O'Meara Peter F, Tourle Vianne, Stirling Christine, Walker Judi, Pedler Daryl
La Trobe University, Bendigo, Victoria, Australia.
Rural Remote Health. 2012;12(2):1978. Epub 2012 Apr 12.
This article identifies trends in the evolving practice of rural paramedics and describes key characteristics, roles and expected outcomes for a Rural Expanded Scope of Practice (RESP) model.
A multiple case study methodology was employed to examine the evolution of rural paramedic practice. Paramedics, volunteer ambulance officers and other health professionals were interviewed in four rural regions of south-eastern Australia where innovative models of rural paramedic practice were claimed to exist. The research team collected and thematically analysed the data using the filter of a sociological framework throughout 2005 and 2006.
The study found that paramedics are increasingly becoming first line primary healthcare providers in small rural communities and developing additional professional responsibilities throughout the cycle of care.
Adoption of the RESP model would mean that paramedics undertake four broad activities as core components of their new role: (1) rural community engagement; (2) emergency response; (3) situated practice; and (4) primary health care. The model's key feature is a capacity to integrate existing paramedic models with other health agencies and health professionals to ensure that paramedic care is part of a seamless system that provides patients with well-organized and high quality care. This expansion of paramedics' scope of practice offers the potential to improve patient care and the general health of rural communities.
本文确定了农村护理人员不断发展的实践趋势，并描述了农村扩大实践范围（RESP）模式的关键特征、作用和预期成果。
采用多案例研究方法来考察农村护理人员实践的演变。在澳大利亚东南部的四个农村地区，对护理人员、志愿救护人员和其他卫生专业人员进行了访谈，这些地区声称存在创新的农村护理人员实践模式。研究团队在2005年至2006年期间，使用社会学框架对数据进行收集和主题分析。
研究发现，护理人员在小型农村社区中越来越多地成为一线初级医疗保健提供者，并在整个护理周期中承担更多的专业职责。
采用RESP模式意味着护理人员承担四项广泛活动作为其新角色的核心组成部分：（1）农村社区参与；（2）应急响应；（3）现场实践；（4）初级卫生保健。该模式的关键特征是有能力将现有的护理人员模式与其他卫生机构和卫生专业人员整合，以确保护理人员的护理是无缝系统的一部分，为患者提供组织有序且高质量的护理。护理人员实践范围的这种扩大有可能改善患者护理和农村社区的整体健康状况。
