Journal article
‘Popping nana back into bed’ - a qualitative exploration of paramedic decision making when caring for older people who have fallen
BMC Health Services Research, Vol.17, 299
2017
Abstract
Background: Older fallers constitute a large proportion of ambulance work, and as many as 25% are not transported to hospital following paramedic assessment. The objective of this study was to explore the decision making process used by paramedics when caring for older fallers. Methods: A qualitative study was conducted using constructivist grounded theory methodology. Purposive sampling was used to recruit paramedics to participate in semi-structured interviews and focus groups. Data analysis commenced with line-by-line coding, developing into formation of theoretical categories. Theoretical sampling was then used to clarify emerging theoretical concepts, with data collection and analysis continuing until theoretical saturation was achieved. Results: A total of 33 paramedics participated in 13 interviews and 4 focus groups. When caring for older fallers, paramedic decision making is profoundly affected by 'role perception', in which the individual paramedic's perception of what the role of a paramedic is determines the nature of the decision making process. Transport decisions are heavily influenced by a sense of 'personal protection', or their confidence in the ambulance service supporting their decisions. 'Education and training' impacts on decision making capacity, and the nature of that training subliminally contributes to role perception. Role perception influences the sense of legitimacy a paramedic attaches to cases involving older fallers, impacting on patient assessment routines and the quality of subsequent decisions. Conclusions: Paramedic decision making processes when caring for older people who have fallen appear to be strongly influenced by their perception of what their role should be, and the perceived legitimacy of incidents involving older fallers as constituting 'real' paramedic work.
Details
- Title
- ‘Popping nana back into bed’ - a qualitative exploration of paramedic decision making when caring for older people who have fallen
- Authors
- Paul Simpson (Author) - Western Sydney UniversityRic Thomas (Author) - Western Sydney UniversityJason Bendall (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringBill Lord (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringStephen Lord (Author) - University of New South WalesJacqueline Close (Author) - University of New South Wales
- Publication details
- BMC Health Services Research, Vol.17, 299; 14
- Publisher
- BioMed Central Ltd.
- Date published
- 2017
- DOI
- 10.1186/s12913-017-2243-y
- ISSN
- 1472-6963; 1472-6963
- Copyright note
- Copyright © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to he Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99451148302621
- Output Type
- Journal article
- Research Statement
- false
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