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Published in Michael Weir, Law and Ethics in Complementary Medicine, 2023
The National Registration and Accreditation Scheme for Health Professions commenced on 1 July 2010, based upon an agreement between the states and territories to provide for a single national registration and accreditation scheme for health professions. The health professions included in the national scheme are currently chiropractic, dental, medical, nursing and midwifery, optometry, osteopathy, pharmacy, physiotherapy, podiatry and psychology, Aboriginal and Torres Strait Islander health practice, Chinese medicine, medical radiation, paramedicine and occupational therapy.
Collaboration and paramedicine
Published in Sanjiv Ahluwalia, John Spicer, Karen Storey, Collaborative Practice in Primary and Community Care, 2019
The professional vulnerability engendered by the nature of 999 work and the reluctance of organisational systems to support the diverse nature of it is common in the paramedic workforce. Overcoming these vulnerabilities by valuing the adaptability, resilience, skills and experience of paramedics and wrapping them in an infrastructure that governs, supports and develops them and their practice has left them feeling less vulnerable and ultimately more capable, leading to the workplace as a secure learning environment being highly valued by the paramedic themselves. The careful support the transition requires to a specialist (yet definitely generalist) role in community paramedicine has been shown to involve various phases – a junctional ‘decision making’ phase then three ‘active’ phases, interwoven with categories: engaging in a community of practice, adjusting to organisational and cultural change, developing critical thinking and mastering skills (Long, 2017).
Are Indian hospitals good places for the dying elderly?
Published in Suhita Chopra Chatterjee, Jaydeep Sengupta, Death and Dying in India, 2017
Suhita Chopra Chatterjee, Jaydeep Sengupta
Returning to our core query: Are hospitals in India good settings for dying elderly? The first thing that strikes any observer is the fragmented landscape of health delivery in which hospitals are located. Acute care centers have remained disjointed from the primary health care system and receive heavy influx both for outpatient and inpatient admissions, thereby stretching their capacity for compassionate care. Presently, India has a huge deficit of 600,000 physicians (Deo, 2013). In comparison to the WHO standard of 4 physicians for every 1,000 patients, India has only 1 doctor to serve 1000 patients – a fact reported by IMS Health commissioned Physician and Chemist survey in 2013 (cf. India Today, 2013). This survey covered 120 Indian cities and over 300,000 doctors. Another doctoral thesis that covered two nodal centers for cancer treatment in the state of Odisha in 2000–2001, found that the doctor-patient ratio was 1:547 and 1:3,314 respectively (Mohanty, 2004). An internal report of the All India Institute of Medical Sciences (AIIMs) shows that there is a critical shortage of human resource and infrastructure in all its ICUs. Lack of space virtually creates congestion (Chatterjee, 2013). More alarmingly, in New Delhi, 41 percent of the private practitioners do not have requisite qualifications in medicine or para-medicine. Yet they relentlessly administer IV fluids and intravenous injections; many of the choices are irrational and dangerous too. Das and Hammer (2007) find that it is the poor quality of care rather than access that shoots up cost for city-based treatments. According to World Bank report (2001), 40 percent of the people admitted to hospitals have to borrow money and 25 percent even go below the poverty level in the process.
Public Health Surveillance of Behavioral Health Emergencies through Emergency Medical Services Data
Published in Prehospital Emergency Care, 2022
Madison K. Rivard, Rebecca E. Cash, Kirsten Chrzan, Jonathan Powell, Gail Kaye, Pamela Salsberry, Ashish R. Panchal
Specific complaints reported by dispatch, or reason provided for the call to EMS, were selected that were pertinent to behavioral health. These included: assault; healthcare professional/admission; overdose, poisoning, or ingestion; psychiatric problem, abnormal behavior, or suicide attempt; sick person; unconscious or fainting/near-fainting; unknown problem or person down; and well person check. The practice level of the EMS personnel was categorized into basic life support (BLS) (first responder/emergency medical responder; basic/emergency medical technician (EMT); BLS-intermediate), advanced life support (ALS) (advanced EMT; ALS-Intermediate; paramedic; community paramedicine), and other (nurse; physician; specialty critical care) (20). Type of service was categorized into 9-1-1 response; interfacility/medical transport; and other. Other was defined as any call that was labeled an intercept, mutual aid, public assistance, or standby. Scene and transport times were collected in minutes and reported as a median and interquartile range. Variables for pertinent barriers to care included psychologically impaired, state of emotional distress, and physically restrained. Variables for scene delay were included: directions or unable to locate; crowd; language barrier; patient access; safety of crew/staging; and safety of patient.
Cardiometabolic, Dietary and Physical Health in Graduate Paramedics during the First 12-Months of Practice – A Longitudinal Study
Published in Prehospital Emergency Care, 2022
Ben Meadley, Alexander P. Wolkow, Karen Smith, Luke Perraton, Kelly-Ann Bowles, Maxine P. Bonham
This was a 12-month longitudinal study of graduate ambulance paramedics (GAP) commencing employment with a state EMS. Paramedics in Australasia are registered health professionals and are required to complete a Bachelor’s degree in paramedicine before applying for an intern or graduate year with an ambulance service. During the undergraduate degree, student paramedics undertake clinical placements with an ambulance service, but in this jurisdiction, placements only occur on day and afternoon shifts, and do not include overnight shifts. The study was conducted at Ambulance Victoria (AV), the single provider of EMS to the nearly 6.4 million inhabitants of the state of Victoria, Australia. At the time of the study, almost 4200 paramedics were employed by AV. GAP are well remunerated and secondary employment to supplement income is uncommon. In their first year, GAP are allocated to a location in regional (rural) Victoria or a major metropolitan area. The general shift pattern follows a consecutive four days “on” and then four days “off” structure. The “on” shift section starts with two ten-hour consecutive day shifts, one 10–12-hour afternoon shift, and then one 12–14-hour night shift. This is followed by four consecutive days off (this pattern may vary slightly). In this study, the term “first day off” represents the day immediately following the end of the final shift of the roster cycle, which is usually a night shift, and the term “rostered day off” refers to days where paramedics did not attend work at all.
Principles to Guide the Future of Paramedicine in Canada
Published in Prehospital Emergency Care, 2021
W. Tavares, A. Allana, L. Beaune, D. Weiss, I. Blanchard
Within Canada, paramedicine is organized as either public or private providers that are provincially or municipally operated. Paramedicine is self-regulated in some, but not all, provinces. Paramedicine generally includes the provision of health care services in a public safety model, offering mostly out-of-hospital emergency services with an emphasis on resuscitation and transportation. Numerous alternative models of care are locally derived in terms of scope, policy, oversight, education, and quality assurance. There is a relatively consistent classification of paramedics across Canada, but scopes of practice vary within these classifications. There is a national competency profile that at the time of this study was in transition and not universally used or accepted (23). Educational models are variable in length of program, content, credential awarded and accreditation status. Entry to practice and maintenance of certification expectations are also variable. Finally, clinical oversight models include both physician-led and collaborative paramedic-physician models. Given this diversity, this study used the term “paramedicine” broadly and included individuals shaping and providing services, the organizations within which they work, and the institutions that guide, regulate, or govern conduct.