Anna Carin Wahlberg

The Emergency Medical Service personnel's perception of the transportation of young children

To our knowledge no previous studies have been made which describe the Emergency Medical Service (EMS) personnels perceptions of transporting children and the care encounter between the child, the parent and the EMS personnel when separating the child and the parent specifically in an ambulance. The aim of this study was to gain an understanding of how EMS personnel perceive ambulance transport of children. The study was carried out in 2012 at one of three ambulance contractors in Stockholm. Twelve semi-structured interviews were conducted and the content analysis showed that transporting children induces stress and is deemed a precarious task by EMS personnel mainly because children are considered more vulnerable than adults and because of the necessity to separate the child from the parent during transport. There is a conflict between medical- and emotional wellbeing and traffic-safety during the transportation of children and a fear of insufficient ability to care for the child. The EMS personnels vulnerability is evident in the complicated care situation associated with transporting children in an ambulance. These findings may be considered a first step in assessing if action is needed to improve care and patient safety during ambulance transportation of children.

Identified obstacles and prerequisites in telenurses’ work environment – a modified Delphi study

BackgroundTelenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses’ work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses’ work environment.MethodsA modified Delphi design, using qualitative as well as quantitative data sequentially through three phases, was taken. Data were initially collected via semi-structured interviews (Phase I) and later using a web survey (Phase II-III) between March 2015 and March 2016.ResultsThe findings present a consensus view of telenurses’ experiences of important obstacles and prerequisites in their work environment. Central to the findings are the aspects of telenurses having a demanding work, cognitive fatigue and having no opportunity for recovery during the work shift was ranked as important obstacles. Highly ranked prerequisites for managing were being able to focus on one caller at a time, working in a calm and pleasant environment and having technical support 24/7.ConclusionsManagers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work.

1 Knowledge desired by ems managers of their ambulance clinicians

Aim Emergency medical service (EMS) managers are responsible for organisational tasking. In this they are dependent on the knowledge possessed by their ambulance clinicians (ACs). Knowledge in EMS may be described as embracing formal education, protocol dependent and containing tacit experienced-based dimensions. However little is known about EMS managers’ approach to this knowledge. The aim of the study was therefore to identify the types of knowledge that Swedish EMS managers considered desirable in their ACs. Methods Thirty-six EMS managers participated in a modified Delphi study. Twenty-six sub-categories emerged in the first open-ended questionnaire. Following the EMS managers were encouraged to rate each sub-category, and the ten with the highest mean were interdependently ranked in the final round. Results The sub-categories covered knowledge related to; contextual aspects, medical and holistic assessments, formal education and organisational issues. Eventually, the sub-category ‘Knowledge to assess the patient’s situation from a holistic perspective’ was the highest ranked, followed by ‘Medical knowledge to assess and care for different diseases’ and ‘Knowledge to be able to care for critically ill patients’. Conclusion The EMS organisations’ primary focus is on providing emergency medical care and treatment. Hence, the present result may have impact on this in order to cover more complex types of knowledge, addressing essentially medical care, contextual aspects and nursing. The boundaries between these may sometimes be elusive, challenging the ACs to balance these areas of knowledge in a complex context. Conflict of interest We declare no conflict of interest. Funding This study was funded by R and D Centre, Sörmlands County Council.