Promotion of knowledge, skill, and performance of emergency medical technicians in prehospital care of traumatic patients: An action-research study

Background: Annually, there is a high rate of mortality due to trauma. Prehospital emergency personnel are the first caregivers present beside trauma patients, and their dexterity to take care of trauma patients is of great significance in the vast majority of patients' survival. Materials and Methods: This study was action research with the participation of 125 prehospital emergency personnel from May 2016 to December 2018 in five stages (observation, reflection, planning, action, and evaluation) in Iran. Knowledge, skills, and performance of personnel were assessed before and after the action. Data collection tools included knowledge questionnaire and PERFECT skill assessment checklist by Objective Structured Clinical Examination method and researcher-made checklist for performance. Data were analyzed using SPSS-21 software. Results: The findings indicated that 67.82 and 84.4 of prehospital emergency staff have median to low knowledge and expertise in respect to trauma care, respectively. Their performance of necessary measurements for trauma patients was poor prior to training. There was a significant difference between the mean knowledge, skills, and performance of medical emergency technicians before and after the training course (P = 0.00). Conclusions: Participation of beneficiaries in planning for trauma patient's care is helpful. Establishment of prehospital trauma life support training in the medical emergency, training curriculum, and its instruction to prehospital emergency personnel while serving in trauma care will be of great benefit

Emergency medical technicians occupational stress scale: development and validation

INTRODUCTION: Several stress factors are experienced by emergency medical technicians (EMTs), the identification and management of which may be a major challenge due to the lack of valid and reliable instruments. This study aimed to develop a relevant and easy-to-use occupational stress scale (OSS) for EMTs with adequate psychometric properties. MATERIAL AND METHODS: A mixed method with an exploratory sequential design was used in this research. Items were generated based on the existing literature and a qualitative study, followed by testing the content and face validity of the items. Exploratory factor analysis (EFA) was done with a random sample of 247 EMTs. Also, internal consistency and stability reliability were investigated. RESULTS: From the initial 74 items, 20 with content validity ratio and content validity index were removed. In EFA, the item set resolved to a 50-item scale in the six dimensions include: Patient and family conditions, Environmental and occupational conditions, Traumatic consequences, Supportive management problems, Lack of support, and Interpersonal and individual tension. Cronbach's alpha and Intra-class correlation coefficient (ICC) showed excellent reliability. CONCLUSIONS: The OSS-EMT represents a psychometrically derived instrument that identified important stressors for EMTs., and is probably among the first studies in Iran. While explaining the methodology precisely, this study evaluated the validity and reliability of the OSS in EMTs based on principles of survey instrument development and validation

A Cross-Sectional Study of the Factors Affecting on Turnover Intention of Nurses

Introduction: Nurses are the largest group of health care professionals in health care systems. One of the main challenges of health care systems is the shortage of qualified nurses and Nurses’ intention to leave the profession is one of the key issues in nursing all over the world. The aim of this study was to investigate the factors affecting nurses' turnover in Iran.Methods: This descriptive cross-sectional study was conducted in the School of Nursing and Midwifery, Tabriz, Iran, in 2018. In this study, 500 nurses were selected Convenience sampling method was used for recruitments of samples. Data were collected using Anticipated Turnover Scale (ATC) and Measurement of the intention to leave the profession in nurses and were analyzed using SPSS (version 16).Results: The results showed that the overall score of the Anticipated Turnover Scale was 4.04 ± 0.53. Factors affecting nurses intention to leave included organizational (3.42 ± 0.66), professional (3.05 ± 0.55), faily-work conflict (3.52 ± 0.82) and economic (3.82 ± 0.80) factors. The results showed a significant differences between the mean score of turnover intention and the variables of nurses gender (P= 0.006, T=2.75) and work experience (P= 0.001, F=5.54).Conclusions: Reduction of economic problems and conflict between family and work makenurses stay in the health care system. Also, nurse managers should consider the needs of nurses based on age, gender, work experience and cultural and social differences

A Comparative Study of Emergency Nursing MSc Curriculum in Iran and the USA

Introduction: Conducting comparative studies is one of the research methods for revising and modernizing educational programs. The aim of this study was to compare the emergency nursing MSc curriculum in Iran and the USA. Methods: This descriptive-comparative study was conducted in 2018 at Tabriz University of Medical Sciences. Vanderbilt University was selected through internet searches due to the relative similarity between the fields of study offered by the given universities and then two curricula were compared using Bereday’s four-stage model: description, interpretation, juxtaposition and comparison. Results: The program offered by both universities had certain mission, vision and goals. The goal of Vanderbilt University was to train professional clinical nurses while the goal of Iran's program was to provide the graduates with the proficiency in the clinical, educational, research and managerial fields. The admission requirements in both universities included holding a bachelor`s degree in nursing and having at least two years of clinical nursing experience. In Iran, the graduate students in Emergency Medicine can also take the examination. Some of the requirements for the admission to Vanderbilt University were a confirmation letter of clinical competence, a confirmation letter of at least three faculty members and a good GPA and students can study at a university whether full-time or part-time. Conclusion: The Emergency Nursing MSc curriculum in Iran was designed as a general program, whereas Vanderbilt University curriculum was more specialized and operational with an emphasis on clinical practice. Differences in course credits offered by Emergency Medicine and Nursing bachelor's programs and their different fields of service make it necessary to revise the relevant curricula or develop separate educational paths for these two fields