Decision making for patients categorised as ‘amber’ in a rural setting
Autor: | Catherine Ingram, Nigel Rees, Mark A Sujan |
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Rok vydání: | 2019 |
Předmět: |
business.industry
030503 health policy & services Rural setting Psychological safety Emergency department medicine.disease 03 medical and health sciences Patient safety 0302 clinical medicine Medicine 030212 general & internal medicine Medical emergency Rural area 0305 other medical science business |
Zdroj: | Journal of Paramedic Practice. 11:239-245 |
ISSN: | 2041-9457 1759-1376 |
Popis: | Background: Reducing unnecessary conveyances to hospital can help relieve pressure on emergency departments. Making decisions about conveyance in rural areas is particularly challenging because of the travel distances involved. Aims: To explore perceptions of paramedics in a rural setting about how they make decisions regarding conveyance and non-conveyance for patients categorised as ‘amber’ (serious but not life-threatening). Methods: Data were collected through interviews with 17 paramedics working in rural areas, which were analysed using inductive thematic analysis. Findings: Paramedics perceive hospitals as places of safety for themselves (psychological safety) and for patients (patient safety). Lower levels of psychological safety (e.g. because of an organisational blame culture) and perceived increased risks to patient safety (e.g. because of a lack of health resources in the community) influence paramedic decision making on conveying patients to hospital. Conclusion: Current practice contributes to increasing pressures on emergency departments. Ambulance services should work towards a non-punitive culture of safety where paramedics feel they can make decisions based on their experience and expertise rather than to protect themselves. |
Databáze: | OpenAIRE |
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