Thumbnail Image
Person

Wilson, Caitlin

Biography
I am a frontline paramedic with North West Ambulance Service NHS Trust and a PhD student at the University of Leeds funded by the NIHR Yorkshire and Humber Patient Safety Translational Research Centre. I have previously been involved in the PASTA Trial as a research paramedic and completed the NIHR Advanced Leadership Programme in 2015/16. During my MSc, I conducted a primary research project on Hyperventilation Syndrome and subsequently led on the JRCALC 2019 Update of the Hyperventilation Syndrome guidelines. My current PhD is a mixed methods multiple sub-study project with the overall aim to explore how enhancing prehospital feedback improves patient safety and staff wellbeing.
Institutional profile
The North West Ambulance Service NHS Trust is proud to be a research-active organisation, which develops and hosts research studies with a focus on pre-hospital healthcare, injuries and emergencies and other clinical specialities. The Trust also explores non-clinical research opportunities involving the organisation and the workforce.

Filters

2017 - 201982020 - 202414
Reset filters

Settings

Citations

Publication Search Results

Now showing 1 - 10 of 26
  • No Thumbnail Available
    PublicationMetadata only
    The role of feedback in emergency ambulance services: a qualitative interview study
    (2022-03-03) Wilson, Caitlin; Howell, Anne-Marie; Janes, Gillian; Benn, Jonathan
  • No Thumbnail Available
    PublicationMetadata only
    Identity, positionality and reflexivity: relevance and application to research paramedics
    (The College of Paramedics, 2022-09-01) Wilson, Caitlin; Janes, Gillian; Williams, Julia
    This article introduces the reader to the concepts of identity, positionality and reflexivity and outlines their relevance to research paramedics. We outline how a researcher’s identity and positionality can influence all aspects of research, including the research question, study design, data collection and data analysis. We discuss that the ‘insider’ position of paramedics conducting research with other paramedics or within their specific clinical setting has considerable benefits to participant access, understanding of data and dissemination, while highlighting the difficulties of role duality and power dynamics. While positionality is concerned with the researcher clearly stating their assumptions relating to the research topic, the research design, context and process, as well as the research participants; reflexivity involves the researcher questioning their assumptions and finding strategies to address these. The researcher must reflect upon the way the research is carried out and explain to the reader how they moved through the research processes to reach certain conclusions, with the aim of producing a trustworthy and honest account of the research. Throughout this article, we provide examples of how these concepts have been considered and applied by a research paramedic while conducting their PhD research studies within a pre-hospital setting, to illustrate how they can be applied practically. Abstract published with permission.
  • No Thumbnail Available
    PublicationMetadata only
    End-of-life care within the paramedic context
    (2020-11-09) Wilson, Caitlin
    Edited by Tania Blackmore (2020), Palliative end of life care for paramedics provides a comprehensive overview of palliative and end-of-life care within the context of paramedic practice. This recently published book is in its first edition and is available in paperback (£29.99) or eBook (£24.99) format. It sits alongside similar publications from the College of Paramedics such as Law and ethics for paramedics and Independent prescribing for paramedics. Some of you may have noticed that these book topics reflect a selection of the paramedic e-Learning modules, which are freely available for College of Paramedic members through the e-Learning for Healthcare Hub website or via My ESR for NHS employees. The subjects covered in the ‘Paramedic – End of Life and Palliative Care’ e-Learning module loosely reflect those covered in this book; however, the book covers everything in much more detail, and includes many references to current supporting evidence, providing the reader with a greater background understanding of palliative care. The team of authors is a well-balanced mixture of academic and clinical health professionals, with three from a paramedic background and three end-of-life care specialists. The front cover of the book indicates that this book is supported by the College of Paramedics, which hints at its incredible relevance for paramedics and emergency ambulance technicians practising in the UK. Sometimes when being taught by specialists outside of the ambulance service, they impart an immense amount of specialist knowledge, yet prehospital clinicians have to decide for themselves how much is actually within their scope of practice and therefore applicable to their clinical role. Although, the editor includes a (very valid and important) disclaimer at the beginning of the book that ‘healthcare professionals should always follow local procedures and be aware of their own scope of practice’, this process of critical appraisal and judgement on applicability is made much easier by the book's close alignment with UK paramedic practice and the frequent references to the JRCALC Clinical Guidelines 2019 (Association of Ambulance Chief Executives (AACE), 2019). In fact, in that way, it is similar to the Emergency birth in the community book that I reviewed in a past issue of the Journal of Paramedic Practice (Wilson, 2019), which was supported by the AACE and JRCALC. The book takes the reader on a logical journey beginning with the broader historical, social and cultural debates about death and dying in chapter 1, followed by the various definitions of palliative care in chapter 2. Chapters 3 and 4 provide an overview of palliative care emergencies and how to recognise them, followed by guidance on symptom management. Subsequently, chapter 5 focuses on softer skills such as communication, while chapter 6 provides an overview of caring for the dying patient, delirium, medication management and discussions surrounding what may constitute a ‘good death’. Chapters 7 and 8 address the topics of ethics and professional resilience, before chapter 9 ties everything together under the title ‘the paramedic as an end of life care specialist’. A clear favourite within this book was chapter 4, which covers symptom management and seemed so applicable that it may join my ever-growing collection of ‘keep-in-helmet-bag’ books. I also really liked the many visuals, such as the image displaying the relative strength of opioids and others illustrating pain pathways and causes of vomiting and nausea. The authors have also included many educational tables, which in chapter 3 provided useful information on manifestations, relevant considerations and treatment for various palliative care emergencies such as neutropenic sepsis, superior vena cava syndrome and terminal haemorrhage. Although it will be impossible for me to remember all of these details, it will be easy to refer to these tables when thinking through differential diagnoses or reflecting on patient encounters. A great learning tool within this book are the case studies included at the end of most chapters. These cases add a practical element to the book and allow the reader to reflect upon what has been discussed in the chapter. However, many of the case studies and associated questions are complex in nature and although they are likely to have more than one right answer, there will definitely be wrong answers. I wonder if, in subsequent editions, the authors could include potential answers or discussions at the end of the book to ensure that readers are following along the right lines. I found the book to be a bit of a slow starter, as the authors use chapters 1 and 2 to introduce the reader to a wide variety of palliative care policies and frameworks in the UK. Although presented in a structured way, it is at times difficult to see how they fit together and which ones apply to paramedics. For those readers finding themselves similarly confused, I would suggest first turning to chapters 3 or 4 and then revisiting the earlier chapters to learn about the broader picture of palliative care. I think working through this book would make a useful exercise for continued professional development (CPD) as part of a paramedic portfolio or even the associate ambulance practitioner programme. In fact, the title, Palliative and end of life care for paramedics may be slightly misleading: this book is by no means solely suitable for qualified paramedics; emergency ambulance staff in other roles such as emergency medical technicians or clinical advisors within the emergency operations centre would definitely benefit from reading this book, although would have to adapt some of the advice to their own scope of practice. Overall, this book is written in simple and easy-to-understand language, provides excellent tips for further reading and cites relevant and up-to-date references throughout—what's not to love? Well, very little to be honest. I have already recommended this book to several colleagues and feel my own care of patients approaching the end of their life has improved since reading this book. I certainly feel more confident and will likely turn back to this book to answer any prehospital palliative care questions I may face in the future. The best way to summarise this book is by expressing my full agreement with the statement on the back cover: ‘it is essential reading for [prehospital clinicians] hoping to better understand the complexities of caring for patients approaching the end of life’. Abstract published with permission.
  • No Thumbnail Available
    PublicationMetadata only
    Predictors, effects and missed opportunities of feedback to emergency ambulance staff: a mixed-methods diary study
    (2023) Wilson, Caitlin; Budworth, Luke; Janes, Gillian; Lawton, Rebecca; Benn, Jonathan
  • No Thumbnail Available
    PublicationMetadata only
    Feedback for emergency ambulance staff: a national review of current practice Informed by realist evaluation methodology
    (2023-08-08) Wilson, Caitlin; Janes, Gillian; Lawton, Rebecca; Benn, Jonathan
  • No Thumbnail Available
    PublicationMetadata only
    Pre-hospital diagnostic accuracy for hyperventilation syndrome
    (2017-10) Wilson, Caitlin; Harley, Clare; Steels, Stephanie
    Background Hyperventilation syndrome (HVS) encompasses a wide variety of symptoms and is diagnosed by excluding organic causes for patients’ symptoms. Literature suggests that HVS should be diagnosed and treated pre-hospitally to avoid costly attendances at Accident and Emergency departments. The study aim was to determine diagnostic accuracy for HVS of paramedics and emergency medical technicians (index test) in comparison to hospital doctors (reference standard). Methods A retrospective cross-sectional audit of routine data utilising linked pre-hospital and in-hospital patient records of adult patients (age ≥18 years) transported via emergency ambulance to two Accident and Emergency departments in the United Kingdom from January 2012 – December 2013. Agreement between pre-hospital and in-hospital HVS diagnoses was calculated using percent agreement, Cohen’s kappa and prevalence-adjusted bias-adjusted kappa. Accuracy was measured using sensitivity, specificity, predictive values and likelihood ratios with 95% confidence intervals. Results A total of 19 386 records were included in the analysis. Percent agreement between pre-hospital clinicians and hospital doctors was 98.73%, producing kappa of κ=0.57 and adjusted kappa of PABAK=0.97. Pre-hospital clinicians had a sensitivity 0.88 (0.82, 0.92) and specificity 0.99 (0.99, 0.99) for diagnosing HVS, with PPV 0.42 (0.37, 0.47), NPV 1.00 (1.00, 1.00), LR +75.2 (65.3, 86.5) and LR- 0.12 (0.08, 0.18). Subgroup analyses for sensitivity were statistically non-significant but for positive predictive values were statistically significant (p<0.001) for the number of pre-hospital diagnoses and patient age. Conclusions Paramedics and emergency medical technicians were able to diagnose HVS pre-hospitally with almost perfect specificity and good sensitivity. Pre-hospital diagnostic accuracy was highest for patients less than 30 years of age and if HVS was the sole diagnosis documented. Following this study, a review of the local ambulance service policy excluding adult HVS patients from referrals to Primary Care Services is anticipated. https://emj.bmj.com/content/34/10/e3.3 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ http://dx.doi.org/10.1136/emermed-2017-207114.9
  • No Thumbnail Available
    PublicationMetadata only
    Ambulance service recognition of health inequalities and activities for reduction: an evidence and gap map of the published literature
    (2024-06-01) Byrne, Rachel; Bell, Fiona; Crabtree, Ruth; Wilson, Caitlin; Miller, Elisha; Byrne, Rachel
    Background: Emergency medical services (EMS) are often patients’ first point of contact for urgent and emergency care needs. Patients are triaged over the phone and may receive an ambulance response, with potential conveyance to the hospital. A recent scoping review suggested disparities in EMS patient care in the United States. However, it is unknown how health inequalities impact EMS care in other developed countries and how inequalities are being addressed. Objectives: This rapid evidence map of published literature aims to map known health inequalities in EMS patients and describe interventions reducing health inequalities in EMS patient care. Methods: The search strategy consisted of EMS synonyms and health inequality synonyms. The MEDLINE/PubMed database was searched from 1 January 2010 to 26 July 2022. Studies were included if they described empirical research exploring health inequalities within ambulance service patient care. Studies were mapped on to the EMS care interventions framework and Core20PLUS5 framework. Studies evaluating interventions were synthesised using the United Kingdom Allied Health Professions Public Health Strategic Framework. Results: The search strategy yielded 771 articles, excluding duplicates, with two more studies added from hand searches. One hundred studies met the inclusion criteria after full-text review. Inequalities in EMS patient care were predominantly situated in assessment, treatment and conveyance, although triage and response performance were also represented. Studies mostly explored EMS health inequalities within ethnic minority populations, populations with protected characteristics and the core issue of social deprivation. Studies evaluating interventions reducing health inequalities (n = 5) were from outside the United Kingdom and focused on older patients, ethnic minorities and those with limited English proficiency. Interventions included community paramedics, awareness campaigns, dedicated language lines and changes to EMS protocols. Conclusions: Further UK-based research exploring health inequalities of EMS patients would support ambulance service policy and intervention development to reduce health inequality in urgent and emergency care delivery. Abstract published with permission.
  • Thumbnail Image
    PublicationMetadata only
    Predictors of effective management of acute pain in children within a UK ambulance service: A cross-sectional study
    (2020-07) Whitley, Gregory; Hemingway, Pippa; Law, Graham Richard; Wilson, Caitlin; Siriwardena, Aloysius
  • No Thumbnail Available
    PublicationMetadata only
    An essential resource for your back pocket
    (2019-02) Wilson, Caitlin
  • Thumbnail Image
    PublicationOpen Access