Postgraduate Program in Health Sciences, Estate University of Maringá, Maringá 87030-230, Brazil; (D.M.S.); (M.P.d.S.); (R.B.P.); (M.D.d.B.C.)
| | - Makcileni Paranho de Souza
- Postgraduate Program in Health Sciences, Estate University of Maringá, Maringá 87030-230, Brazil; (D.M.S.); (M.P.d.S.); (R.B.P.); (M.D.d.B.C.)
| | | | - Raíssa Bocchi Pedroso
- Postgraduate Program in Health Sciences, Estate University of Maringá, Maringá 87030-230, Brazil; (D.M.S.); (M.P.d.S.); (R.B.P.); (M.D.d.B.C.)
| | - Maria Dalva de Barros Carvalho
- Postgraduate Program in Health Sciences, Estate University of Maringá, Maringá 87030-230, Brazil; (D.M.S.); (M.P.d.S.); (R.B.P.); (M.D.d.B.C.)
| | - Sandra Marisa Pelloso
- Postgraduate Program in Health Sciences, Estate University of Maringá, Maringá 87030-230, Brazil; (D.M.S.); (M.P.d.S.); (R.B.P.); (M.D.d.B.C.)
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Han W, Yuan JY, Li R, Yang L, Fang JQ, Fan HJ, Hou SK. Clinical application of a body area network-based smart bracelet for pre-hospital trauma care. Front Med (Lausanne) 2023; 10:1190125. [PMID: 37593406 PMCID: PMC10427851 DOI: 10.3389/fmed.2023.1190125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/10/2023] [Indexed: 08/19/2023] Open
Abstract
Objective This study aims to explore the efficiency and effectiveness of a body area network-based smart bracelet for trauma care prior to hospitalization. Methods To test the efficacy of the bracelet, an observational cohort study was conducted on the clinical data of 140 trauma patients pre-admission to the hospital. This study was divided into an experimental group receiving smart bracelets and a control group receiving conventional treatment. Both groups were randomized using a random number table. The primary variables of this study were as follows: time to first administration of life-saving intervention, time to first administration of blood transfusion, time to first administration of hemostatic drugs, and mortality rates within 24 h and 28 days post-admission to the hospital. The secondary outcomes included the amount of time before trauma team activation and the overall length of patient stay in the emergency room. Results The measurement results for both the emergency smart bracelet as well as traditional equipment showed high levels of consistency and accuracy. In terms of pre-hospital emergency life-saving intervention, there was no significant statistical difference in the mortality rates between both groups within 224 h post-admission to the hospital or after 28-days of treatment in the emergency department. Furthermore, the treatment efficiency for the group of patients wearing smart bracelets was significantly better than that of the control group with regard to both the primary and secondary outcomes of this study. These results indicate that this smart bracelet has the potential to improve the efficiency and effectiveness of trauma care and treatment. Conclusion A body area network-based smart bracelet combined with remote 5G technology can assist the administration of emergency care to trauma patients prior to hospital admission, shorten the timeframe in which life-saving interventions are initiated, and allow for a quick trauma team response as well as increased efficiency upon administration of emergency care.
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Affiliation(s)
- Wei Han
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
- Emergency Department of Shenzhen University General Hospital, Shenzhen, Guangdong, China
| | - Jin-Yang Yuan
- Emergency Department of Shenzhen University General Hospital, Shenzhen, Guangdong, China
| | - Rui Li
- Emergency Department of Shenzhen University General Hospital, Shenzhen, Guangdong, China
| | - Le Yang
- Emergency Department of Shenzhen University General Hospital, Shenzhen, Guangdong, China
| | - Jia-Qin Fang
- School of Microelectronics, South China University of Technology, Guangzhou, Guangdong, China
| | - Hao-Jun Fan
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Shi-Ke Hou
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
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Kosydar-Bochenek J, Religa D, Knap M, Czop M, Knap B, Mędrzycka-Dąbrowska W, Krupa S. Safety climate perceived by pre-hospital emergency care personnel-an international cross-sectional study. Front Public Health 2023; 11:1192315. [PMID: 37529436 PMCID: PMC10390026 DOI: 10.3389/fpubh.2023.1192315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/23/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Improving patient safety is one of the most critical components of modern healthcare. Emergency medical services (EMS) are, by nature, a challenging environment for ensuring patient safety. It is fast-paced, physically dangerous, and highly stressful, requiring rapid decision-making and action. This can create risks not only for patients but also for employees. We assessed variations in perceptions of safety culture in prehospital emergency care among an international sample of paramedics and nurses. Methods The Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) was used for the study. The instrument measures six domains of safety culture in the workplace: teamwork climate, job satisfaction, safety climate, working conditions, stress recognition, and perceptions of management. A total of 1,128 EMS from 9 countries participated in this study. Results Safety Climate was 81.32/100 (SD 6.90), Teamwork Climate 84.14/100 (SD 8.74), Perceptions of Management 76.30/100 (SD 10.54), Stress Recognition 89.86/100 (SD 5.70), Working Conditions 81.07/100 (SD 9.75), and Job Satisfaction 70.71/100 (SD 7.21). There was significant variation in safety culture scores across countries for teamwork climate (TWC), working conditions (WC), and job satisfaction (JS). Among the individual variables (age, gender, level of education, and work experience), variations in safety culture scores were unaffected by age, gender, or work experience. Organizational characteristics: employment status and position type were linked to significant variations in safety culture domain scores. Conclusion Participants' perceptions of the patient safety climate were not particularly satisfactory, confirming that there is still a need to develop a culture of patient safety in prehospital emergency care.
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Affiliation(s)
- Justyna Kosydar-Bochenek
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, Rzeszów, Poland
| | - Dorota Religa
- Division for Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden
| | - Małgorzata Knap
- Institute of Health Sciences, Collegium Medicum of the Jan Kochanowski University of Kielce, Kielce, Poland
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, Lublin, Poland
| | - Bartosz Knap
- Doctoral School, Medical University of Lublin, Lublin, Poland
- Chair and Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anesthesiology Nursing and Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | - Sabina Krupa
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, Rzeszów, Poland
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6
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Sánchez-Almagro CP, Romero-Sánchez JM, White-Ríos M, González Del Pino CA, Paloma-Castro O. NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care. J Adv Nurs 2022; 78:3273-3289. [PMID: 35506570 PMCID: PMC9545537 DOI: 10.1111/jan.15280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/12/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Aim To determine the prevalence of NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre‐hospital emergency care setting. Design Retrospective descriptive study of electronic record review. Methods Eight thousand three hundred three episodes recorded during the year 2019 were recovered from the electronic health records of a public emergency care agency. The prevalence of NANDA International nursing diagnosis, Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions was determined. A cross‐tabulation analysis was performed to determine the linkages. Data were accessed in November 2020. Results NANDA International nursing diagnoses Anxiety (00146) and Fear (00148) represented more than 90% of the diagnoses recorded in the domain. Anxiety level (1211) and emotional support (5270) were the most recorded Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions, with almost 20% and 5% of total records, respectively. The linkage between nursing diagnosis Anxiety (00146), outcome Anxiety level (1211) and intervention Anxiety reduction (5820) was the most recorded with slightly more than 3% of the total. Conclusion Eight different NANDA International nursing diagnoses in the coping/stress tolerance domain were recorded. Nursing Outcomes Classification outcomes were selected aimed mainly at psychological well‐being and Nursing Interventions Classification interventions to support coping. In general, linkages were aimed to provide emotional support, physical well‐being, information, education and safety. Impact This study showed that pre‐hospital emergency care nurses diagnose and treat human responses in the coping/stress tolerance domain. Expert consensus‐based linkages may be complemented by the results of this study, increasing the levels of evidence of both individualized and standardized care plans for critical patients assisted by pre‐hospital emergency care nurses.
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Affiliation(s)
- César Pedro Sánchez-Almagro
- Empresa Pública de Emergencias Sanitarias (EPES), Servicio Provincial de Cádiz, Cádiz, Spain.,Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain
| | - José Manuel Romero-Sánchez
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain.,Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
| | | | | | - Olga Paloma-Castro
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain.,Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
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7
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Mosca CG, Stein C, Lawrence H. South African pre-hospital emergency care personnel's lived experiences of managing paediatric emergencies: A qualitative research design utilising one-on-one interviews. Health SA 2021; 26:1558. [PMID: 34394964 PMCID: PMC8335770 DOI: 10.4102/hsag.v26i0.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/21/2021] [Indexed: 11/28/2022] Open
Abstract
Background The phenomenon of managing paediatric emergencies in the pre-hospital environment within the South African setting is poorly understood with specific regard to what emergency care personnel are experiencing when managing paediatric emergencies. Aim The aim of this study was to explore and describe the lived experiences of emergency care personnel in managing paediatric patients in the pre-hospital environment and to understand the meaning and the significance of these experiences. Setting All participants were purposively sampled from emergency medical services agencies operating within the Johannesburg metropolitan city area. Methods This study followed a qualitative, exploratory, descriptive, phenomenological design, whereby participants purposively sampled within the Johannesburg metropolitan city voluntarily consented to one-on-one interviews (n = 10). Results Three main themes, with 11 contributing categories, were identified and contextualised with available literature. Emerging from the main themes was an overall sense that managing paediatric emergencies is a negative experience, coloured with feelings of inadequacy, stress, anxiety and even fear. Conclusions The findings of this study provided new insights into what South African EMS are experiencing when managing paediatric emergencies, which enables future research efforts to identify research and practice gaps that are relevant to paediatric pre-hospital emergency care, and that are specific to the South African environment. Contribution This research provides preliminary insight into the lived experiences of prehospital personnel managing paediatric emergencies as well as emerging recommendations for the improvement of the prehospital care of paediatric patients.
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Affiliation(s)
- Colin G Mosca
- Department of Emergency Medical Care, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Christopher Stein
- Department of Emergency Medical Care, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Heather Lawrence
- Department of Allied Health Professions, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
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8
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Abate H, Mekonnen C. Knowledge, Practice, and Associated Factors of Nurses in Pre-Hospital Emergency Care at a Tertiary Care Teaching Hospital. Open Access Emerg Med 2020; 12:459-469. [PMID: 33408536 PMCID: PMC7781023 DOI: 10.2147/oaem.s290074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Pre-hospital emergency care is a medical care given to patients before arrival in the hospital after activation of the emergency team. Poor knowledge and practice about pre-hospital emergency care hurt the health outcomes of the patients. OBJECTIVE This study aimed to assess knowledge and practice nurses at the University of Gondar Compressive Specialized Hospital, Northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted from March 20 to April 10, 2020. A stratified sampling technique was used to select the study participants. Data were collected using a pretested structured self-administered questionnaire. Data were analyzed using SPSS version 20. To explain study variables, frequency tables and percentages were used. Logistic regression analysis was used to see the association between independent and dependent variables. RESULTS Out of the total 378 respondents, less than half (42.9%) had good knowledge; similarly, 49.5% of them had good practice about pre-hospital emergency care. Male sex and attend formal training were significant associations with both knowledge and practice of pre-hospital emergency nursing care. Male participants (adjusted odds ratio (AOR) = 6.57, 95% confidence interval (CI) (3.79-11.36)) and having training (AOR=1.74, 95% CI (1.83-3.66)) were significantly associated with knowledge of pre-hospital emergency care, whereas male sex (AOR=1.73, 95% CI (1.09-2.73)) and having training (AOR=6.16, 95% CI (2.69-14.10)) were significantly associated with the practice of pre-hospital emergency care. CONCLUSION Knowledge and practice of nurses regarding pre-hospital emergency care was found to be inadequate as compared to previous studies. Male sex and attend formal training showed a positive and significant association with both knowledge and practice of pre-hospital emergency nursing care. The responsible body ought to allow professional development and attending formal training for nurses.
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Affiliation(s)
- Hailemichael Abate
- Department of Medical Nursing, College of Health Science, Gondar, Ethiopia
| | - Chilot Mekonnen
- Department of Medical Nursing, College of Health Science, Gondar, Ethiopia
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Mai HT, Vu HM, Ngo TT, Vu GT, Nguyen HLT, Hoang MT, Tran BX, Latkin CA, Ho CSH, Ho RCM. The Status of First Aid and Its Associations with Health Outcomes among Patients with Traffic Accidents in Urban Areas of Vietnam. Int J Environ Res Public Health 2020; 17:E4600. [PMID: 32604838 DOI: 10.3390/ijerph17124600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/18/2020] [Accepted: 06/24/2020] [Indexed: 11/17/2022]
Abstract
While it is well-evident that proper first aid would significantly promote survival and later treatment outcomes, little attention has been paid to improving its capacity in Vietnam. Thus, we conducted this study to assess the status of first aid and its associations with health outcomes among patients in traffic accidents in urban areas of Vietnam. We conducted a cross-sectional study on 413 patients in traffic accidents from October to December 2018 at six hospitals in Thai Binh province. Socio-demographics, first aid characteristics, and health outcomes were collected via face-to-face interviews using a structured questionnaire. We used a chi-square test to determine the differences in health outcomes among those who received first aid and those without. In addition, a multivariable regression was performed to determine the factors associated with first aid. The results indicated that less than half of the patients received first aid (48.1%), and only one fourth received first aid within 10 min after an accident. The proportions of having problems with mobility, self-care, usual activities, and pain/discomfort were significantly lower among those who received first aid compared to those without it. The regression model showed that those with multiple injuries were less likely to receive first aid.
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10
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King JC, Franklin RC, Robertson A, Aitken PJ, Elcock MS, Gibbs C, Lawton L, Mazur SM, Edwards KH, Leggat PA. Review article: Primary aeromedical retrievals in Australia: An interrogation and search for context. Emerg Med Australas 2019; 31:916-929. [PMID: 31729193 DOI: 10.1111/1742-6723.13405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 08/07/2019] [Accepted: 09/20/2019] [Indexed: 11/28/2022]
Abstract
Primary aeromedical retrievals are a direct scene response to patients with a critical injury or illness using a medically equipped aircraft. They are often high-acuity taskings. In Australia, information on primary retrieval taskings is housed by service providers, of which there are many across the country. This exploratory literature review aims to explore the contemporary peer-reviewed literature on primary aeromedical retrievals in Australia. The focus is on adult primary aeromedical retrievals undertaken in Australia and clinical tools used in this pre-hospital setting. Included articles were reviewed for research theme (clinical and equipment, systems and/or outcomes), data coverage and appraisal of the evidence. Of the 37 articles included, majority explored helicopter retrievals (n = 32), retrieval systems (n = 21), compared outcomes within a service (n = 10) and explored retrievals in the state of New South Wales (n = 19). Major topics of focus included retrieval of trauma patients and airway management. Overall, the publications had a lower strength of evidence because of the preponderance of cross-sectional and case-study methodology. This review provides some preliminary but piecemeal insight into primary retrievals in Australia through a localised systems lens. However, there are several areas for research action and service outcome improvements suggested, all of which would be facilitated through the creation of a national pre-hospital and retrieval registry. The creation of a registry would enable consideration of the frequency and context of retrievals, comparison across services, more sophisticated data interrogation. Most importantly, it can lead to service and pre-hospital and retrieval system strengthening.
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Affiliation(s)
- Jemma C King
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Richard C Franklin
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,World Safety Organization Collaborating Centre for Disaster Health and Emergency Response, Townsville, Queensland, Australia
| | - Anita Robertson
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,Royal Flying Doctor Service, Townsville, Queensland, Australia
| | - Peter J Aitken
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,Aeromedical Retrieval and Disaster Management Branch, Prevention Division, Department of Health, Brisbane, Queensland, Australia
| | - Mark S Elcock
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,Aeromedical Retrieval and Disaster Management Branch, Prevention Division, Department of Health, Brisbane, Queensland, Australia
| | - Clinton Gibbs
- Retrieval Services Queensland, Aeromedical Retrieval and Disaster Management Branch, Prevention Division, Department of Health, Brisbane, Queensland, Australia.,College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Department of Emergency Medicine, The Townsville Hospital, Townsville, Queensland, Australia
| | - Luke Lawton
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Department of Emergency Medicine, The Townsville Hospital, Townsville, Queensland, Australia
| | - Stefan M Mazur
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,Department of Emergency Medicine, The Townsville Hospital, Townsville, Queensland, Australia.,SAAS MedSTAR Emergency Medical Retrieval Service, SA Ambulance Service, Adelaide, South Australia, Australia.,Emergency Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Kristin H Edwards
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Peter A Leggat
- Discipline of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,World Safety Organization Collaborating Centre for Disaster Health and Emergency Response, Townsville, Queensland, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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11
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Dadashzadeh A, Rahmani A, Hassankhani H, Boyle M, Mohammadi E, Campbell S. Iranian pre-hospital emergency care nurses' strategies to manage workplace violence: A descriptive qualitative study. J Nurs Manag 2019; 27:1190-1199. [PMID: 31104356 DOI: 10.1111/jonm.12791] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/27/2019] [Accepted: 05/14/2019] [Indexed: 11/29/2022]
Abstract
AIM To explore the experiences of Iranian nurses working in pre-hospital emergency care services and the strategies used to manage of workplace violence. BACKGROUND Pre-hospital emergency nurses are subject to workplace violence; however, little research addresses their experiences, particularly related to their strategies in dealing with workplace violence. METHODS A descriptive qualitative study that involved nineteen male nurses who were working in pre-hospital services collected data using semi-structured interviews and analysed it using qualitative content analysis. RESULTS Data analysis yielded four descriptive categories including no reaction to violence (tolerance and acceptance as common workplace conflicts), situational management (patient and scene management), confrontation (direct and indirect) and escaping the scene. Patient management was the dominant strategy used and had the best outcomes related to both patient and personnel safety. CONCLUSION This study showed that pre-hospital nurses use different strategies to manage violence and patient management was a common and useful strategy for managing workplace violence. However, the pre-hospital nurses have little training, insufficient support and are poorly prepared to manage workplace violence. IMPLICATIONS FOR NURSING MANAGEMENT The development of context-based guidelines, continuing education, better-equipped ambulances that include medical and defence equipment, as well as better coordination of the police force in ambulance operations, can help to reduce workplace violence.
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Affiliation(s)
- Abbas Dadashzadeh
- Medical-Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Medical-Surgical Department, Nursing and Midwifery Faculty, Medical Education Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Hassankhani
- Medical-Surgical Department, Nursing and Midwifery Faculty, Center of Qualitative Studies, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Malcolm Boyle
- Academic Lead in Paramedic Education, School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - Eisa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Suzanne Campbell
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
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12
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Mikolaizak AS, Lord SR, Tiedemann A, Simpson P, Caplan GA, Bendall J, Howard K, Webster L, Payne N, Hamilton S, Lo J, Ramsay E, O'Rourke S, Roylance L, Close JC. A multidisciplinary intervention to prevent subsequent falls and health service use following fall-related paramedic care: a randomised controlled trial. Age Ageing 2017; 46:200-207. [PMID: 28399219 DOI: 10.1093/ageing/afw190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 10/14/2016] [Indexed: 01/04/2023] Open
Abstract
Background approximately 25% of older people who fall and receive paramedic care are not subsequently transported to an emergency department (ED). These people are at high risk of future falls, unplanned healthcare use and poor health outcomes. Objective to evaluate the impact of a fall-risk assessment and tailored fall prevention interventions among older community-dwellers not transported to ED following a fall on subsequent falls and health service use. Design, setting, participants Randomised controlled trial involving 221 non-transported older fallers from Sydney, Australia. Intervention the intervention targeted identified risk factors and used existing services to implement physiotherapy, occupational therapy, geriatric assessment, optometry and medication management interventions as appropriate. The control group received individualised written fall prevention advice. Measurements primary outcome measures were rates of falls and injurious falls. Secondary outcome measures were ambulance re-attendance, ED presentation, hospitalisation and quality of life over 12 months. Analysis was by intention-to-treat and per-protocol according to self-reported adherence using negative binominal regression and multivariate analysis. Results ITT analysis showed no significant difference between groups in subsequent falls, injurious falls and health service use. The per-protocol analyses revealed that the intervention participants who adhered to the recommended interventions had significantly lower rates of falls compared to non-adherers (IRR: 0.53 (95% CI : 0.32-0.87)). Conclusion a multidisciplinary intervention did not prevent falls in older people who received paramedic care but were not transported to ED. However the intervention was effective in those who adhered to the recommendations. Trial registration the trial is registered at the Australian New Zealand Clinical Trials Registry: ACTRN 12611000503921, 13/05/2011.
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Affiliation(s)
- A Stefanie Mikolaizak
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Stephen R Lord
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Anne Tiedemann
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Paul Simpson
- Western Sydney University, School of Science and Health, Campbelltown, New South Wales, Australia
| | - Gideon A Caplan
- Post Acute Care Services, Prince of Wales Hospital, Randwick, Sydney, New South Wales 2031, Australia
| | - Jason Bendall
- University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Kirsten Howard
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyndell Webster
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Narelle Payne
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Sarah Hamilton
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Joanne Lo
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Elisabeth Ramsay
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Sandra O'Rourke
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Linda Roylance
- Falls Balance Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - J C Close
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Prince of Wales Clinical School, Randwick, New South Wales, Australia
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13
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Côté E, Hearn R. The medical response to the Boston Marathon bombings: an analysis of social media commentary and professional opinion. Perspect Public Health 2016; 136:339-344. [PMID: 27161388 DOI: 10.1177/1757913916644480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To explore the differences in perception of the medical response to the victims of the 2013 Boston Marathon bombings between laypeople and healthcare professionals. METHODS Commentary accessible and available on Internet discussion websites by non-medically trained persons and in the academic literature by healthcare professionals was analysed qualitatively. RESULTS Major themes were found relating to both the pre-hospital and hospital-based phases of the medical response to the disaster. Laypeople focused more on pre-hospital care and the actions of specific bystanders, while healthcare professionals focused on hospital care, the importance of a disaster plan, and frequent training for the success of the response. CONCLUSION Laypeople and healthcare professionals have positive but differing perceptions of the medical response to the victims of the bombings. This may have implications for future funding and implementation of disaster preparedness.
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Affiliation(s)
- Emilie Côté
- KUMEC, Department of Primary Care and Public Health Sciences, King's College London, UK
| | - Russell Hearn
- KUMEC, Department of Primary Care and Public Health Sciences, King's College London, UK
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14
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Abstract
OBJECTIVES A previous study showed that Norwegian GPs on call attended around 40% of out-of-hospital medical emergencies. We wanted to investigate the alarms of prehospital medical resources and the doctors' responses in situations of potential cardiac arrests. DESIGN AND SETTING A three-month prospective data collection was undertaken from three emergency medical communication centres, covering a population of 816,000 residents. From all emergency medical events, a sub-group of patients who received resuscitation, or who were later pronounced dead at site, was selected for further analysis. RESULTS 5,105 medical emergencies involving 5,180 patients were included, of which 193 met the inclusion criteria. The GP on call was alarmed in 59 %, and an anaesthesiologist in 43 % of the cases. When alarmed, a GP attended in 84 % and an anaesthesiologist in 87 % of the cases. Among the patients who died, the GP on call was alarmed most frequently. CONCLUSION Events involving patients in need of resuscitation are rare, but medical response in the form of the attendance of prehospital personnel is significant. Norwegian GPs have a higher call-out rate for patients in severe situations where resuscitation was an option of treatment, compared with other "red-response" situations. Key points This study investigates alarms of and call-outs among GPs and anaesthesiologists on call, in the most acute clinical situations: Medical emergencies involving patients in need of resuscitation were rare. The health care contribution by pre-hospital personnel being called out was significant. Compared with other acute situations, the GP had a higher attendance rate to patients in life-threatening situations.
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Affiliation(s)
- Erik Zakariassen
- a National Centre for Emergency Primary Health Care , Uni Research Health , Bergen , Norway
- b Department of Research , The Norwegian Air Ambulance Foundation , Drøbak , Norway
- c Department of Global Public Health and Primary Care, Research Group for General Practice , University of Bergen , Bergen , Norway
| | - Steinar Hunskaar
- a National Centre for Emergency Primary Health Care , Uni Research Health , Bergen , Norway
- c Department of Global Public Health and Primary Care, Research Group for General Practice , University of Bergen , Bergen , Norway
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15
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Eidenbenz D, Taffé P, Hugli O, Albrecht E, Pasquier M. A two-year retrospective review of the determinants of pre-hospital analgesia administration by alpine helicopter emergency medical physicians to patients with isolated limb injury. Anaesthesia 2016; 71:779-87. [PMID: 27091515 DOI: 10.1111/anae.13462] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2016] [Indexed: 11/28/2022]
Abstract
Up to 75% of pre-hospital trauma patients experience moderate to severe pain but this is often poorly recognised and treated with insufficient analgesia. Using multi-level logistic regression analysis, we aimed to identify the determinants of pre-hospital analgesia administration and choice of analgesic agent in a single helicopter-based emergency medical service, where available analgesic drugs were fentanyl and ketamine. Of the 1156 patients rescued for isolated limb injury, 657 (57%) received analgesia. Mean (SD) initial pain scores (as measured by a numeric rating scale) were 2.8 (1.8), 3.3 (1.6) and 7.4 (2.0) for patients who did not receive, declined, and received analgesia, respectively (p < 0.001). Fentanyl as a single agent, ketamine in combination with fentanyl and ketamine as a single agent were used in 533 (84%), 94 (14%) and 10 (2%) patients, respectively. A high initial on-scene pain score and a presumptive diagnosis of fracture were the main determinants of analgesia administration. Fentanyl was preferred for paediatric patients and ketamine was preferentially administered for severe pain by physicians who had more medical experience or had trained in anaesthesia.
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Affiliation(s)
- D Eidenbenz
- Medical School of the University of Lausanne, Lausanne, Switzerland
| | - P Taffé
- Institute for Social and Preventive Medicine (IUMSP), Lausanne, Switzerland
| | - O Hugli
- Emergency Service, Lausanne, Switzerland
| | - E Albrecht
- Anaesthesiology Service, Lausanne, Switzerland
| | - M Pasquier
- Emergency Service, Lausanne University Hospital, Lausanne, Switzerland
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