Ambulance Nurses’ Competence and Perception of Competence in Prehospital Trauma Care

Abstract

Introduction We focus on trauma care conducted in the context of a simulated traumatic event. This is in this study defined as a four-meter fall onto a hard surface, resulting in severe injuries to extremities in the form of bilateral open femur fractures, an open tibia fracture, and a closed pelvic fracture, all fractures bleeding extensively. Methods The simulated trauma care competence of 63 ambulance nurses in prehospital emergency care was quantitatively evaluated along with their perception of their sufficiency. Data was collected by means of simulated trauma care and a questionnaire. Results Life-saving interventions were not consistently performed. Time to perform interventions could be considered long due to the life-threatening situation. In comparison, the ambulance nurses' perception of the sufficiency of their theoretical and practical knowledge and skills for trauma care scored high. In contrast, the perception of having sufficient ethical training for trauma care scored low. Discussion This study suggests there is no guarantee that the ambulance nurses' perception of theoretical and practical knowledge and skill level corresponds with their performed knowledge and skill. The ambulance nurses rated themselves having sufficient theoretical and practical knowledge and skills while the score of trauma care can be considered quite low.

Knowledge, Practice, and Associated Factors of Nurses in Pre-Hospital Emergency Care at a Tertiary Care Teaching Hospital

“…In this study, the overall prevalence of good knowledge was found to be 42.9% with 95%, CI (37.8–47.6). The finding was lower than the studies conducted in South Africa (51.7%), 21 Nepal (52%), 26 Sweden (71%), 27 Brazil (83.2%), 28 and Iran (72.2%). 29 The finding also lower than the studies done in Iran (61%), 30 India (69%), 23 and other two similar studies in India (48%), 13 and (52%) 25 of knowledge questions.…”

“…43 The possible explanation might be due to the skill of an individual can improve the practice aspects of pre-hospital emergency care. 27 In a multivariable logistic regression analysis, variables like sex, marital status, educational level, experience, having training were found to have significantly associated with the practice of nurses in pre-hospital emergency nursing care. Being male was found to be nearly two times more to have good practice as compared with its counterparts.…”

“… 13 , 25 However, it was lower than the study done in Sweden in which 70% of the participants had a good practice. 27 The possible explanation might be because there are huge socio-demographic variations between Ethiopia and Sweden by far. As it is known practice of a certain aspect in our case pre-hospital emergency care could be affected by the knowledge level as per participants’ level of specialty.…”

“… 43 The possible explanation might be due to the skill of an individual can improve the practice aspects of pre-hospital emergency care. 27 …”

Balancing structure and flexibility in the ambulance service: the pursuit of professional judgement in caring and learning

“…A basic condition for creating a structure for caring was performing a structured medical assessment as a fundamental dimension of the professional role, in which the students demonstrated varying levels of confidence in and preparedness for when entering their clinical practice (Studies I, II, III, IV). Performing advanced and structured medical assessments and deciding about medical treatment are identified as two of the most fundamental tasks defining the professional work of AS professionals [18,40,41,75,164,171]. As indicated by the findings in this thesis, the advanced medical assessment in the professional AS role is seen as requiring a competence that RNs need to further develop through further education, additional training, and clinical experiences to strengthen patient safety and professional security [40,172].…”