First responder, clinician, and non-clinical support staff knowledge, attitudes, and behaviours towards people presenting for emergency care following self-harm: a mixed evidence synthesis

2021 ◽  
Vol 2021 (12) ◽  
Author(s):  
Sarah Fortune ◽  
Alina Pavlova ◽  
Sarah E Hetrick ◽  
Bonnie Scarth ◽  
Keith Hawton ◽  
...  
Keyword(s):  
Emergency Care ◽  
Evidence Synthesis ◽  
Support Staff ◽  
First Responder ◽  
Clinical Support ◽  
Self Harm

Service users’ experiences of emergency care following an episode of self-harm: a mixed evidence synthesis

2021 ◽  
Vol 2021 (12) ◽  
Author(s):  
Bonnie Scarth ◽  
Alina Pavlova ◽  
Sarah E Hetrick ◽  
Katrina G Witt ◽  
Keith Hawton ◽  
...  
Keyword(s):  
Emergency Care ◽  
Evidence Synthesis ◽  
Service Users ◽  
Self Harm

Developing a Lay First Responder Program in Chad: A 12-Month Follow-Up Evaluation of a Rural Prehospital Emergency Care Program

2020 ◽  
Vol 35 (5) ◽  
pp. 546-553 ◽  
Author(s):  
Canaan J. Hancock ◽  
Peter G. Delaney ◽  
Zachary J. Eisner ◽  
Eric Kroner ◽  
Issa Mahamet-Nuur ◽  
...  
Keyword(s):  
Knowledge Acquisition ◽  
Emergency Care ◽  
Prehospital Emergency Care ◽  
Voluntary Participation ◽  
First Responder ◽  
Taxi Drivers ◽  
Post Test ◽  
Prehospital Emergency ◽  
Motorcycle Taxi

AbstractIntroduction:The World Health Organization (WHO; Geneva, Switzerland) recommends lay first responder (LFR) programs as a first step toward establishing formal Emergency Medical Services (EMS) in low- and middle-income countries (LMICs) to address injury. There is a scarcity of research investigating LFR program development in predominantly rural settings of LMICs.Study Objective:A pilot LFR program was launched and assessed over 12 months to investigate the feasibility of leveraging pre-existing transportation providers to scale up prehospital emergency care in rural, low-resource settings of LMICs.Methods:An LFR program was established in rural Chad to evaluate curriculum efficacy, using a validated 15-question pre-/post-test to measure participant knowledge improvement. Pre-/post-test score distributions were compared using a Wilcoxon Signed-Rank test. For test evaluation, each pre-test question was mapped to its corresponding post-test analog and compared using McNemar’s Chi-Squared Test to examine knowledge acquisition on a by-question basis. Longitudinal prehospital care was evaluated with incident reports, while program cost was tracked using a one-way sensitivity analysis. Qualitative follow-up surveys and semi-interviews were conducted at 12 months, with initial participants and randomly sampled motorcycle taxi drivers, and used a constructivist grounded theory approach to understand the factors motivating continued voluntary participation to inform future program continuity. The consolidated criteria for reporting qualitative research (COREQ) checklist was used to guide design, analysis, and reporting the qualitative results.Results:A total of 108 motorcycle taxi participants demonstrated significant knowledge improvement (P <.001) across three of four curricular categories: scene safety, airway and breathing, and bleeding control. Lay first responders treated 71 patients over six months, encountering five deaths, and provided patient transport in 82% of encounters. Lay first responders reported an average confidence score of 8.53/10 (n = 38). In qualitative follow-up surveys and semi-structured interviews, the ability to care for the injured, new knowledge/skills, and the resultant gain in social status and customer acquisition motivated continued involvement as LFRs. Ninety-six percent of untrained, randomly sampled motorcycle taxi drivers reported they would be willing to pay to participate in future training courses.Conclusion:Lay first responder programs appear feasible and cost-effective in rural LMIC settings. Participants demonstrate significant knowledge acquisition, and after 12 months of providing emergency care, report sustained voluntary participation due to social and financial benefits, suggesting sustainability and scalability of LFR programs in low-resource settings.

Experiences of nursing care for patients who self‐harm and suggestions for future practices: The perspectives of emergency care nurses

2021 ◽  
Author(s):  
Christina Østervang ◽  
Lærke Geisler Johansen ◽  
Anne Friis‐Brixen ◽  
Charlotte Myhre Jensen
Keyword(s):  
Nursing Care ◽  
Emergency Care ◽  
Self Harm

Improving emergency care for people who self harm

BMJ ◽  
2016 ◽  
pp. i2440
Author(s):  
Naomi Salisbury
Keyword(s):  
Emergency Care ◽  
Self Harm

scholarly journals Tools for ‘safety netting’ in common paediatric illnesses: a systematic review in emergency care

2015 ◽  
Vol 101 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Evelien de Vos-Kerkhof ◽  
Dorien HF Geurts ◽  
Mariska Wiggers ◽  
Henriette A Moll ◽  
Rianne Oostenbrink
Keyword(s):  
Emergency Care ◽  
Clinical Symptoms ◽  
Evidence Synthesis ◽  
Educational Interventions ◽  
Therapeutic Interventions ◽  
Level Of Evidence ◽  
Study Results ◽  
Best Evidence Synthesis ◽  
Safety Netting

ContextFollow-up strategies after emergency department (ED) discharge, alias safety netting, is often based on the gut feeling of the attending physician.ObjectiveTo systematically identify evaluated safety-netting strategies after ED discharge and to describe determinants of paediatric ED revisits.Data sourcesMEDLINE, Embase, CINAHL, Cochrane central, OvidSP, Web of Science, Google Scholar, PubMed.Study selectionStudies of any design reporting on safety netting/follow-up after ED discharge and/or determinants of ED revisits for the total paediatric population or specifically for children with fever, dyspnoea and/or gastroenteritis. Outcomes included complicated course of disease after initial ED visit (eg, revisits, hospitalisation).Data extractionTwo reviewers independently assessed studies for eligibility and study quality. As meta-analysis was not possible due to heterogeneity of studies, we performed a narrative synthesis of study results. A best-evidence synthesis was used to identify the level of evidence.ResultsWe summarised 58 studies, 36% (21/58) were assessed as having low risk of bias. Limited evidence was observed for different strategies of safety netting, with educational interventions being mostly studied. Young children, a relevant medical history, infectious/respiratory symptoms or seizures and progression/persistence of symptoms were strongly associated with ED revisits. Gender, emergency crowding, physicians’ characteristics and diagnostic tests and/or therapeutic interventions at the index visit were not associated with revisits.ConclusionsWithin the heterogeneous available evidence, we identified a set of strong determinants of revisits that identify high-risk groups in need for safety netting in paediatric emergency care being related to age and clinical symptoms. Gaps remain on intervention studies concerning specific application of a uniform safety-netting strategy and its included time frame.

scholarly journals Staff perceptions on the role and value of chaplains in first responder and military settings: A scoping review

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Katie Tunks Leach ◽  
Joanne Lewis ◽  
Tracy Levett-Jones
Keyword(s):  
Scoping Review ◽  
English Language ◽  
Research Question ◽  
Grey Literature ◽  
Support Staff ◽  
First Responder ◽  
Staff Perceptions ◽  
The Military ◽  
The Impact

Background Chaplains in first responder and military services support staff prior to, during and after critical incidents. Some studies have explored the role of chaplains in these settings predominantly in the military and from chaplains’ perspectives. However, few studies have explored the perspective of staff. This scoping review aims to map the literature on staff perceptions of the role and value of chaplains in first responder and military settings.   Method A scoping review using the Arksey & O’Malley (2003) and Joanna Briggs Institute Scoping Review Methodology was conducted. English language peer-reviewed and grey literature in CINAHL, PubMed, PsychINFO, ProQuest and Google Scholar from 2004-2019 was reviewed for inclusion. Records were included if they provided staff perspectives on the role and value of chaplains in first responder and military settings. The initial search identified 491 records after removal of duplicates. All titles and abstracts were then screened for relevance to the research question and 84 were selected for full-text review. Seven records were included in final review; five dissertations and two peer-reviewed articles. Five of these were from the military and two from the police. Data were extracted and thematically analysed to identify staff perceptions of the role, skills and attributes, and value of chaplains in first responder and military settings.   Results Staff understood the role of chaplain to include the provision of spiritual and pastoral care and guidance and, in the case of police, providing scene support. Staff from all of the services identified requisite skills and attributes for chaplains such as being available, approachable and engaged; counselling; maintaining confidentiality and trust; being organisationally aware; and possessing distinct personality traits and knowledge of specialty content areas. The value chaplains brought to their services emerged from chaplains being trusted as a result of being proactively available for staff, families and bystanders for formal and informal conversation; organisational belonging and awareness resulting in enhanced staff satisfaction and retention; and promoting staff physical, mental, social and spiritual wellbeing.   Conclusions Although military and police staff identified spiritual, psychological and social benefits to chaplains maintaining an active and visible role in their services, the small number of papers identified make generalisation of these findings to other first responder services problematic. Further research is therefore required to understand the impact of the chaplain’s role as part of the care team in first responder services.

Overdose and poisoning

2016 ◽  
Keyword(s):  
Emergency Care ◽  
Illicit Drugs ◽  
Toxic Substance ◽  
Accidental Poisoning ◽  
Nursing Assessment ◽  
Common Presentation ◽  
Self Harm

Accidental or non-accidental poisoning is a relatively common presentation to emergency care settings. Patients may have been accidentally exposed to a toxic substance or have ingested or inhaled a substance as a form of self-harm. The nursing assessment and management of common medications and toxins are presented, as well as of poisoning from alcohol and illicit drugs.

Domestic Violence Victims More Likely to Seek Emergency Care for Self-Harm

2006 ◽  
Vol 28 (11) ◽  
pp. 1
Author(s):  
Ruth SoRelle
Keyword(s):  
Domestic Violence ◽  
Emergency Care ◽  
Domestic Violence Victims ◽  
Self Harm

Primary care will not meet demand unless practices take on more clinical support staff, say experts

BMJ ◽  
2019 ◽  
pp. l1299
Author(s):  
Abi Rimmer
Keyword(s):  
Primary Care ◽  
Support Staff ◽  
Clinical Support

A feasibility study using a touchscreen tool in the AYA population.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9575-9575
Author(s):  
Jonathan R. Espenschied ◽  
Julie Anna Wolfson ◽  
Alicia Bogardus ◽  
Yanjun Chen ◽  
Jeanelle Folbrecht ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Feasibility Study ◽  
Negative Impact ◽  
Support Staff ◽  
Ease Of Use ◽  
Completion Rate ◽  
Care Team ◽  
Care Needs ◽  
Clinical Support

9575 Background: Adolescent and young adults (AYA) 15 to 39 years present unique health care needs; however, barriers to communication of treatment-related and psychosocial difficulties exist. We hypothesized that a tailored AYA Touchscreen Tool (AYATT) in cancer patients/survivors would facilitate patient-provider communication, toward the larger goal of timely intervention. As a first step, we evaluated the feasibility of such a tool, operationally defined as an 80% acceptance and completion rate. Methods: Eligible City of Hope AYA patients receiving treatment and follow up care for oncologic or hematologic disease were systematically approached for study participation. Target accrual to assess feasibility was set at 50 participants. Consented patients completed a concise AYATT battery, mostly standardized measures, assessing access to care (CHIS), needs, neurocognitive function (BRIEF-A, CogState), and other quality of life (PedsQL) issues. Patients and clinical/support staff completed satisfaction and ease-of-use surveys to further evaluate feasibility. Results: 54 participants were accrued over 8 weeks, with a 96% completion rate exceeding our primary feasibility criteria. At the time of participation: Mean age=26.2 years; Range 15.3 to 38.9 years. Acceptability was high with positive responses throughout the survey. Based on patient responses, the AYATT helped 52% remember issues they had, or have, with their care or treatment; 39% were encouraged to discuss medical issues with their care team that they might not have discussed; 92% found it a useful way to communicate with their health care team; and 98% would recommend that other patients use AYATT. A separate survey from 31/36 clinical/support staff reported AYATT had minimal negative impact in clinic or patient care, increased communication, and was useful in maintaining/improving care. Conclusions: The aggregate findings from this feasibility study support utilizing a tailored touchscreen device in the AYA oncology population. Predictably, high levels of computer knowledge in our AYA cohort may account for the success and acceptance of using such a tool. These results provide evidence for further exploration and continued use in the AYA clinic and patient care setting.

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