ORCID Profile
0000-0002-5237-8457
Current Organisations
Charles Sturt University
,
University of Tasmania
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Publisher: Elsevier BV
Date: 03-2023
Publisher: Springer Science and Business Media LLC
Date: 07-03-2023
DOI: 10.7759/CUREUS.35859
Publisher: Emerald
Date: 20-12-2022
DOI: 10.1108/IJES-05-2021-0025
Abstract: This study aims to map and examine the existing evidence to provide an overview of what is known about the structure and characteristics of the Anglo-American paramedic system in developed countries. The review includes results examining the structure and characteristics of the Anglo-American paramedic system in English-speaking developed countries. Databases, including Embase, MEDLINE, Web of Science, EBSCOhost, CINAHL, Google Scholar and Epistemonikos, were searched from the inception of the databases. A grey literature search strategy was conducted to identify non-indexed relevant literature along with forward and backward searching of citations and references of included studies. Two reviewers undertook title and abstract screening, followed by full-text screening. Finally, data extraction was performed using a customised instrument. Included studies were summarised using narrative synthesis structured around broad themes exploring the structure and characteristics of the Anglo-American paramedic system. The synthesis of information shows that varying models (or subsystems) exist within the Anglo-American paramedic system. The use of metaphorical models based on philosophical underpinnings are used to describe two novel subsystems within the Anglo-American paramedic system. These are the professionally autonomous and directive paramedic systems, with the directive model being further categorised into the rescue and hospital-managed submodels. This study is the first of its kind to explore the modern subcategorisation of the Anglo-American paramedic system using a realist lens as the basis for its approach.
Publisher: Mark Allen Group
Date: 21-05-2014
Publisher: Elsevier BV
Date: 09-2022
Publisher: SAGE Publications
Date: 2016
Abstract: This editorial outlines the process as paramedics head towards registration
Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.AUEC.2022.05.001
Abstract: This narrative review presents a brief chronological history of the Anglo-American paramedic system, combining decades of stories from across ambulance services in western, English-speaking developed countries METHODS: Databases, including Embase, MEDLINE, Web of Science, CINAHL and Google Scholar were searched from the inception of the databases. A grey literature search strategy was conducted to identify non-indexed relevant literature along with forwards and backwards searching of citations and references of included studies. Two reviewers undertook title and abstract screening, followed by full-text screening. Included studies were summarised using narrative synthesis structured around the exploration of the history of the Anglo-American paramedic system. The research team structured the narrative in chronological order and used metaphorical models based on philosophical underpinnings to describe in detail each era of paramedicine. The narrative explores several key milestones including, industrial orientation, scope of practice, innovation, education and training, regulation as well as significant clinical and technological advancements in the delivery of traditional and non-traditional paramedic care to patients. Paramedicine, like other allied health professions, has successfully navigated the pathway toward professionalisation in a considerably short period of time. From its noble beginnings as stretcher bearers in times of war, the profession has looked outwards to emulate the success of our healthcare colleagues in establishing its own unique body of knowledge supported by strong clinical governance, national registration, professional regulatory boards, self-regulation, and a move towards higher education supported by the development of entry-to-practice degrees. Whilst the profession has achieved many great milestones, their application across multiple jurisdictions within the Anglo-American paramedic system remains inconsistent, and more research is needed to explore why this is.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.IENJ.2014.07.004
Abstract: The last decade has seen rapid advancement in Australasian paramedic education, clinical practice, and research. Coupled with the movements towards national registration in Australia and New Zealand, these advancements contribute to the paramedic discipline gaining recognition as a health profession. The aim of this paper was to explore paramedic students' views on paramedic professionalism in Australia and New Zealand. Using a convenience s le of paramedic students from Whitireia New Zealand, Charles Sturt University and Monash University, attitudes towards paramedic professionalism were measured using the Professionalism at Work Questionnaire. The 77 item questionnaire uses a combination of binary and unipolar Likert scales (1 = Strongly disagree/5 = Strongly agree Never = 1/Always = 5). There were 479 students who participated in the study from Charles Sturt University n = 272 (56.8%), Monash University n = 145 (30.3%) and Whitireia New Zealand n = 62 (12.9%). A number of items produced statistically significant differences P < 0.05 between universities, year levels and course type. These included: 'Allow my liking or dislike for patients to affect the way I approach them' and 'Discuss a bad job with family or friends outside work as a way of coping'. These results suggest that paramedic students are strong advocates of paramedic professionalism and support the need for regulation. Data also suggest that the next generation of paramedics can be the agents of change for the paramedic discipline as it attempts to achieve full professional status.
Publisher: Mark Allen Group
Date: 25-06-2010
DOI: 10.12968/JPAR.2010.2.6.48813
Abstract: Ambulance services around the world are facing significant management and leadership challenges associated with the rapid growth of call volumes increasing adoption of sophisticated technology a broadening scope of clinical practice greater expectations of citizens, patients and system governors and the ever increasing complexity of working in both the health and public safety environments. The sustainability of vibrant, healthy and high performing ambulance services depends on competent, experienced and well-educated leaders and managers.
Publisher: SAGE Publications
Date: 2016
Abstract: With evidence-based practice now the norm, paramedics today can confidently and readily search for answers to clinical questions. For anyone seeking to better understand the non-clinical aspects of paramedic practice, however, looking to social theory can be a starting point. Understanding social theory gives paramedic researchers a lens through which to closely examine every day events and behaviours that affect paramedic practice within the context of society. Arguably, the move towards professionalisation is one of the most significant events impacting paramedicine today. Alongside this professional evolution, the practitioner identity is gradually being challenged and reshaped, raising a number of important questions. The purpose of this article is to explore how paramedic researchers can use two prominent social theorists, Bourdieu and Goffman, to explore inevitable questions related to professions and professional identity.
Publisher: SAGE Publications
Date: 2022
DOI: 10.33151/AJP.19.1011
Abstract: The aim of this study was to provide a snapshot of Australian remote and industrial paramedics’ patient clinical presentations, experience with physician consultations and options for patient transport to tertiary care. This exploratory, cross-sectional descriptive study employed a purpose-built online survey. Participants were 78 paramedics working in Australian rural and remote industrial settings recruited in 2015 using web-based, respondent-driven s ling. In addition to a series of closed ended questions, respondents were asked to recall the number of times they encountered specific clinical presentations during the past year. Data were analysed using descriptive statistics and modes were calculated for ordinal data associated with clinical presentations. The traumatic presentations that participants recalled encountering at least 10 times the preceding year included back pain (39.7%), minor lacerations (38.5%), joint (36.4%) and hand (30.8%) injuries. Respondents selected headache (64.1%), nausea, vomiting or diarrhoea (52.6%), respiratory infections (50%), ear, nose or throat problems (43.6%) and localised infections or rash (39.7%) as the most common medical presentations. Of the respondents, 38.4% managed patients with mental health presentations a minimum of six times in the preceding year, and 45.3% treated at least one patient in cardiac arrest. While 94.8% of participants said topside support was available, over half described consulting physicians infrequently and if they did, it was typically by telephone. Most respondents (61%) indicated that their worksite was located over 100 km from a hospital. Survey findings indicate that paramedic participants recall encountering a wide range of clinical presentations and managing low acuity illnesses more commonly than traumatic injuries. Most respondents were located at least 100 km from the nearest hospital and although almost all had access to topside support, over half stated they consulted physicians infrequently.
Publisher: Springer Science and Business Media LLC
Date: 20-01-2021
Publisher: SAGE Publications
Date: 2018
Abstract: This study aimed to explore first year university paramedic students’ perceptions of volunteerism during a community placement. In this exploratory study we employed a cross-sectional methodology utilising a convenience s le of first year undergraduate students. Administering a paper-based survey, we measured students’ perceptions of their experience of a 50-hour placement as a volunteer within a community organisation. Of the 191 students available to participate in the study, 88 completed the survey yielding a 46.1% response rate. Survey results were positive overall and indicated that students view volunteering in a community placement as a good experience. The majority of students signalled that they had a positive impact during their placement and were inclined towards future volunteering including as paramedic volunteers. Our results suggest that paramedic students positively perceive volunteering during a community placement and may be predisposed to future volunteer opportunities.
Publisher: Springer Science and Business Media LLC
Date: 04-01-2021
Publisher: Mark Allen Group
Date: 08-04-2013
DOI: 10.12968/JPAR.2013.5.4.212
Abstract: Objective: To determine the incidence of unrecognised oesophageal intubation by paramedics in a metropolitan setting. Methods: A retrospective observational analysis was conducted. Patient health care records from the Ambulance Service of New South Wales were used to identify patients who had been intubated by paramedics between 1 January 2007 and 31 December 2010, and transported to St George Hospital, Sydney. Medical records from St George Hospital were reviewed to determine the position of the endotracheal tube (ETT) on arrival in the Emergency Department. Results: During the study period, 196 patients were identified as having an ETT in-situ on arrival to the emergency department. There was inadequate documentation for 67 patients to determine ETT placement. Of the 129 patients included in the final analysis, 4 (3.1%, 95% confidence interval (CI) 0.9–7.8%) had an unrecognised oesophageal intubation. The final ETT positions of the remaining 125 patients were 85.3% (95% CI 78–90.9%) located in the trachea, 10.1% (95% CI 5.5–16.6%) located in a primary bronchus, 0.8% (95% CI 0–4.2%) in the larynx and 0.8% (95% CI 0–4.2%) in the pharynx. Conclusion: The incidence of unrecognised oesophageal intubations in this study was consistent with other reports in the literature, although higher than expected given the training and equipment used in this setting. An incidence of unrecognised oesophageal intubations of zero should be the goal of emergency medical services. The incidence of unrecognised oesophageal intubations may be reduced through recursive training programs and the use of quantitative waveform capnography.
Publisher: SAGE Publications
Date: 02-06-2023
DOI: 10.1177/27536386231174097
Abstract: British Columbia Emergency Health Service trialled the use of intranasal (IN) ketamine given by Primary Care Paramedics (PCPs). Prior to this practice change, the PCPs had not performed weight-based drug calculations, given medications intranasally, nor been responsible for controlled and targeted substances. This study aimed to use the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domain Framework (TDF) to identify enablers and barriers to implementing IN paramedic administered ketamine analgesia (iPAKA) for PCPs. This was a parallel convergent mixed methods study with two phases. The quantitative phase consisted of longitudinal staff surveys to assess PCP knowledge and perceptions of ketamine and controlled and targeted substances policies. The qualitative phase involved staff focus groups on programme implementation. Descriptive statistics of survey results were integrated with coded focus group data and analysed using the COM-B model and TDF. Evidence-based behavioural change techniques were mapped to each TDF domain. Our analysis revealed barriers and enablers across several TDF domains. Implementing ketamine was enabled by quality education, strong organisational support and the availability of cognitive aides. Trial success was attributed in part to participant's feelings of optimism and their increased job satisfaction. Key barriers included a knowledge gap involving drug dosage calculations, negative emotions associated with performance anxiety and a lack of field education and supervision to monitor paramedic practice. The use of theoretical frameworks and models like COM-B/TDF serves to improve the sustainable implementation of behaviour and clinical practice change in paramedicine. When project teams use theory to guide design and implementation, they can systematically identify and target in idual and organisational enablers and barriers to adopting routine practices. The iPAKA study reveals key barriers and facilitators in several TDF domains and presents theory-linked targeted behavioural techniques to support on-going implementation of PCP-administered IN ketamine for analgesia.
No related grants have been discovered for Joseph Acker.