Background Ambulance services play an important role in the healthcare system when it comes to handling accidents or acute illnesses outside of hospitals. At the time of patient handover from emergency medical technicians (EMTs) to the nurses and physicians in emergency departments (EDs), there is a risk that important information will be lost, the consequences of which may adversely affect patient well-being. The study aimed to describe healthcare professionals’ experience of patient handovers between ambulance and ED staff and to identify factors that can affect patient handover quality. Methods The Vancouver School’s phenomenological method was used. The participants were selected using purposive sampling from a group of Icelandic EMTs, nurses, and physicians who had experience in patient handovers. Semi-structured individual interviews were conducted and were supported by an interview guide. The participants included 17 EMTs, nurses, and physicians. The process of patient handover was described from the participants’ perspectives, including examples of communication breakdown and best practices. Results Four main themes and nine subthemes were identified. In the theme of leadership, the participants expressed that it was unclear who was responsible for the patient and when during the process the responsibility was transferred between healthcare professionals. The theme of structured framework described the communication between healthcare professionals before patient’s arrival at the ED, upon ED arrival, and a written patient report. The professional competencies theme covered the participants’ descriptions of professional competences in relation to education and training and attitudes towards other healthcare professions and patients. The collaboration theme included the importance of effective teamwork and positive learning environment. Conclusions A lack of structured communication procedures and ambiguity about patient responsibility in patient handovers from EMTs to ED healthcare professionals may compromise patient safety. Promoting accountability, mitigating the diffusion of responsibility, and implementing uniform practices may improve patient handover practices and establish a culture of integrated patient-centered care.
Background There have been major developments in healthcare services as well as changes in demographics in recent years, and this has, among other things, led to increased demand for ambulance services. In general, this has also led to calls for more highly educated paramedics. Main body Erasmus + provided a grant for three universities and one public service provider in four Nordic countries to work on a harmonised model curriculum for a bachelor’s degree in paramedic education. The project group has now completed the first phase of the project, which was to examine what paramedic education is available in the participating countries and what laws and regulations affect both the operation of ambulance services and the education of paramedics. At the end of the project, a harmonised exemplary curriculum will be available to anyone interested in educating paramedics at the university level. Conclusions The growing need for highly educated paramedics should be addressed by offering a bachelor’s degree university education with an exemplary curriculum and coordinating it within Europe. The added value of a harmonised education programme within Europe would thus enable further and deeper collaboration.
INTRODUCTION: This study investigated the use of fixed-wing air ambulance in Iceland between 2012 and 2020. MATERIAL: Medical records were filled out during each flight and information afterwards entered into an electronic database. METHODS: The annual number of patient transports nationwide; triage scale category; reason for transportation, age and gender; and departure and arrival airports were analyzed. Response time and total transport time were compared between years and locations. Poisson regression analysis was used to compare the yearly number of transports. One-way ANOVA was used to compare response time and total transport time by year and departure site. RESULTS: In total, 6011 patients were transported in fixed-wing air ambulances during the study period. Majority were male (54.3%). Median age was 64 years (range 0-99 years). Most patients were transported due to medical conditions; 15.8% due to trauma. Thirty percent of women aged 20 to 44 years were transported due to pregnancy or childbirth. Two-thirds of patients were transported to Reykjavik (n=3937), and one-fifth to Akureyri (n=1139). Median response time for acute transports was 84 minutes (range 0-2870 minutes). Median total transport time was 150 minutes (range 50-2930 minutes). Differences were found in total transport time from departure locations (F=32.19; DF 9, 2678; p<0.001). Egilsstaðir, Norðfjörður, Höfn, and, partly, Ísafjörður had the longest total transport times. CONCLUSION: Icelandic air ambulance flights are often long, likely affecting outcomes for patients with time-sensitive medical conditions. Access to specialized healthcare is unequal among places of residence, and it is important to address this.
Background Fixed-wing air ambulances play an important role in healthcare in rural Iceland. More use of helicopter ambulances has been suggested to shorten response times and increase equity in access to advanced emergency care. In finding optimal base locations, the objective is often efficiency—maximizing the number of individuals who can be reached within a given time. This approach benefits people in densely populated areas more than people living in remote areas, but the solution is not necessarily fair. This study aimed to find efficient and fair helicopter ambulance base locations in Iceland. Methods We used high-resolution population and incident data to estimate the service demand for helicopter ambulances, with possible base locations limited to 21 airports and landing strips around the country. Base locations were estimated using both the maximal covering location problem (MCLP) optimization model, which aimed for maximal coverage of demand, and the fringe sensitive location problem (FSLP) model, which also considered uncovered demand (i.e., beyond the response time threshold). We explored the percentage of the population and incidents covered by one to three helicopter bases within 45-, 60-, and 75-minute response time thresholds, conditioned or not conditioned on the single existing base located at Reykjavík Airport. This resulted in a total of 18 combinations of conditions for each model. The models were implemented in R and solved using Gurobi. Results Model solutions for base locations differed between the two demand datasets for 2 out of 18 combinations, both with the lowest service standard. Base location differed between the MCLP and FSLP models for one combination involving a single base, and for two combinations involving two bases. Three bases covered all or almost all demand at longer response time thresholds, and the models differed in four of six combinations. The two helicopter ambulance bases can possibly obtain 97% coverage within 60 minutes, with bases in Húsafell and Grímsstaðir. Bases at Reykjavík Airport and Akureyri would cover 94.6%, whereas bases at Reykjavík Airport and Egilsstaðir would cover 89.2%. Conclusion An efficient and fair solution would be to locate bases at Reykjavík Airport and in Akureyri or Egilsstaðir.
Background Adverse events healthcare are often caused by communication failure. Patient handover from ambulance personnel to specialized nurses and doctors in Emergency Departments carries the risk that that important information will be lost during the process, with consequences that may adversely affect patient well-being. The objective of this qualitative study was to analyze communication and transfer of responsibility during handover of patients arriving with ambulances in Emergency Departments in Iceland. Method Vancouver school method of phenomenology was used. Participants were selected with a purpose sampling. Semi-structured individual interviews were conducted and supported by interview guide. The interviews were themed, followed by construction of an individual analysis model and overall analysis model. Results A total of 17 ambulance workers, registered nurses and doctors described their experience of a patient handover in Emergency Department and the process of exchange of written and verbal information between health professionals involved in the handover of care. The main finding of the study was that structured communication and information disclosure have a great impact on the quality of patient handover. This is described in four main themes (Transfer of professional responsibility; Information dialogue; Personal and professional factors and Organizational factors) and nine sub-themes. Conclusion Standardized handover protocol, clear procedures and education to healthcare professionals can potentially improve communication and transfer of responsibility for patients brought to emergency departments with ambulances, thus potentially improving patient safety.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.