Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study

Shaw, Deborah and Siriwardena, A. Niroshan (2014) Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study. BMC Emergency Medicine, 14 (18). pp. 1-9. ISSN 1471-227X

Full content URL: http://www.biomedcentral.com/1471-227X/14/18

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Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study
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Abstract

Background
Acute asthma is a common reason for patients to seek care from ambulance services. Although better care of acute asthma can prevent avoidable morbidity and deaths, there has been little research into ambulance clinicians' adherence to national guidelines for asthma assessment and management and how this might be improved. Our research aim was to explore paramedics' attitudes, perceptions and beliefs about prehospital management of asthma, to identify barriers and facilitators to guideline adherence.
Methods
We conducted three focus group interviews of paramedics in a regional UK ambulance trust. We used framework analysis supported by NVivo 8 to code and analyse the data.
Results
Seventeen participants, including paramedics, advanced paramedics or paramedic operational managers at three geographical sites, contributed to the interviews. Analysis led to five themes: (1) guidelines should be made more relevant to ambulance service care; (2) there were barriers to assessment; (3) the approach needed to address conflicts between clinicians' and patients' expectations; (4) the complexity of ambulance service processes and equipment needed to be taken into account; (5) and finally there were opportunities for improved prehospital education, information, communication, support and care pathways for asthma.
Conclusions
This qualitative study provides insight into paramedics' perceptions of the assessment and management of asthma, including why paramedics may not always follow guidelines for assessment or management of asthma. These findings provide opportunities to strengthen clinical support, patient communication, information transfer between professionals and pathways for prehospital care of patients with asthma.

Keywords:asthma, prehospital care, emergency medical services, paramedic, clinical guidelines, oaopen, oapublisher
Subjects:B Subjects allied to Medicine > B990 Subjects Allied to Medicine not elsewhere classified
B Subjects allied to Medicine > B780 Paramedical Nursing
A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science
ID Code:14599
Deposited On:11 Aug 2014 08:19

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