Sherratt Frances C, Snape Darlene, Goodacre Steve, Jackson Mike, Pearson Mike, Marson Anthony G, Noble Adam J
Department of Psychological Sciences, University of Liverpool, Liverpool, UK.
School of Health and Related Research, University of Sheffield, Sheffield, UK.
BMJ Open. 2017 Jan 9;7(1):e014024. doi: 10.1136/bmjopen-2016-014024.
The UK ambulance service often attends to suspected seizures. Most persons attended to will not require the facilities of a hospital emergency department (ED) and so should be managed at scene or by using alternative care pathways. Most though are transported to ED. One factor that helps explain this is paramedics can have low confidence in managing seizures.
With a view to ultimately developing additional seizure management training for practicing paramedics, we explored their learning needs, delivery preferences and potential drivers and barriers to uptake and effectiveness.
Semistructured interviews were conducted with a purposive sample of paramedics from the English ambulance service. Interviews were transcribed and thematically analysed.
A diverse sample of 19 professionals was recruited from 5 different ambulance NHS trusts and the College of Paramedics.
Participants said seizure management was neglected within basic and postregistration paramedic training. Most welcomed additional learning opportunities and identified gaps in knowledge. This included how to differentiate between seizure types and patients that do and do not need ED. Practical, interactive e-learning was deemed the most preferable delivery format. To allow paramedics to fully implement any increase in skill resulting from training, organisational and structural changes were said to be needed. This includes not penalising paramedics for likely spending longer on scene.
This study provides the first evidence on the learning needs and preferences of paramedics regarding seizures. It can be used to inform the development of a bespoke training programme for paramedics. Future research should develop and then assess the benefit such training has on paramedic confidence and on the quality of care they offer to seizure patients.
英国救护车服务经常处理疑似癫痫发作的情况。大多数接受治疗的人不需要医院急诊科（ED）的设施，因此应在现场或通过其他护理途径进行处理。然而，大多数人还是被送往了急诊科。有助于解释这一现象的一个因素是护理人员在处理癫痫发作时信心不足。
为了最终为在职护理人员开发额外的癫痫发作管理培训，我们探讨了他们的学习需求、授课偏好以及接受培训和培训效果的潜在驱动因素和障碍。
对来自英国救护车服务的护理人员进行了有目的抽样的半结构化访谈。访谈内容被转录并进行了主题分析。
从5个不同的国民保健服务救护车信托机构和护理人员学院招募了19名专业人员组成的多样化样本。
参与者表示，在基础护理人员培训和注册后培训中，癫痫发作管理被忽视了。大多数人欢迎额外的学习机会，并指出了知识上的差距。这包括如何区分癫痫发作类型以及哪些患者需要和不需要去急诊科。实用的交互式电子学习被认为是最可取的授课形式。为了让护理人员能够充分运用培训带来的技能提升，据说需要进行组织和结构上的变革。这包括不因护理人员可能在现场花费更长时间而对其进行惩罚。
本研究首次提供了护理人员对癫痫发作的学习需求和偏好的证据。它可用于为护理人员量身定制培训计划提供参考。未来的研究应该开发并评估这种培训对护理人员信心以及他们为癫痫患者提供的护理质量的益处。
