CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • harvard-cite-them-right
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Situation awareness in Sweden’s emergency medical services: a goal-directed task analysis
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)ORCID iD: 0000-0002-1789-8158
University of Borås, Faculty of Librarianship, Information, Education and IT. University of Borås, Faculty of Caring Science, Work Life and Social Welfare. PICTA – Prehospital Innovation Arena, Lindholmen Science Park, Göteborg, Sweden. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Centre of Interprofessional Collaboration Within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden. (PreHospen)
2023 (English)In: Discover Health Systems, ISSN 2731-7501, Vol. 2, article id 44Article in journal (Refereed) Published
Abstract [en]

Situation awareness is knowing what is going on in the situation. Clinicians working in the emergency medical services (EMS) encounter numerous situations in various conditions, and to be able to provide efficient and patient safe care they need to understand what is going on and possible projections of the current situation. The design of this study encompassed a Goal-Directed Task analysis where situation awareness information requirements were mapped in relation to goals related to various aspects of the EMS mission. A group of 30 EMS subject matter experts were recruited and answered a web-based survey in three rounds related to what they though themselves or a colleague might need to achieve situation awareness related to the specific goals of various situations. The answers were analysed using content analysis and descriptive statistics. Answers reached consensus at a predetermined level of 75%. Those who reached consensus were entered into the final goal-directed task analysis protocol. The findings presented that EMS clinicians must rely on their own, or their colleagues prior experience or knowledge to achieve situation awareness. This suggests that individual expertise plays a crucial role in developing situation awareness. There also seems to be limited support for situation awareness from organizational guidelines. Furthermore, achieving situation awareness also involves collaborative efforts from the individuals involved in the situation. These findings could add to the foundation for further investigation in this area which could contribute to the development of strategies and tools to enhance situation awareness among EMS clinicians, ultimately improving patient care and safety.

Place, publisher, year, edition, pages
2023. Vol. 2, article id 44
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-30937DOI: 10.1007/s44250-023-00061-7OAI: oai:DiVA.org:hb-30937DiVA, id: diva2:1815331
Available from: 2023-11-28 Created: 2023-11-28 Last updated: 2024-01-18Bibliographically approved
In thesis
1. Clinical reasoning among emergency medical service clinicians: An iterative and fragmented process involving the collaborative effort(s) of many
Open this publication in new window or tab >>Clinical reasoning among emergency medical service clinicians: An iterative and fragmented process involving the collaborative effort(s) of many
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of the thesis was to generate knowledge and understanding of clinical reasoning in the context of EMS from the perspective of EMS clinicians.

Method: Three different methodologies were employed to describe various aspects of clinical reasoning. In Study I, an integrative literature review was conducted to summarise the existing literature related to clinical reasoning in EMS. After conducting systematic searches and screening, 38 articles were identified and analysed through an inductive thematic analysis. Studies II and III were conducted as case studies within an EMS organisation to capture clinical reasoning as it takes place in the naturalistic environment. In total, 34 patient encounters were observed, and group and individual interviews were conducted with EMS clinicians and organisational representatives at various hierarchical levels within the EMS organization. The data were analysed through pattern matching and triangulation in a computerised software program for qualitative analysis. Study IV was conducted as a goal-directed task analysis which focused on what EMS clinicians need in terms of achieving situation awareness. An online survey was created and answered by 30 EMS subject matter experts, consisting of active EMS clinicians, academic teachers in specialist ambulance nursing programmes, and researchers in the field of EMS. The data were analysed using qualitative content analysis and descriptive statistics.

Main results: Clinical reasoning in EMS is a continuously ongoing, iterative, and fragmented process. Information is gathered, analysed, and utilised at any given point during the mission. This information is then reasoned against various goals or instructions provided by the EMS organisation or what is perceived as the most suitable action by the EMS clinician. In the reasoning process, the clinicians take the patients’ and their relatives’ points of interest into account, striving to fulfil these. The clinical reasoning process continues after and between the missions well, and clinicians constantly evaluate their decisions and care provision for future improvement. Even if medical and caring interventions are the focus of clinical reasoning, this process involves the consideration of other aspects as well, such as logistics and safety for everyone present. Nevertheless, there seems to be a vague mandate for decision making among EMS clinicians in relation to other collaborative partners. Furthermore, organisational support for clinical reasoning and development is lacking, often due to economic limitations.

Conclusion: This thesis contributes to the caring science field with an increased understanding of the complexity of clinical reasoning in EMS. EMS clinicians today need to rely on themselves or their partners to have sufficient knowledge or experience to handle the situation encountered and provide safe patient care. As the reasoning process involves more than the physical patient encounter, additional support is needed to inform clinicians in decisions related to logistics and safety. As the reasoning process involves more than the physical patient encounter, additional support is needed to inform clinicians in decisions related to logistics and safety. EMS clinicians today need to rely on themselves or their partner to have sufficient knowledge or experience to handle situations encountered and provide patient safe care. 

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2023
Series
Skrifter från Högskolan i Borås, ISSN 0280-381X ; 142
Keywords
Emergency medical services, Clinical reasoning, Ambulance, Pre-hospital, Health and well-being
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29844 (URN)978-91-89833-11-1 (ISBN)978-91-89833-12-8 (ISBN)
Public defence
2023-11-10, C203, Allégatan 1, Borås, 09:00 (Swedish)
Opponent
Available from: 2023-10-20 Created: 2023-05-29 Last updated: 2023-12-12Bibliographically approved

Open Access in DiVA

fulltext(901 kB)19 downloads
File information
File name FULLTEXT01.pdfFile size 901 kBChecksum SHA-512
6ca6c24f039d3d0e0103ef71ec80f4581252a5977e33177b63d3a9170c54ef9676fcebb1b6a6fc1314549bb6b3dab0b917a70243ee16cc6108d76ba333516786
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Authority records

Andersson, UlfMaurin Söderholm, HannaAndersson Hagiwara, MagnusAndersson, Henrik

Search in DiVA

By author/editor
Andersson, UlfMaurin Söderholm, HannaAndersson Hagiwara, MagnusAndersson, Henrik
By organisation
Faculty of Caring Science, Work Life and Social WelfareFaculty of Librarianship, Information, Education and IT
Nursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 19 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 101 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • harvard-cite-them-right
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf