scholarly journals The identification of factors contributing to negative experiences of pre-hospital emergency care personnel in Johannesburg, South Africa

2021 ◽  
Vol 18 ◽  
Author(s):  
Andrew William Makkink ◽  
Christopher Owen Alexander Stein ◽  
Stevan Raynier Bruijns
Keyword(s):  
South Africa ◽  
Emergency Care ◽  
Descriptive Analysis ◽  
Hospital Setting ◽  
Data Communication ◽  
Hospital Emergency ◽  
Negative Experiences ◽  
Qualitative Descriptive ◽  
Formed Part ◽  
Patient Handover

Introduction The handover of a patient in the pre-hospital setting is different to other handover settings and therefore requires a different definition and description to that of other patient handover environments. Identifying those factors that affect the efficacy of handover could provide useful for formulating improvement strategies. Aim This research set out to describe the negative experiences of pre-hospital emergency care personnel handing over in the emergency centre in Johannesburg, South Africa, with a view to identifying potential areas for improvement. This paper reports on responses to an open-ended question that formed part of a purpose-designed, paper-based questionnaire that formed part of a mixed-methods study. Methods Data were collected from pre-hospital emergency care personnel within Johannesburg, South Africa. Responses from 140 participants were captured verbatim into Atlas.ti® for coding, analysis and interpretation using a qualitative descriptive methodology. Two themes were generated from a qualitative descriptive analysis of the data: communication barriers, and process barriers to emergency centre handover. These were confirmed by the categories and codes that made up these themes. Conclusion This study identifies some of the factors perceived by pre-hospital emergency care personnel to negatively affect emergency centre handover. It provides insights into how communication and process within the emergency centre have the potential to negatively impact emergency centre handover efficacy.

scholarly journals The process of handover in the busy emergency centre: A pre-hospital perspective from Johannesburg, South Africa

2021 ◽  
Vol 18 ◽  
Author(s):  
Andrew William Makkink ◽  
Christopher Owen Alexander Stein ◽  
Stevan Raynier Bruijns
Keyword(s):  
South Africa ◽  
Emergency Care ◽  
Future Research ◽  
Structured Interviews ◽  
Hospital Emergency ◽  
Hospital Perspective ◽  
Face To Face ◽  
Explanatory Mixed Methods ◽  
Qualitative Descriptive ◽  
To Receive

Background Emergency centre handover usually takes place between the pre-hospital emergency care personnel who deliver the handover and the emergency centre personnel who receive the handover. Handover that is not effective may present risks to patient safety. One factor that may affect handover delivery is the process of handover within a busy emergency centre. Methods The data reported on in this study formed the qualitative component of a sequential explanatory mixed methods study. It used face-to-face, semi-structured interviews to gather data. Fifteen interviews were conducted with pre-hospital emergency care personnel from a range of qualification and scopes in South Africa. Interviews were transcribed verbatim and imported into Atlas.ti® for coding and analysis using a qualitative descriptive methodology. Results Pre-hospital emergency care participants identified a lack of emergency centre staff available to receive handover as a barrier to effective handover and attributed this to emergency centres being overworked and understaffed. This potentiated interruptions to handover and having to deliver multiple handovers for the same patient. Pre-hospital emergency care participants indicated a preference for handing over directly to a doctor. Conclusion Several potential process barriers to effective emergency centre handover were identified, including lack of personnel to receive handover, interruptions and the need to perform multiple handovers for the same patient. Generally, these barriers were attributed to the busy understaffed and overworked nature of emergency centres. We would encourage future research in emergency centre handover, specifically from the perspective of the personnel who receive handovers.

Registered nurses’ experiences of assessing patients with mental illness in emergency care: A qualitative descriptive study

2020 ◽  
Vol 40 (3) ◽  
pp. 151-161
Author(s):  
Mats Holmberg ◽  
Staffan Hammarbäck ◽  
Henrik Andersson
Keyword(s):  
Mental Illness ◽  
Registered Nurses ◽  
Emergency Care ◽  
Descriptive Study ◽  
Main Theme ◽  
Patient Assessment ◽  
Hospital Emergency ◽  
Self Confidence ◽  
Qualitative Descriptive ◽  
Existential Dimension

Patients with mental illness are exposed and experience themselves as not being taken seriously in emergency care. Registered nurses need to assess patients with mental illness from a holistic perspective comprising both a physical and an existential dimension. The aim of the study was to describe registered nurses’ (RNs) experiences of assessing patients with mental illness in emergency care. Twenty-eight RNs in prehospital and in-hospital emergency care were individually interviewed. The interviews were analysed descriptively. The design followed the COREQ-checklist. One main theme ‘A conditional patient assessment’ and two themes; ‘A challenged professional role’ and ‘A limited openness for the patient’, comprising in turn four sub-themes emerged. Although the RNs showed willingness to understand the mental illness aspects of their patients, they were insufficient in their assessments. This implies the importance of developing emergency care RNs’ competence, knowledge and self-confidence in assessments and care of patients with mental illness.

scholarly journals The need for purposeful teaching, learning and assessment of crisis resource management principles and practices in the undergraduate pre-hospital emergency care curriculum: A narrative literature review

2021 ◽  
Vol 18 ◽  
Author(s):  
Mugsien Rowland ◽  
Anthonio Oladele Adefuye ◽  
Craig Vincent-Lambert
Keyword(s):  
Resource Management ◽  
Situation Awareness ◽  
Emergency Care ◽  
Care Setting ◽  
Clinical Skills ◽  
Hospital Setting ◽  
Technical Skills ◽  
Care Plan ◽  
Crisis Resource Management ◽  
Hospital Emergency

IntroductionTraditionally, undergraduate emergency medical care (EMC) training programs have, over the years, typically focussed on developing individuals with proficiency in clinical skills who can perform complex procedures in the act of administering safe and effective emergency care in the pre-hospital setting. A shortcoming of this training relates to the attention given to the soft skills needed to work efficiently in a team-based environment. Crisis resource management (CRM) is a structured, evidence-based approach to training that is designed to enhance teamwork performance in critical circumstances where the absence of coordinated teamwork could lead to undesired outcomes. MethodsA narrative review of GOOGLE SCHOLAR, MEDLINE, PUBMED, CINAHL as well as paramedic-specific journals was conducted. Articles were included if they examined the importance of CRM in pre-hospital emergency care; training undergraduate pre-hospital emergency care students on the principles and practices of CRM; and non-technical skills in pre-hospital emergency care. DiscussionResearchers found limited articles related to CRM and the pre-hospital emergency care setting. Our findings reveal that CRM focusses on addressing non-technical skills necessary for effective teamwork and that those identified to be relevant for effective teamwork in pre-hospital emergency care setting include situation awareness, decision-making, verbal communication, teamwork as well as leadership and followership skills. ConclusionEffective team management is a core element of expert practice in emergency medicine. When practised in conjunction with medical and technical expertise, CRM can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of a pre-hospital emergency care plan.

scholarly journals 315 Descriptive Analysis of Out-of-Hospital Emergency Care in Kampala, Uganda

2018 ◽  
Vol 72 (4) ◽  
pp. S124
Author(s):  
B. Abebe ◽  
J. Kalanzi ◽  
C. Bills ◽  
T. Reynolds ◽  
S. Kivlehan
Keyword(s):  
Emergency Care ◽  
Descriptive Analysis ◽  
Hospital Emergency

scholarly journals Factors That Influence Human Error and Patient Safety in the Pre-hospital Emergency Care Setting: Perspectives of Emergency Care Practitioners in a Middle-income Country

2021 ◽  
Author(s):  
Mugsien Rowland ◽  
Anthonio Oladele Adefuye
Keyword(s):  
South Africa ◽  
Patient Safety ◽  
Public Sector ◽  
Emergency Care ◽  
Medical Error ◽  
Hospital Care ◽  
Human Error ◽  
Care Setting ◽  
Hospital Environment ◽  
Hospital Emergency

Abstract Background: Delivering pre-hospital emergency care has the potential to be hazardous, and the patient could experience an adverse event. Despite these potential, yet known, threats, little is known about patient safety in the pre-hospital care setting, in contrast to in-hospital care. In South Africa, there are no reports on patient safety and human error issues in the pre-hospital care setting. This study investigated the perspectives of emergency care practitioners (ECPs) in South Africa on the types of errors that occur in the pre-hospital emergency care setting, as well as factors that influence patient safety and precipitate errors during pre-hospital care.Methods: This research was designed as an exploratory study that used a questionnaire administered on 2000 ECPs to obtain their perceptions on factors the influence human error and patient safety in the pre-hospital emergency care environment. Results: Of the 2000 questionnaires distributed, 1,510 were returned, giving a response rate of 76%. Analysis of the respondents’ responses in relation to the types of human errors in the pre-hospital environment yielded five dominant themes, namely errors relating to poor judgement, poor skill/knowledge, fatigue, and communication, and human error. According to the participants, inadequate equipment, environmental factors, personal safety concerns, practitioner’s incompetence, and ineffective teamwork are the top five factors that influence patient safety in the pre-hospital emergency care setting. The majority (65.1%; p < 0.001) of public sector ECPs reported that they had not received training on patient safety, nor do they have a protocol for managing medical error at their workplace (65.7%; p < 0.007). Conclusion: In conclusion, this study investigated paramedics’ views on types of errors that occur in the pre-hospital emergency care setting, and factors that influence patient safety and precipitate errors during pre-hospital care. It was found that public-sector emergency medical service (EMS) in South Africa seldom train their staff on patient safety or have a protocol for managing medical error. The study advocates that, to overcome medical errors, EMS in South Africa should establish a culture of safety that focuses on system improvement and personnel training.

scholarly journals Emergency care education in South Africa: past, present and future

2019 ◽  
Vol 16 ◽  
Author(s):  
Simpiwe Sobuwa ◽  
Lloyd Denzil Christopher
Keyword(s):  
South Africa ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Education And Training ◽  
Medical Services ◽  
Hospital Emergency ◽  
Care Education ◽  
Emergency Medical ◽  
The Many ◽  
And Training

There have been major changes in pre-hospital emergency care training and education in South African over the past 30 years. This has culminated in the publication of a regulation that brings an end to an era of short courses in emergency care and paves the way for the implementation of the National Emergency Care Education and Training (NECET) policy. The policy envisions a 1-year higher certificate, a 2-year diploma and the 4-year professional degree in emergency medical care. This paper aims to describe the history of emergency care education and training in South Africa that culminated in the NECET policy. The lessons in the professional development of pre-hospital emergency care education and training may have application for emergency medical services in other countries.The migration of existing emergency medical services personnel to the new higher education qualification structure is a major challenge. The transition to the new framework will take time due to the many challenges that must be overcome before the vision of the policy is realised. Ongoing engagement with all stakeholders is necessary for the benefits envisioned in the NECET policy to be realised.  

scholarly journals FKUB’s Communication Strategy in Mantaining Religious Harmony in Medan

2020 ◽  
Vol 3 (3) ◽  
pp. 1541-1551
Author(s):  
Fauji Wikanda ◽  
Mohd. Hatta ◽  
Abdullah Abdullah
Keyword(s):  
Data Collection ◽  
Field Observation ◽  
Communication Strategies ◽  
Descriptive Analysis ◽  
Data Communication ◽  
Target Audience ◽  
Communication Strategy ◽  
Gender Education ◽  
Qualitative Descriptive ◽  
Religion And Ethnicity

The objective of this study is to investigate communication strategies implemented by Forum Kerukunan Umat Beragama (Indonesian: Religious Harmony Forum) in maintaining religious harmony in Medan. The research used a qualitative descriptive analysis and a method of data collection which consisted of indepth interviews with research informants, interviews using observation techniques with direct field observation, and document study to explore data. Communication strategies implemented by Forum Kerukunan Umat Beragama (FKUB) in maintaining religious harmony in Medan include determining communicators based on the communicants’ religion and ethnicity; grouping the target audience by adjusting the program’s theme to the communicants’ age, gender, education, work and religion; gathering informative, persuasive and educational messages; and utilizing printed, electronic and outdoor media.

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