• Breaking bad news and managing family during an out-of-hospital cardiac arrest

      Mainds, Matthew D.; Jones, Colin (2018-07)
      Abstract published with permission. The management of family during out-of-hospital cardiac arrests and death notification to the family of the deceased in the out-of-hospital setting are topics that are poorly evidenced. Two focus groups consisting of six participants in each were conducted, discussing the two subjects. The results suggest that paramedics prefer family not to be present in the room for a number of reasons and that they don’t feel sufficiently trained by their paramedic courses in order to manage family during resuscitation or breaking bad news. The study highlighted a need for more research on both subjects.
    • Exploratory study into the views of paramedics on paramedic prescribing

      Duffy, Iain; Jones, Colin (2017-07)
      Abstract published with permission. The purpose of this paper is to establish the views of a group of Paramedics on Paramedic prescribing. Although at the time of writing the proposal to the Commission on Human Medicines they rejected prescribing for Paramedics, work is still ongoing with various bodies to move forward with the application. A focus group of a small number of Paramedics was held, and the researcher performed a review of relevant literature. The development of the role of paramedic from an ambulance driver to a highly skilled and knowledgeable healthcare professional was discussed. It was established that the profession's close links with higher education institutions would be pivotal if paramedics are to be given prescribing rights. The study concluded that paramedics believe they should be able to become independent prescribers, as it would help further their career, giving the profession added credibility. As paramedics already give a rounded healthcare approach to their patients, this would only be enhanced by prescribing rights, as a ‘complete’ health care attitude could be established.
    • Kerbside consultations: advice from the advanced paramedic to the frontline

      Jackson, Mike; Jones, Colin (2012-09)
      Abstract published with permission. Aim To observe the issues, benefits and challenges of providing dynamic telephone clinical advice to frontline clinicians by advanced paramedics of the North West Ambulance Service NHS Trust. Method In order to focus on the key issues the study used a mixed method approach. A group of 11 advanced paramedics took part in two focus groups which was then followed up with a questionnaire to frontline clinicians. Using focus groups in the research not only allows for the possibility of multiple realities but also for participant validation. Using a qualitative approach allowed theory to develop and emerge which was then codified into themes and the data was then used to develop a questionnaire for frontline clinicians who had received clinical advice in the past in order to provide an element of quantitative data. Findings Five themes emerged from the stud: function, responsibility, barriers, education and support. Conclusion The study finds that clarity is required in relation to responsibilities and clinicians would benefit from a structured model to communicate information over the telephone—we believe the introduction of remote advice has improved patient safety and support to staff and has created opportunity for additional learning.
    • Paramedic attitudes towards DNACPR orders

      Armitage, Ewan; Jones, Colin (2017-10)
      Abstract published with permission. Background: Qualitative research involving paramedics and their involvement in end-of-life (EoL) care has already been published, but there have been no published attitudinal studies specifically relating to do not attempt cardiopulmonary resuscitation (DNACPR) orders and paramedics working in the pre-hospital setting in the UK. Objective: To gain an understanding of paramedic attitudes towards an increasingly common aspect of paramedic practice, focusing specifically on the pre-hospital environment and identifying any corelation between gender, length of service, and level of educational attainment. Design: A paper-based questionnaire was distributed to all paramedic grades, operational out of two ambulance stations of a regional NHS ambulance service in March 2017. The questionnaires were designed using a combination of free-text boxes and Likert scales. A total of 33 questionnaires were issued and 11 completed questionnaires were returned. Results: Respondents indicated the importance of communication in relation to DNACPR orders, as well as the role of allied health professionals and family members in the process. Respecting the patient’s wishes was considered paramount, as was educational provision surrounding DNACPRs. Conclusion: The majority of respondents reported that they were comfortable incorporating DNACPR orders in their clinical practice, although more modest responses were returned regarding the level of education received in this area of paramedicine.