Australasian Journal of Paramedicine最新文献

{"title":"Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration","authors":"Robbie King, F. Oprescu, B. Lord, B. Flanagan, T. Downer","doi":"10.1177/27536386231163721","DOIUrl":"https://doi.org/10.1177/27536386231163721","url":null,"abstract":"Understanding patient experience is associated with quality, safe, and effective healthcare. However, there is a scarcity of knowledge explaining how patients experience non-conveyance, a setting where individuals receive unscheduled ambulance service response and paramedic-led care that results in a decision to not attend a hospital emergency department (ED). This research project aimed to investigate patients’ experiences of non-conveyance within an Australian ambulance service setting. Constructivist Grounded Theory methods were used to generate and analyse data from in-depth, semi-structured interviews with 21 participants who received paramedic-led healthcare from an Australian ambulance service between August 2020 and October 2021 that resulted in non-conveyance. A substantive theory centred on ‘Restoring self-efficacy’ was generated. It comprises three categorical concepts and their interconnected relationships, explaining how patients experience non-conveyance. ‘Losing independence’ conceptualises how a precipitating event forces patients to realise their circumstantial vulnerabilities, motivating action to seek support that leads to ambulance service response. ‘Restoring self-confidence’ emerged as the core concept, central to overall experience and a key influence on patients navigating the non-conveyance decision. When patients perceive that they have received professionally thorough and compassionate healthcare from paramedics, they form a trusting partnership resulting in the interpretation that their circumstances do not require conveyance to ED. With this reconstructed perspective, patients demonstrate increased ability for ‘Self-management’, by continuing to cope with their circumstances on their own after the episode of care. This paper provides a theoretical model for understanding how patients experience non-conveyance. Experience is influenced by dynamic, complex factors associated with restoring self-efficacy in relation to managing a health topic of interest. Restoration of self-efficacy was influenced by the patients’ interpretation of their interactions with paramedics. Future research may consider investigating the impacts of applying this knowledge to paramedic education and practice, and to quality indicators surrounding non-conveyance situations.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"19 1","pages":"63 - 78"},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83481363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of general practitioner attendance following paramedic-to-general practitioner referral in Victoria, Australia","authors":"Belinda Delardes, Shamant Prakash, Karen Smith, S. Chakraborty, K. Bowles","doi":"10.1177/27536386231160786","DOIUrl":"https://doi.org/10.1177/27536386231160786","url":null,"abstract":"Introduction Previous evaluations of paramedic-to-general practitioner (GP) referrals have focused on subsequent emergency department presentations or ambulance representations; however, we aimed to appreciate patient adherence where paramedics have recommended follow-up with a GP. Methods This was a prospective cohort study of adult patients in Victoria, Australia, who were referred to a GP by a paramedic over a 28-day period in June 2021. Patients were then contacted within five days to determine subsequent GP attendance. Results Of the 752 patients who met the inclusion criteria, 47% (n = 353) consented to participate. At the time of the survey, 65% of patients had followed up with their GP, with a further 15% booked in for a future appointment. Factors associated with the increased adjusted likelihood of the participant following up with a GP after paramedic referral included female gender (adjusted odds ratio [AOR] 2.21, 95% confidence interval [CI] 1.22–3.99, P = 0.009) and those given a specific time frame for the follow-up appointment by the paramedics (AOR 3.98, 95% CI 2.26–7.02, P < 0.001). Participants who presented to ambulance services overnight were less likely to follow up with a GP (AOR 0.34, 95% CI 0.17–0.68, P = 0.002). The three most commonly stated reasons for not following up with a GP were that the patient felt it was unnecessary (n = 48), their regular GP was unavailable (n = 33) or they had followed up with an alternative service (n = 31). Conclusion Most patients who are referred to a GP by attending paramedics will follow up with a GP within 72 h. The most common barrier to GP follow-up is the patients’ perception that follow-up is unnecessary.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"44 1","pages":"79 - 88"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90888628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing quality of scoping reviews in paramedicine research – guidance for authors","authors":"Paul Simpson, R. Pap","doi":"10.1177/27536386231161942","DOIUrl":"https://doi.org/10.1177/27536386231161942","url":null,"abstract":"Scoping reviews are an increasingly common method for conducting evidence synthesis in paramedicine. Over the past decade clear methodological guidance has emerged, adding rigour and credibility to this review approach. Paramedicine receives many scoping review submissions, and views these as valid evidence synthesis capable of helping the journal achieve its strategic vision and mission. However the Editorial Board has noted that submissions frequently fail to adhere to essential elements of scoping methodology and reporting standards. This editorial aims to provide guidance to authors regarding Paramedicine's expectations and requirements for scoping review submissions, with the hope of contributing to a greater understanding of scoping review science and enhancement of quality.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"36 1","pages":"35 - 37"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81085985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with pain reporting and severity of pain in the prehospital setting","authors":"R. Quinn, S. Masterson, D. Willis, D. Hennelly, C. Deasy, C. O’donnell","doi":"10.1177/27536386231162609","DOIUrl":"https://doi.org/10.1177/27536386231162609","url":null,"abstract":"An effective pain management strategy requires understanding of the epidemiology of pain in the population of interest and accurate measurement upon which to base quality improvement plans. The aims of this study were to estimate the incidence of pain in the prehospital setting and to explore features that impact on (1) documentation of pain; (2) severity of pain reported by patients. This retrospective cohort study included 212,401 care episodes attended by National Ambulance Service practitioners during 2020. Descriptive analysis of patient and care episode characteristics and regression analyses for the outcomes pain recorded and severity of pain were performed. We also used text pattern-matching of the notes field to estimate the proportion of patients in pain for whom a pain score assessment had not been documented. Sixty-five percent of all patients had a pain score documented and 29.5% were in pain (11% in severe pain). Likelihood of pain being recorded was most strongly associated with: Glasgow Coma Scale (GCS) Score, working diagnosis of the patient, location of the incident, and patient age. Likelihood of pain severity was most strongly associated with: transport status of patient, GCS score, and patient age. We treated missing data as a separate category and found consistent associations between the outcomes and missing data. We also found that pain was a symptom in approximately 15% of cases where no formal pain score assessment was documented. The data showed associations between routinely collected variables and the likelihood of pain recording and pain severity. Our findings also demonstrate the impact of missing data. To mitigate missing data impact, we suggest that EMS agencies consider making pain score assessment a mandatory requirement of their reporting for every patient. We also recommend that services report the extent and impact of missing data when measuring clinical performance.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"13 1","pages":"51 - 59"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86631763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of Australian prehospital care quality indicators: An explanatory sequential mixed methods study","authors":"R. Pap, M. Stephenson, Paul Simpson, C. Lockwood","doi":"10.1177/27536386231158390","DOIUrl":"https://doi.org/10.1177/27536386231158390","url":null,"abstract":"Background Systematically developed quality indicators (QIs) facilitate the measurement and monitoring of quality of care and ultimately meaningful quality improvement. The aim of this study was to evaluate the acceptability of a predetermined suite of 84 scientifically valid prehospital care QIs from the provider perspective. Methods An explanatory sequential mixed methods study design was used. Quantitative data were obtained from 36 participants of an online survey in which they rated the acceptability of the QIs using a five-point numerical rating scale. Qualitative data were gathered by conducting semi-structured interviews with a purposive sample of nine survey participants. The successional collection of quantitative and qualitative data facilitated integrated interpretations and conclusions about the acceptability of the QIs. Results Generally, the acceptability of all QIs in the suite was rated highly. Data suggested a positive association between acceptability and other key characteristics of QIs. QIs that were seen as clear, supported by scientific evidence, practical and meaningful tended to be more acceptable than those which were not. The benefits of outcome type QIs were recognised, but participants raised concerns about their sensitivity in the measurement of prehospital quality of care. To be acceptable, QIs which included time intervals needed to be specific about time-critical interventions. Further, the high acceptability of the QIs was explained by a connection to participants’ professional values and qualities. Assessing the QIs’ acceptability from a healthcare provider perspective meant that QIs on patient satisfaction frequently received lower ratings. Conclusion The findings of this study provide evidence of the acceptability of prehospital care providers of a proposed suite of QIs. Future research should evaluate the feasibility and reliability of the QIs. There is also a need to investigate how acceptable the proposed QIs are to patients and communities.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"310 1","pages":"38 - 50"},"PeriodicalIF":0.0,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86767959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The definition of a community paramedic: An international consensus","authors":"Brenda N. Shannon, Sascha L Baldry, P. O'Meara, Nicole Foster, Angela C Martin, Matthew Cook, K. Stewart, Alecka Miles","doi":"10.1177/27536386221148993","DOIUrl":"https://doi.org/10.1177/27536386221148993","url":null,"abstract":"Community paramedicine is a globally evolving model of care where paramedics provide community-based, preventative and primary healthcare services. With increased global interest and adaptation of the community paramedicine model, there is a lack of a clear definition of the role of a community paramedic. This study sought to come to an international consensus on the definition of a community paramedic. A four-phase Delphi methodology was utilised to achieve a global consensus on the definition of a community paramedic. A systematic approach to expert identification was performed and reported in line with the Conducting and REporting of DElphi Studies standard. A total of 94 community paramedicine experts were identified and 76 experts consented to involvement in this Delphi. Response rate ranged from 81.6% (Phase 1) to 63.1% (Phase 2). Participants expressed the importance of community paramedic definition having components attributed to primary health care, health promotion, chronic disease management and advanced clinical assessment. Participants expressed that these are essential components of the community paramedic skill set, which distinguishes the role from other frontline paramedics. A final consensus with 91% agreement on the definition of a community paramedic was achieved. The four-phase Delphi achieved consensus on the definition of a community paramedic as follows: A community paramedic provides person-centred care in a diverse range of settings that address the needs of the community. Their practice may include the provision of primary health care, health promotion, disease management, clinical assessment and needs-based interventions. They should be integrated with interdisciplinary healthcare teams which aim to improve patient outcomes through education, advocacy and health system navigation. The adoption of the global consensus on the definition of a community paramedic will enhance efforts to promote the value of this specialist role, enabling a better understanding of how a community paramedic contributes to the wider healthcare system. SAGE-Journals-Accessible-Video-Player 10.1177/27536386221148993.M1 sj-vid-1-pam-10.1177_27536386221148993","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"20 1","pages":"4 - 22"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91178869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paramedicine: A new research-focused international journal committed to advancing and transforming the profession","authors":"Paul Simpson","doi":"10.1177/27536386221151522","DOIUrl":"https://doi.org/10.1177/27536386221151522","url":null,"abstract":"The Australasian College of Paramedicine is pleased to introduce Paramedicine, its relaunched, official peer-reviewed scientific journal. Paramedicine is the culmination of two decades of research publishing in paramedicine, and represents a game-changing evolution in partnership with Sage Publishing. Paramedicine’s vision is to advance and transform the discipline of paramedicine through high-quality research dissemination and discourse. Paramedicine’s mission is to deliver excellence in paramedicine through an international research forum that inspires robust discussion, enables research translation, encourages innovative thinking and informs leadership. Paramedicine will be distinctively different in what it will offer authors and how it will impact the profession internationally. It is a paramedic-led journal that has a clear focus on high-quality research underpinned by excellent science, embraces diverse quantitative and qualitative methodologies and seeks to create an uplift in the paramedicine research publishing experience for authors and readers. Through its professional publishing partnership with Sage Publishing, Paramedicine will pursue an international agenda that brings together the diverse systems, models of care, practice settings and professional philosophies that characterise paramedicine internationally, creating a connected dialogue aimed at advancing the profession.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"9 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89129660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the number of Emergency Medical Dispatchers (EMDs) scheduled based on the judgment of the managers with predictions of the Erlang C formula: a brief report","authors":"P. Saberian, Alireza Baratloo, Parisa Hasani-Sharamin, E. Karimialavijeh","doi":"10.33151/ajp.19.986","DOIUrl":"https://doi.org/10.33151/ajp.19.986","url":null,"abstract":"Introduction: Currently, at Tehran Emergency Medical Service (EMS) centre, Emergency Medical Dispatchers (EMDs) are scheduled based on the managers’ experimental estimates. In this study, we planned to evaluate the conformity of managers’ predictions with the Erlang C formula estimates in scheduling EMDs. \u0000Methods: First, the Emergency Medical Communication Centre (EMCC) performance was evaluated over one week. Afterwards, the number of required EMDs was calculated using the Erlang C formula. Finally, the predictions of the Erlang C formula were compared with those of managers’ judgments.\u0000Results: During the study period, 79,583 calls were received by the Tehran EMCC. The average number of EMDs per hour ranged between 9.5 and 22.7. The actual number of EMDs was more than Erlang C formula predictions during the 24 hours in all but three time points, i.e. 14:00–14:59, 15:00–15:59 and 18:00–18:59. In all hours, 90% of calls were answered in less than 10 seconds, and the average waiting time for a total of one week was 7.3 seconds. Also, only 2.1% of all calls were answered after 10 seconds. \u0000Conclusion: In the current study, we found that the number of EMDs scheduled based on the managers’ experimental estimates was higher than that of the Erlang C formula calculations. Also, it was found that the waiting time for emergency calls was lower than the defined standards. Although the primary results of the current study indicated that, at least on paper, the Erlang C formula has the potential to be used as a predicting model in the Tehran EMCC, further research is required to evaluate its effect on the actual performance of the EMCCs. ","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41371003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming Stigma of Mental Illness in Paramedicine – A Model for Future Practice","authors":"L. Brewster, R. Bear, Sonja Maria","doi":"10.33151/ajp.19.1023","DOIUrl":"https://doi.org/10.33151/ajp.19.1023","url":null,"abstract":"Introduction \u0000Mental health presentations are a rapidly growing proportion of cases seen by paramedics who are often at the frontline of care delivery. How paramedics perceive persons with mental illness is vital as their experiences in providing care can significantly impact decision-making. This article aims to investigate these paramedics' experiences and how these influence patient care. \u0000Methods \u0000This qualitative research study uses a narrative design where the researchers conducted two focus groups with operational paramedics (six paramedics), and the data recorded and transcribed. The team closely examined the data using thematic analysis to identify, analyse, and interpret patterns of meaning within transcribed data. After thematic analysis, a model for future practice was generated, which pictorially demonstrates the overlap of the common themes. \u0000Results \u0000Five themes ultimately were identified that profoundly appeared to be important to the paramedics within the focus groups. Paramedics have varying experiences when caring for people with mental illness. They are empathetic towards the circumstances of the person with mental illness. They perceive that the stigmatisation of persons with mental illness occurs in some cases. Paramedics are also affected in their clinical decision-making by the training and education they have received and the profession's cultural influences. \u0000Conclusion \u0000The stigmatisation of people with mental illness is apparent in paramedic practice. Despite mental illness being a common presenting problem, paramedics feel underprepared and have difficulty in treating these people. The patients' behaviour can often be reflected in the conduct of paramedics. The impact of burnout due to high exposure to people with mental illness, especially in metropolitan areas, may lead to decreased levels of empathy and compassion.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41704977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific Publishing in a Pandemic","authors":"M. Boyle","doi":"10.33151/AJP.18.896","DOIUrl":"https://doi.org/10.33151/AJP.18.896","url":null,"abstract":"Worldwide, 2020 was a difficult and challenging year for everyone, including for publishers of scientific journals. Many journals had difficulty sourcing reviewers because people were busier in unexpected ways and could not review a manuscript, or those who were able to review a manuscript often struggled to get it done in the prescribed time due to work and personal commitments. Even with this challenging year, the AJP published 51 research-related articles, slightly more than in 2019. We are confident that 2021 will also prove to be a positive in a publishing sense as we continue to receive manuscripts from national and international authors covering a broad range of topics. So, as we enter another year of uncertainty, the AJP's editorial team look forward to meeting the challenges of 2021 as we continue to publish peer-reviewed articles from Australasia and around the world.","PeriodicalId":55865,"journal":{"name":"Australasian Journal of Paramedicine","volume":"18 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69510605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}