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Identifier 000446520
Title Η πρακτική των αλγορίθμων και η δια βίου εκπαίδευση ιατρών, νοσηλευτών και διασωστών του νομού Ηρακλείου στη βασική και εξειδικευμένη υποστήριξη της ζωής σε παιδιά και ενήλικες
Alternative Title The practice of algorithms and the lifelong training of doctors, nurses, and rescuers of the prefecture of Heraklion in pediatric and adult basic and advanced life support
Author Κορέλα, Δάφνη
Thesis advisor Μπριασούλης, Γεώργιος
Reviewer Ηλία, Σταυρούλα
Αγγουριδάκης, Παναγιώτης
Abstract Background: Immediate and effective treatment of life-threatening conditions and cardiac arrest is probably the biggest challenge for healthcare systems. Severe disease and trauma situations in children and adult are potentially reversible, if timely and properly managed. Therefore, it is vital for emergency healthcare personnel to provide the best possible care to patients. Hence, and also to have a universal line of response, best practice algorithms have been established for adult and pediatric basic and advanced life support. Studies have highlighted the importance of education on emergencies and the need for lifelong training of doctors, nurses, and rescuers, in line with the current guidelines. Objective: To study the theoretical approach of the healthcare personnel on the management of severe disease and serious trauma in children and adults. The healthstructures involved were the Emergency Departments (EDs) and clinics of the University General Hospital of Heraklion (PAGNH) and the General Hospital of Heraklion “Venizelio - Pananio” (BGNH), the Emergency Medical Service (EMS), and the Health Centers and Local Health Units in Heraklion Crete. Also, to encourage self-assessment and formulation of proposals by physicians, nurses and rescuers concerning education and continuing training in emergency medicine. Methods: A 5month cross sectional study was conducted using an anonymous questionnaire based on the latest Advanced Life Support (ALS), Advanced Paediatric Life Support (APLS), Basic Life Support (BLS), Paediatric Life Support (PLS) guidelines, to ED nurses and clinicians in PAGNH, BGNH, Healthcare Centers, Local Healthcare Units and EMS. The statical package used was the SPSS28. Results: A total of 500 questionnaires were distributed, of which 300 were completed (60%). Out of the participants, 36,7% were doctors, 52,7% nurses and 10,7% rescuers. Education in BLS or ALS was reported in 70,7% (n=212), in APLS 0,7% (n=2), in two different pediatric and adult seminars 17% (n=51), while 11,7% (n=35) had never been trained in any kind of BLS or ALS seminar. Significantly more physicians were trained in ALS (60, 54.4%) compared to nurses (38, 24.1%) or rescuers (8, 25%). The patients’ resuscitation process differed between healthcare units, with lower rates being recorded in Local Healthcare Units or Pediatric Departments and higher in Cardiology, Internal Medicine Departments, EDs, ICUs, and EMS. More than half of the physicians answered the questions correctly (57.5±19.2%) compared to nurses (41.7±18.5%) and rescuers (42.3±14.9%, p<0.001). Significantly different rates of correct responses per workplace were recorded, with higher rates of responders >50% recorded in the ICUs, Pediatric and Cardiology Departments and lower <50% in Surgery and Pulmonary Departments, and Healthcare Centers (p=0.004). The rates of a theoretically complete emergency education covering adult and pediatric cases were very low in total (17%) with statistically significant differences (p<0.001) in the individual occupational groups and between workplaces. Unlike the employees of the EMS, nurses and doctors in large part did not report any repeat ALS seminar; a few, who had resumed a similar seminar, have done it two years ago (p<0.001). Lower rates of workplace education are reported by physicians (33.6%). Apart from EMS (61.5%) and ED (68.8%), other workplace education is below 50% (4 - 47.1%) (p<0.001). Most healthcare workers from all structures (93.8 - 95.5%) reported that they wanted to undertake continuing lifelong education regardless of the workplace (84.6 – 100%). Higher rates of physicians and nurses (almost 50%) describe their BLS knowledge as moderate or below average compared to rescuers (28.2%, p=0.04). Evaluating their emergency preparedness indirectly, physicians, and nurses reported more than double the PLS (70%) deficiency ratio than rescuers (31%, p=0.003). Conclusion: This study highlighted the low level of education of doctors, nurses and rescuers of hospitals, Healthcare Centers, Local Healthcare Units and EMS of the prefecture of Heraklion Crete, regarding BLS and ALS in children and adults. There was a lack of training regarding the resuscitation algorithms, a low self-confidence in the application of practical skills, a self-assessment of knowledge as “moderate or below average”, a high percentage in the treatment of adults and a higher percentage in the treatment of pediatric emergencies. The majority of respondents stated a strong preference for continuing education. In conclusion, it is necessary for healthcare personnel from all healthcare service structures to be systematically trained in adult and pediatric BLS and ALS.
Language Greek
Subject Αλγόριθμοι
Issue date 2022-03-30
Collection   School/Department--School of Medicine--Department of Medicine--Post-graduate theses
  Type of Work--Post-graduate theses
Permanent Link https://elocus.lib.uoc.gr//dlib/b/a/1/metadata-dlib-1647247083-502185-9569.tkl Bookmark and Share
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