British Columbia Emergency Health Services, 2955 Virtual Way, Vancouver, BC, V5M 4X6, Canada.
School of Health and Related Research, University of Sheffield, Sheffield, UK.
CJEM. 2022 Mar;24(2):167-173. doi: 10.1007/s43678-021-00224-6. Epub 2021 Dec 7.
Progression in Anglo-American models of out-of-hospital care has resulted in the development of alternative roles for paramedics, including advanced paramedics providing teleconsultations to frontline paramedics. Traditionally provided by physicians, little is known about how paramedics perceive peer-to-peer teleconsultations. This research aimed to explore paramedic perceptions of paramedic-delivered teleconsultations.
This investigation employed a constructivist grounded theory methodology. Six focus groups were conducted with purposive and theoretical sampling and data analyzed using open coding and continual comparative analysis.
33 paramedics from across British Columbia, Canada, participated in the focus groups. Seven key themes emerged during the focus groups; the perceived roles and status of paramedic specialists and physicians in healthcare, the influence of relationships and culture on clinical consultations, practicalities of out-of-hospital care and the importance of lived experience, provision of appropriate clinical advice, professional trust and respect, mentorship in out-of-hospital care and clinical governance and education requirements. This led to the development of the grounded theory paramedics increasing ownership of their profession.
Paramedics reported a number of areas in which paramedic-delivered teleconsultations provided benefits not seen with traditional physician-delivered teleconsultation model. Emergency health systems delivering an Anglo-American model of care should consider the possible benefits of paramedic-delivered teleconsultations.
英美学派的院外急救模式不断发展，使护理人员的角色发生转变，包括为一线护理人员提供远程咨询的高级护理人员。传统上由医生提供的远程咨询服务，而护理人员对同行间的远程咨询服务的看法鲜为人知。本研究旨在探讨护理人员对护理人员提供的远程咨询服务的看法。
本研究采用建构主义扎根理论方法。通过目的性和理论性抽样，对来自加拿大不列颠哥伦比亚省的 33 名护理人员进行了 6 次焦点小组讨论，并采用开放式编码和持续比较分析对数据进行分析。
33 名来自不列颠哥伦比亚省的护理人员参加了焦点小组讨论。在焦点小组讨论中出现了 7 个关键主题：护理专家和医生在医疗保健中的角色和地位、关系和文化对临床咨询的影响、院外护理的实际情况和生活经验的重要性、提供适当的临床建议、专业信任和尊重、院外护理的指导和临床治理以及教育要求。这导致了护理人员增加对自己职业的所有权的扎根理论的发展。
护理人员报告了一些远程咨询服务为他们提供了一些传统的医生提供的远程咨询模型所没有的好处的领域。提供英美学派医疗模式的紧急医疗系统应考虑护理人员提供的远程咨询服务的可能好处。
