References
Patient comfort in prehospital emergency care: a challenge to clinicians
Abstract
Aim:
The aim of this paper is to report on a study that compared ambulance clinicians’ views of two different types of patient coverings, focusing on core caring concepts such as comfort, dignity, and safety.
Design:
Ambulance clinicians’ views were gathered in respect of two types of patient coverings, and 128 ambulance patients were randomly distributed into a control or experimental group receiving respectively either the traditional cotton blanket or a multi-layered TelesPro rescue covering. Views were gathered using a short questionnaire developed by the authors.
Findings:
Ambulance clinicians, in their own view, maintained the core caring concepts no matter which type of covering was used. Findings suggest strongly that the rescue covering provided for a superior patient experience in respect of all core concepts and one functional aspect.
Conclusions:
Ambulance clinicians undertake caring that encompasses the core caring concepts of comfort, safety, and dignity, while remaining vigilant to threats to these constituents of caring.
Pre-hospital emergency care services are vital components of the health service, with responsibility for immediate assessment and treatment during the most acute stage of the journey for acutely ill andinjured patients. Such care has always had a focus on immediate life support and management of traumaand medical emergencies.
The process encompasses the emergency call and dispatch, a race to the scene of the incident, accessing the patient at any potential location during any weather condition, triage and emergency management, and finally, if required, transporting the patient to the nearest emergency department (ED) or trauma centre as quickly and safely as possible. Within the United Kingdom (UK), the Department of Health (DH) has set specific time targets for ambulance clinicians to reach the scene of the incident. This is normally close to eight minutes. In this study, ambulance clinicians include paramedics and ambulance nurses.
The patient experience of this journey can be stressful, strapped in a chair or onto a trolley within an unfamiliar environment such as an ambulance with limited space. This journey is a rapid one, guided by the Golden Hour rule that suggests that patients should be transported to the ED within one hour of the incident to maximise survival and minimise complications (Lerner and Moscati, 2001). In 2006 the patient experience was included as one of nine ‘ambulance design challenges’ and was listed for improvement in the design of future ambulances (Hignett et al, 2009). The principal concerns were focused on patient safety, response times, dignity, modesty, and carers. Furthermore, the authors reported that within one of the other identified design challenges (space and layout), patient care and comfort were specified as central concerns.
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