Workers' Clinical Skills at Out-of-Hospital Emergency Care

2015 ◽  
Vol 05 (06) ◽  
Author(s):  
Mari Salminen Tuomaala ◽  
Päivi Leikkola ◽  
Riitta Mikkola ◽  
Eija Paavilainen
2021 ◽  
Vol 18 ◽  
Author(s):  
Mugsien Rowland ◽  
Anthonio Oladele Adefuye ◽  
Craig Vincent-Lambert

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.


2017 ◽  
Vol 6 (1) ◽  
pp. 51
Author(s):  
Riitta Mikkola ◽  
Mari Salminen-Tuomaala ◽  
Eija Paavilainen ◽  
Päivi Leikkola

Objective: This follow-up study is part of a larger study on emergency medical services. Its purpose was to describe emergency care providers’ perceptions of their work, its challenges and their clinical competence. The study aimed at producing knowledge of the perceived influence of an educational intervention, to be used in developing emergency care providers’ further and updating education.Methods: Data were collected from staff working in out-of-hospital emergency care of a hospital district in Finland using a questionnaire developed for this purpose. The results were analyzed statistically using SPSS for Windows 24.Results: Over 90% of the respondents found that their work was interesting and provided sufficient challenges. The majority were also interested in continuous professional development. After the educational intervention, respondents found the work somewhat more challenging and slightly more strenuous both physically and mentally compared to the first survey. Respondents more commonly reported that new capacities were required at work and they rated their practical skills lower than in the first survey. However, work in a multiprofessional environment was found less challenging. Over 70% of the respondents planned to have further education in the near future. They rated their clinical skills as good, but slightly lower compared to the first survey.Conclusions: The results regarding work, its challenges and self-rated clinical competence remained the same or were somewhat poorer after the educational intervention. The results help improve the education to meet the needs of emergency staff.


2012 ◽  
Vol 98 (1) ◽  
pp. 16-18
Author(s):  
D Newman

AbstractThis article examines the non clinical skills and training required for effective maritime pre-hospital emergency care provision within a Role Two Afloat facility, allowing for a Primary Retrieval Team to be deployed in support of boarding operations. The provision of pre-hospital emergency care and sending a retrieval team forward has been trialled in various forms. In 2010 and 2011 a R2A team was deployed aboard RFA FORT VICTORIA. This included a Primary Retrieval Team consisting of an Emergency Nurse Specialist, a Medical Assistant which can be enhanced when required by an Emergency Care or Anaesthetic Consultant. This differs from the land operations support provided by the airborne Medical Emergency Response Team (MERT) as the maritime environment requires a bespoke solution for casualty retrieval as the method of deployment and the type of casualties and their locations may be more varied, requiring greater flexibility of approach.


2021 ◽  
Author(s):  
Marciane Mueller ◽  
Rejane Frozza ◽  
Liane Mählmann Kipper ◽  
Ana Carolina Kessler

BACKGROUND This article presents the modeling and development of a Knowledge Based System, supported by the use of a virtual conversational agent called Dóris. Using natural language processing resources, Dóris collects the clinical data of patients in care in the context of urgency and hospital emergency. OBJECTIVE The main objective is to validate the use of virtual conversational agents to properly and accurately collect the data necessary to perform the evaluation flowcharts used to classify the degree of urgency of patients and determine the priority for medical care. METHODS The agent's knowledge base was modeled using the rules provided for in the evaluation flowcharts comprised by the Manchester Triage System. It also allows the establishment of a simple, objective and complete communication, through dialogues to assess signs and symptoms that obey the criteria established by a standardized, validated and internationally recognized system. RESULTS Thus, in addition to verifying the applicability of Artificial Intelligence techniques in a complex domain of health care, a tool is presented that helps not only in the perspective of improving organizational processes, but also in improving human relationships, bringing professionals and patients closer. The system's knowledge base was modeled on the IBM Watson platform. CONCLUSIONS The results obtained from simulations carried out by the human specialist allowed us to verify that a knowledge-based system supported by a virtual conversational agent is feasible for the domain of risk classification and priority determination of medical care for patients in the context of emergency care and hospital emergency.


Resuscitation ◽  
2007 ◽  
Vol 72 (3) ◽  
pp. 386-393 ◽  
Author(s):  
Seth C. Hawkins ◽  
Alan H. Shapiro ◽  
Adrianne E. Sever ◽  
Theodore R. Delbridge ◽  
Vincent N. Mosesso

Nutrition ◽  
2019 ◽  
Vol 66 ◽  
pp. 142-146 ◽  
Author(s):  
C. Bolado Jiménez ◽  
H. Fernádez Ovalle ◽  
MF Muñoz Moreno ◽  
R. Aller de la Fuente ◽  
DA de Luis Román

2020 ◽  
Author(s):  
Gabriele Ciminelli ◽  
Sílvia Garcia-Mandicó

This paper draws from daily death registry data on 4,000 Italian municipalities to investigate two crucial policies that can dramatically affect the toll of COVID-19: the shutdown of non-essential businesses and the management of the emergency care system. Our results, which are robust to controlling for a host of co-factors, offer strong evidence that the closure of service activities is very effective in reducing COVID-19 mortality - this was about 15% lower in municipalities with a 10 percentage points higher employment share in shut down services. Shutting down factories, instead, is much less effective, plausibly because factory workers engage in more limited physical interactions relative to those in the consumer-facing service sector. Concerning the management of the health care system, we find that mortality strongly increases with distance from the intensive care unit (ICU). Municipalities at 10 km from the closest ICU experienced up to 50% higher mortality. This effect - which is largest within the epicenter and in days of abnormally high volumes of calls to the emergency line - underscores the importance of improving pre-hospital emergency services and building ambulance capacity to ensure timely transportation of critical patients to the ICU.


2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Chris O'Connor ◽  
Joe O'Hara

<p><strong>Background</strong></p><p>Since the mid 1980’s, reflective practice has become formally acknowledged and adopted as a key strategy for learning and has become one of the cornerstones of medical education for doctors, nurses, and many of the allied healthcare professions. In the education of pre-hospital emergency care practitioners in Ireland, it is only in the last decade that the notion of reflective practice has been tentatively approached.  Indeed until recently it has largely been ignored by practitioners and educators alike, who have been slow to engage with this new way of learning. This paper explores the attitudes of practitioners to the use of a reflective discussion forum to encourage and support reflection and reflective practice among pre-hospital emergency care practitioners in Ireland.  It also examines the experiences of practitioners who participated in a collaborative reflective discussion forum.</p><p><strong>Literature</strong></p><p>The research was informed by reviewing literature from a number of areas including:  Adult Learning, Reflective Practice, Educational Research directly relating to Emergency Medical Services (EMS), and EMS &amp; Nursing Journals and publications.</p><p><strong>Methodologies</strong></p><p>This paper is part of a larger project which consisted of three cycles of action research.  Data was collected via an online survey questionnaire, and by conducting a series of semi-structured interviews with participants in the reflective discussion forum.  These included all three clinical levels of pre-hospital emergency care practitioners and the three hierarchical levels within the organisation.</p><p><strong>Findings</strong></p><p>The collaborative reflective discussion forum was found to be beneficial.  Among the benefits cited were, the opportunity to draw on the experience of more experienced colleagues, the development of critical thinking skills, and the potential for use as part of a mentoring process.  It was also felt that the collaborative nature of the forum had the potential to improve workplace relationships through the empowerment of the staff. Concerns were raised regarding the potential for abuse and misuse, particularly in relation to the areas of patient confidentiality and a lack of trust within organisations.</p><p><strong>Recommendations</strong></p><p>The establishment of a regular Reflective Discussion Forum within organisations as a key learning strategy. Any collaborative forum must be chaired by a trusted, experienced and highly skilled facilitator. A learning contract for all participants and faculty, including a confidentiality agreement, must be in place prior to the establishment of any collaborative forum.</p>


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