Abstract
Objective:
To examine the level of knowledge and attitudes of emergency department (ED) personnel towards the paramedic profession in Israel, and to examine opinions of the ED staff regarding integration of paramedics into the ED work staff.
Study design:
Cross-sectional survey conducted among health care workers.
Sample and setting:
The research population was physicians and nurses in four level 1 hospitals in Israel. The sample population includes 92 physicians (approximately 61%) and 102 nurses (approximately 34%).
Methods:
The questionnaire, distributed from November 2011 to February 2012, was composed of five parts: demographics, questions examining interactions with paramedics, knowledge about the paramedics’ work, their assessment of paramedics’ skills, and their attitudes about expanding the paramedic's scope of practice. The questionnaire was sent to 150 personal emails of ED staff members (physicians and nurses). 68 additional questionnaires were filled in EDs.
Results:
About one fifth of the physicians (21.7%) reported encountering a paramedic on a daily basis, while 87.3% of the nurses reported encountering a paramedic on a daily basis. 72% of the physicians and 77.5% of the nurses knew how to distinguish between a paramedic and a basic or intermediate EMT based on differences in their uniforms. Only 31.5% of the physicians and 43.1% of the nurses knew that the majority of MICUs (Mobile Intensive Care Unit) in Israel have no physician on board. Most physicians and nurses had a high degree of knowledge of the scope of practice of paramedics and a high regard for their clinical skills. Although both physicians and nurses agreed that paramedics can expand their scope of practice to EDs, physicians supported such a measure more than nurses.
The interaction between healthcare professionals is a crucial part of their daily work. While physicians and nurses usually work together, paramedics work mostly among themselves, and their interactions with other healthcare professionals are limited and occur at predefined moments, mainly in the pre-hospital setting and in emergency departments (EDs). This interaction includes physicians and nurses. These interactions are usually limited in their scope and it is not therefore clear whether other health professionals know what the paramedics scope of practice is, or even if they can distinguish paramedics from other EMTs. A literature review carried out prior to this study found no research examining how other healthcare professionals perceive paramedics and their clinical competency, and their attitude towards incorporating paramedics in the ED work force. This study set out to examine the ED staff knowledge and attitudes towards the paramedic profession in Israel.
The paramedic profession developed in the 1960s in the USA as a need to address a growing number of injuries and critical patients who did not receive adequate treatment in the pre-hospital setting (Tintinalli et al, 2010).
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