Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study

BMC Emergency Medicine

Research Article

Deborah Shaw¹  Aloysius Niroshan Siriwardena² 

[1] Clinical Audit and Research Department, East Midlands Ambulance Service NHS Trust, East Division Headquarters, Cross O’Cliff Court, LN4 2HL, Lincoln, England;Clinical Audit and Research Department, East Midlands Ambulance Service NHS Trust, East Division Headquarters, Cross O’Cliff Court, LN4 2HL, Lincoln, England;Community and Health Research Unit, School of Health and Social Care, College Social Science, University of Lincoln, Brayford Pool, LN6 7TS, Lincoln, England;

关键词: Asthma;    Prehospital;    Emergency medical services;    Paramedic;    Clinical guidelines;   

DOI  :  10.1186/1471-227X-14-18

 received in 2013-11-13, accepted in 2014-07-25,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAcute asthma is a common reason for patients to seek care from ambulance services. Although better care of acute asthma can prevent avoidable morbidity and deaths, there has been little research into ambulance clinicians’ adherence to national guidelines for asthma assessment and management and how this might be improved. Our research aim was to explore paramedics’ attitudes, perceptions and beliefs about prehospital management of asthma, to identify barriers and facilitators to guideline adherence.MethodsWe conducted three focus group interviews of paramedics in a regional UK ambulance trust. We used framework analysis supported by NVivo 8 to code and analyse the data.ResultsSeventeen participants, including paramedics, advanced paramedics or paramedic operational managers at three geographical sites, contributed to the interviews. Analysis led to five themes: (1) guidelines should be made more relevant to ambulance service care; (2) there were barriers to assessment; (3) the approach needed to address conflicts between clinicians’ and patients’ expectations; (4) the complexity of ambulance service processes and equipment needed to be taken into account; (5) and finally there were opportunities for improved prehospital education, information, communication, support and care pathways for asthma.ConclusionsThis qualitative study provides insight into paramedics’ perceptions of the assessment and management of asthma, including why paramedics may not always follow guidelines for assessment or management of asthma. These findings provide opportunities to strengthen clinical support, patient communication, information transfer between professionals and pathways for prehospital care of patients with asthma.

【 授权许可】

CC BY   
© Shaw and Siriwardena; licensee BioMed Central Ltd. 2014