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Paramedics providing end-of-life care: an online survey of practice and experiences

Paramedics providing end-of-life care: an online survey of practice and experiences
Paramedics providing end-of-life care: an online survey of practice and experiences
Background: global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics’ current practice and experiences providing end-of-life care was undertaken.

Methods: cross-sectional online survey design. Quantitative data were analysed using descriptive statistics and qualitative free text responses using Framework Analysis. The survey link was distributed to registered paramedics employed by all 11 NHS Trusts employing paramedics in England, United Kingdom.

Results: nine hundred and twenty responses were received. They reported shortfalls in availability of healthcare professionals for advice and/or referral. Respondents often, always or sometimes: lacked patient medical history (91%, 839), access to existing advance care planning documentation (98%, 900) and specific medicines needed (80%, 737); encountered conflicting views (89%, 819); and reported lack of pre-registration training (81%, 743) or continuing professional development (77%, 708) influenced their ability to meet patient needs.

Conclusions: this first national survey of paramedic practice and experiences in delivering end-of-life care provides new evidence and insight into the challenges faced by paramedics and the potential impact of these challenges on their perceived levels of competence and confidence. Respondents reported multiple challenges, which potentially impact their ability to provide good quality end-of-life care and increase the risk of hospital conveyance. Paramedic practice at end-of-life must be supported via improved access to: patient records; anticipatory medicines and authority to administer; 24/7 palliative care advice (for shared decision-making); and paramedic specific palliative and end-of-life care training and education (including via integrative ways of working between palliative care and ambulance services). Action is required to integrate paramedicine within the wider healthcare professional team, with robust education and training to support care delivery.
1472-684X
Campling, Natasha
0e0410b0-a9cd-486d-a51f-20d80df04791
Turnbull, Joanne
cd1f8462-d698-4a90-af82-46c39536694b
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Voss, Sarah
82739f35-bc92-4deb-af42-b55f2a0ff2ff
Scott-Green, Jennifer
3573a59e-7782-481b-a194-b83dba3b15fc
Logan, Shane
a0e5ba4b-ecd4-4f19-94a9-daac2c2ce4c2
Latter, Sue
83f100a4-95ec-4f2e-99a5-186095de2f3b
Campling, Natasha
0e0410b0-a9cd-486d-a51f-20d80df04791
Turnbull, Joanne
cd1f8462-d698-4a90-af82-46c39536694b
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Voss, Sarah
82739f35-bc92-4deb-af42-b55f2a0ff2ff
Scott-Green, Jennifer
3573a59e-7782-481b-a194-b83dba3b15fc
Logan, Shane
a0e5ba4b-ecd4-4f19-94a9-daac2c2ce4c2
Latter, Sue
83f100a4-95ec-4f2e-99a5-186095de2f3b

Campling, Natasha, Turnbull, Joanne, Richardson, Alison, Voss, Sarah, Scott-Green, Jennifer, Logan, Shane and Latter, Sue (2024) Paramedics providing end-of-life care: an online survey of practice and experiences. BMC Palliative Care, 23, [297]. (doi:10.1186/s12904-024-01629-7).

Record type: Article

Abstract

Background: global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics’ current practice and experiences providing end-of-life care was undertaken.

Methods: cross-sectional online survey design. Quantitative data were analysed using descriptive statistics and qualitative free text responses using Framework Analysis. The survey link was distributed to registered paramedics employed by all 11 NHS Trusts employing paramedics in England, United Kingdom.

Results: nine hundred and twenty responses were received. They reported shortfalls in availability of healthcare professionals for advice and/or referral. Respondents often, always or sometimes: lacked patient medical history (91%, 839), access to existing advance care planning documentation (98%, 900) and specific medicines needed (80%, 737); encountered conflicting views (89%, 819); and reported lack of pre-registration training (81%, 743) or continuing professional development (77%, 708) influenced their ability to meet patient needs.

Conclusions: this first national survey of paramedic practice and experiences in delivering end-of-life care provides new evidence and insight into the challenges faced by paramedics and the potential impact of these challenges on their perceived levels of competence and confidence. Respondents reported multiple challenges, which potentially impact their ability to provide good quality end-of-life care and increase the risk of hospital conveyance. Paramedic practice at end-of-life must be supported via improved access to: patient records; anticipatory medicines and authority to administer; 24/7 palliative care advice (for shared decision-making); and paramedic specific palliative and end-of-life care training and education (including via integrative ways of working between palliative care and ambulance services). Action is required to integrate paramedicine within the wider healthcare professional team, with robust education and training to support care delivery.

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ParAid survey paper -13.12.24 - Accepted Manuscript
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s12904-024-01629-7 - Version of Record
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Figure 1 - On average, how often do you attend patient in their last year of life
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Figure 2 - Summary of challenges encountered and perceived impact on paramedic experience attending patients in the last year of life
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Figure 3 - Overall, how competent and confident
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Table 1 - Respondent characteristics
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Table 2 - Frequency of actions when attending patients in the last year of life
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ParAid questionnaire (supplementary file 1)
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Service improvement (supplementary file 2)
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Accepted/In Press date: 18 December 2024
e-pub ahead of print date: 21 December 2024
Published date: 21 December 2024

Identifiers

Local EPrints ID: 497368
URI: http://eprints.soton.ac.uk/id/eprint/497368
ISSN: 1472-684X
PURE UUID: fcf24363-fbab-4f44-b954-f14c4022cd16
ORCID for Natasha Campling: ORCID iD orcid.org/0000-0002-4158-7894
ORCID for Joanne Turnbull: ORCID iD orcid.org/0000-0002-5006-4438
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Sue Latter: ORCID iD orcid.org/0000-0003-0973-0512

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Date deposited: 21 Jan 2025 17:40
Last modified: 22 Aug 2025 02:13

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Contributors

Author: Joanne Turnbull ORCID iD
Author: Sarah Voss
Author: Jennifer Scott-Green
Author: Shane Logan
Author: Sue Latter ORCID iD

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