Tesi: "Ambulance"

1

Reeves, Claire Elspeth. "Integrated scheduling for ambulances and ambulance crews". Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/86516/1/Claire_Reeves_Thesis.pdf.

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This project developed three mathematical models for scheduling ambulances and ambulance crews and proceeded to solve each model for test scenarios based on real data. Results from these models can serve as decision aids for dispatching or relocating ambulances; and for strategic decisions on the ambulance crews needed each shift. This thesis used Flexible Flow Shop Scheduling techniques to formulate strategic, dynamic and real time models. Metaheuristic solutions techniques were applied for a case study with realistic data. These models are suitable for ambulance planners and dispatchers.

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2

Thi, Nguyen Ngoc-Hien. "Quantitative Analysis of Ambulance Location-allocation and Ambulance State Prediction". Licentiate thesis, Linköpings universitet, Kommunikations- och transportsystem, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-113346.

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3

Persson, Kristian, e Max Renberg. "Ambulance Safety: MADDE". Thesis, Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-42610.

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Safety, a word that can be linked and interpreted in many different ways. Personal safety, that you should feel safe in your everyday life depending on your surroundings. IT security, to protect a persons or organization's valuable assets such as information. Flight safety, the safety of flying in its various kinds. There are safety issues in almost every area you look at, but this project that you will read about in this report is about traffic safety, more specifically, the safety of working in the back of an ambulance. Imagine working as an ambulance paramedic. You and your colleague have just picked up a “Prio 1” (most critical degree), classified patient who needs urgent care. You are sitting in the back of the ambulance and will take care of the patient while your colleague is driving the car. The situation is so critical that your colleague needs to drive as quickly as possible to get to the hospital in time. Thus, you must sit tight with a seat belt in order not to risk your own safety during the ride. Around you, there are a number of components you need to care of for the patient. You cannot reach these components because of the belt that clings to the chair. What are you going to do? Do you unbutton your belt to reach the components, but risk your own safety while driving? Or do you wear the belt incorrectly, so that you use the belt, but only over the hips (for example), so that you can reach the tools? Both of these alternatives are how the majority of ambulance paramedics use the seatbelt today to be able to do their job. Either you unbutton and release yourself completely from the belt or you use it, but incorrectly to reach everything the person in question needs in the ambulance. Both actions have resulted in a big amount of injuries to the caregivers and the numbers continues to increase continuously. This project is about just that. A solution to the problem of the working environment in the back of ambulances. Further in this report you will read about how two students at Halmstad University encountered the problem, but first and foremost how they solved it.
Säkerhet, ett ord som kan kopplas och tolkas på många olika sätt. Personlig säkerhet, att man ska känna sig trygg i sin vardag beroende på omgivning. IT-säkerhet, att skydda en persons eller en organisations värdefulla tillgångar som exempelvis information. Flygsäkerhet, säkerheten vid flygning av dess olika slag. Det finns säkerhetsfrågor inom nästan varje område, men arbetet som du kommer få läsa om i denna rapport handlar om trafiksäkerhet, mer specifikt, säkerheten vid arbete bak i en ambulans. Föreställ dig att du arbetar som ambulanssjukvårdare. Du och din kollega har precis plockat upp en “Prio 1” (mest akuta graden), klassad patient som behöver akut vård. Du sitter bak i ambulansen och ska vårda patienten medan din kollega kör bilen. Läget är så kritiskt att din kollega behöver köra så snabbt som möjligt för att hinna till sjukhuset i tid. Därmed måste du sitta fastspänd med bilbälte för att inte riskera din egen säkerhet under körningen. Runtomkring dig finns det ett antal komponenter du behöver för att vårda patienten. Du når inte dessa produkter på grund av bältet som håller fast dig i sätet. Vad gör du? Knäpper du loss bältet för att kunna nå komponenterna, men riskerar din egen säkerhet under bilfärden? Eller tar du på dig bältet på ett inkorrekt sätt, så du sitter bältad, men bara över höfterna (exempelvis), så att du kan nå verktygen? Båda alternativen är hur majoriteten av ambulanssjukvårdare går till väga idag för att kunna utföra sitt jobb. Antingen knäpper man loss och frigör sig helt från bältet eller så använder man det, fast på ett inkorrekt sätt för att kunna nå allt personen i fråga behöver i ambulansen. Båda handlingarna har lett till flertalet skador på vårdarna och antalet fortsätter öka kontinuerligt. Arbetet handlar just om detta. En lösning på problemet med arbetsmiljön bak i ambulanser. Vidare i denna rapport kommer du få läsa om hur två studenter vid Högskolan i Halmstad kom i kontakt med problemet, men framförallt hur de fann en lösning till det.

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4

Nasiri, Faranak. "Ambulance Optimization Allocation". OpenSIUC, 2014. https://opensiuc.lib.siu.edu/theses/1462.

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Facility Location problem refers to placing facilities (mostly vehicles) in appropriate locations to yield the best coverage with respect to other important factors which are specific to the problem. For instance in a fire station some of the important factors are traffic time, distribution of stations, time of the service and so on. Furthermore, budget limitation, time constraints and the great importance of the operation, make the optimum allocation very complex. In the past few years, several research in this area have been done to help managers by designing some effective algorithm to allocating facilities in the best way possible. Most early proposed models were focused on static and deterministic methods. In static models, once a facility assigns to a location, it will not relocate anymore. Although these methods could be utilized in some simple settings, there are so many factors in real world that make a static model of limited application. The demands may change over time or facilities may be dropped or added. In these cases a more flexible model is desirable, thus dynamic models are proposed to be used in such cases. Facilities can be located and relocated based on the situations. More recently, dynamic models became more popular but there were still many aspects of facility allocation problems which were challenging and would require more complex solutions. The importance of facility location problem becomes significantly more relevant when it relates to hospitals and emergency responders. Even one second of improvement in response time is important in this area. For this reason, we selected ambulance facility allocation problem as a case study to analyze this problem domain. Much research has been done on ambulances allocation. We will review some of these models and their advantages and disadvantages. One of the best model in this areas introduced by Rajagopalan. In this work, his model is analyzed and its major drawback is addressed by applying some modifications to its methodology. Genetic Algorithm is utilized in this study as a heuristic method to solve the allocation model.

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5

Rotter, Erica, e Schröder Ann Dolk. "Yrkesutförandet och ambulanspersonalens fysiska hälsa : En beskrivande litteraturstudie". Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-20678.

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Sammanfattning Bakgrund; Inom ambulansyrket utsätts personalen dagligen för tunga lyft, ofta i icke ergonomiska arbetsställningar samt i många fall under tidspress. Dessutom arbetar ambulanspersonal i regel skift och ibland hela dygn vilket medför en rubbad dygnsrytm. Syfte; Att beskriva hur yrkesutförandet påverkar den fysiska hälsan hos ambulanspersonalen, samt att beskriva vilken urvalsmetod som använts i valda artiklar. Metod; Litteraturstudien har en deskriptiv design och består av tolv vetenskapliga artiklar hämtade från databaserna Cinahl och Scopus. I tio av artiklarna har en kvantitativ ansats använts och de andra två består av en mixad ansats. Artiklarna har granskats utifrån likheter. I den metodologiska aspekten urvalsmetod har skillnader och likheter granskats. Resultat; Resultatet visade att ambulanspersonal i högre utsträckning än normgrupper lider av muskuloskeletala besvär. Vilket kan relateras till hög fysisk belastning samt icke ergonomiska arbetsställningar. Ambulanspersonal upplever dessutom högt stresspåslag i arbetet. Resultatet visar även att de oregelbundna arbetstiderna påverkar ambulanspersonalens sömnkvalitét samt kost och motionsvanor negativt. De urvalsmetoder som använts i artiklarna är; slumpmässigt urval, stratifierat sannolikhetsurval, totalurval samt bekvämlighetsurval. Slutsats; Såväl muskelsmärta, störd dygnsrytm, sömnbrist, samt ökat stresspåslag hos ambulanspersonal kan relateras till yrkesutförandet. Oregelbundenheten i arbetet försämrar möjligheten att äta hälsosamt och träna regelbundet. Ambulanspersonal skulle gynnas av bättre träningsmöjligheter på arbetet, längre återhämtningstid och bättre möjligheter till regelbundna måltider.
Abstract Background; Ambulance personnel are in their work exposed for heavy lifting, often in non-ergonomic postures, and in many cases under time pressure. Ambulance personnel also work in shifts and sometimes 24-hours, resulting in a circadian rhythm. Aim; Describe how professional performence affects the physical healt of ambulance personnel and to describe wich sampling method, used in included articles. Method; The literature study has a descriptive design and consists of 12 scientific articles, selected from Cinahl and Scopus databases. In 10 of the articles there is a quantitative approach and 2 of them has a mixed approach. The articles were audited on the basis of similarities. In the methodologocal aspect; sampling method, diffrences and similarities has been audited. Results; The result showed that ambulance personnel in greater occurence than norm groups, suffer from muscle pain. Which can be related to high physical exposure and non-ergonomic postures. Ambulance personnel also experiencing high level of stress in their work. The result also showed that irregular working hours affect the ambulance personnel´s quality of sleep aswell as diet and exercise habits negatively. The sampling method used are; Randomized sampling, stratified probability sampling, total sampling and convenience sampling. Conclusion; Musclepain aswell as disruption of circadian cycles, lack of sleep and increased level of stress in the ambulance personnel can be related to professional performence. The irregularity in the work impair possibilities to eat healthy and exercise regularly. Ambulance personnel would benefit from better exercise opportunities at work, longer recovery and better possibilities to regular meals.

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Lindfors, Martin. "Kvalitetsgranskning av ambulansjournaler : en retrospektiv journalgranskningsstudie". Thesis, Sophiahemmet Högskola, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1857.

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SAMMANFATTNING Ambulanssjuksköterskan har en komplex arbetssituation, hon ska självständigt bedöma och behandla akuta tillstånd hos patienten. Arbetet försvåras av flera faktorer, tiden med patienten är i regel kort, möjligheten till rådfrågning är liten, utrymmet och tillgången till hjälpmedel är begränsade. Trots det ställs höga krav på vården i ambulansen, många gånger samma krav som på vården på en akutmottagning. Ett av dessa krav är en god dokumentation, kraven på patientjournalen är desamma i ambulansen som i övriga vården. I journalen dokumenteras uppgifter om iakttagelser, omvårdnadsåtgärder, medicinska åtgärder och information rörande transporten. Journalen från ambulanssjuksköterskan innehåller uppgifter som är av stort värde för den fortsatta vården såsom observationer, åtgärder och behandling på hämtplats och under transport. Dessa uppgifter är unika då sjuksköterskan i ambulansen är den första vårdpersonal som träffar patienten. Dessutom utgör journalen ett viktigt verktyg för en korrekt överrapportering. Syftet med studien var att belysa kvalitet på journaler, skrivna av sjuksköterska i ambulans, avseende dokumentation av observationer med speciell hänsyn till patientsäkerheten vid prioritet 1 uppdrag. Studien är en retrospektiv deskriptiv journalgranskningsstudie med kvantitativ ansats. Trehundra journaler granskades och poängsattes med hjälp av ett journalgranskningsinstrument. Resultatet redovisas som deskriptiv statistik. I studien var medianvärdet av antal relevanta observationer dokumenterade 68 procent med ett lägsta värde på 25 procent och ett högsta på 86 procent. Samtliga parametrar ingående i Rapid Emergency Triage and Treatment System (RETTS) och en Emergency Symtoms and Signs (ESS) kod var dokumenterade i 77 procent av journalerna. Samtliga parametrar från Global Trigger Tool (GTT) inom slutenvården som är möjliga att dokumentera i ambulans var dokumenterade 66 procent av journalerna. Sjuksköterskor med specialistutbildning i ambulanssjukvård uppnår i studien ett resultat på 72 procent (median) av relevanta observationer dokumenterade. Det kan jämföras med allmänsjuksköterskor och övriga specialistsjuksköterskor som uppnår ett resultat på 67 procent (median). Studien visar ingen skillnad på resultatet avseende relevanta observationer dokumenterade mellan manliga och kvinnliga patienter. Det finns tydliga brister i dokumentationen av observationer i ambulansjournaler. Inga skillnader finns i resultat för manliga och kvinnliga patienter. Dokumentation av parametrar ingående i RETTS sker i stor utsträckning. Journaler skrivna av sjuksköterskor med specialistutbildning i ambulanssjukvård och journaler skrivna vid uppdrag med längre vårdtid har bättre resultat jämfört med övriga.

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Pasha, Imtiyaz. "Ambulance management system using GIS". Thesis, Linköping University, Department of Computer and Information Science, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7058.

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For emergency service providers, giving their service in least time shows their best performance. Emergency hospitals will be at their best if the ambulance reaches the site in Golden hour where life of injured persons can be saved. Ambulance uses the road network to reach the accident site. Today there are many GIS based systems being developed for routing of ambulance using GPS and other real-time technologies. These systems are useful and play a major role in solving the routing problem. But now roads are so congested that it difficult for the Ambulance drivers to travel and reach the accident.

In this thesis present study area is studied and problems faced by emergency service providers on road network are identified. In this thesis GIS/GPS/GSM based prototype system has been developed for routing of ambulance on road network of Hyderabad city (AMS). This prototype is designed such that it finds the accident location on the road network and locates the nearest ambulance to incident site using the real-time technologies (GPS/GSM). AMS creates the fastest route from nearest ambulance to accident site, and from there to nearest hospital. Congestion on roads during peak hours is considered, and the fastest route on both major and minor roads is created.

In this thesis AMS user interface has been developed using VBA, ArcGIS (network analyst). This Ambulance management system has been developed using software engineering model rapid prototyping model and has been evaluated by GIS users

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Ekstrand, Magnus, e Kristina Hed. "Ambulanssjuksköterskors upplevelser av smärtlindring av barn i en prehospital kontext - en kvalitativ intervjustudie". Thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-33449.

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Syftet med denna studie är att studera ambulanssjuksköterskors upplevelser av att bedöma och vårda barn under tio års ålder med akut smärta i en prehospital kontext. Metod: Studien utfördes som en kvalitativ empirisk intervjustudie baserad på fem öppna frågor. Tio ambulanssjuksköterskor intervjuades och fick beskriva positiva och negativa upplevelser av att omhänderta barn 0-10 år med akut smärta i prehospital kontext. Materialet analyserades genom en kvalitativ innehållsanalys med en manifest och latent ansats. Resultat: Upplevelser av det vårdande mötet var en utmaning. Ambulanssjuksköterskan förberedde sig inför smärtbehandling under framkörningen till barnet. En bra smärtlindring var förenad med ett gott omhändertagande men smärtbehandlingen var svår och mångfacetterad. Vikten av stöd och samarbete prehospitalt från kollegorna och andra personalgrupper framkom liksom frustration som följd av kommunikationssvårigheter med barnet. Vikten av att skapa en god kontakt med barnet och dess anhöriga betonades och det fanns en upplevelse av otillräcklighet och utrymme för förbättring kring barn och smärta. Ambulanssjuksköterskan upplevde otillräcklighet i sitt yrkesutövande och mer utbildning önskades. Behovet av alternativa behandlingsprinciper lämpliga för barn där ambulanssjuksköterskan inte behöver sticka barnet efterfrågades. Slutsats: Den prehospitala vården behöver utvecklas ytterligare på flera områden avseende riktlinjer, metoder för att skatta barns smärta och vid omhändertagandet av de yngsta barnen. Mera utbildning kring barn och smärta är önskvärt samt utveckling kring andra administrationssätt än perifer venkateter.
The purpose of this study is to find out the ambulance nurses experience in assessing and nursing children under the age of ten with acute pain in a prehospital context. Method: The study was conducted as a qualitative empirical interview study based on five open-ended questions. Ten ambulance nurses were interviewed and were asked to describe positive and negative experiences in caring for children 0-10 years old with acute pain in a prehospital context. The material was analyzed through a qualitative content analysis with a manifest and latent approach. Results: Experiences of the caring encounter was a challenge. Ambulance nurses prepare themselves for pain treatment while they drove to the child. A good pain relief was associated with good care but pain treatment was difficult and multifaceted. Importance of support and cooperation from prehospital colleagues and other staff groups was found as frustration due to communication difficulties with the child. The importance of creating a good contact with the child and their family was important and there was a feeling of inadequacy, and room for improvement around children and pain. Ambulance nurses experienced inadequacy in their professional practice and more training was desired. As well as alternative modes of administration where the stick torque is not needed. Summary: The prehospital care need to be developed further in several areas regarding policies, methods to estimate the child's pain and the care of the youngest children. More education about children and pain is desirable as well as development on other alternatives than intravenous drug administration.

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Cotnoir, Paul D. "Ambulance Vibration Suppression via Force Field Domain Control". Digital WPI, 2010. https://digitalcommons.wpi.edu/etd-dissertations/132.

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This PhD dissertation experimentally characterized the vibration amplitude, frequency, and energy associated with ambulance travel and defined the relationship of the vibration to safety, comfort and care of ambulance patients. Average vertical vibration amplitudes of .46 to 2.55 m/sec2 were recorded in the patient compartment of four ambulances over four road surfaces at three speed settings. Power spectrum analysis of the data revealed that the vibration energy and resulting vertical acceleration forces were concentrated in the .1 to 6 Hz range. Relationships between the measured ambulance vibration and the impact of whole body vibration on human physiology and performance were quantified. It was found that the accelerations measured in the ambulances were in excess of what is considered to be a normal human comfort level. Furthermore, the vibration measured was in a spectrum which could present physical impediments to optimum task performance for the on-board medical team. Phase portrait analysis combined with the power spectrum data revealed the presence of nonlinearities, stochastic fluctuations and time delays inherent in the data. The ambulance vibration data was then used to create a unique analytical model and library of forcing functions corresponding to the vehicles, road surfaces and vehicle speeds that were tested. Using the example of a vibration absorbing force plate fit over an existing ambulance floor, it was demonstrated how the model and forcing functions could be used to develop a control law equation to select parameters for active control of vibration to produce sustainable regions of patient safety, comfort and care.

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Gleby, Fia. "Ambulance in Red Zones in Cape Town, South Africa : Waiting time for patients when ambulance requires armed escort". Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-14723.

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Background. In South Africa violence related crimes are frequent, and interpersonal violence is one of the most common causes of injury and death. Violence can be related to social structures, poverty and income inequality. In South Africa 25% of the population live in extreme poverty, and 16% of households in Western Cape live in Informal dwellings. Drug and alcohol miss-use is a big problem. EMS personnel all over the world are exposed to violence. The last couple of years the rate of incidents of violence against the ambulances and EMS personnel in Western Cape and Cape Town has escalated, and a protocol to protect the personnel has been established. The protocol of Red Zones requires an armed escort for the ambulance and EMS personnel when working in certain areas. The red zones are often in low income areas, which makes United Nations’ Sustainable Development Goal of Reduced inequality relevant. The Purpose of this study is to describe how red zones affect patient waiting times and mission times for the ambulance in the Western Cape province of South Africa. Method. Quantitative analysis of priority 1 assignments in one month periods in 2016, 2017 and 2018 to Hanover Park, a suburb of Cape Town. Hanover Park has been considered a red zone since September 2016. Result. Seven different time periods in the missions were analyzed, comparing the City of Cape Town and Hanover park in 2016, 2017 and 2018. Conclusion. The result shows an increase in waiting times for EMS in Hanover Park, even though the precise response time could not be described. Call times and mission times for the entire City of Cape Town seem to have increased, indicating a problem beyond the red zones, potentially affecting everyone in need of an ambulance in the city. Further studies are encouraged.
Bakgrund. I Sydafrika är våldsrelaterade brott vanligt förekommande, och interpersonellt våld är en av de vanligaste orsakerna till skada och död. Våldet kan relateras till sociala strukturer, fattigdom och inkomstskillnad. I Sydafrika lever 25% av befolkningen i extrem fattigdom och 16% av hushållen i Western Cape lever i informella bostäder. Missbruk av droger och alkohol är ett stort problem. Ambulanspersonal över hela världen utsätts för våld. De senaste åren har graden av våldshändelser mot ambulanser och dess personal i Western Cape och Kapstaden eskalerats och ett protokoll för att skydda personalen etablerats. Protokollet för Röda Zoner kräver en beväpnad eskort för ambulans och personal vid arbete i vissa områden. De röda zonerna är ofta i låginkomstområden, vilket gör FN: s hållbara utvecklingsmål för minskad ojämlikhet relevant. Syftet med denna studie är att beskriva hur röda zoner påverkar patienters väntetid och uppdragstider för ambulansen i Western Cape i Sydafrika. Metod. Kvantitativ analys av prio 1-uppdrag under en månadsperiod i 2016, 2017 och 2018 till Hanover Park, en förort till Kapstaden. Hanover Park har ansetts vara en röd zon sedan september 2016. Resultat. Sju olika tidsperioder i uppdragen analyserades, och jämfördes mellan hela Kapstaden och Hanover Park 2016, 2017 och 2018. Slutsats. Resultatet visar ökad väntetid för ambulansvård i Hanover Park, även om den exakta framkörningstiden inte kunde beskrivas. Uppdragstider för hela staden Cape Town verkar ha ökat, vilket indikerar ett problem bortom de röda zonerna, vilket potentiellt kan påverka alla som behöver en ambulans i staden. Ytterligare studier rekommenderas.

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Chen, Bin. "Handheld Wi-Fi applications in ambulance systems". Thesis, University of Ottawa (Canada), 2007. http://hdl.handle.net/10393/27819.

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This thesis describes the design and implementation of handheld Wi-Fi applications in ambulance systems, which propose a solution that allows ambulance staff to access remote resources in Emergent Medical Services (EMS) from any location, record life measurements on site by using handheld PCs, and transfer patients' life measurements to the Emergency Room (ER) on the way to the hospital. The handheld Wi-Fi applications aim to provide mobility and efficiency for ambulance staff when saving a life. The handheld Wi-Fi applications afford ambulance staff more flexibility and high performance in accessing and sharing the patient's life data between the ambulance centre and hospitals in time-sensitive circumstances. The handheld Wi-Fi applications provide instant information transportation support for both ambulance staff and healthcare staff. The patient's life measurements are received before the ambulance reaches the hospital.

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Manuel, Richard A. "Street supervision in the BC Ambulance Service". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ59459.pdf.

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13

Knoops, Lorinde, e Tilda Lundgren. "Modeling ambulance dispatching rules for EMS-systems". Thesis, KTH, Optimeringslära och systemteori, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-189023.

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This thesis presents a study on efficient dispatching rules in ambulance dispatching. By efficient dispatching rules, we mean such dispatching rules that lower response times for priority 1 calls while keeping response times for priority 2 calls at an adequate level. A Markov process and a simulation model were developed in order to evaluate the performance of several existing and newly designed dispatching rules. On four different response areas, five different dispatching rules were tested and their performances were compared. Particular focus was put upon the dispatch rule currently used by the Swedish emergency service provider SOS Alarm; the Closest rule. Our findings indicate that the four priority-based dispatching rules all outperform the Closest rule in decreasing the mean response time for calls of priority degree 1. Furthermore, implementing restrictions on the travel time for priority 2 calls was proven an efficient way to control the trade-off between the mean response time of priority 1 and 2 calls. The conclusion was drawn that the possibilities for more efficient ambulance dispatching are many and that SOS Alarm should consider implementing priority-based dispatching rules, alike the ones presented in this thesis, in their dispatching process. A study of the ambulance operator and controller profession, and the operator’s and controller’s interplay with the decision support system used by SOS Alarm in the ambulance dispatching process, was conducted in parallel. The properties of the interaction dynamics between operator and automation and the dangers linked to it were mapped out, described and analyzed.
Denna kandidatexamensuppsats behandlar effektiva dirigeringsstrategier inom ambulansdirigering. Effektiva dirigeringsstrategier åsyftar dirigeringsstrategier som lyckas sänka svarstiden för inkommande prioritet 1-samtal, samtidigt som svarstiden för prioritet 2-samtal hålls på en tillfredsställande nivå. I syfte att utvärdera olika dirigeringsstrategier utvecklades både en Markovsk modell och en simuleringsmodell. På fyra olika geografiska områden testades och jämfördes. Fem olika dirigeringsstrategier, varav två existerande och tre nyutvecklade. Särskilt fokus riktades mot Closest rule, vilket är den dirigeringsstrategi som används i SOS Alarms verksamhet idag. Från resultaten kunde utläsas att de prioritets-baserade dirigeringsstrategierna resulterade i en lägre genomsnittlig svarstid för prioritet 1-fall än Closest rule. Dessutom konstaterades det att en begränsning av svarstiderna för prioritet 2-samtal var ett effektivt sätt att kontrollera balansen mellan de genomsnittliga svarstiderna för samtal av prioritet 1, respektive 2. Slutsatsen drogs att möjligheterna för att utveckla nya effektiva dirigeringsstrategier är många och att SOS Alarm bör överväga att implementera prioritetsbaserade dirigeringsstrategier likt dem som presenterats i denna uppsats. Parallellt studerades ambulansoperatörens och -dirigentens yrkeskunnande, samt operatörens och dirigentens samspel med det beslutsstödssystem som används i SOS Alarms dirigeringsverksamhet. Interaktionen mellan operatör och automatisering samt de relaterade riskerna kartlades, beskrevs och analyserades.

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Newton, Andrew. "Ambulance Service 2030 : the future of paramedics". Thesis, University of Hertfordshire, 2014. http://hdl.handle.net/2299/15437.

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Some innovations are termed ‘disruptive’, a designation that is normally applied to technology; examples include computers, digital cameras, and mobile phones. The term can also be applied to groups of workers, particularly if they are able to offer specific technical capabilities within a market at lower cost, but broadly equal and effective to that offered by traditional products or services. Paramedics could be described in this way and are a newly professionalised group, with distinctive capabilities in terms of responding to the needs of not just the acutely ill and injured, but increasingly those patients with undifferentiated non-life- threatening conditions, which increasingly make up the bulk of 999 call demand. The key to their transition from an artisan, skilled worker to professional status is the acquisition of certain ‘hallmarks’. Perhaps the most important of these is the completion of more prolonged education that affords the opportunity to graduate with enhanced decision-making and other clinical skills in order to meet the needs of the full spectrum of patients in the pre-hospital setting. Paramedics were surveyed to determine how they rated their ‘traditional’ preparation and to establish what their attitudes were to a more educationally based approach. Paramedics themselves proved to be realistic regarding shortcomings in established training and education systems, while also being strongly motivated to learn more within a higher education setting, particularly if this additional effort would result in being able to offer a wider range of care to their patients. During the study, major changes in the health care environment and the role of the Ambulance Service took place, leading to a requirement to undertake a second phase of research. This took the form of ‘Horizon Scanning’ in an attempt to detect ‘signals’, themes and trends in relation to newly emerging ‘competitors’ to the paramedic role. These included nursing, new practitioners and most critically, the rapidly emerging medical sub-speciality of pre-hospital care, staffed by medical personnel on a pattern found specifically in some European countries, sometimes termed the ‘Franco-German’ model/System (FGM/S). Hitherto, the model of provision in the UK had followed the ‘Anglo-American’ model/System (AAM/S), approach, with paramedics providing direct patient care in the field and medical staff largely involved in medical oversight, teaching, clinical governance and other higher level roles. As part of this research, the evidence base for change was examined and consideration given to the factors that might help clarify what the likely situation could be in 2030 in respect of ambulance services, pre-hospital care and paramedics. This future is uncertain, but factors have been identified that would militate in favour of one or other model prevailing, with close links established between educational preparation, system design, career structure and the continuance of the professionalisation process favouring paramedic progression. However, other factors, most specifically professional power, the absence of a clear evidence base and an apparent reluctance to clearly acknowledge this in some respects, lead to the conclusion that the future of pre-hospital care remains uncertain and contested, but also potentially amenable to a well-directed influencing strategy.

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15

Burström, Johanna, e Maria Hosinsky. "Ambulanssjuksköterskans upplevelse av att handleda studenter på grundnivå". Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-201215.

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ABSTRACT Background: As a nurse it is a part of your work description to precepting students. A good relationship between preceptor and student is important for a successful precepting witch can be rewarding for both parties. There are many studies on how nurses in hospital departments experience precepting students, however it is not as explored in the prehospital care. Objective: To describe ambulance nurses' experience of precepting nursing students in the third and final year of university-level nursing school. Method: A qualitative study was conducted. Nine respondents at two ambulance stations in central Sweden were selected with the help of strategic convenience sample. The informants were nurses with specialist education in ambulance/prehospital care who had experience of working in the ambulance unit for at least a year. Result: The majority of participants were positive to precepting students and the time seemed adequate. Primarily in emergency situations the nurses felt that there was not enough time. Despite this, the nurses felt that this wasn’t a problem since they usually had time afterwards to talk and reflect over the expired events. However, many felt that because of the short internship it was hard to get to know the students, which led to an uncertainty in letting the student take care of the patient in certain situations. Conclusion: The study shows new results regarding ambulance nurse's perception of the supervision process. The study also shows differences between supervision in emergency medical services and ward care. This shows that the results from studies of the tutorial are not directly transferable to the prehospital care. Larger studies with more variation among the participants would be able to raise additional aspects in the precepting area. Keywords: nurse, ambulance, student and precepting

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16

Corderfeldt, Robert, e Jens Olhammer. "Anestesisjuksköterskors upplevelser av interhospitala patienttransporter". Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-24438.

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Anestesisjuksköterskan kan arbeta över flera områden där arbete vid en anestesiklinik är det vanligaste. I arbetet på en anestesiklinik ingår även uppgiften att medverka vid patienttransporter mellan sjukhus, interhospitala transporter. Tidigare studier har visat att många specialistsjuksköterskor är oroliga och bekymrade över dessa uppdrag. De upplevde otrygghet, osäkerhet och brist på tydliga riktlinjer. Ansvaret är stort och ibland är det långt mellan sjukhusen. Studiens syfte var att undersöka hur samtliga anestesisjuksköterskor på en anestesiklinik i sydvästra Sverige upplever att medverka vid patienttransporter mellan sjukhus. Studien genomfördes med en kvantitativ ansats och empirisk data samlades in med hjälp av ett frågeformulär. Deskriptiv statistik användes för att redovisa resultat. Resultatet av studien visar att anestesisjuksköterskornas erfarenheter av interhospitala patienttransporter är varierande. Flera svarade att de tyckte att det fanns svårigheter att utföra god omvårdnad under transporterna. Spridningen bland anestesisjuksköterskornas svar var stor på frågan om de kände sig stressade eller obekymrade över dessa uppdrag, de flesta befann sig kring mitten av skalan. Samarbetet med ambulanssjuksköterskorna var något som överlag fungerade mycket väl, och de hade stort förtroende för deras kompetens. Att helt avstå från att medverka vid interhospitala patienttransporter var något en fjärdedel av anestesisjuksköterskorna önskade. Behovet av mer forskning inom detta område är stort.
Nurse anesthetist work in several areas but working at an anesthetic clinic is the most common. Working at a clinic involves overseeing patients during interhospital patienttransports. Earlier studies have shown that many specialist nurses are worried and concerned over transporting patients. They experience feelings of insecurity, vulnerability, and a lack of clear guidelines. The responsibility is major and sometimes there are long distances between the hospitals. The aim of the study was to evaluate how the nurse anesthetists experience their participation during the transport of patients. The study was conducted using a quantitative approach and empirical data was collected using a questionair. Descriptive statistics were used to present the results. The results showed that the nurse anesthetists experiences of transporting patients varied greatly. Several responded that they found it difficult to give good care during the transport. There was also a large range of the answers to the question about whether they felt stressed or unconcerned during these assignments, but most were in the middle of the scale. Cooperation between the nurse anesthetists and the ambulance nurses generally worked well, they even had a strong confidence in their competence. One fourth of the nurse anesthetists reported they would prefer not to be involved in interhospital patienttransports. More research is needed in this area is great.

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17

O'Meara, Peter Francis Public Health &amp Community Medicine Faculty of Medicine UNSW. "Models of ambulance service delivery for rural Victoria". Awarded by:University of New South Wales. Public Health and Community Medicine, 2002. http://handle.unsw.edu.au/1959.4/18771.

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The primary aim of the research project was to develop conceptual models of rural ambulance service delivery based on different worldviews or philosophical positions, and then to compare and contrast these new and emerging models with existing organisational policy and practice. Four research aims were explored: community expectations of pre-hospital care, the existing organization of rural ambulance services, the measurement of ambulance service performance, and the comparative suitability of different pre-hospital models of service delivery. A unique feature was the use of soft systems methodology to develop the models of service delivery. It is one of the major non-traditional systems approaches to organisational research and lends itself to problem solving in the real world. The classic literature-hypothesis-experiment-results-conclusion model of research was not followed. Instead, policy and political analysis techniques were used as counter-points to the systems approach. The program of research employed a triangulation technique to adduce evidence from various sources in order to analyse ambulance services in rural Victoria. In particular, information from questionnaires, a focus group, interviews and performance data from the ambulance services themselves were used. These formed a rich dataset that provided new insight into rural ambulance services. Five service delivery models based on different worldviews were developed, each with its own characteristics, transformation processes and performance criteria. The models developed are titled: competitive; sufficing; community; expert; and practitioner. These conceptual models are presented as metaphors and in the form of holons and rich pictures, and then transformed into patient pathways for operational implementation. All five conceptual models meet the criteria for systemic desirability and were assessed for their political and cultural feasibility in a range of different rural communities. They provide a solid foundation for future discourse, debate and discussion about possible changes to the way pre-hospital services are delivered in rural Victoria.

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18

Aartun, Eirik Nikolai, e Håkon Leknes. "Strategic ambulance location: optimization with multiple performance measures". Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for industriell økonomi og teknologiledelse, 2014. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-26097.

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Emergency medical services (EMS) have been of interest for operations research since the middle of the 1960‘s. Since then there have been published numerous articles on the location of ambulances stations, allocation of ambulances, dispatching of vehicles, re-deployment of ambulances and evaluation methods. This thesis presents a new problem for the location of ambulance stations and allocation of ambulances in heterogeneous regions, referred to as the Maximum Expected Performance Location Problem for Heterogeneous Regions (MEPLP-HR). The problem applies multiple performance measures as well as station specific probabilities for the availability of ambulances at a station. Compared with earlier problems, the MEPLP-HR is more realistic for heterogeneous regions as the service rate of ambulances in the problem depends on the area a station covers. A mixed integer linear model is proposed to solve the problem. The probability for available ambulances is found by utilizing queuing theory together with the service rate and arrival rate of calls for each station. In contrast to recent models, the probability for available ambulances is calculated within the model. Hence, it is not necessary to use iterative solution approaches. The formulation is strengthened using valid inequalities and a reformulation of a restriction. With the strengthening constraints, both the solutions and the best bounds are improved.The computational studies are performed on the heterogeneous region of Sør-Trøndelag in Norway. For this region, the model is able to find a realistic solution that has a higher expected performance than the current solution on each of the given performance measures. The model is also tested with different weights for the performance measures, with the conclusion that the weights significantly affect the locations and allocation of stations and ambulances. By using the model as a decision support tool, three real managerial cases are analyzed together with potential solutions. The first case concerns the importance of taking multiple time periods into account when planning. The results from the computational study indicate that it is sufficient to plan for the busiest period. The second case analyzes the consequences and potential mitigating actions for closing down a local emergency room (ER). By closing the local ER, the travel time to ER will increase significantly for the zones close to the local ER. However, adding an extra ambulance and ambulance station can to some degree mitigate this effect. The third case concerns the benefit of transferring all non-urgent transport calls to designated non-urgent transport vehicles. The analysis in this case shows that there is a potential to reduce the number of ambulances by one fifth if designated non-urgent vehicles are introduced.This thesis consists of a report and two articles. The report is the main part of the thesis and contains all of our results and analyses. The articles are found as separate works after the report. The first one, "Strategic ambulance location for heterogeneous regions", presents the problem, the proposed model and technical characteristics. The second article, "Strategic Emergency Medical Service Planning - Three Case Studies", presents how the model can be applied as a decision support tool. The articles are based on the report, hence the report and articles are to some degrees overlapping.

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19

Smyth, Michael A. "Prehospital recognition of sepsis by ambulance clinicians (PRoSAiC)". Thesis, University of Warwick, 2017. http://wrap.warwick.ac.uk/103086/.

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Context: Prehospital recognition of adult patients with sepsis may inform scene management by ambulance clinicians, improve decisions concerning both appropriate hospital destination and urgency of transport, as well as facilitate early intervention before arriving at hospital. Objective: To develop a prehospital sepsis screening tool, derived from prehospital data, for use by ambulance clinicians. Design: The thesis comprises a systematic review of sepsis among adult patients in the prehospital environment, followed by the derivation and validation of a sepsis screening tool, utilising a retrospective data cohort comprising data from West Midlands Ambulance Service (WMAS) and the Emergency Department at University Hospital North Staffordshire (UHNS). This is followed by a comparison with alternate screening tools. Patients: Consecutive patients transported by WMAS (n=38483) to UHNS between 01 July 2013 and 30 June 2014. Records were linked using LinkPlus® software. Successful linkage was achieved in 33289 cases (86%). Eligible patients included adult, non-trauma, non-mental health, non-cardiac arrest cases. Of 33289 linked cases, 22945 cases were eligible. The eligible cases were randomly divided into derivation (n=16063, 70%) and validation (n=6882, 30%) cohorts. Outcome Measure: High risk of sepsis, as defined by the 2016 National Institute for Health and Care Excellence (NICE) Sepsis guideline (NG51). Results: High risk of sepsis was present in 3.7% of both derivation (n=593) and validation (n=254) cohorts. The Screening to Enhance PrehoSpital Identification of Sepsis (SEPSIS) tool is composed of the following variables: age, respiratory rate, peripheral oxygen saturations, heart rate, systolic blood pressure, temperature and level of consciousness (p < 0.001 for all variables). Area under the receiver operating characteristic curve was 0.87 (95%CI 0.85-0.88) for the derivation cohort, and 0.86 (95%CI 0.84-0.88) for the validation cohort. Applying a cut-off of 3 or higher, sensitivity for the SEPSIS screening tool was 0.80 (95%CI 0.74-0.84), specificity was 0.78 (95%CI 0.77-0.79), positive predictive value was 0.12 (95%CI 0.10-0.14), negative predictive value was 0.99 (95%CI 0.99-0.99), positive likelihood ratio was 3.56 (95%CI 3.30-3.85), negative likelihood ratio was 0.26 (95%CI 0.21-0.34) and the diagnostic odds ratio was 13.5 (95%CI 9.9-18.4). Conclusion: The SEPSIS screening tool was significantly associated with high risk of sepsis status on arrival at the Emergency Department. It performs marginally better than both the UK Sepsis Trust “Red Flag” algorithm and National Early Warning Score (NEWS≥5) in an undifferentiated, adult, medical population. The SEPSIS screening tool requires external validation, in clinical practice by ambulance clinicians, in an independent population.

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20

Alfakir, Omar, e Viktor Larsson. "Ambulance CPR Application : Using cross-platform mobile development". Thesis, Högskolan i Halmstad, Akademin för informationsteknologi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-45561.

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The overall purpose of this project is to develop a cross-platform CPR (cardiopulmonary resuscitation) application mainly for iOS and Android devices. This application aims to guide healthcare workers in the different processes and expected medication during cardiac arrest, which can often be a fast-paced and stressful scenario. The application will need to provide time-based and previous action-based recommendations for following medication and steps. Each step taken as well as at what time it was performed will also need to be documented automatically through the usage of the application. This application is implemented using the framework React Native. Facebook developed React Native in 2015 targeting mobile application development. The base structure of React Native is based on React, a JavaScript library released in 2013 used to build web interfaces. React Native allows creation of mobile applications that can run on iOS and Android devices with a single codebase. This project resulted in a mobile application capable of running on both iOS and Android platforms. The application has enough functionality to be used in a simulation for the CPR procedure during a cardiac arrest rescue scenario.
Det övergripande syftet med detta projekt är att utveckla en cross-platform HLR (hjärt- och lungräddnings) applikation främst för iOS och Android enheter. Syftet med denna applikation är att hänvisa sjukvårdspersonal genom de olika processer och den förväntade medicineringen vid hjärtstopp, vilket ofta kan vara ett väldigt hög tempo och stressfyllt scenario. Applikationen kommer behöva ge tidsbaserade och tidigare åtgärds baserade rekommendationer för följande medicinering och steg. Varje steg som tas samt när de tas kommer även behöva dokumenteras automatiskt genom användandet av applikationen. Denna applikation implementeras med hjälp av ramverket React Native. Facebook utvecklade React Native 2015 med inriktning på mobilapplikationsutveckling. Bas strukturen hos React Native är baserad på React, ett JavaScript bibliotek släppt 2013 som används till att bygga webbgränssnitt. React Native tillåter skapande av mobilapplikationer som kan användas på iOS och Android enheter med en enda kodbas. Detta projekt resulterade i en mobilapplikation kapabel att köras på både iOS och Android plattformar. Denna applikation har tillräcklig funktionalitet att användas i en simulering för HLR proceduren under ett hjärtstopps scenario.

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21

Ghorbani, Josef Abadi Naser. "Uppföljning och återkoppling efter prehospital bedömning och behandling". Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-28494.

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The Swedish prehospital/ambulance organization has the last decades evolved from a transport organization to a an organization that focus on alleviate and treating acute medical conditions in the field as well as transporting patient to the emergency ward. The ambulance service is developing continually and offers today a high-tech and highly specialized nursing/care. Which in turn demand a higher standard and competence on the care provider. Ambulance mission can vary in priority and magnitude. This in turn demand a high medical competence our capacity. One of the most important task ́s in pre-hospital work is to prioritize and assess the patient status. The medical judgment lies as a foundation for further caring focus and triage. Feedback and patient monitoring from the hospital can be pin pointing the right diagnosis and support the ambulance nurse to decide if the right pre hospital diagnosis was judged. The aim of the study was to describe specialist educated ambulance nurses need of feedback according to the medical judgment and treatment after terminated ambulance mission. The study was performed as a survey investigation with a quantitative descriptive design. Fifteen specialist educated ambulance nurses in two ambulance stations in Halland participated in the study. The majority of the ambulance nurses recognized the need of feedback/patient monitoring and found it difficult to receive information about patient that been transported to the hospital. Personal relationships to certain patient responsible nurses on caring units showed in some cases important to obtain information about patients. To design a plan for a regular feedback according to judgment and treatment after concluding the assessment could serve as a cost efficient education to the ambulance nurses and increase patient assurance. The result could in the future be used to design a action plan for recurring feedback in regard to assessment and treatment after completed mission. In conclusion one can claim that this is a free of charge competence improvement where all parts can be benefiting if we let the ambulance nurse have the opportunity to patient follow up.
Det senaste decenniet har den svenskaambulanssjukvården utvecklats från att vara en transportorganisation till enorganisation som även fokuserar på att lindra och behandla akuta tillstånd.Ambulanssjukvården utvecklas fortlöpande och i dagsläget är det enhögteknologisk och högspecialiserad vård vilken ställer större krav påpersonalens kompetens. Ambulansuppdrag kan variera i prioritet och omfattningvilket ställer krav på en hög medicinsk kompetens. En av de viktigasteuppgifterna inom prehospitalt arbete är att prioritera och bedöma patienterstillstånd. Bedömningen ligger som grund förfortsatt vårdinriktning och prioritering. Återkoppling/patientuppföljningfrån sjukhuset kan innebära att rätt diagnos sätts samt hjälpaambulanssjuksköterskan att avgöra om prehospitalt bedömt tillstånd varitkorrekt. Syftet med studien var att beskriva specialistutbildadeambulanssjuksköterskors behov av återkoppling avseende bedömning och behandlingefter avslutat ambulansuppdrag. Studien genomfördes som en enkätundersökning.Femton specialistutbildade ambulanssjuksköterskor från två ambulansstationer iHalland ingick i studien. Majoriteten av ambulanssjuksköterskorna såg behovetav återkoppling/patientuppföljning samt ansåg att det är svårt att fåinformation om de patienter som lämnats på sjukhuset. Personliga relationertill patient ansvarigsjuksköterska på vårdande enheter visade sig spela en vissroll när det gällde att får information om patienterna. Utformande av enhandlingsplan för regelbunden återkoppling avseende bedömning och behandlingefter avslutat ambulansuppdrag skulle utgöra en relativt kostnadseffektivutbildning för ambulanssjuksköterskor som skulle kunna öka patientsäkerheten.Resultatet kan komma att användas i framtiden för att utforma en handlingsplanför regelbunden återkoppling avseende bedömning och behandling efter avslutat ambulansuppdrag.Avslutningsvis kan påstås att det är gratis kompetenshöjning där alla ärvinnare om ambulanssjuksköterskan får möjlighet till patientuppföljning.

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Yu, Kim-ching. "A study of the feasibility of privatising ambulance services in Hong Kong". Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21036706.

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23

Wong, Chun-kit. "St. John Ambulance Brigade Kln & N.T. Command Headquarters". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25953382.

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24

Yeung, Man-pun. "A review of the mode of service delivery of emergency ambulance service (EAS) in Hong Kong". Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36443062.

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25

Wong, Lut-man. "Contemporary pre-hospital ambulance services in Hong Kong a study of development and reform /". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41006057.

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26

Aharonson-Daniel, Limor. "Application of operations research in studies of ambulatory care services". Thesis, Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B17054928.

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27

Eriksson, Annelie, e Monica Sundström. "Smärta i rygg, leder och muskler samt sömnproblem hos ambulanspersonal". Thesis, University of Gävle, Ämnesavdelningen för vårdvetenskap, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-6182.

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Abstract (sommario):

Syftet med studien var att beskriva ambulanspersonalens självskattning/upplevelse av smärta i rygg, leder och muskler samt sömn, vila och återhämtning. Ytterligare ett syfte var att undersöka om det finns några skillnader i nämnda besvär relaterat till kön och yrkeskategori. Data samlades in med enkäter och personal vid fyra ambulansstationer i Mellansverige deltog i studien. Sammanlagt delades 110 enkäter ut och 89 enkäter besvarades (svarsfrekvens 81 %). Resultatet avseende själskattad smärta visade att 53 personer (59,6 %) uppgav att de hade haft ländryggsbesvär de senaste 12 månaderna. Trettionio personer (43,6 %) uppgav nacksmärta de senaste12 månaderna. Tjugonio personer (32,6 %) uppgav skuldra/axelsmärta. Resultatet visade ingen statistisk signifikant skillnad mellan kön och yrkeskategorier. Resultatet avseende sömn visade att 72 personer (81 %) upplevde att de sov ganska bra till mycket bra. Cirka hälften av de 89 deltagarna 53 % uppgav att de kunde återhämta sig efter varje arbetspass och under lediga perioder uppgav 49 personer (55 %) att de kunde återhämta sig i stort sett varje period. Resultatet visade ingen statistisk signifikant skillnad mellan kön eller yrkeskategorier när det gällde smärt – och sömnbesvär.

Slutsats: För att förbättra arbetsmiljön för ambulanspersonal bör åtgärder inriktas mot belastningsergonomiska faktorer i arbetet.

The purpose of the study was to describe the ambulance personnel’s self-assessment/experiences of pain in the back, joints and muscles as well as sleep, rest and recovery. A further aim was to investigate whether there are any differences in the problems related to gender and profession. Data were collected with questionnaires, and personnel at four ambulance stations in central Sweden participated in the study. A total of 110 questionnaires were distributed, and the overall response rate was 81 %. The results for soul-rated pain showed that 53 persons (59, 6 %) reported low back pain in the last 12 months. Thirty-nine persons (43, 6 %) reported neck pain the past 12 months. Twenty-nine persons (32, 6 %) reported shoulder/shoulder pain. The results show no statistically significant difference between gender and occupational categories. The results showed that 72 persons (81 %) experience that they slept pretty good to very good. Approximately half of the 89 participants, 53 % reported they could recover after each session and during her free period reported 49 persons (55 %) experience that they could recover almost every period. The results show no statistically significant difference between gender or occupational categories regarding.

Conclusion: To improve the work environment for ambulance personnel, measures should be focused on load and strain ergonomic factors.

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Eriksson, Björn. "Risker med att patienter som behandlats prehospitalt för hypoglykemi kvarstannar i hemmet". Thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-23851.

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Abstract (sommario):

Att som ambulanssjuksköterska behandla patienter med hypoglykemi i hemmet är en vanlig åtgärd, i relation till den ökade belastningen på akutmottagningarna är det viktigt att kunna identifiera vilka patienter som behöver transporteras in till sjukhus. De flesta av patienterna vill stanna kvar i hemmet efter behandling, att vara medveten om vilka potentiella risker som finns om patienten stannar kvar hemma kan göra att det är lättare att bedöma vilken patient som bör åka med till sjukhus. Syftet med denna studie är att belysa riskerna med att patienter som behandlas för hypoglykemi kvarstannar i hemmet. Studien genomfördes i form av en litteraturstudie. Sökningar gjordes i databaserna PubMed samt Cinahl. Dessa sökningar resulterade i fyra artiklar som inkluderades i resultatet. Under analysen av artiklarna framkom två problemområden, risk för återkommande hypoglykemi samt bristande uppföljning. För att kunna identifiera de patienterna som har ökad risk för återkommande hypoglykemi krävs en adekvat bedömning av sjuksköterskan samt att det finns beslutsstöd till hjälp. Bristande uppföljning av patienterna är det andra problemområdet, där krävs ett förbättrat samarbete mellan ambulans, sjukhus samt primärvård för att kunna förbättra uppföljningen, analysen visade på att även om risken för återkommande hypoglykemi inom 48 timmar är låg, så har många av patienterna upprepade hypoglykemi episoder sett ur ett längre perspektiv vilket understryker vikten av uppföljning. Där kan ambulanssjuksköterskan vara den som initierar uppföljningen, det är dock viktigt att beslutet tas i samråd med patienten.
That as an ambulance nurse treating patients with hypoglycemia in the home is a common practice, in relation to the increased burden on emergency departments, it is important to identify which patients need to be transported to the hospital. Most patients want to stay at home after treatment, to be aware of the potential risks that exist if the patient stays at home can make it easier to determine which patient should go to the hospital. The purpose of this study is to highlight the risks of patients being treated for hypoglycemia remains in the home. The study was conducted in the form of a literature review. Searches were made in the PubMed and Cinahl. These searches resulted in four articles that were included in the results. During the analysis of the articles revealed two problem areas, the risk of recurrent hypoglycemia and inadequate follow-up. In order to identify those patients who are at increased risk for recurrent hypoglycemia requires an adequate assessment of the nurse and that there are decision supportto help. Lack of follow-up of patients is the second problem area, which require improved cooperation between ambulance, hospital and primary care to improve monitoring, analysis showed that although the risk of recurrent hypoglycemia within 48 hours is low, so many of the patients repeated hypoglycemic episodes from a longer perspective, which emphasizes the importance of follow-up. There, ambulance nurse to be the initiating follow-up, it is important that the decision taken in consultation with the patient.

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Dyrinder, Petersson Anders, e Daniel Källman. "Sista länken i den prehospitala vårdkedjan : Upplevelsen av återkoppling hos sjuksköterskor inom ambulanssjukvården". Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-102143.

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Sammanfattning Bakgrund: Återkoppling är ett eftersatt område inom ambulanssjukvården. Utan återkoppling på avslutat patientfall får inte sjuksköterskan veta om den agerat samt tänkt rätt. Detta skulle kunna hämma sjuksköterskans utveckling och leda till att eventuella begångna misstag drabbar även nästkommande patient. Syfte: Syftet med studien var att undersöka upplevelsen av återkoppling hos sjuksköterskor inom ambulanssjukvården. Metod: En kvalitativ intervjustudie med induktiv ansats. 12 intervjuer med sjuksköterskor inom ambulanssjukvården genomfördes inom två ambulansområden inom en region i södra Sverige. Intervjuerna analyserades med kvalitativ innehållsanalys enligt Erlingsson & Brysiewicz (2017). Resultat: Intervjuernas data resulterade i två olika kategorier med sex tillhörande underkategorier om upplevelsen av återkoppling bland sjuksköterskor inom ambulanssjukvården. Kategorierna var Professionell utveckling och Psykosocial arbetsmiljö. Slutsats: Återkoppling genererade upplevelser associerade med lärande samt utveckling på individ- och verksamhetsnivå. Det beskrevs att upplevelser relaterade till psykosociala aspekter kunde vara av både positiv och negativ karaktär, vilket går i linje med tidigare forskning. Återkoppling upplevdes sammansvetsande för arbetsgruppen samt främjade samverkan interprofessionellt. Återkopplingens sammansvetsande egenskaper verkar vara ett relativt outforskat område i tidigare forskning. En arbetsmiljö som främjar återkoppling har potential att stärka kompetensen i arbetsgruppen, vilket gynnar patientsäkerheten. Ytterligare forskning behövs som undersöker debriefingens följder djupare, återkopplingens sammansvetsande egenskaper samt dess inverkan på patientsäkerheten.
Abstract Background: Feedback is a neglected area in ambulance care. Without feedback on the previous patient, the nurse may not know if it acted and thought correctly. This could hamper the nurse's development and lead to any mistakes made also affecting the next patient. Purpose: The purpose of the study was to investigate the experience of feedback among nurses in the ambulance service. Method: A qualitative interview study with inductive approach. 12 interviews with nurses in the ambulance care were conducted in two different ambulance areas in a southern Swedish region. The interviews were analyzed with qualitative content analysis according to Erlingsson and Brysiewicz (2017). Result: The interview data resulted in two categories with six subcategories about the experience of feedback among nurses in the ambulance service. The categories were Professional development and Psychosocial work environment. Conclusion: Feedback generated experiences associated with learning and development at the individual and organisational level. It was described that experiences related to psychosocial aspects could be both positive and negative, which is confirmed in previous research. Feedback was described to have a welding effect on the team and promote interprofessional collaboration. The welding effect seems to be a relatively unexplored area in previous research. A work environment that promotes feedback has potential to strengthen competence in the team, which promotes patient safety. Further research examining the consequences of debriefing, the welding effect of feedback and its impact on patient safety is needed.

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30

Henderson, R. J. "A low frequency pneumatic suspension for an ambulance stretcher". Thesis, University of Canterbury. Mechanical Engineering, 1997. http://hdl.handle.net/10092/6034.

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Ambulance suspensions often give a poor ride which may result in deterioration in the condition of ill or injured patients. To reduce patient vibration, purpose-built ambulances or ambulances with modified chassis can be used. A potentially lower cost and more effective alternative is to provide additional isolation for the stretcher only. This thesis describes the design and performance of a pneumatic stretcher suspension which uses a novel linkage to provide isolation in bounce and pitch. Results of linear and non-linear analyses are presented which characterise the behaviour of the suspension. The kinematics of the suspension linkage are shown to give to a vertical stiffness which reduces in compression. Pneumatic cylinders connected to auxiliary tanks are used as springs. These give the suspension essentially load-independent natural frequencies of around 0.46 Hz in bounce and pitch. Damping is provided by fitting a flow restriction between the cylinders and tanks. By simulating the response of the stretcher to realistic random floor vibrations, it is concluded that a low level of damping is required and that an orifice restriction is preferable to a capillary restriction. These simulations are believed to be the first for which pneumatic damping is assessed by using a realistic random input. Additional simulation results demonstrate that improved isolation is possib1e by using an innovative semi-active pneumatic damper which is controlled according to the skyhook damping principle. A mechanical shaker which uses adjustable stroke round cams is described. Suspension tests carried out using this shaker are detailed. Various combinations of patient mass, pneumatic damping level, and shaker stroke and frequency are used. Acceleration transmissibilities are presented which indicate both that good levels of vertical isolation are obtained (eg. greater than 90% isolation above 5.2 Hz), and that isolation performance is largely independent of patient mass. Coulomb damping is shown to have a detrimental effect on isolation - particularly for low acceleration or high frequency inputs. The results of road tests are presented. These show that the suspension provides isolation above 1 Hz and reduces r.m.s. accelerations by 45-60%. The suspension is concluded to offer the potential to reduce patient vibration at reasonable cost, although improvements to the design are required in moving to a production model.

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31

Wong, Chun-kit, e 黃駿傑. "St. John Ambulance Brigade Kln & N.T. Command Headquarters". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31984204.

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32

Tareghian, H. R. "Application of hybrid simulation models to ambulance services problems". Thesis, Cranfield University, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.374009.

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33

Lo, Shun-tong. "A feasibility study on privatization of emergency ambulance services in Hong Kong". Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22054431.

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34

Leek, Fredrik, e Patrik Martebo. "En modell för lärande utifrån erfarenheter : En studie om uppföljning och feedback inom ambulanssjukvården". Thesis, Mälardalen University, School of Health, Care and Social Welfare, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-7496.

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Bakgrunden är att vi har identifierat brister i lärandet för ambulanspersonal, det föreligger ett dåligt utvecklat lärande i form av feedback/uppföljning efter ambulansuppdrag. Vi har, efter litteraturgenomgång, skapat en modell med de komponenter som behövs för att organisationen och individernas lärande skall fungera och lärandet ska bli lyckat.

Syftet med studien är att genom intervju av fyra ambulansöverläkare inom femklöverns ambulansorganisationer, jämföra vår modell om optimalt lärande med hur feedback/uppföljning för ambulansbesättningar ser ut i vekligheten i en kvalitativ undersökning med en deduktiv ansats. Studien innefattar fyra intervjuer av ambulansöverläkarna inom region femklövern. Ambulansöverläkarna är garanter för vårdkvalitén och därmed ansvariga för utbildningsinsatser och de anställdas kompetens/kompetensutveckling. Studien visade att inom femklövern sker det idag ingen kontinuerlig uppföljning eller feedback efter ambulansuppdragen. Däremot finns det sporadisk uppföljning i form av avvikelsehantering och uppföljning efter större händelser. Denna uppföljning fokuserar dock oftast på annat än patientomhändertagandet. Vår modell för optimalt lärande skiljer sig alltså från verkligheten. Uppföljning och feedback måste ingå i patientuppdragen och ske i samband med avlämnandet på mottagande sjukvårdsenhet. Insatser krävs för att förändra synen på lärande och integrera det i organisationen, först då kan man skapa bra vägar för feedback och uppföljning och lära sig av sina erfarenheter.

The background to this study is that we have identified deficiencies in learning for ambulance personnel. Learning in the form of feedback/follow-up after ambulance commissions is none existent. The aim with the study is through interview of ambulance senior physicians within the “femklöverns” ambulance organizations, compare our model about optimized learning with how feedback/follow-up for ambulance crews works in reality. This is a qualitative survey with a deductive approach. The study includes four interviews with the ambulance senior physicians within region of “femklövern”. The ambulance senior physicians are guarantors for the care quality and thereby responsible for educational initiatives and the employees competence/skill development. We have, after literature review, created a model with the components that is needed for both the organization as well as the individuals' to learn properly and that itself will result in successful learning. The study showed that within the “femklövern” there are no continuous feedback or follow-up after ambulance commissions. On the other hand, it exists sporadic follow-up due to incident reports and follow-up after bigger accidents. These kind of follow-ups focuses mostly on other things then the patient care treatment. Our model for optimized learning differs from how the reality presents itself. Follow-up and feedback have to be a part of every ambulance commission and be used every time a patient is admitted to a hospital or another institution. Initiatives are required in order to change the opinion of learning and how to integrate it in the organization, first then can feedback and follow ups be a successful tool for optimized learning.

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35

Eriksson, Anna, e Sanna Olsson. "Överrapportering mellan ambulans och akutmottagning : En enkätstudie med sjuksköterskor på akutmottagningen". Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-200413.

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Syfte: Syftet med denna studie är att beskriva hur överrapporteringen fungerar mellan ambulanssjuksköterskor i Uppsala län och sjuksköterskor på akutmottagningen på Akademiska sjukhuset i Uppsala från mottagande sjuksköterskors perspektiv. Metod: Empirisk deskriptiv tvärsnittsstudie med kvantitativ ansats. 60 enkäter delades ut varav 33 besvarades. Det gav en svarsfrekvens på 55 %. Resultat: Sjuksköterskorna på akutmottagningen har delade meningar kring hur överrapporteringen fungerar med ambulanssjuksköterskorna. Majoriteten anser att överrapporteringen med dess riktlinjer kan förbättras och förtydligas. Likaså användandet av SBAR, som de flesta menar används delvis. Den faktorn som uppges påverka sjuksköterskorna mest vid mottagandet av en patient är arbetsbelastningen. Hög arbetsbelastning leder till stress vilket gör det svårt att fokusera på rapporten. Samtliga anser att deras fortsatta omhändertagande av patienten i någon grad blir påverkade av ambulanssjuksköterskornas bedömning. Slutsats: Bland sjuksköterskorna på akutmottagningen finns en önskan om att förbättra och förtydliga överrapporteringen och de riktlinjer och verktyg som föreligger som grund för överrapporteringen, till exempel SBAR.
Objective: To describe how the handover of a patient functions between ambulance nurses in Uppsala and nurses at the Emergency Department at Akademiska hospital in Uppsala from the perspective of the recipient nurses. Method: Empirical descriptive cross- sectional study with quantitative approach. 60 surveys were shared of which 33 were completed. The response rate was 55 %. Results: The nurses at the Emergency Department have different opinions about how the handover of a patient from the ambulance nurses functions. The majority find it necessary for the handover- process with its guidelines to be improved and explained. SBAR is partly used and the majority believe that the use of SBAR should be improved too. The key factor that has the most impact on the nurses during the handover- process is the work load. High workload leads to stress which makes it difficult to focus on the report. All nurses believe that their subsequent nursing to some extent is influenced by the assessments of the ambulance nurses. Conclusion: The nurses at the Emergency Department request an improved and explained handover- process and guidelines, for example SBAR.

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Gulden, Birsen. "A Geographical Information System Application For Ambulance Routing Services:a Prototype". Master's thesis, METU, 2004. http://etd.lib.metu.edu.tr/upload/2/12605085/index.pdf.

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In public safety, geography plays a significant role. One of the most important front-line elements of public safety is an efficient emergency transport and care system. The capacity to access and process information rapidly and organize resources where needed can be critically important in an emergency situation. Information about the locality of an event or a disaster is often vital in knowing how to respond. A significant operation in handling emergency situations is the routing of ambulances to incident sites and then to the closest appropriate hospitals. One of the important steps to survival in an emergency is quick response time. The aim of this thesis study is to build an immediate, rapid and efficient emergency medical transport system prototype, called Ambulance Routing Service Application Prototype (ARSAP), to be used in Middle East Technical University (METU) Emergency Service, Ankara, Turkey. In the study, geographical information systems (GIS) technology is used in assisting the development and implementation of an emergency medical service (EMS) response system. In this prototype, while choosing a proper facility, the available quantity of beds, respiratory equipments and doctors in a hospital'
s intensive care room and the best traffic routes to the hospital in hand are also considered. The ARSAP is expected to shorten the commuting time and hence to reduce the damage to the patient to the lowest level and allow the ambulance staff to perform their task better. The results generated using the ARSAP are validated and analyzed by comparing with currently practiced emergency call paths data collected with the help of METU Emergency Service ambulance drivers.

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37

Schinbein, John Richard. "Occupational stress and the British Columbia Ambulance Service management staff". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0005/MQ41838.pdf.

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38

James, A. E. C. "Stress in the ambulance service : An investigation into the sources of occupational stress perceived by managerial, control and operational staff of the Devon ambulance service". Thesis, University of Bradford, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.381016.

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39

Lindgren, Raimo. "Does the use of ambulance helicopter shorten the transport time for trauma patients in Arvika Hospitals catchment area in comparison with land-based ambulance transport?" Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-70089.

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Introduction: The ambulance helicopter has been an established part of the trauma care in Värmland since 2014. European studies comparing the ambulance helicopters with land-based ambulance often show reduced mortality among patients handled by helicopter. A factor often considered as a risk reducer is shortened transport time. As a step to evaluate trauma care in Swedish rural areas, a study of pre-hospital transport times is required. Aim: The aim of this pilot study was to compare the transport times of the ambulance helicopter with the ground ambulance for trauma patients in the Arvika Hospital catchment area. Methods: Retrospective data from the ambulance register in Värmland and the ambulance helicopter register in Värmland from September to December in 2017 were compared. The transport time of trauma patients from alarm to the start of medical care in hospital was compared between ground- and airborne ambulances. Results: 9 ground ambulance transports were compared with 4 airborne. All helicopter transports in the study were faster than land-based ambulance services with comparable transport distances. No helicopter transport for shorter transports than 134 km was included in the study. Conclusion: In our study, it is shown that for a total transport distance of more than 134 km the transport with helicopter of trauma patients from Arvika Hospital's catchment area to the nearest healthcare facility is faster than by regular ambulance.This study includes only a few transports, and to ensure statistical significance, a larger sample and a more accurate analysis of the complex trauma care are required.

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40

Andersson, Lennart, e Lars Hellqvist. "Den prehospitala omvårdnaden av patienter med bröstsmärta ur ett tidsperspektiv". Thesis, Örebro universitet, Hälsoakademin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-17226.

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Utvecklingen inom ambulanssjukvården de senaste decennierna har varit omfattande och står idag för både avancerad sjukvård utanför sjukhuset och transporten av dessa patienter till sjukhus. Fler vårdkedjor startas vilket innebär att mer vård utförs på plats hos patienten, efter det transporteras patienten direkt till behandlande specialistavdelning, utan att fördröjas på akutmottagningen. Denna utveckling ställer ökade krav på fler specialistutbildade ambulanssjuksköterskor. Det är ofta snabba och svåra beslut som skall tas och felaktiga beslut kan ge svåra konsekvenser för patienten. Syfte: Syftet med studien var att beskriva förändringar i tid med och utan prehospital omvårdnad för patienter med bröstsmärtor i ett treårsperspektiv. Metod: Studien var retrospektiv med en komparativ design. Data från januari under 2009-2011 samlades in i form av ärenderapporter från SOS-alarm, som sedan jämfördes med varandra. Resultat: I studien ingick 254 patienter. En jämförelse av den totala prehospitala tiden visade att den hade ökat signifikant (p 0,026) under de tre åren. Tiden utan omvårdnad hade ökat från 2009-2010 men sedan sjunkit något mellan 2010-2011. Både SOS och ambulansens hanteringstider ökade under de tre åren. Det var en signifikant (p 0,032) ökning i tiden med prehospital omvårdnad. Slutsats: De prehospitala omvårdnadstiderna ökar. Ökade omvårdnadstider leder till ökat utnyttjande av befintliga resurser. Utan resurstillskott riskerar det att leda till brist på ambulansresurser och därmed längre väntan på omvårdnad för patienten.
A development in ambulance care in recent decades has been extensive and accounts for both the advanced medical care outside the hospital and transport of these patients to the hospital. More care chains start which means that more care is provided at the premises of the patient and then immediately transported to the treating specialist department and will not be delayed in the emergency department. This development leads to increasing demands for more specialized trained ambulance nurses. It is often fast and difficult decisions to be taken and wrong decisions can result in severe consequences for the patient. Aim: The aim of this study was to describe changes in time with and without pre-hospital care for patients with chest pain in a three-year perspective. Method: The study was retrospective with a comparative design. Data from January during 2009-2011 were collected from case reports from the SOS alarm which was compared. Results: The study included 254 patients. A comparison of the total prehospital time showed that it had increased significantly (p 0.026) in the three years. The time without care had increased from 2009-2010 but then dropped slightly between 2010-2011. Both SOS and ambulance handling times increased during the three years. There was a significant (p 0.032) increase in the time of prehospital care. Conclusion: The prehospital care time increases. Increased nursing hours leads to increased utilization of existing resources. Without additional resources, it risks leading to a lack of ambulance resources and longer waiting for care for the patient

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41

Lingsarve, Johan. "Beslutsstöd i svåra prehospitala vårdsituationer : Vilka beslutsstöd behöver ambulanssjuksköterskor?" Thesis, Uppsala University, Caring Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108600.

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42

Schwank, Isabelle. "The Suicide Behavior Attitude Questionnaire (SBAQ): översättning, re översättning och validering för användning i ambulanssjukvården". Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-23822.

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År 2011 uppgick antalet personer som suiciderat i Sverige till 1387. Studier visar att den suicidbenägna patientens första kontakt med sjukvården är avgörande för hur det kommande vårdförloppet kommer att utvecklas. Ambulanspersonal är en av många yrkesgrupper som möter suicidbenägna patienter. Studier visar även på att om patienten möts av dåliga attityder så kan det medföra negativa konsekvenser för patienten. Syftet med studien var att översätta, re översätta och validera en engelsk enkät: the Suicide Behavior Attitude Questionnaire (SBAQ): för användning i den svenska ambulanssjukvården. Metoden i att översätta, re översätta och validera SBAQ följde de tio stegen som tagits fram av the translation and cultural adaptation group. Elva ambulanssjuksköterskor medverkade i valideringen av den svenska SBAQ. Resultatet åskådliggör att det är möjligt att översätta och validera den engelska enkäten SBAQ till svenska. Studien kan därför ligga till grund för en mer omfattande studie inom ambulanssjukvården med den svenska SBAQ som instrument. Det här kan bidra till ökad uppmärksamhet och vid behov förbättringar avseende ambulanspersonalens bemötande i framtida situationer med suicidbenägna patienter.
In 2011, the number of persons who committed suicides in Sweden amount to 1387. Studies show that the suicide-prone patient's first contact with health services is crucial for how the future care process develops. Ambulance personnel is one of many professional groups that meet suicide prone patients and studies make clear that if the patient is met with bad attitudes it can result in negative consequences for the patient. The aim of the study was to translate, retranslate and validate an English questionnaire: the Suicide Behavior Attitude Questionnaire (SBAQ) for use in the Swedish ambulance service. The method to translate, retranslate and validate SBAQ followed the ten steps developed by the translation and cultural adaptation group. Eleven ambulance nurses participated in in the validation of the Swedish translated SBAQ. The results illustrate that it is possible to translate and validate the English SBAQ survey to Swedish. The study can therefore be the basis for a more comprehensive study within the ambulance service with the Swedish SBAQ as tool. This may help increase attention and, if necessary, improvements by ambulance personnel treatment in future situations with suicidal patients.

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43

Jones, Anna L. "An ergonomic evalution of equipment to support patient movement and transfer in the ambulance service". Thesis, Loughborough University, 2007. https://dspace.lboro.ac.uk/2134/8036.

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It is commonly accepted that ambulance staff undertake a large amount of lifting and handling in their daily work. Their primary role is to provide pre-hospital care and to transport sick and injured people to hospital. The emergency nature of the job means that ambulance workers have to assist people who are incapable of moving themselves in awkward and potentially hazardous environments. While safer lifting policies have been introduced ambulance workers still lift weights which other healthcare workers can avoid. However since the introduction of manual handling regulations and more recently CEN standards, ambulance services and manufacturers have been trying to find new ways of moving and transferring patients. Ambulance services have purchased new equipment to reduce musculoskeletal risks but there is little scientific evidence to support their purchasing choices. This thesis presents two case studies describing ergonomic equipment evaluations of stretcher loading systems and mobility equipment to provide a scientific basis to support purchasing decisions. Case study one is a comparative analysis of stretcher loading equipment used in UK ambulance services. The study was carried out in two phases. Phase 1 was a field study which used observation and interview methods to identify issues affecting equipment use in a range of environments. Phase 2 was a simulation study which used task simulation to assess the postures adopted during loading and unloading activities with each system. Both phases identified the tail lift as the preferred system to reduce manual handling and improve patient and operator safety. Case study two is a comparative evaluation of mobility equipment. User trials were carried out to evaluate 12 transport chairs and 4 stretchers for Accident and Emergency and Patient Transport Service staff to identify preferred equipment for each team. 16 staff assessed the equipment by conducting task simulations and completing questionnaires for each product. Postures adopted during the tasks were assessed using Rapid Entire Body Assessment. The mechanised stair climber chair was the preferred chair for both teams. The stretcher analysis was inconclusive. This thesis has used two case studies to establish a protocol for field and lab based evaluations of movement and transfer equipment in the future for the ambulance vehicle. A more comprehensive procurement process is recommended to include detailed ergonomic evaluation, ensuring that the end user is fully represented. The thesis concludes that automation is way forward to reduce manual handling risks posed to ambulance workers. The output from case study 1 (tail lift) has been included in the national specification for future Emergency Ambulances in the UK.

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44

Hayes, Jared, e n/a. "Reducing the impact of decision complexity in ambulance command and control". University of Otago. Department of Information Science, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080404.160620.

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The overriding goal of this work was to present information to ambulance command and control (AC2) operators in a manner that complemented their dispatchers decision making processes whilst minimising the effects of a number of identified complexities. It was theorised that presenting information in this manner would improve the decision making performance of the dispatchers. The initial stages of this work involved identifying the strategies that AC2 operators use when making decisions regarding the allocation of ambulances to emergency incidents and the complexities associated with these decisions. These strategies were identified after the analysis of interviews with AC2 operators using an interview approach called the Critical Decision Method. The subsequent analysis of the interview transcripts using an Emergent Themes Analysis provided a significant number of insights regarding the decision making processes of the operators and the information required to support these decisions. Of particular significance was the importance of situation awareness in the decision making process. For example, when dispatchers have a sound understanding of incidents and additional factors such as the ambulances under their control, the dispatch decision becomes less complicated. To extend the understanding of the dispatcher�s work in the communication centres, a number of factors that could contribute to the complexity of the dispatch task were identified from an additional analysis of the interview transcripts. However it was not possible to establish from this the contribution of these factors to the perceived complexity encountered by the operators. To address this, a questionnaire was circulated requiring dispatchers to rate the contribution of a number of factors to the complexity of the dispatch task and the frequency that these factors occurred. The results showed that the most prevalent factors related to a number of the cognitive processes that the dispatchers performed to manage the dispatch task. Such processes included determining the resource most likely to arrive at the scene of an emergency incident the quickest. There were also differences in regard to which areas of the dispatch process the dispatchers in the two centres considered to be the most complex. The final stage of this research was the design of a prototype interface that complemented the decision making strategies used by the dispatchers and addressed the identified complexities. At this stage the scope of the research was narrowed to focus primarily on the resource assessment and allocation phases of the dispatch process and several of the complexities associated with these. The prototype interface made use of a novel display technology that allowed the presentation of information across two overlapping LCD displays (referred to as a Multi Layered Display (MLD)). To test the effectiveness of this display a laboratory experiment was conducted comparing the perfomance of participants using the MLD with participants using a Single Layered Display (SLD) that presented the same information. The results indicated that in almost all cases the participants using the multi layer display performed better. However these differences did not prove to be significant.

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45

Peters, Jeremy. "An evaluation of ambulance service performance using a Geographic Information System". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/mq30253.pdf.

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46

Campbell, Hilary. "Riding third : exploring the role of social work in ambulance work". Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/33737.

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The research explains whether the creation of a new social work role would benefit situations in ambulance work, what this role would look like, and provides recommendations for the education of this position. An ethnographic study included semi-structured interviews, observations, and a collection of vignettes, with data collected over 300 hours while riding on ambulances in various locations. Data collected suggests that a social work role would provide needed psychosocial care during ambulance calls and would possess unique qualities and challenges from other traditional social work roles.

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47

O'Neill, M. "Carriage with compassion : an ethnographic study of a Welsh ambulance service". Thesis, Swansea University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.638352.

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The ambulance service through one of the most visible areas of health care provision is also one of the least researched. This study presents an analysis to how members of this particular group manage their occupational identity in the wider social milieu. By an examination of the cultural rules of the organisation and the implications of both history and occupational relations, this study provides a holistic examination of how such identity is managed and maintained on the various stages that ambulance workers perform their daily working activities. As will be explained in the study, during the past ten years there have been many developments in ambulance provision in the UK, a central one of which has been the organisation now not only provides transport for the sick and injured but also active medical care. One consequences of this changing role is a nascent "professional" occupational identity, which has to negotiate its position in relation to other "professional" groups. The main findings of the research were that the organisation was characterised by its large spatially spread out nature, which had implications for the development of multi organisational sub-cultures, which, in turn, had ramifications for occupational identity. In order for ambulance workers to manage such identity in the wider milieu they need to draw on occupational classifications that exist in society. The study also presents an analysis of the classificatory systems that staff utilise to address the contingencies of their working environment, which it is argued other studies in this field have failed to analyse sufficiently.

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48

Gamble, Robert Paul. "The health, physical fitness and occupational demands of Belfast's Ambulance Service". Thesis, Queen's University Belfast, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.333812.

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49

Elks, Eric Desmond. "A Cultural Historical Activity Theory Perspective of the Queensland Ambulance Service". Thesis, Griffith University, 2005. http://hdl.handle.net/10072/367378.

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The study relates to the diverse Queensland community which contributes to the service provided by the Queensland Ambulance Service (QAS). The QAS motive of improving the health and well being of all Queenslanders has remained stable since 1892, despite changes in organisational structure and the actions employed by paramedics in achieving motive. The QAS is primarily focused on the pre-hospital facets of health care and in this study the changing nature of paramedic actions are juxtaposed with the longevity of QAS motive. The research deals with QAS vocational training coupled with technological innovation and evolving community expectation in meeting the demands of contemporary clinical paramedic practice. The thesis focus is on the contemporary work practices of QAS paramedics, why dominant practices prevail above the plethora of alternatives thus pointing the way to future development of the service. The theoretical framework of the study takes account of Queensland's geographical and sociological diversity, coupled with the heterogenous nature of paramedic practice. Cultural Historical Activity Theory (CHAT) informs a study into a broad range of mediating influences, unified into an account of current QAS motive, culture and clinical interventions. The CHAT approach provides ongoing potential to inform QAS policy and optimise the clinical performance of rural paramedics. The empirical framework, congruent with paramedic practice, contains elements of both scientific practice and deductive reasoning. These elements lend themselves to the descriptive nature of qualitative research methods to facilitate the application of scientific principles while visualising the multi-faceted human health experience as experienced by paramedics. Research tools including literature review, interview and questionnaire facilitate a study of specific areas of paramedic practice. The research reveals paramedics as diverse and complex individuals with professional practices unique to the individual, yet remaining within the acceptable parameters of QAS convention on most occasions. The study identifies and interprets a number of workplace contradictions in terms of the meanings that paramedics attribute to them and the consequences of these tensions for paramedic practice. The study concludes that paramedic practices are a consequence of complexities within an activity system which belie the simplicity of direct relationships between QAS education, directives and practice. Findings relate to paramedic dissatisfaction with several restrictions imposed on their clinical practice - explicit restrictions as prescribed in the QAS Clinical Practices Manual 2001 to which QAS paramedic are required to adhere. Paramedic perceptions of identified contradictions are inductively and numerically analysed leading to data synthesis and a narrative summary of findings. Identified contradictions embedded in work practices of QAS paramedics have been argued to provide the impetus for either positive or negative development within the system. The summary of findings visualises the collective paramedic experience and thus speak to recommendations aimed at the amelioration of identified systemic contradictions. Recommendations include reviewing the clinical practice profile of paramedics in remote rural areas, review of clinical accreditation levels, the retaining of clinical placements in preliminary training and the provision of more comprehensive information technology support for paramedics. In this study, recommendations are portrayed in a positive light as signals of opportunities for both expansive paramedic learning and for organisational expansion through policy initiatives embracing the contemporary demands on the QAS and its operational paramedics.
Thesis (Professional Doctorate)
Doctor of Education (EdD)
School of Vocational, Technology and Arts Education
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50

Ahern, Anthony J. "The management of information technology investments in the Australian ambulance services". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1994. https://ro.ecu.edu.au/theses/1105.

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Information Technology plays a significant role in the administration and operation of most organisations today. This is certainly the case with each of the Australian Ambulance Services. With the rapid increase in the use of Information Technology and the expectation about its use by both staff and the general public, the Ambulance Service managements' are faced with the dilemma of trying to ensure that their organisations are able to get the full advantage of advances in Information Technology and at the same time ensure that investments in IT are maintained at appropriate levels that will ensure the maximum return on the investment in terms of the Ambulance Service achieving its mission and objectives. The research considers three questions: How are IT investment decisions determined? How are levels of IT investments determined? Do IT investments contribute to the organisation's overall effectiveness? The general feeling by the ambulance service CEOs is that the investment in IT has been worthwhile in terms of contributing to the organisation being more effective. These findings are contrary to a study by United Research/Business Week and described by LaPlante (1988) where less than half of CEOs surveyed felt that their organisation did an excellent job of linking computer strategy to corporate goals.

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Tesi sul tema "Ambulance"

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