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Pre-hospital treatment of snake envenomation in patients presented AT a tertiary care hospital in Northwestern India

Chauhan,S.; Faruqi,S.; Bhalla,A.; Sharma,N.; Varma,S.; Bali,J.
Fonte: Centro de Estudos de Venenos e Animais Peçonhentos - CEVAP, Universidade Estadual Paulista - UNESP Publicador: Centro de Estudos de Venenos e Animais Peçonhentos - CEVAP, Universidade Estadual Paulista - UNESP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2005 Português
Relevância na Pesquisa
46.13%
Snakebite is an important medical emergency. Anti-snake venom along with supportive care is the only specific treatment. However, many people put their faith in non-registered medical practitioners. Where medical aid is available, lack of trained health personnel jeopardizes the situation. This retrospective study, the first of its kind, was aimed at studying the pre-hospital treatment as well as the behavior of patients bitten by snakes and referred to the Postgraduate Institute of Medical Education and Research, Chandigarh, India. A total of 88 cases that occurred between January 1997 and December 2001 were studied. Seventy patients received treatment prior to admission (the majority was treated by non-registered medical practitioners, registered medical practitioners, and MBBS doctors). The various treatment modalities used were: anti-snake venom (ASV), tourniquet, incision and drainage (I&D), tetanus toxoid, injections, and tablets. Non-registered medical practitioners still preferred tourniquet and I&D. The patients who were referred within 24 hours stayed less time in the hospital and spent less money on the treatment compared to those who were referred after 24 hours. Non-registered medical practitioners and inadequately trained health staff are often the first contact of snakebite victims. Their traditional and unscientific methods of treatment lead to unnecessary morbidity and increased treatment cost. It is therefore necessary to train these people adequately so that proper treatment can be instituted at the earliest.

Trends and district variations in the hospital care of childhood asthma: results of a regional study 1970-85.

Anderson, H R
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1990 Português
Relevância na Pesquisa
35.84%
Trends and district variations in the pre-hospital and hospital care of children aged 0-14 years admitted with acute asthma were surveyed in all 13 districts of a health region by examining case notes for 1970, 1978, and 1985. From 1970 to 1985 there was a substantial increase in admissions and some reduction of hospital stay. Over this time adrenergic drugs remained the most frequently used treatment with a large shift towards selective beta2 agonists administered by nebulisation. Use of corticosteroids fell in the under 5s with a decrease in the parenteral route of administration but rose in the 5-14 age group with an increase in the oral route of administration. There was an increase the use of oral xanthines but this was outweighed by falls in the use of suppositories and in parenteral administration. The use of antibiotics became less frequent and that of sedatives and antihistamines fell to almost nil. There were also important changes in other aspects of management, notably an increase in the use of lung function tests (from 3% to 70%) and falls in the use of chest radiographs, blood tests, bacteriology, and physiotherapy. In nearly all aspects of management there were significant and often very extreme variations in practice between districts...

Patient and doctor delay in acute myocardial infarction: a study in Rotterdam, The Netherlands.

Bleeker, J K; Simoons, M L; Erdman, R A; Leenders, C M; Kruyssen, H A; Lamers, L M; van der Does, E
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/1995 Português
Relevância na Pesquisa
25.92%
BACKGROUND--Early thrombolytic therapy for patients having a myocardial infarct size and improves survival. AIM--A study was undertaken to examine the components of pre-hospital delay in patients with retrospectively proven myocardial infarction. METHOD--Data were gathered from 300 patients with a documented myocardial infarction admitted to three hospitals in Rotterdam, the Netherlands. Interviews were carried out with patients, questionnaires were given to their spouses or significant others, medical information was provided by cardiologists, and logbook information was gathered from the ambulance service. RESULTS--Half of all patients (51%) called for medical help within 30 minutes of symptom onset. General practitioners arrived within 11 minutes in half of the 257 cases to which they were called. However, in half of the 257 cases, decision making by the general practitioner before the patient was sent to a hospital took more than 82 minutes. The ambulance arrived within 15 minutes in 90% of all 242 cases, while the time required for stabilization of the patient by the ambulance staff and transport to the hospital took a median of 15 minutes. CONCLUSION--Compared with earlier studies, patients with a myocardial infarction called for help sooner. However...

Open access exercise electrocardiography: a service to improve management of ischaemic heart disease by general practitioners.

Sulke, A N; Paul, V E; Taylor, C J; Roberts, R H; Norris, A D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1991 Português
Relevância na Pesquisa
25.91%
An initial study of the use of open access exercise electrocardiography by general practitioners (GPs) in South East Kent showed that patient selection and interpretation of test results was frequently incorrect. After issuing guidelines, modifying the request form and instituting registrar review of all requests, significant improvements in both referral pattern, result interpretation and patient management have resulted. Forty-nine GPs requested 110 exercise tests during 1988/89. Twelve per cent were not undertaken after discussion with the referring practitioner. Eighty-four per cent of those tested would have been referred to the district general hospital cardiology outpatient department in the absence of open access exercise electrocardiography service. Six per cent of patients were referred directly for invasive investigation. Thirty-five per cent were referred to the district general hospital cardiology outpatient department, whilst 42% were spared hospital referral based on the result of the investigation. Better use of the modified service was suggested by: referral of fewer patients with non-cardiac chest pains (P = 0.002); more patients with a moderate pre-test probability of ischaemic heart disease (P less than 0.05); fewer inappropriate requests (P less than 0.01); and fewer inappropriately undertaken tests (P less than 0.001) than in the previous study. All patients with strongly positive test results were appropriately managed. Open access exercise electrocardiography in the format investigated is potentially a cost-effective and useful tool to improve diagnosis and management of heart disease by GPs.

Searching for the evidence in pre-hospital care: a review of randomised controlled trials. On behalf of the Ambulance Response Time Sub-Group of the National Ambulance Advisory Committee.

Brazier, H; Murphy, A W; Lynch, C; Bury, G
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/1999 Português
Relevância na Pesquisa
45.91%
OBJECTIVES: To identify randomised controlled trials (RCTs) which evaluate aspects of pre-hospital care; to perform categorisation by theme; to compare the sensitivity and precision of the search databases. DATA SOURCES: August 1997 updates of MEDLINE and EMBASE databases, using the Datastar online system. Papers published in 1987 or later were included, with no language restrictions. STUDY SELECTION: A trial was eligible for inclusion if it was judged, by two independent and blinded assessors, that participants followed up in the trial were definitely or possibly assigned prospectively to one of two or more alternative forms of healthcare with random allocation or a quasi-random method of allocation. RESULTS: The literature search retrieved 849 papers, of which 569 (67%) were in MEDLINE and 486 (57%) in EMBASE. Forty one (5%) were confirmed as reports of RCTs or quasi-RCTs, and the total number of individual trials was 38. Ten of these trials dealt with thrombolytic drugs; 14 were concerned with other drugs, 12 with equipment, and two with other interventions. Four trials were based on a sample size of more than 1000, and seven reported a statistically significant effect on mortality. All 41 papers were in EMBASE, and all but one were also in MEDLINE. CONCLUSIONS: Evidence based policy making with respect to the organisation of pre-hospital services cannot depend on RCTs. In the current relative absence of such evidence...

Feasibility, safety, and efficacy of domiciliary thrombolysis by general practitioners: Grampian region early anistreplase trial. GREAT Group.

Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 05/09/1992 Português
Relevância na Pesquisa
36.01%
OBJECTIVE--To assess the feasibility, safety, and efficacy of domiciliary thrombolysis by general practitioners. DESIGN--Randomised double blind parallel group trial of anistreplase 30 units intravenously and placebo given either at home or in hospital. SETTING--29 rural practices in Grampian admitting patients to teaching hospitals in Aberdeen (average distance 36 (range 16-62) miles). PATIENTS--311 patients with suspected acute myocardial infarction and no contraindications to thrombolytic therapy seen at home within four hours of onset of symptoms. MAIN OUTCOME MEASURES--Time saving, adverse events, Q wave infarction, left ventricular function. RESULTS--Anistreplase was administered at home 101 minutes after onset of symptoms, while anistreplase was given in hospital 240 minutes after onset of symptoms (median times). Adverse events after thrombolysis were infrequent and, apart from cardiac arrest, not a serious problem when they occurred in the community: seven of 13 patients were resuscitated after cardiac arrest out of hospital. By three months after trial entry the relative reduction of deaths from all causes in patients given thrombolytic therapy at home was 49% (13/163 (8.0%) v 23/148 (15.5%); difference -7.6% (95% confidence interval -14.7% to -0.4%)...

Guidelines for the early management of patients with myocardial infarction. British Heart Foundation Working Group.

Weston, C. F.; Penny, W. J.; Julian, D. G.
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em 19/03/1994 Português
Relevância na Pesquisa
25.95%
In light of recent publications relating to resuscitation and pre-hospital treatment of patients suffering acute myocardial infarction of British Heart Foundation convened a working group to prepare guidelines outlining the responsibilities of general practitioners, ambulance services, and admitting hospitals. The guidelines emphasise the importance of the rapid provision of basic and advanced life support; adequate analgesia; accurate diagnosis; and, when indicted, thrombolytic treatment. The working group developed a standard whereby patients with acute myocardial infarction should receive thrombolysis, when appropriate, within 90 minutes of alerting the medical or ambulance service--the call to needle time. Depending on local circumstances, achieving this standard may involve direct admissions to coronary care units, "fast track" assessments in emergency departments, or pre-hospital thrombolytic treatment started by properly equipped and trained general practitioners.

Tourniquet use in the civilian prehospital setting

Lee, C; Porter, K M
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /08/2007 Português
Relevância na Pesquisa
25.91%
Tourniquets are an effective means of arresting life‐threatening external haemorrhage from limb injury. Their use has not previously been accepted practice for pre‐hospital civilian trauma care because of significant concerns regarding the potential complications. However, in a few rare situations tourniquet application will be necessary and life‐saving. This review explores the potential problems and mistrust of tourniquet use; explains the reasons why civilian pre‐hospital tourniquet use may be necessary; defines the clear indications for tourniquet use in external haemorrhage control; and provides practical information on tourniquet application and removal. Practitioners need to familiarise themselves with commercial pre‐hospital tourniquets and be prepared to use one without irrational fear of complications in the appropriate cases.

Implantação de uma Unidade Sentinela Centro de Referência em Medicina Internacional e de Viagem no Hospital das Clínicas da Universidade Federal de Goiás (HC / UFG); Introduction of Sentinel Unit Reference Center in International and Travel Medicine in General Hospital at Federal University of Goiás.

AIRES, Leticia Mara Conceição
Fonte: Universidade Federal de Goiás; BR; UFG; Mestrado em Ciências da Saúde; Ciências da Saúde - Medicina Publicador: Universidade Federal de Goiás; BR; UFG; Mestrado em Ciências da Saúde; Ciências da Saúde - Medicina
Tipo: Dissertação Formato: application/pdf
Português
Relevância na Pesquisa
25.93%
Introduction: The number of domestic and international travel has increased in past years. This way, Travel Medicine, has become an important subject, with the emergence of services that provide health care to travelers. Objective: To evaluate strategies used in deploying Sentinel Unit Reference Center for International and Travel Medicine at the HC / UFG. Methods: First approach: Systematic Review of Literature using the keywords: "Travel and medicine", "Travel and prevention", "Travel and Disease and Medicine" and "Traveler and medicine . Then were selected articles in English, Spanish and Portuguese, from 2004 to 2008. Second approach: a descriptive, qualitative and quantitative, with evaluation of actions taken during the period preceding the implementation of the Unit. Results: In the literature review were found 1,301 articles, and 72 included for analysis, we observed that malaria is the most studied disease, the main preventive measures discussed are chemoprophylaxis for malaria and vaccination. Health professionals working in Travel Medicine are general practitioners, pharmacists and nurses in various parts of the world, and among the obstacles we stress the lack of information in travelers, the lack of professional preparation and last-minute travelers. In a qualitative and quantitative research was performed a retrospective study in which differences were observed between physicians at the General Hospital and the tropical Diseases Hospital...

Continuous professional competence (CPC) for emergency medical technicians in Ireland: educational needs assessment

Knox, Shane; Cullen, Walter; Dunne, Colum
Fonte: BioMed Central Publicador: BioMed Central
Tipo: info:eu-repo/semantics/article; all_ul_research; ul_published_reviewed
Português
Relevância na Pesquisa
35.84%
peer-reviewed; Background: As in other countries, the Irish Regulator for Pre-Hospital practitioners, the Pre-Hospital Emergency Care Council (PHECC), will introduce a Continuous Professional Competence (CPC) framework for all Emergency Medical Technicians (EMTs), Paramedics and Advanced Paramedics (APs). This framework involves EMTs participating in regular and structured training to maintain professional competence and enable continuous professional developments. To inform the development of this framework, this study aimed to identify what EMTs consider the optimum educational outcomes and activity and their attitude towards CPC. Methods: All EMTs registered in Ireland (n = 925) were invited via email to complete an anonymous online survey. Survey questions were designed based on Continuous Professional Development (CPD) questionnaires used by other healthcare professions. Quantitative and qualitative analyses were performed. Results: Response rate was 43% (n = 399). 84% of participants had been registered in Ireland for less than 24 months, while 59% had been registered EMTs for more than one year. Outcomes were: evidence of CPC should be a condition for EMT registration in Ireland (95%), 78% believed that EMTs who do not maintain CPC should be denied the option to re-register. Although not required to do so at the time of survey...

A qualitative assessment of practitioner perspectives post-introduction of the first continuous professional competence (CPC) guidelines for emergency medical technicians in Ireland.

Knox, Shane; Dunne, Suzanne S.; Cullen, Walter; Dunne, Colum
Fonte: BioMed Central Publicador: BioMed Central
Tipo: info:eu-repo/semantics/article; all_ul_research; ul_published_reviewed
Português
Relevância na Pesquisa
55.95%
peer-reviewed; Background: In November 2013, the Irish Regulator for emergency medical technicians (EMTs) introduced the first mandatory requirement for registrants to demonstrate evidence of continuous professional development (CPD)/ continuous professional competence (CPC). This qualitative study assessed the experience of practitioners with CPC-related materials provided to them by the Regulator in addition to identifying perceived or encountered practical challenges and suggested improvements six months following introduction of the requirement. Methods: Five fora were utilised, comprising two distinct groupings: a group of student EMTs (n = 62) and four discrete groups of qualified EMTs (total n = 131) all of whom had commenced the newly-introduced CPC process. All 193 volunteers were members of the Civil Defence (an auxiliary/voluntary organisation) and represented a nationwide distribution of personnel. Responses were categorised as ‘perceived’ challenges to CPC, relating to student EMTs, and ‘experienced’ challenges to CPC, relating to qualified EMTs. Responses also included suggestions from both groups of EMTs on how to improve the current system and guidance material. Audio/visual recordings were made, transcribed and then analysed using NVivo (version 10). A coding framework was developed which identified unifying themes. Results: All participants agreed that CPC for pre-hospital practitioners was a welcomed initiative believing that CPC activities would help ensure that EMTs maintain or enhance their skills and be better enabled to provide quality care to the patients they might encounter. Two specific areas were identified by both groups as being challenging: 1) the practicalities of completing CPC and 2) the governance and administration of the CPC process. Challenging practicalities included: ability of voluntary EMTs to gain access to operational placements with paramedics and advanced paramedics; the ability to experience the number of patient contacts required and the definition of what constitutes a ‘patient contact’. With regard to the governance and administration of CPC...

A model of continuous professional development for registered pre-hospital practitioners in Ireland

Knox, Shane
Fonte: University of Limerick Publicador: University of Limerick
Tipo: info:eu-repo/semantics/doctoralThesis; all_ul_research; ul_published_reviewed; ul_theses_dissertations
Português
Relevância na Pesquisa
96.4%
peer-reviewed; The introduction of a Regulatory body in Ireland with responsibility for ensuring high standards of education and professionalism for ambulance, and other pre-hospital, practitioners was a welcomed initiative in 2001 due to a need for improvement in care delivered to patients before arrival at hospital. This Regulatory body, the Pre-Hospital Emergency Care Council (PHECC), was established under Statutory Instrument with an initial priority being to develop three levels of pre-hospital practitioner: Emergency Medical Technician (EMT); Paramedic; Advanced Paramedic (AP). The introduction of these three levels meant that only such registered practitioners could practice in the pre-hospital environment. However for practitioners to renew their registration, they had only to meet simple and minimal criteria with no requirement to demonstrate any level of competence. The Council’s 2011-2014 Strategic plan identified the need to introduce a system of continuous professional development/competence as a priority. The purpose of the studies in this thesis was to engage with the three levels of practitioner in Ireland and to seek their views and opinions so as to identify factors that would inform the implementation of a continuous professional competence (CPC) framework for all pre-hospital practitioners. The expectation in when initiating this work was that the results would assist in the introduction of a framework for one group of registrants in particular...

Management of diagnostic uncertainty in children with possible meningitis: a qualitative study.

Brennan, Cathy A; Somerset, Maggie; Granier, Stephen K; Fahey, Tom P; Heyderman, Robert S
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/2003 Português
Relevância na Pesquisa
26.04%
BACKGROUND: Neisseria meningitidis serogroup B is the most common cause of bacterial meningitis in children and young adults. Early recognition and prompt intervention with antibiotics are thought to be key to preventing serious complications. AIM: Explore how general practitioners evaluate and manage febrile children with possible meningitis or meningococcal septicaemia. DESIGN OF THE STUDY: Qualitative study using one-to-one, semi-structured interviews. SETTING: General practices in the Avon Health Authority district. METHOD: Twenty-six general practitioners were purposefully sampled, using a sampling frame to ensure a range of experience and practices in a variety of settings Data management and analysis were conducted using a grounded theory approach. RESULTS: Key themes to emerge were the effect that fear of meningitis has upon parents and general practitioners; the difficulties associated with reaching a diagnosis; and the existence of barriers to the use of guidelines and pre-hospital penicillin. When assessing a febrile child, participating general practitioners rarely thought that meningitis or meningococcal septicaemia were likely, but were aware that this was frequently the principal parental concern. They relied upon intuitive rather than systematic methods to distinguish serious from self-limiting conditions...

GP recruitment and retention: a qualitative analysis of doctors' comments about training for and working in general practice.

Evans, Julie; Lambert, Trevor; Goldacre, Michael
Fonte: Royal College of General Practitioners Publicador: Royal College of General Practitioners
Tipo: Artigo de Revista Científica
Publicado em /02/2002 Português
Relevância na Pesquisa
25.94%
BACKGROUND AND AIMS: General practice in the UK is experiencing difficulty with medical staff recruitment and retention, with reduced numbers choosing careers in general practice or entering principalships, and increases in less-than-full-time working, career breaks, early retirement and locum employment. Information is scarce about the reasons for these changes and factors that could increase recruitment and retention. The UK Medical Careers Research Group (UKMCRG) regularly surveys cohorts of UK medical graduates to determine their career choices and progression. We also invite written comments from respondents about their careers and the factors that influence them. Most respondents report high levels of job satisfaction. A noteworthy minority, however, make critical comments about general practice. Although their views may not represent those of all general practitioners (GPs), they nonetheless indicate a range of concerns that deserve to be understood. This paper reports on respondents' comments about general practice. ANALYSIS OF DOCTORS' COMMENTS: Training Greater exposure to general practice at undergraduate level could help to promote general practice careers and better inform career decisions. Postgraduate general practice training in hospital-based posts was seen as poor quality...

General practitioners and emergency treatment for patients with suspected myocardial infarction: last chance for excellence?

Rawles, J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1992 Português
Relevância na Pesquisa
35.87%
Pre-hospital coronary care usually consists of a medically staffed coronary care ambulance going into the community from a hospital base, as pioneered in Northern Ireland. In today's medicopolitical and economic climate, this model is not viable in mainland United Kingdom. Current proposals seem to favour a 'scoop and run' policy for heart attack victims, that utilizes the ambulance service but bypasses the general practitioner. Since the majority of telephone calls from people with suspected myocardial infarction are directed to general practitioners, a preferable alternative would be a 'stay and stabilize' strategy that uses the existing referral pattern and builds on general practitioners' medical education and skills. The role of the general practitioner in the management of patients with suspected myocardial infarction is discussed.

A comparison of the attitudes shown by general practitioners, hospital doctors and medical students towards alternative medicine.

Perkin, M R; Pearcy, R M; Fraser, J S
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1994 Português
Relevância na Pesquisa
26.04%
The aim of this study was to compare and contrast the views of general practitioners (GPs), hospital doctors and medical students to alternative medicine. A questionnaire was sent to a random sample of 100 GPs and 100 hospital doctors in the South West Thames Regional Health Authority (SWTRHA). A convenience sample of 237 pre-clinical medical students at St George's Hospital Medical School was also given a questionnaire. Eighty-seven GPs and 81 hospital doctors replied. Five therapies were investigated: acupuncture; chiropractice; homeopathy; naturopathy; and osteopathy. All respondents were asked about their attitude towards and knowledge of these therapies. Doctors were asked how often they referred patients for such treatment and whether they practised it themselves. GPs and hospital doctors had similar levels of knowledge of the therapies. Medical students were the least informed but the most enthusiastic respondents. Seventy per cent of hospital doctors and 93% of GPs had, on at least one occasion, suggested a referral for alternative treatment. GPs were making these referrals more frequently and earlier. Twelve per cent of hospital doctors and 20% of GPs were practising alternative medicine. The majority of the respondents felt that alternative medicine should be available on the National Health Service (NHS) and that medical students should receive some tuition about alternative therapies. A considerable proportion of those doctors referring patients to alternative practitioners were ignorant of their official qualifications.

Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review

Mitchell, E; Macdonald, S; Campbell, N C; Weller, D; Macleod, U
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
45.88%
Colorectal cancer is a major global health problem, with survival varying according to stage at diagnosis. Delayed diagnosis can result from patient, practitioner or hospital delay. This paper reports the results of a review of the factors influencing pre-hospital delay – the time between a patient first noticing a cancer symptom and presenting to primary care or between first presentation and referral to secondary care. A systematic methodology was applied, including extensive searches of the literature published from 1970 to 2003, systematic data extraction, quality assessment and narrative data synthesis. Fifty-four studies were included. Patients' non-recognition of symptom seriousness increased delay, as did symptom denial. Patient delay was greater for rectal than colon cancers and the presence of more serious symptoms, such as pain, reduced delay. There appears to be no relationship between delay and patients' age, sex or socioeconomic status. Initial misdiagnosis, inadequate examination and inaccurate investigations increased practitioner delay. Use of referral guidelines may reduce delay, although evidence is currently limited. No intervention studies were identified. If delayed diagnosis is to be reduced, there must be increased recognition of the significance of symptoms among patients...

A national study of Continuous Professional Competence (CPC) amongst pre-hospital practitioners

Knox, Shane; Cullen, Walter; Dunne, Colum P.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 02/12/2015 Português
Relevância na Pesquisa
35.69%

A model of continuous professional development for registered pre-hospital practitioners in Ireland

Knox, Shane
Fonte: University of Limerick Publicador: University of Limerick
Tipo: info:eu-repo/semantics/doctoralThesis; all_ul_research; ul_published_reviewed; ul_theses_dissertations
Português
Relevância na Pesquisa
96.39%
peer-reviewed; The introduction of a Regulatory body in Ireland with responsibility for ensuring high standards of education and professionalism for ambulance, and other pre-hospital, practitioners was a welcomed initiative in 2001 due to a need for improvement in care delivered to patients before arrival at hospital. This Regulatory body, the Pre-Hospital Emergency Care Council (PHECC), was established under Statutory Instrument with an initial priority being to develop three levels of pre-hospital practitioner: Emergency Medical Technician (EMT); Paramedic; Advanced Paramedic (AP). The introduction of these three levels meant that only such registered practitioners could practice in the pre-hospital environment. However for practitioners to renew their registration, they had only to meet simple and minimal criteria with no requirement to demonstrate any level of competence. The Council’s 2011-2014 Strategic plan identified the need to introduce a system of continuous professional development/competence as a priority. The purpose of the studies in this thesis was to engage with the three levels of practitioner in Ireland and to seek their views and opinions so as to identify factors that would inform the implementation of a continuous professional competence (CPC) framework for all pre-hospital practitioners. The expectation in when initiating this work was that the results would assist in the introduction of a framework for one group of registrants in particular...

The value of the pre-hospital learning environment as part of the emergency nursing programme

van Wyk,Sonett; Heyns,Tanya; Coetzee,Isabel
Fonte: Health SA Gesondheid (Online) Publicador: Health SA Gesondheid (Online)
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 Português
Relevância na Pesquisa
66.05%
BACKGROUND: Professional nurses enrolled in a post-basic emergency nursing programme presented at a tertiary nursing education institution in South Africa are placed in different clinical learning environments to reach the set clinical outcomes and gain appropriate clinical experience. These students are placed in the hospital environment (emergency department and critical care unit) and pre-hospital environment (road ambulance services) to ensure they gain the necessary clinical exposure in order to learn the relevant and necessary skills and knowledge which in turn will help them become safe and independent emergency nurse practitioners. Controversy about the value of placing emergency nursing students in the pre-hospital environment has raised questions from specifically the private healthcare sector. During the pre-hospital placement, emergency nursing students are absent from the hospital environment which is costly and, according to the healthcare services, unnecessary. OBJECTIVE: The study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme. METHODS: A qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of self-reported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews. The data was analysed using content analysis. RESULTS: Four major themes were identified: an unpredictable environment...