Impact of education, demographics and professional culture, on paramedic infection control decision making

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IMPACT OF EDUCATION, DEMOGRAPHICS AND PROFESSIONAL CULTURE, ON PARAMEDIC INFECTION CONTROL DECISION MAKING

TABLE OF CONTENT

Chapter One            Introduction

1.1         Background of the study

1.2         Statement of the problem

1.3         Purpose of the study

1.4         Significance of study

1.5         Research questions

1.6         Scope of study

1.7         Limitation of study

1.8         Definition of terms

Chapter Two

2.0         Literature Review

Chapter Three

3.0         Methodology

Chapter Four

4.0              Data Analysis

Chapter Five 

5.0         Summary, Conclusion and Recommendations

References Questionnaires

CHAPTER ONE

INTRODUCTION

1.1  Background to the study

Paramedicine is a new and ever-changing profession that has recently undergone considerable evolution from its origins as ‘stretcher bearers’ to its current recognition as professional paramedics with considerable autonomy and scope of practice Cooper , (2014) & Burges, Sanoff, Mackintosh (2012). The progression of paramedicine is clearly articulated in the significant increase in the clinical scope of practice granted to frontline paramedics over the past two decades. In 1990, a New South Wales Ambulance (NSWA) officer’s focus was on transport, with only basic symptom management and treatment provided. This has since rapidly increased to include advanced patient monitoring and diagnosis, e-health, advanced critical care, retrieval, administration of sedating and aesthetic agents, public health programmes and low acuity as well as primary healthcare initiatives for patients across all demographics, conditions and levels of healthcare Fletcher PJ, Stewart P, Savage L. (2003). The speed of this advancement has resulted in organisations such as NSWA having a diverse workforce of individuals that include current employees who joined via several different pathways—as an ambulance driver or ambulance officer, or as a vocational paramedic or tertiary trained paramedic—all of whom operate within the same position description and with the same clinical responsibility NSW, (2016). The clinical effectiveness and safety of such workforce diversity is, however, untested, as research and evidencebased practice have only recently been introduced into paramedicine; thus, much of paramedic practice, workforce management and accreditation has not been suitably

1.2  Statement of the Problem

Following the rapid transition from ambulance driver to ambulance officer, and finally today’s paramedic, there has been an exceptional increase in a paramedic’s professional autonomy and authority(4) , especially over the last 30 years(32, 45). The unsupervised, critical and complex nature of modern paramedic practice(4) , demands high standards of governance and paramedic competency to protect patients in the delivery of out-of-hospital care. Despite the diverse paramedic workforce(46), there is an ongoing assumption across many statutory ambulance services that a paramedic’s background, initial entry training and demographics do not influence their clinical performance and decision making. This assumption extends so far to providing ongoing support for grandfathering clauses within statutory ambulance services such as NSWA. In 2017, NSWA did not allow the differentiation of a paramedic’s clinical scope of practice or training requirements based on factors such as if they entered the profession as an ambulance driver through vocational certificate courses or as a graduate paramedic through a tertiary pathway(10). There was also no distinction in training, supervision or skill practice requirements for paramedics working in rural areas managing on average less than a quarter of the incidents than their metropolitan colleagues(47, 48). To inform effective and efficient paramedic education and governance, it is important that a rigorous mixed methods study is conducted to determine how clinical decision making varies across paramedics of different educational, pathway of entry and personal backgrounds. This research could then be used to make recommendations on governance standards and training requirements to best improve the standard and safety of paramedic-delivered patient care. The geographical dispersion of paramedics and the current reliance on face-to-face education and assessment(49) means that the value of this study would be further magnified with the creation and validation of new online clinical decision making platforms to assess and improve paramedic performance into the future.

1.3  Objective of the study

To examine the effect of educational culture on paramedic infection control discussion making

To examine the effect of demographics culture on paramedic infection control discussion making

To examine the effect of professional culture on paramedic infection control discussion making

1.4  Research Question

What is the effect of educational culture on paramedic infection control discussion making?

What is the effect of demographics culture on paramedic infection control discussion making?

What is the effect of professional culture on paramedic infection control discussion making?

1.5  Hypothesis

There is no significant effect of educational culture on paramedic infection control discussion making

There is no significant effect of demographics culture on paramedic infection control discussion making

There is no significant effect of professional culture on paramedic infection control discussion making

1.6  Significance of the study

The foundational principle of all elements of this study is to further contribute to the knowledge of the paramedic profession. Despite the significant potential patient safety implications, there is currently no consensus and there has been limited research on the variables that influence paramedic clinical decision making and performance.

Further, to date no study has used multimedia and online decision making tools to examine paramedic clinical decision making. While paramedics operate in a unique and unsupervised out-of-hospital emergency service environment.

The findings here may be used across paramedicine to advance the understanding of this under-researched field. The geographically dispersed nature of paramedics and the demonstrated value of e-learning supports both the need and potential value of the online education and research instruments that were developed by this study to assess and improve paramedic clinical decision making.

1.7  Limitation of the Study

       In every research work, it is likely that the researcher may encounter some limitations. The researcher encountered some challenges during the period of carrying out this research. Some of these challenges include the dearth of materials for a proper and effective research work constituted a major limitation. Again, how to get the true and required information from the students through questionnaire also constituted a constraint in the study.

IMPACT OF EDUCATION, DEMOGRAPHICS AND PROFESSIONAL CULTURE, ON PARAMEDIC INFECTION CONTROL DECISION MAKING

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