Emergency medicine journal : EMJ
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Whether a cardiac arrest treated by the ambulance service results in return of spontaneous circulation (ROSC), is dependent on the actions of the emergency call handler and their ability to induce bystander CPR. The objective was to develop an Utstein style reporting tool as a stand-alone software reporting module that also allows users and researchers to enrich current data collection by integrating standardised call handling data from the software version of the Medical Priority Dispatch System protocol (ProQA) into current Utstein based reports, resulting in a more accurate and detailed analysis of the specific stages of call taking. ⋯ The newly developed reporting tool makes analysis and comparison of Emergency Medical Dispatch resuscitation data possible and meaningful using universal measurements. It allows for more detailed evaluation between cardiac arrest variables, including comparison between individual staff and centres, with a view to identifying areas for performance and system improvements.
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NHS health policy emphasises the crucial role of patient experience as a core component of high quality care, alongside effectiveness and safety. Patient Reported Experience Measures (PREMs) measure patients' experiences with their healthcare. They are increasingly being seen as valuable for assessing patient outcomes and differences in quality between health care providers. Previous patient surveys to assess ambulance service care have not been implemented routinely or in a standardised way. This research forms part of a doctoral study to develop a PREM for use in UK ambulance services. ⋯ The construction of the PREM has incorporated the views of patients that the measure is ultimately designed for, and conforms to the concept of patient-centred care-the theoretical foundation of the research. Once completed, the PREM will enable ambulance trusts to measure differences in patient experiences, between and within organisations. This can result in positive changes to patient experience through the introduction of feedback, training and education to prehospital clinicians.
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Data has been collected from suspected major trauma patient clinical records since the launch of the major trauma system in the South West in April 2012. In an internal report it was identified that 50% of overtriaged suspected major trauma patients were attributed to a suspected pelvic fracture. The National Consensus Statement on the Pre-Hospital Management of Pelvic Fractures provided a flow diagram depicting the appropriate application of the pelvic binder. ⋯ Applying the flow diagram criteria has shown to improve accuracy of appropriate pelvic binder applications in suspected major trauma patients. The flow diagram has been summarised into four key points and included in a new Trust Clinical Guideline for pelvic injury. A follow up audit will be conducted looking at the same groups of patients in the year following publication of the guideline to analyse whether accuracy of pelvic binder applications has increased.
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Does current pre-hospital care for patients at the end of their life reflect best practice guidance?
The end of life care good practice guide encourages organisations to enable terminally ill patients to be cared for and die outside of hospital. Ambulance services play a critical role in achieving this goal, however little guidance exists for ambulance crews. ⋯ Crews are not able to access out-of-hours information for end of life patients and are therefore not always aware of the patient's wishes. The care provided to the majority of patients was good, but the questionnaire showed most respondents were not sufficiently confident when treating end of life patients. Further work is needed to ensure crews are able to determine patients' wishes and training could increase confidence treating this patient group.
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The contribution of service users to identifying and prioritising research issues is vital to make practice and policy more relevant to their needs. Their experiences and knowledge can complement those of clinicians, health professionals and researchers. The aim of this research was to explore service-user perceptions of ambulance service care and patient safety. ⋯ Despite the relatively small number of participants, the findings provide useful service-user perspectives relevant to pre-hospital emergency care policy and practice, as well as the wider urgent and emergency care context. It is important that such views can be represented through public/patient involvement in decision making at organisational and service commissioning level.