Monash University Centre for Ambulance and Paramedic Studies (MUCAPS) Submission to the Department of Human Services (DHS), in response to the DHS Discussion Paper examining the regulation of the Health Professions in Victoria

Boyle, Malcolm; Burgess, Stephen; Chilton, Mark; Fallows, Brian; Lord, Bill; Shugg, David; Williams, Brett; Wyatt, Andrea

doi:10.33151/ajp.1.3.208

Cited by 4 publications

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“…Working independently in an uncontrolled environment with little oversight and assistance places an increased level of responsibility on paramedics. 47 To facilitate a successful wider implementation of ketamine, BCEHS can use these findings and associated BCTs involving restructuring the physical environment in consultation with PCPs.…”

Section: Discussionmentioning

confidence: 99%

Barriers and enablers to implementing intranasal ketamine for Primary Care Paramedics in Canada – A parallel convergent mixed methods study

et al. 2023

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Introduction British Columbia Emergency Health Service trialled the use of intranasal (IN) ketamine given by Primary Care Paramedics (PCPs). Prior to this practice change, the PCPs had not performed weight-based drug calculations, given medications intranasally, nor been responsible for controlled and targeted substances. This study aimed to use the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domain Framework (TDF) to identify enablers and barriers to implementing IN paramedic administered ketamine analgesia (iPAKA) for PCPs. Methods This was a parallel convergent mixed methods study with two phases. The quantitative phase consisted of longitudinal staff surveys to assess PCP knowledge and perceptions of ketamine and controlled and targeted substances policies. The qualitative phase involved staff focus groups on programme implementation. Descriptive statistics of survey results were integrated with coded focus group data and analysed using the COM-B model and TDF. Evidence-based behavioural change techniques were mapped to each TDF domain. Findings Our analysis revealed barriers and enablers across several TDF domains. Implementing ketamine was enabled by quality education, strong organisational support and the availability of cognitive aides. Trial success was attributed in part to participant's feelings of optimism and their increased job satisfaction. Key barriers included a knowledge gap involving drug dosage calculations, negative emotions associated with performance anxiety and a lack of field education and supervision to monitor paramedic practice. Conclusion The use of theoretical frameworks and models like COM-B/TDF serves to improve the sustainable implementation of behaviour and clinical practice change in paramedicine. When project teams use theory to guide design and implementation, they can systematically identify and target individual and organisational enablers and barriers to adopting routine practices. The iPAKA study reveals key barriers and facilitators in several TDF domains and presents theory-linked targeted behavioural techniques to support on-going implementation of PCP-administered IN ketamine for analgesia.

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Section: Discussionmentioning

confidence: 99%

Barriers and enablers to implementing intranasal ketamine for Primary Care Paramedics in Canada – A parallel convergent mixed methods study

et al. 2023

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“…The debate now taking place in regard to the future registration and regulation of paramedics in Australia is a healthy sign of a growing professional identity amongst paramedics. [3][4][5][6] The catalyst for this debate has been the Federal Government moves to set-up a unified national registration scheme for health professionals. 7 In order to be considered for entry into this regulatory framework, paramedics need to be recognised and acknowledged as an emerging profession.…”

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confidence: 99%

Paramedics marching toward professionalism

O’Meara

2009

Australasian Journal of Paramedicine

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Community paramedicine model of care: an observational, ethnographic case study

O’Meara

Stirling

Ruest³

et al. 2015

BMC Health Serv Res

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BackgroundCommunity paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform. Our aim was to identify and analyse how community paramedics create and maintain new role boundaries and identities in terms of flexibility and permeability and through this develop and frame a coherent community paramedicine model of care that distinguish the model from other innovations in paramedic service delivery.MethodsUsing an observational ethnographic case study approach, we collected data through interviews, focus groups and field observations. We then applied a combination of thematic analysis techniques and boundary theory to develop a community paramedicine model of care.ResultsA model of care that distinguishes community paramedicine from other paramedic service innovations emerged that follows the mnemonic RESPIGHT: Response to emergencies; Engaging with communities; Situated practice; Primary health care; Integration with health, aged care and social services; Governance and leadership; Higher education; Treatment and transport options.ConclusionsCommunity engagement and situated practice distinguish community paramedicine models of care from other paramedicine and out-of-hospital health care models. Successful community paramedicine programs are integrated with health, aged care and social services and benefit from strong governance and paramedic leadership.

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Monash University Centre for Ambulance and Paramedic Studies (MUCAPS) Submission to the Department of Human Services (DHS), in response to the DHS Discussion Paper examining the regulation of the Health Professions in Victoria

Cited by 4 publications

References 0 publications

Barriers and enablers to implementing intranasal ketamine for Primary Care Paramedics in Canada – A parallel convergent mixed methods study

Barriers and enablers to implementing intranasal ketamine for Primary Care Paramedics in Canada – A parallel convergent mixed methods study

Paramedics marching toward professionalism

Community paramedicine model of care: an observational, ethnographic case study

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