Emergency and Disaster Research Unit, Oviedo University, Oviedo, Asturias, Spain.
SAMU-Asturias, Oviedo, Asturias, Spain.
Prehosp Disaster Med. 2022 Jun;37(3):314-320. doi: 10.1017/S1049023X22000462. Epub 2022 Mar 18.
The objective of this study was to identify the perceived problems by medical and nursing professionals that have arisen in the Spanish Emergency Medical Services (EMS) as a consequence of the first wave of the severe acute respiratory syndrome-coronavirus-2/SARS-CoV-2 pandemic, as well as the measures or solutions adopted to manage those problems and improve response.
This was a cross-sectional study of quantitative and qualitative methodology ("mixed methods") using a self-administered questionnaire in 23 key informants of EMS of Spain selected by purposeful sampling, followed by the statistical analysis of both types of variables and an integration of the results in the discussion.
Common problems had been identified in many EMS, as well as similar solutions in some of them. Among the former, the following had been found: lack of leadership and support from managers, initial shortage of personal protective equipment (PPE), lack of participation in decision making, initial lack of clinical protocols, and slowness and/or lack of adaptability of the system, among others. Among the solutions adopted: reinforcement of emergency call centers, development of specific coronavirus disease 2019 (COVID-19) telephone lines and new resources, personal effort of professionals, new functions of EMS, support to other structures, and reinforcement of the role of nursing.
The general perception among the respondents was that there was a lack of support and communication with health care managers and that the staff expertise was not used by policy makers to make decisions adapted to reality, also expressing the need to improve the capacity for analysis of the EMS response. Few respondents reported good overall satisfaction with their EMS response. The EMS adopted different types of measures to adapt to the COVID-19 pandemic.
本研究旨在确定西班牙急救医疗服务(EMS)中的医疗和护理专业人员因严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)/新冠疫情第一波而感知到的问题,以及为管理这些问题和改善应对措施而采取的措施或解决方案。
这是一项采用定量和定性方法(“混合方法”)的横断面研究,使用目的抽样选择的 23 名西班牙 EMS 关键信息提供者进行自填式问卷,然后对两种类型的变量进行统计分析,并将结果整合到讨论中。
许多 EMS 都发现了共同的问题,并且在其中一些 EMS 中也采用了类似的解决方案。前者包括:管理层缺乏领导力和支持、最初个人防护设备(PPE)短缺、缺乏参与决策的机会、最初缺乏临床方案以及系统缓慢和/或缺乏适应性等。所采用的解决方案包括:加强紧急呼叫中心、开发特定的 2019 年冠状病毒病(COVID-19)电话线路和新资源、专业人员的个人努力、EMS 的新功能、对其他结构的支持以及加强护理的作用。
受访者普遍认为,他们缺乏与医疗保健管理人员的支持和沟通,决策者没有利用员工的专业知识做出适应现实的决策,还表示需要提高 EMS 应对能力的分析能力。很少有受访者报告对其 EMS 应对措施总体满意度高。EMS 采取了不同类型的措施来适应 COVID-19 大流行。