Barriers and requirements in the off-line emergency medical protocols implementation in Iranian Pre-hospital system: A qualitative study.
Journal of Education and Health Promotion · 2021-01-01 · Qualitative study
Abstract
BACKGROUND: To avoid making decisions based on the unproven opinions of emergency medical technicians (EMTs), many emergency medical service (EMS) systems rely on emergency medical protocols. As protocol-based on-scene decision-making is influenced by many challenges, identifying these challenges can result in providing appropriate conditions for EMTs' decision-making. Therefore, this study aimed to identify the barriers and requirements in the off-line emergency medical protocols implementation m in the prehospital emergency medical system. MATERIALS AND METHODS: To conduct this study, qualitative content analysis using 10 field observations, 22 interviews, and 2 rounds of focus group discussions was applied. The duration of interviews lasted from October 2019 to January 2020. The Graneheim and Lundman approach was used to analyze the data. RESULTS: Seven categories (15 subcategories) including education and awareness (professional training and education and community-based education); attitudes (professional attitude and community attitude); interactions and coordination (interpersonal interactions, organizational interferences, and community's interactions); rules and instructions (instructions and supportive rules); control system (monitoring and evaluation and motivational system); accessibility (recourses and communication); and organization (structure and process) were obtained as the obstacles and challenges in the offline emergency medical protocol implementation in the prehospital system. CONCLUSIONS: There are many challenges in implementing offline emergency medical protocols in the prehospital emergency system. To achieve the effectiveness and efficiency of offline prehospital emergency protocols, it is necessary to facilitate these challenges and improve the EMTs' knowledge, attitude, and performance through cooperative and skill-based education. The findings of this study can be useful for EMS systems from national to local levels.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Implementation · Medical direction & oversight · Paramedics & EMTs
Related articles
- Designing a theory-informed feedback system for prehospital cardiac arrest care: a qualitative study. (Emerg Med J, 2026)
- Implementation of a point-of-care ultrasound archiving system and governance framework in a UK physician-paramedic staffed helicopter emergency medical service. (Scand J Trauma Resusc Emerg Med, 2024)
- [Potential and effectiveness of a telemedical rescue assistance system. Prospective observational study on implementation in emergency medicine]. (Anaesthesist, 2015)
- Knowledge translation in emergency medical services: a qualitative survey of barriers to guideline implementation. (Resuscitation, 2010)
- Stakeholder perspectives of piloting pre-hospital COVID-19 lateral flow testing and direct admissions pathway: exploring why well-received ideas have low uptake. (Br Paramed J, 2022)
- Community Implementation of a Prehospital Spinal Immobilization Guideline. (Prehosp Emerg Care, 2016)