Out‐of‐hospital emergency care providers' work and challenges in a changing care environment

Abstract

Acutely ill patients are often treated on site instead of being transported to hospital, so wide-ranging professional competence is required from staff. The aim of this study was to describe and produce new information about out-of-hospital emergency care providers' competence, skills and willingness to engage in self-development activities, and to uncover challenges experienced by care providers in the midst of changing work practices. A quantitative questionnaire was sent to out-of-hospital emergency care providers (N = 142, response rate 53%) of one Finnish hospital district. Data were analysed using spss for Windows 22 software. Almost all respondents found their work interesting and their ability to work independently sufficient. The majority found the work meaningful. Almost 20% felt that work was dominated by constant rush, and 40%, more than half of 25-year-olds but <10% of over 45-years-olds, found the work physically straining. The majority indicated that they had a sufficient theoretical-practical basis to perform their regular duties, and more than one-third felt that they had sufficient skills to deal with multiple patient or disaster situations. Over 20% stated that they were unsure about performing new or infrequent procedures. A number of factors experienced as challenging were revealed. The results provide a basis for improving care providers' initial and further training.

Situational awareness in the identification of abuse – Out-of-hospital emergency care providers’ experiences

“…[13] As in the other high risk and high stress industries, the rapidly changing situations typical of EMS make it important that team members possess SA and actively share their observations when they assess patients, anticipate risks and make decisions in order to secure the safety of all those present at scene. [5,14] Some research exists on SA in prehospital EMS. [5,8,[14][15][16] Norri-Sederholm's studies on paramedic field supervisors' SA focused on the flow of information, formulating the field supervisors' information interest profile and revealing their four roles, those of a decision-maker, planner, analyst and situation follower.…”

“…[5,14] Some research exists on SA in prehospital EMS. [5,8,[14][15][16] Norri-Sederholm's studies on paramedic field supervisors' SA focused on the flow of information, formulating the field supervisors' information interest profile and revealing their four roles, those of a decision-maker, planner, analyst and situation follower. The most important information categories in developing SA were events, action patterns, decision and means.…”

Out-of-hospital emergency care providers’ work and clinical skills in Finland: A follow-up study

“…The results of the first survey have been published in greater detail in earlier articles. [9,12] 2.4 Ethical considerations All participants were voluntary and they had been informed of the various phases of the study. In the report, the results have been anonymized so that respondents cannot be identified.…”

“…The results show that, compared to the initial survey, emergency care providers' assessment of their work, its challenges and their clinical skills remained the same or deteriorated to some extent. [9,12] The same questionnaire was sent to the same target group, to the out-of-hospital emergency staff of a hospital district, but the respondents were slightly older and the share of nurses was significantly higher in the follow-up study. It would not seem, however, that the changes in the age and professional structure could explain the differences discerned between the survey results.…”

“…Emergency care providers collaborate with various authorities, hospital staff and other professional groups. [9] Besides caring for patients, encountering and attending to family members is an essential part of emergency care providers' work in non-conveyance situations. A special challenge is posed by the need to ensure appropriate follow-up care and counseling.…”