References
Evaluation of a paramedic student patient hand-off curriculum using simulation
Abstract
Introduction:
Even though patient handoffs are at high risk for errors and adverse events, there is not a standardised approach to how these should be taught to paramedic students. The goal of this study was to evaluate the feasibility and effectiveness of implementing a lecture-based training involving the IMIST-AMBO mnemonic in paramedic education.
Methods:
Paramedic students were randomised into a control group of standard national paramedicine curriculum and an intervention group who received an additional EMS patient handover lecture including IMIST-AMBO protocol. Outcomes were measured through simulation exercises, with learners randomised to either a low-fidelity tabletop or high-fidelity mannequin-based session.
Results:
There were three paramedic student teams in each arm of the study. There were no statistical differences in the reporting of any of the IMIST-AMBO components or the total number reported between the control and the intervention group. The intervention group took significantly longer to give their patient handoff: 78.2 s versus 49.2 s.
Discussions:
The formal education on patient handoffs was successfully implemented. There was a trend toward more data being reported in the intervention group but this came at the cost of a significantly longer report.
Conclusions:
We were able to successfully implement formal education on patient handoffs but the small size of the study limited the ability to evaluate its effectiveness. Patient handoffs are a high-risk area in medicine and more studies are needed to determine the most effective way to teach this to paramedic students.
Emergency medical service (EMS) providers handoff approximately 28 million patients every year in the United States (Federal Interagency Committee on Emergency Medical Services, 2012). A patient handoff refers to the transfer of information, through either physical or mental process, from one healthcare provider to the next (Patterson et al, 2004). Inaccuracies in this critical and unavoidable process contribute to the 44 000 to 98 000 deaths that occur every year due to medical errors (Kohn et al, 2000). In a recent study, 98% of survey participants from two large urban medical schools reported witnessing an error in a written handoff and 64% of those same participants witnessed an error due to a verbal handoff (Arora et al, 2013). While at high risk for communication errors and adverse events, patient handoff education has not been formally addressed in primary EMS education. The National Standard Curriculum makes mention of an oral report only once in its 962 pages by stating: ‘The paramedic must also be able to accurately report orally and in writing, all relevant patient data’ (Stoy and Margolis, 1998). Absent from the text is a standardised approach to how this should be accomplished.
Subscribe to get full access to International Paramedic Practice
Thank you for visiting International Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
What's included
-
CPD Focus
-
Develop your career
-
Stay informed