A Retrospective Review of Patient Records and Factors Associated with Decisions Made by Community Nurse-Paramedics' in Finland.

Tuija Rasku,Elizabeth Thyer,Katja Joronen,Mika Helminen,Eija Paavilainen,Marja Kaunonen

doi:10.3390/nursrep11030065

Abstract

Community paramedicine (CP) has extended the role of paramedics and the main goal is to provide non-emergency care, which reduces the visits to emergency departments. The aim of this study was to describe the Finnish CP and examine the factors that were involved in CNPs’ decision-making processes. The study was based on data from 450 consecutive CP patient records from three hospital districts. A more detailed analysis was carried out on 339 cases in patients’ homes and elderly care homes, and the data analysis included multivariate logistic regression to examine the impact of variables on the CNPs’ decisions. These patients’ most common health issues were general weakness (15.9%) and fever (10.6%), and over half (58.7%) could remain at home after the CP visit. There were five independent factors associated with the CNPs’ decisions of the patient’s care continuum: the hospital district, if the patient could walk, whether the troponin test was performed, a physician was consulted, and the nature of the task. CP units played a valuable role in non-emergency care. Understanding the factors associated with CNP decision-making can increase the safety and effectiveness of reducing hospital visits, by providing patient care at home, or in elderly care facilities.

Highlights

In 2018, the World Health Organization (WHO) launched its vision for primary health care pathways that centre on people rather than services (WHO, 2018)
The analysis was carried out from those community paramedicine (CP) patients (n = 339, 75.3%) who lived at home or in elderly care homes These home-care patients had a median age of 83 years and more than one-third (38.2%) were 85 years or older
This study provides a reflection of CP models in Finland and detailed factors associated with the Community nurse-paramedics (CNP)’ decisions, which will be useful for further research

Summary

Introduction

In 2018, the World Health Organization (WHO) launched its vision for primary health care pathways that centre on people rather than services (WHO, 2018). Since 2005, community paramedicine (CP) programmes have undertaken health promotion and illness prevention work at community levels in Australia, Canada, the United States of America, and the United Kingdom. They have filled care gaps and decreased pressure on emergency departments (EDs) by dealing with patients who did not need that level of attention [3,5]. Various CP programmes have been provided by pre-hospital and post-hospital or community health services [3]. Post-hospital and community health services are run by CP programmes and provide follow-up care for recently discharged patients

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