A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

<p>Abstract</p> <p>Background</p> <p>Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS) documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs).</p> <p>Methods</p> <p>Records from police, Emergency Medical Communication Centers (EMCC), ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic blood pressure (SBP) was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend).</p> <p>Results</p> <p>25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p < 0.001). Also, documentation of repeated assessment was more frequent for low RTS categories of GCS, RR, and SBP (All: p < 0.001). Mechanism of injury was documented in 80% of cases by ground and 92% of cases by air ambulance.</p> <p>Conclusion</p> <p>EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our finding indicates a need for improved procedures, training, and tools for EMS documentation. Documentation is in itself a quality criterion for appropriate care and is crucial to trauma research.</p

Методика поиска и отбора документов личного происхождения в деятельности архива образовательного учреждения

Erratum The original article [1] contains an error whereby all authors’ names were mistakenly interchanged. The original article has now been corrected to present the authors’ names correctly

Nurses learning climate and job satisfaction, 2001

Comparing the importance of the different learning condition factors for graduates versus more experienced nurses and degree of job satisfaction

Er det noen sammenheng mellom arbeidsvarslingsfeil som avdekkes i forkant av en ulykke og de feil som avdekkes etter en ulykke?

Prosjektoppgave i EPT-100 Sikkerhetsstyring av vegtrafikken. Høsten 2013, Universitetet i Stavange

Systematic reporting to improve the emergency medical response to major incidents: A pilot study

Background: Major incidents affect us globally, and are occurring with increasing frequency. There is still no evidence-based standard regarding the best medical emergency response to major incidents. Currently, reports on major incidents are non-standardised and variable in quality. This pilot study examines the first systematic reports from a consensus-based, freely accessible database, aiming to identify how descriptive analysis of reports submitted to this database can be used to improve the major incident response. Methods: Majorincidentreporting.net is a website collecting reports on major incidents using a standardised template. Data from these reports were analysed to compare the emergency response to each incident. Results: Data from eight reports showed that effective triage by experienced individuals and the use of volunteers for transport were notable successes of the major incident response. Inadequate resources, lack of a common triage system, confusion over command and control and failure of communication were reported failures. The following trends were identified: Fires had the slowest times for several aspects of the response and the only three countries to have a single dialling number for all three emergency services had faster response times. Helicopter Emergency Medical services (HEMS) were used for transport and treatment in rural locations and for triage and treatment in urban locations. In two incidents, a major incident was declared before the arrival of the first Emergency Medical Services (EMS) personnel. Conclusion: This study shows that we can obtain relevant data from major incidents by using systematic reporting. Though the sample size from this pilot study is not large enough to draw any specific conclusions it illustrates the potential for future analyses. Identified lessons could be used to improve the emergency medical response to major incidents

A retrospective survey study of paramedic students’ exposure to SARS‑CoV‑2, participation in the COVID‑19 pandemic response, and health‑related quality of life

Background: Healthcare workers have reported increased anxiety while working in hospitals during the COVID-19 pandemic, and the role of healthcare students in a health crisis has been discussed among clinicians and researchers. The simultaneous international shortage of personal protection equipment (PPE) during the first wave of the pandemic potentially exposed healthcare workers and students to the virus during their work and clinical training. Our aim was therefore to evaluate the extent to which paramedic students in Oslo, Norway, were exposed to the SARS-CoV-2 virus and were involved in voluntary and/or paid healthcare-related work. An evaluation was also made of the students’ COVID-19-related symptoms and of their health-related quality of life (HRQoL) during the first wave of the pandemic. Methods: Paramedic students (n = 155) at Oslo Metropolitan University, Norway, were invited to complete an online survey five months after the first cases of COVID-19 were detected. The university was situated in the epicenter of the pandemic in Norway. The responses were analyzed using descriptive statistics, independent sample t-tests, and linear regression analysis. Results: Of the 109 respondents (70.3%), 40 worked in patient-related healthcare work. Of those, seven (17.5%) students experienced insufficient supplies of PPE, six (15.0%) participated in aerosol-generating procedures without adequate PPE, and nine (22.5%) experienced insufficient time to don PPE. Seventy-five (70.1%) students experienced no COVID-19-related symptoms, and no students tested positive for COVID-19. HRQoL was scored 0.92 (sd 0.12), which was significantly higher than for the general population before the pandemic (p = 0.002). Students continued with their education and participated in a variety of pandemic-related emergency tasks during the first wave of the pandemic. Conclusions: Paramedic students were valuable contributors to the national pandemic response. Despite potential exposure to SARS-CoV-2 in unpredictable emergency settings with limited supplies of personal protection equipment, no students tested positive for COVID-19. Their health-related quality of life remained high. Students’ participation and utilization in similar health crises should be considered in future health crises