Best Practice – Beispiel für ein Notfallsanitäterkompetenzsystem im Rahmen der Anwender- und Patientensicherheit: der Reutlinger Weg

Schempf, Benjamin; Dorau, Wolfgang; Eppler, Fabian; Heinemann, Niklas; Metzger, Markus; Häske, David

doi:10.1007/s10049-022-00989-y

Cited by 5 publications

(2 citation statements)

References 33 publications

(35 reference statements)

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“…This was then embedded in a competence system for Emergency Medical Services. 9,10 Here, 36.7% of the performed IV lines were placed in the hospital and 53.9% of vein punctures were performed prehospital. This is interesting, because the hospital was traditionally seen as the most important component in practical-clinical training.…”

Section: Discussionmentioning

confidence: 99%

Learning Success and Influencing Factors in Out-of-Hospital Placement of Intravenous Catheters

Häske

Dorau

Eppler

et al. 2022

Prehosp. Disaster med.

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Introduction: Placing peripheral intravenous catheters (“IV lines”) is a standard procedure for health care professionals in acute and emergency medicine. The study aimed to determine the learning curve and success rates in applying IV lines during a three-year paramedic training and the factors influencing successful placement. Methods: This was a prospective and noninterventional observational study to determine the influencing factors, learning outcomes, and performance in the placement of IV lines by trainees and experienced paramedics. Trial registration: German Clinical Trials Register, ID DRKS00024631. Results: From February 1, 2016 through December 31, 2021, a total of 3,547 peripheral venous accesses attempts were performed: 76.5% (n = 2,712) by trainees and 23.5% (n = 835) by experienced practitioners. The trainee group had one-to-three years of training and the experienced group had 11 (SD = 11) years of work experience after training (one-to-35 years). The learning or success curve in the successful placement of peripheral venous accesses was 85.2% in the first year of training, 88.5% in the second year of training, and 92.5% in the third year (and the end of training). It was then 94.3% in the fourth year (first year of being experienced). Successful insertion of peripheral venous accesses in the experienced group was up to 97.0%. The first-attempt success rate was 90.4% across the entire trainee group versus 95.9% in the experienced group (P <.0001). Significant factors influencing successful placement of IV lines were puncture site (P = .022), catheter size (OR = 0.600; P = .002), and number of attempts (OR = 0.370; P <.001). The time of day (or night) was not influential. Work experience, patient age, or blood pressure were also not significant.

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Section: Discussionmentioning

confidence: 99%

Learning Success and Influencing Factors in Out-of-Hospital Placement of Intravenous Catheters

Häske

Dorau

Eppler

et al. 2022

Prehosp. Disaster med.

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“…Indications for esketamine include all moderate to severe pain (NRS ≥ 5, trauma-associated pain, low back pain, and abdominal pain) [ 11 – 13 ]. This advanced delegation is deemed appropriate training, standard operating procedure (SOP), along with annual competence checks [ 14 ]. Emergency medical services in Germany are organized by the state and are operationally dependent on the federal state and county.…”

Section: Methodsmentioning

confidence: 99%

Patient-reported side effects and satisfaction of pre-hospital analgesia with low-dose esketamine: a cross-sectional study

Häske,

Eppler,

Heinemann

et al. 2023

BMC Emerg Med

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Background Analgesia is a core intervention in emergency medicine. Pain is subjective, so patient-reported experience with pain and analgesia is essential for healthcare professionals. The aim of this study was to evaluate patient-reported side effects and satisfaction associated with pre-hospital analgesia with low-dose esketamine. Methods This is an observational cross-sectional study conducted as part of quality assurance measures of the German Red Cross Emergency Medical Service, Reutlingen, Germany. The survey was administered to all patients who received prehospital esketamine analgesia from paramedics. Addresses were obtained from medical records and mailed 10 days after the event. Patient feedback was anonymous and could not be linked to operational documentation. Results A total of 201 patients were contacted, and 119 responses were received via the online questionnaire and postal mail (response rate 59%). The mean age of the patients was 68±13 years, with 64.7% (n=77) being female. The main diagnosis reported was fractures of the extremities in 69.7%. Patients reported initial median pain intensity on a Numeric Rating Scale (NRS) of 10 [8-10]. Pain was unbearable for 96.3% of patients. After administration of analgesia, 95.3% were satisfied or very satisfied. Patients reported no side effects in 78.5%, minor side effects in 10.0%, significant but well tolerable side effects in 11.3%, borderline tolerable side effects in 0.2%, and no unbearable side effects. Borderline tolerable nausea was reported in 2% of patients along with dreams in 0.8%. No nightmares were reported. Further analysis showed that patients older than 80 years reported significantly more side effects (p < 0.001) and were thus less satisfied with the analgesia. Conclusions Both patient perception and analgesia with few side effects were important for both safety and satisfaction. In the present study, low-dose esketamine analgesia was associated with low side effects and high patient satisfaction.

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Eigenverantwortliche Heilkundeausübung durch Notfallsanitäter in Bayern: ein landesweiter Konsens zur Anwendung des § 2a NotSanG

Gottschalk,

Dittmar,

Meier

et al. 2024

Notfall Rettungsmed

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Zusammenfassung Hintergrund Die eigenverantwortliche Heilkundeausübung in Notfällen ist ein wesentlicher Bestandteil des Berufsbilds der Notfallsanitäter (NotSan). Bis dato liegt kein konsentierter spezifischer Tätigkeitskatalog für eigenverantwortliche Handlungen nach § 2a Notfallsanitätergesetz (NotSanG) vor, an dem sich die Aus- und Fortbildung sowie der einzelne NotSan orientieren kann. Methoden In einem informellen Gruppenprozess wurde eine modulare Kompetenzmatrix entlang der gesetzlichen Anforderungen an die eigenverantwortliche Heilkundeausübung durch NotSan erstellt und mögliche heilkundliche Maßnahmen und Medikamente den Kategorien der Matrix zugeordnet. Dies wurde im Anschluss von den Durchführenden des Rettungsdiensts und den Ärztlichen Leitern Rettungsdienst Bayern konsentiert. Ergebnisse Die Kompetenzmatrix zur eigenverantwortlichen Heilkundeausübung unterscheidet drei Kategorien: die Standardkompetenz wird nach der Berufsausbildung von jedem NotSan erwartet und umfasst 23 Medikamente und 18 Maßnahmen. Durch Berufserfahrung und definierte zusätzliche Bildungsmaßnahmen kann ein erweitertes Kompetenzniveau erreicht werden (bis zu 10 Medikamente und 2 Maßnahmen). Nicht unter den Anwendungsbereich von § 2a NotSanG fallen 20 vorgehaltene Pharmaka und alle sonstigen invasiven Maßnahmen. Schlussfolgerung Das vorliegende konsentierte Konzept definiert für Bayern die spezifischen Inhalte der NotSan-Ausbildung nach § 4 Abs. 2 Nr. 1c NotSanG sowie den Umfang der Garantenstellung der NotSan und bietet den NotSan eine berufliche Entwicklungsmöglichkeit. Für die Zukunft ist eine Konkretisierung der Anforderungen für das erweiterte Kompetenzniveau vorgesehen.

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Best Practice – Beispiel für ein Notfallsanitäterkompetenzsystem im Rahmen der Anwender- und Patientensicherheit: der Reutlinger Weg

Cited by 5 publications

References 33 publications

Learning Success and Influencing Factors in Out-of-Hospital Placement of Intravenous Catheters

Learning Success and Influencing Factors in Out-of-Hospital Placement of Intravenous Catheters

Patient-reported side effects and satisfaction of pre-hospital analgesia with low-dose esketamine: a cross-sectional study

Eigenverantwortliche Heilkundeausübung durch Notfallsanitäter in Bayern: ein landesweiter Konsens zur Anwendung des § 2a NotSanG

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