Emergency Healthcare Professionals Research Articles

Investigation of The Factors Affecting the Vaccine Preferences of Pre-Hospital Emergency Healthcare Professionals

Objective: The aim of this study was to examine the factors affecting the vaccine preferences of prehospital emergency health workers and the status of vaccine opposition. Materials and Methods: This study was planned as a descriptive study to examine the factors affecting the vaccine preferences of prehospital emergency health care workers working in 112 emergency health services stations and command and control centers affiliated to the Ministry of Health in Aydın province between April 2022 and January 2023, their anti-vaccine status and their attitudes towards Covid-19 vaccine. The population of the study consisted of physicians, emergency medical technicians/technicians (ATT/Paramedics) and ambulance drivers (drivers) working in 112 emergency health services stations and command control centers affiliated to the Ministry of Health in Aydın province (N: 577). The sample selection method was not used and it was aimed to reach the whole population. Data were collected by sending online questionnaire forms to social media groups. The Case Report Form consisting of 12 (twelve) questions including socio-demographic characteristics such as age, gender, educational status, Attitudes Towards Covid-19 Vaccine Scale and Anti-Vaccine Scale were used. The data obtained in the study were analyzed using the SPSS for Windows 25.0 program. Findings: The population of the study was 577 people. 89.7% (n:427) people participated in our study. 51.5% (n:220) of the participants were female. 48.9% (n:209) were found to have Covid-19 infection. 95.8% (n:427) of the participants were vaccinated. Among the vaccinated participants, 70.4% (n:288) received Biontech, 70.4% (n:288) received Sinovac and 5.1% (n:21) received Turkovac vaccine types. When the scores of the attitudes towards Covid-19 vaccine scale and its dimensions were compared according to the descriptive characteristics of the participants, it was found that the positive attitude dimension scores of male participants (3.81) were higher than those of female participants (3.51). It was determined that the positive attitude dimension scores of the participants with chronic diseases and the participants who were vaccinated, and the positive attitude dimension scores of the participants whose vaccine type was Biontech, Sinovac and Turkovak were higher than those of the participants who were not vaccinated. It was determined that the positive attitude dimension and attitudes towards Covid-19 vaccine scale scores of the participants whose vaccine dose was three doses and more were higher than the participants whose vaccine dose was one dose and two doses, and the positive attitude dimension and attitudes towards Covid-19 vaccine scale scores of the participants who had a death due to Covid-19 infection in the family or close environment were higher than those of the participants who did not. According to the findings of our study, the view that there is no vaccine protection in those with chronic diseases has a higher score. Participants who did not have Covid-19 infection, who were not vaccinated, and who had no death loss in their close environment had higher scores on the anti-vaccination scale. Conclusion: In this study, which examined the hesitancy of prehospital emergency healthcare workers about Covid-19 vaccination, it was found that Covid-19 vaccines were administered at a very high rate. However, it was also found that 4.2% of the employees had high hesitation about vaccines and were not vaccinated. Pre-hospital emergency healthcare workers have an important role and responsibility in the acceptance of Covid-19 vaccine by the public and other healthcare professionals, as in other disaster situations. In a pandemic, vaccination of all members of the society is necessary for the control of the pandemic. For this reason, scientific studies should be conducted for emergency healthcare workers who are not vaccinated and who are hesitant about vaccines, including basic concerns about vaccines and examining potential side effects of vaccines. Training programs should be organized to ensure that healthcare workers are vaccinated with existing Covid-19 vaccines.

AI Enabled MED Drone for Healthcare Application

The project proposes the development of an AI-enabled MedDrone for medication delivery, introducing an innovative and efficient solution to enhance healthcare logistics. The MedDrone, equipped with artificial intelligence capabilities, aims to revolutionize the process of medication delivery by leveraging autonomous aerial technology. The system integrates advanced algorithms to optimize route planning, ensuring timely and accurate delivery of medications to designated locations. The AI component enables the drone to adapt to real-time variables such as weather conditions and traffic, enhancing the reliability and responsiveness of the delivery process. This project addresses the challenges of traditional medication distribution, offering a futuristic and intelligent approach to healthcare logistics through the deployment of AI-enabled autonomous drones for efficient and timely medication delivery. The proposed system integrates AI algorithms for real-time route optimization, obstacle avoidance, and decision-making, enabling the drone to autonomously navigate complex environments and deliver essential medical supplies such as first aid kits, defibrillators, and medications to the point of need. Through the utilization of machine learning techniques, the drone continuously learns from its interactions with the environment, enhancing its adaptability and performance over time. Additionally, the system incorporates advanced communication technologies to enable seamless coordination with emergency responders and healthcare professionals, ensuring timely delivery and proper utilization of resources. The efficacy of the proposed AI-based medical drone system is demonstrated through simulations and real-world trials, highlighting its potential to revolutionize emergency response efforts and improve healthcare accessibility, particularly in challenging or resource-constrained environments.

Advance directives in the emergency department–a systematic review of the status quo

BackgroundProviding individualised healthcare in line with patient wishes is a particular challenge for emergency healthcare professionals. Documentation of patient wishes (DPW), e.g. as advance directives, can guide clinicians in making end-of-life decisions that respect the patient’s wishes and autonomy. However, patient centered decisions are hindered by limited availability of DPWs in emergency settings.ObjectiveThis systematic review aims to congregate present data on recorded rates for DPW existence and availability in the emergency department (ED) as well as contributing factors for these rates.MethodsWe searched MEDLINE, Google Scholar, Embase and Web of Science databases in September 2023. Publications providing primary quantitative data on DPW in the ED were assessed. Publications referring only to a subset of ED patients (other than geriatric) and investigating DPW issued after admission were excluded.ResultsA total of 22 studies from 1996 to 2021 were included in the analysis. Most were from the US (n = 12), followed by Australia (n = 4), Canada (n = 2), South Korea, Germany, the United Kingdom and Switzerland (n = 1 each). In the general adult population presenting to the ED, 19.9–27.8% of patients reported having some form of DPW, but only in 6.8% or less it was available on presentation. In the geriatric population, DPW rates (2.6–79%) as well as their availability (1.1–48.8%) varied widely. The following variables were identified as positive predictors of having DPW, among others: higher age, poorer overall health, as well as sociodemographic factors, such as female gender, having children, being in a relationship, higher level of education or a recent previous presentation to hospital.ConclusionsExistence and availability of a recorded DPW among ED patients was low in general and even in geriatric populations mostly well below 50%. While we were able to gather data on prevalence and predictors, this was limited by heterogeneous data. We believe further research is needed to explore the quality of DPW and measures to increase both rates of existence and availability of DPW in the ED.

Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care.

To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services. Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021). The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health. The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care. Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality. The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

Reaching consensus on the definition of person-centred handover practices in emergency departments: A modified online Delphi.

To reach consensus on the definition and attributes of 'person-centred handover practices' in emergency departments. Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person-centred handover practices may enhance the delivery of person-centred care in emergency departments. A three-round online Delphi survey. Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted. Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated. Person-centred handover practices have not been implemented in emergency departments. Yet, person-centred handover practices may enhance the delivery of person-centred care, which has multiple benefits for patients and healthcare practitioners. Person-centred care is not generally implemented in emergency departments. Person-centred handover practices can lead to person-centred care. Handover practices in emergency departments are a high-risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person-centred handover practices in emergency departments. The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist. Improve handover practices and patient care. Improve person-centred care in emergency departments. Emergency care practitioners and nurses experienced in handover practices and/or person-centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds.

Examination of workload perception, burnout, and perceived organizational support in emergency healthcare professionals: A structural equation model.

Job stress is one of the important factors affecting employee behavior. One of the most important factors in reducing burnout caused by stress is organizational support. In this context, the aim of this study is to identify the moderating role of perceived organizational support in the effect of workload perception on burnout within the emergency healthcare professionals' universe. The data for this study were collected from 703 health professionals working in emergency health services in three major cities of Turkey. The relationships and the model of the study is analyzed by the Structural Equation Model technique. The results indicate that perceived workload is a factor that causes employee burnout, and perceived organizational support is a factor that reduces employee burnout. This study contributes to researchers and health managers by revealing the importance of workload planning and organizational activities that support employees to reduce burnout in health workers.

The effect of ambulance response time on patient and transfer to hospital

This study investigates the critical relationship between ambulance response time and its impact on patient outcomes during the transfer to the hospital. Timely and efficient ambulance responses are fundamental in emergency medical services, significantly influencing patient morbidity and mortality rates. The research employs a retrospective analysis of ambulance response times and patient transfer data collected over a specific period. Key variables include response time intervals, patient demographics, medical conditions, and outcomes during hospital transfer. Statistical analyses, including regression modeling, are utilized to assess the correlation between response times and patient outcomes, considering potential confounding factors. Preliminary findings indicate a noteworthy association between extended ambulance response times and adverse patient outcomes, emphasizing the urgency of swift emergency medical interventions. This research contributes valuable insights to emergency medical service providers, policymakers, and healthcare professionals, aiming to enhance pre-hospital care strategies and improve overall patient well-being. The implications of these findings extend beyond statistical correlations, emphasizing the imperative need for efficient emergency response systems to optimize patient care and outcomes. Keywords: Ambulance response time, Patient care, Emergency medical service, Hospital.

Are Health-care Professionals Meeting Patient’s Expectations? – A Comparative Study Done in Emergency Setup of a Teaching Hospital in North India

Abstract Background: User satisfaction in healthcare is an important measure of the quality of services provided to the patient and their carers. Since treatment of psychiatric patients requires long follow-up periods, and this long follow-up treatment patients depends on their initial experience with health service,therefor user satisfaction is of increasing importance in the mental health field. Aims and Objectives: Assess the user satisfaction and perceptions of the attitude of emergency health-care professionals (including paramedical staff and physicians of respective specialties) toward psychiatric and nonpsychiatric patients as experienced by the patients and carers. To compare the user satisfaction and perceived attitude of emergency staff in patients with psychiatric illness and nonpsychiatric illness. To determine the service users’ decision to revisit the same health-care facility in case of the same problem. Materials and Methods: This study was done in the hospital wing of a tertiary care teaching university hospital in northern India, and ethics approval was obtained from the institutional ethics committee patients’ sociodemographic details and psychiatric and other relevant medical history after obtaining informed consent. The psychiatric diagnosis was made according to the ICD-10. A self-report questionnaire, comprising 9 questions, and was designed to assess the perceived attitudes of health-care workers toward the patient of psychiatric illness. The questionnaire was designed in Hindi. Descriptive statistics for categorical variables were done. Inferential statistics were calculated using the Chi-square test. Results: Out of a total of 95 respondents, 69 patients were diagnosed with a psychiatric disorder and the remaining 26 patients had medical illness or other non-psychiatric disorders. Females were a majority in both groups. Our study majorly showed that service users perceived the attitudes of medical and paramedical staff in emergency units mostly as satisfactory or extremely satisfactory, as well as the majority of service users reported that they were satisfied with the reaction of emergency paramedical staff towards the emotional well-being of the patient. Conclusions: The major strengths of this study were the quantitative analysis of health workers’ attitudes toward patients with psychiatric illnesses, which showed user-rated satisfactory attitudes. There was less stigma and more of a positive impact noted. The semi-structured questionnaire was designed in the local language and tailored to cover topics such as emotional well-being and psychoeducation that can all affect the user experience.

Sleep analysis of hospital and out-of-hospital emergency professionals

IntroductionSleep deprivation is associated with poorer cognitive functioning and a greater risk of serious diseases. Herein, we analyzed differences in the quality of sleep and excessive daytime sleepiness between hospital emergency services and out-of-hospital emergencies services, and investigated its association with sociodemographic and labor variables. MethodThis is a cross-sectional observational study carried out between April 2019 and February 2020, including healthcare professionals from different emergency departments, who were evaluated through the following instruments: “Pittsburgh Sleep Quality Index“ and “Epworth Sleepiness Scale”. ResultsFour-hundred and four healthcare professionals were included (mean age 40.4 ± 11.1 years), predominantly women (61.4%) from hospital emergency departments (62.6%). A total of 65.3% of the workers had poor sleep quality and 27.7% had excessive sleepiness. Women had poorer sleep quality (p = 0.022) and higher sleepiness (p = 0.010) than men. Hospital emergency workers presented 2-fold increased risk of poor sleep quality (OR = 1.93, p = 0.003) and sleepiness (OR = 1.93, p = 0.009) than out-of-hospital emergency workers. The more optimistic were less likely to have poor sleep quality (OR = 0.73, p = 0.01) or sleepiness (OR = 0.70, p = 0.002). Nurses, emergency medical technicians and nursing assistants also had a higher risk of poor sleep quality compared to physicians (OR = 1.60; p = 0.043). ConclusionsEmergency healthcare professionals working in hospital emergency departments had a two-times higher risk of poor sleep quality and sleepiness than out-of-hospital emergency healthcare professionals.

FIRECARE: An Evidence-Based Prevention Program to Reduce Burnout among Prehospital Caregivers: Benefits of a Combined Mindfulness, Heart Coherence Training, and Positive Psychology Intervention

Background Burnout among emergency health care professionals is well-described, especially during the COVID-19 pandemic. Prevention interventions, such as mindfulness, focus on the management of stress. Objective To evaluate the effects of the FIRECARE program (a mindfulness intervention, supplemented by heart coherence training and positive psychology workshops) on burnout, secondary stress, compassion fatigue, and mindfulness among advanced life support ambulance staff of the Paris Fire Brigade. Materials and methods We used a non-randomized, two-group quasi-experimental study design with a waitlist control and before-and-after measurements in each group. The intervention consisted of six, once-weekly, 2.5-h sessions that included individual daily meditation and cardiac coherence practice. The study compared intervention and waitlist control groups, and investigated baseline, post-program, and 3-month follow-up change on burnout (measuring using the ProQOL-5 scale) and mindfulness (measuring using the FMI scores). Baseline burnout (measured using the ProQOL-5) was evaluated and used in the analysis. Results Seventy-four 74 participants volunteered to participate; 66 were included in the final analysis. Of these, 60% were classified as suffering from moderate burnout, the ‘burnout cluster’. A comparison of intervention and waitlist control groups found a decrease in the burnout score in the burnout cluster (p = 0.0003; partial eta squared = 0.18). However, while secondary stress fell among the burnout cluster, it was only for participants in the intervention group; scores increased for those in the waitlist group (p = 0.003; partial eta squared = 0.12). The pre-post-intervention analysis of both groups also showed that burnout fell in the burnout cluster (p = 0.006; partial eta squared = 0.11). At 3-month follow-up, the burnout score was significantly reduced in the intervention group (p = 0.02; partial eta squared = 0.07), and both the acceptance (p = 0.007) and mindfulness scores (p = 0.05; partial eta squared = 0.05) were increased in the baseline burnout cluster. Conclusion FIRECARE may be a useful approach to preventing and reducing burnout among prehospital caregivers.

Applying a Smartwatch to Predict Work-related Fatigue for Emergency Healthcare Professionals: Machine Learning Method.

Healthcare professionals frequently experience work-related fatigue, which may jeopardize their health and put patient safety at risk. In this study, we applied a machine learning (ML) approach based on data collected from a smartwatch to construct prediction models of work-related fatigue for emergency clinicians. We conducted this prospective study at the emergency department (ED) of a tertiary teaching hospital from March 10-June 20, 2021, where we recruited physicians, nurses, and nurse practitioners. All participants wore a commercially available smartwatch capable of measuring various physiological data during the experiment. Participants completed the Multidimensional Fatigue Inventory (MFI) web form before and after each of their work shifts. We calculated and labeled the before-and-after-shift score differences between each pair of scores. Using several tree-based algorithms, we constructed the prediction models based on features collected from the smartwatch. Records were split into training/validation and testing sets at a 70:30 ratio, and we evaluated the performances using the area under the curve (AUC) measure of receiver operating characteristic on the test set. In total, 110 participants were included in this study, contributing to a set of 1,542 effective records. Of these records, 85 (5.5%) were labeled as having work-related fatigue when setting the MFI difference between two standard deviations as the threshold. The mean age of the participants was 29.6. Most of the records were collected from nurses (87.7%) and females (77.5%). We selected a union of 31 features to construct the models. For total participants, CatBoost classifier achieved the best performances of AUC (0.838, 95% confidence interval [CI] 0.742-0.918) to identify work-related fatigue. By focusing on a subgroup of nurses <35 years in age, XGBoost classifier obtained excellent performance of AUC (0.928, 95% CI 0.839-0.991) on the test set. By using features derived from a smartwatch, we successfully built ML models capable of classifying the risk of work-related fatigue in the ED. By collecting more data to optimize the models, it should be possible to use smartwatch-based ML models in the future to predict work-related fatigue and adopt preventive measures for emergency clinicians.

Hacking Acute Care: A Qualitative Study on the Health Care Impacts of Ransomware Attacks Against Hospitals

Cyberattacks are an increasing threat to health care institutions which potentially impair patient outcomes. Current research is limited and focuses mainly on the technical consequences, whereas little is known about health care staff experiences and the effect on emergency care. This study aimed to explore the acute care effect of several large ransomware attacks against hospitals that occurred in Europe and the United States between 2017 and2022. This interview-based qualitative study assessed the experiences of emergency health care professionals and information technology (IT) staff and investigated the challenges during the acute and recovery phase of hospital ransomware attacks. The semistructured interview guideline was based on relevant literature and cybersecurity expert consultation. Transcripts were anonymized, and traceable information regarding participants and/or their organizations was removed for privacy purposes. Nine participants were interviewed, including emergency health care providers and IT-focused staff. Five themes were constructed from the data: effects and challenges regarding patient care continuity, challenges during the recovery process, personal effect on health care staff, preparedness and lessons identified, and future recommendations. According to the participants of this qualitative study, ransomware attacks have a significant effect on emergency department workflow, acute care delivery, and the personal well-being of health care providers. Preparedness for such incidents is limited, and many challenges are encountered during the acute and recovery phase of attacks. Although there was profound hesitancy among hospitals to participate in this study, the limited number of participants provided valuable information that can be used to develop response strategies for hospital ransomware attacks.

Work-life balance and burnout among emergency healthcare professionals during the COVID-19 pandemic: A cross-sectional study

ABSTRACT The aim of this study was to examine the correlation between work-life balance and burnout among emergency healthcare professionals during the COVID-19 pandemic. This was a cross-sectional, descriptive, and correlational study which was conducted with 428 subjects between February and July 2021. A Descriptive Characteristics Form, the Maslach Burnout Inventory (MBI), and the Work-Life Balance Scale (WLBS) were used to collect data. The findings of the study revealed that there was a statistically significant negative correlation between their total WLBS and MBI scores (P < 0.05). Participants’ Work-Life Balance scores explained 28.5% of the variance in burnout levels (R 2 = 0.285). Those who did not have to be away from their families during the pandemic had higher total WLBS scores than those who did. Those who received positive support from their families during the pandemic despite their heavy schedules were satisfied with their jobs and unit, and moreover had statistically higher total WLBS scores and statistically lower total MBI scores compared to the others.

The evaluation of treat and release attitudes of pre-hospital emergency healthcare professionals in case of hypoglycemia

AimIt is aimed to evaluate the knowledge of Pre-Hospital Emergency Health Services (PHEMS) staff about the treat and release criteria in hypoglycemia cases and their attitudes in the decision-making processes related to hospitalization. Materials and MethodsThe sample of this descriptive cross-sectional study consisted of 714 paramedics working in PHEMS in Turkey. A survey developed in Microsoft Forms, which includes various features such as age, gender, years of professional experience, developed in line with the literature, and questions covering treat and release in hypoglycemia cases and absolute hospital transport criteria, was used in the collection of data. Participants who agreed to participate in the study answered the online survey. FindingsOf the 714 participants, 402 (56.30%) were female and 312 (43.70%) were male. 598 (83.75%) of the participants, who had a dilemma regarding the transfer of hypoglycemia cases that became stable after treatment to the hospital, decide to transfer the patient to the emergency room. 706 (98.88%) reported that the presence of another emergency that needs intervention in addition to hypoglycemia was decisive in the decision to transfer to the absolute hospital, and 586 (82.07%) reported that the patient's who did not return to his normal mental state after emergency medical intervention was decisive in the treatment and release decision. ConclusionPHEMS employees have high knowledge and awareness related to treat and release criteria in hypoglycemia cases with which they have high experience. PHEMS employee, who has a dilemma related to making a treat and release decision, decides to transfer to the hospital with a high rate. PHEMS systems should define the treat and release protocols for hypoglycemia cases more clearly in order to use emergency services and health resources effectively.

Addressing Compassion Fatigue in Trauma Emergency and Intensive Care Settings: A Pilot Study.

Emergency and intensive care health care professionals are experiencing exhaustion and helplessness, which may cause compassion fatigue. Unaddressed compassion fatigue impacts staff morale and patient safety. Structured debriefing sessions may reduce compassion fatigue by providing social support and increasing job satisfaction. To investigate the feasibility of a 12-week pilot of structured debriefing sessions and its impact on compassion fatigue experienced by emergency and intensive care health care professionals after patient death. In this 12-week pilot study (March 2021 to May 2021), we used a preintervention/postintervention design to determine the feasibility of structured debriefing among trauma health care professionals experiencing patient death in an urban, academic, 300-bed, Midwest, Level II trauma center. Compassion fatigue was measured using the Professional Quality of Life Measure survey. Univariate descriptive statistics, independent unpaired t tests, and χ2 tests examined the intervention impact. Fifty-six health care professionals participated in 20 debriefing sessions during the 12-week intervention: 37 (80%) registered nurses, 10 (5.6%) respiratory therapists, and 5 (11.2%) nursing assistants or emergency medical technicians. The debriefings covered nearly half of all patient deaths (38%). No significant differences were seen in burnout (M = 25.5, SD = 5.4, p = .47), secondary traumatic stress (M = 23.9, SD = 5.6, p = .99), or compassion satisfaction (M = 36.8, SD = 6.4, p = .61). Structured debriefings to address compassion fatigue among trauma health care professionals are feasible, but further research on effectiveness is needed. Administration-provided emotional support strategies may assist health care professionals in processing work-related stress.

Burnout in emergency medicine professionals after 2 years of the COVID-19 pandemic: a threat to the healthcare system?

BackgroundBurnout is a common problem among healthcare professionals (HCPs), in particular young doctors and nurses working in emergency medical services. The coronavirus disease 2019 (COVID-19) pandemic has generated a substantial increase in the workload of those working in front-line services, and there is evidence of physical and mental distress among professionals that may have caused an increase in burnout.ObjectiveThe objective of the study was to evaluate the level of burnout in the different professionals of emergency medical services.Design and participantsIn January and February 2022, we conducted an online survey based on the Abbreviate Maslach inventory with the addition of three questions focused on possible modifying factors. The survey was disseminated to HCP via the list of European Society for Emergency Medicine contacts.Outcome measuresThe analysis was based on two of the three elements of the Maslach burnout concept, ‘depersonalisation’, ‘emotional exhaustion’, and ‘personal accomplishment’. Overall burnout was defined when at least one of the two elements ‘depersonalisation’ or ‘emotional exhaustion’ reached the level of high burnout.ResultsThe number of responders was 1925, 84% of which were physicians, 12% nurses, and 2% paramedics. Burnout was present in 62% of all responders. A high burnout level was reported for depersonalisation, emotional exhaustion, and personal accomplishment in 47%, 46%, and 48% of responders, respectively. Females reported a higher proportion of burnout compared with males 64% vs. 59%, difference −6% [95% confidence interval CI, −8 to −1.9], and nurses higher than physicians, 73% vs. 60%, difference −13 (95% CI, −18.8 to −6). Less experienced professionals reported higher levels of burnout: those with less than 5 years of experience the burnout level was 74% compared with the group with more than 10 years, 60%, difference −26% (95% CI, −32 to −19.5). Reported frequent understaffing situations were associated with a higher risk of burnout: 70% vs. 37%, difference −33% (95% CI, −41 to −25). Burnout was associated with a higher risk of desire to change the workplace: 87% vs. 40%, difference −47% (95% CI, −52 to −42). Survey responders reported having access to support programmes in 41% of cases.ConclusionIn this study, there is a high reported level of burnout among emergency HCPs. Several risk factors were identified such as being understaffed, female, or having less experience. HCPs with burnout thought more frequently about leaving the workplace, posing a threat to healthcare systems.

Resilience and job satisfaction among out-of-hospital emergency medical service professionals: A cross-sectional multi-centric study.

We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals. The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work. A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale. Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73). There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals.

Stress in Emergency Healthcare Professionals: The Stress Factors and Manifestations Scale.

Background: Healthcare workers are continuously exposed to a high level of stress, especially emergency department professionals. In the present research, we aimed to determine the internal consistency and validity of the Stress Factors and Manifestations Scale for in-hospital and out-of-hospital emergency workers. Methods: A quantitative, prospective, cross-sectional, and observational study including 269 emergency service professionals. Results: The scale was composed of 21 items, with a Cronbach’s α value of 0.908. The hospital workers (38.4 ± 10.8 vs. 35.1 ± 9.9, p = 0.014) and women (39.3 ± 11.4 vs. 34.2 ± 8.6, p < 0.001) had higher levels of stress. The sensitivity, specificity, and predictive values of the scale were adequate. Conclusion: In the present study, including in-hospital and out-of-hospital emergency workers, the Stress Factors and Manifestations Scale presented appropriate usefulness, internal consistency, and validity, with optimal predictive ability. Higher levels of anxiety, female gender, being less optimistic, and working in hospital emergency departments were related to increased stress levels. Further studies are warranted to validate our results and potentially extend the Stress Factors and Manifestations Scale to other contexts.

Health professionals’ perspectives of patients’ and family members’ needs in emergency departments and patient pathway improvement: a qualitative study in Denmark

ObjectiveBesides working in a fast-paced environment, healthcare professionals (HCPs) in the emergency department (ED) are required to promptly respond to patients’ needs and simultaneously achieve their organisational goals, which can...

Quantity and Quality of Healthcare Professionals, Transfer Delay and In-hospital Mortality Among ST-Segment Elevation Myocardial Infarction: A Mixed-Method Cross-Sectional Study of 89 Emergency Medical Stations in China.

BackgroundTransfer delay provokes prolongation of prehospital time, which contributes to treatment delay that endangers patients with ST-segment elevation myocardial infarction (STEMI). A key constraint in reducing transfer delay is the shortage of emergency healthcare workers. This study was to explore the influence of the quality and quantity of healthcare professionals at emergency medical stations on transfer delay and in-hospital mortality among STEMI patients.MethodsA cross-sectional study using mixed methods was conducted at 89 emergency stations in 9 districts in China's Shenzhen province. Based on a sample of 31 hospitals, 1,255 healthcare professionals, and 3,131 patients with STEMI, a generalized linear model was used to explore the associations between the quality and quantity of healthcare professionals and transfer delay and in-hospital mortality among STEMI patients. Qualitative data were collected and analyzed to explore the reasons for the lack of qualified healthcare professionals at emergency medical stations.ResultsThe analysis of the quantity of healthcare professionals showed that an increase of one physician per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 5.087 min (95% CI −6.722, −3.452; P < 0.001). An increase of one nurse per 100,000 individuals was associated with decreased transfer delay by 1.471 min (95% CI −2.943, 0.002; P=0.050). Analysis of the quality of healthcare professionals showed that an increase of one physician with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 8.508 min (95% CI −10.457, −6.558; P < 0.001). An increase of one nurse with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay by 6.645 min (95% CI −8.218, −5.072; P < 0.001). Qualitative analysis illustrated that the main reasons for low satisfaction of healthcare professionals at emergency medical stations included low income, limited promotion opportunities, and poor working environment.ConclusionsThe quantity and quality of emergency healthcare professionals are key factors influencing transfer delay in STEMI patients. The government should increase the quantity of healthcare professionals at emergency medical stations, strengthen the training, and improve their performance by linking with clinical pathways to enhance job enthusiasm among emergency healthcare professionals.