Abstract
Background: It has been suggested that emergency care providers’ decision-making competence should be strengthened regarding whether or not to transport the patient. This qualitative study describes challenges related to non-conveyance situations from emergency care providers’ perspective. Methods: Data were collected by a questionnaire from emergency care providers of a hospital district in Finland in 2014. Responses to open questions were analyzed using inductive content analysis to examine the difficulty of non-conveyance decisions, reasons for non-conveyance and challenges related to the non-conveyance decision after immediate care. Results: The majority (70%) of care providers did not experienced difficulty in making non-conveyance decisions, although those working in basic emergence care found decision-making slightly more challenging than workers in advanced emergency care. Care providers’ reasons for not transporting patients were most commonly connected with their assessment of care needs and the conclusion that no hospital care was required. Other reasons involved treating the patient on site, psychosocial reasons and not seeing the patient as an emergency care client. Difficulty of reaching mutual understanding with patients was considered the greatest challenge. Other challenges included worrying about the patient’s coping at home and problems in inter-professional co-operation, related to hurry and the concern that doctors did not always document requests for care instructions. Conclusions: The results suggest that care providers’ skills in assessing care needs and making decisions based on assessments are a decisive factor in non-conveyance situations. Reaching a mutual understanding with the patient is the greatest challenge.
Highlights
It has been suggested that emergency care providers’ decision-making competence should be strengthened regarding whether or not to transport the patient
Emergency care providers have a variety of reasons for not transporting patients to hospital care and they face multiple challenges in the situation related to non-transportation, most respondents in this study did not find nonconveyance decisions difficult
This research suggests that care providers’ skills in assessing care needs and making decisions based on the assessment are essential when having to decide whether the patient should be transported
Summary
Not very much is yet known about emergency care admin- competence, increase patient safety and bring out the role istered in the patient’s home or in another out-of-hospital of the paramedic practice as a source of research topics for setting, and relatively little research knowledge exists on nursing science.[1,3]. A population within a single hospital district, must form as well as possible, care providers need to have the right information[16] and focused guidelines to support their decision making.[20] Support and training are needed to increase be served based on a principle of equality.[8] Finnish law sets out qualification requirements for emergency health care providers’ confidence, and with appropriate training, it is possible to treat even aged patients at home safely.[17]. The connection between data and interpretation was demonstrated by quantitative
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