EMS World

OCT 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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66 OCTOBER 2018 | EMSWORLD.com S P O T L I G H T: Work-Related Burnout Is Associated With Higher Odds of Turnover Intention, Sickness Absence, and Injury in EMS Author: Remle Crowe, PhD, NREMT Associate authors: Rebecca E. Cash, MPH, NRP, Madison K. Rivard, BS, NREMT, Antonio R. Fernandez, PhD, NRP, Robert Wronski, MBA, NRP, Ashish R. Panchal, MD, PhD Introduction—Work-related burnout is associated with higher odds of turnover intention, sickness absence, and injury in EMS. EMS professionals frequently encounter high-risk, high-stress, and emotionally demanding situations that could increase risk of occupational burnout. Few studies have explored potential negative outcomes related to burnout in EMS. Objective—To assess the relationship between work-related burnout and sickness absence, turnover intentions, and occu- pational injury in EMS. Methods—The study used a cross-sectional analysis using an electronic survey administered to all licensed, practicing EMS professionals in South Carolina. Work-related burnout was measured using the Copenhagen Burnout Inventory. General- ized estimating equations with robust standard error estimates were used to account for clustering at the EMS agency level and control for confounding variables. Confounding variables were identified using directed acyclic graphs and included age, sex, full-time employment status, certification level, and years of EMS experience. Sickness absence, intent to leave EMS, and occupational injury were self-reported. High sickness absence was defined as more than 10 days over the most recent 12 months based on data from the Bureau of Labor Statistics. A nonresponder survey was conducted. Results—Of 8,059 surveys sent out, 1,490 were returned (19%). After excluding emergency medical responders and those who had not provided patient care in the last 30 days, 1,271 were included in the analysis. More than one third (38%) were experiencing work-related burnout. Odds of high sickness absence were 83% higher for those experiencing burnout (OR 1.83; 95% CI, 1.01–3.32). There was more than a fourfold increase in odds of intending to leave the profession within the next 12 months for those with burnout (OR 4.12; 95% CI, 2.84–6.00). Work-related burnout was associated with more than a two- fold increase in odds of having suffered an injury in the past 12 months (OR 2.60; 95% CI, 2.02–3.33). No differences were detected between responders and nonresponders in terms of work-related burnout. Conclusion—Burnout among EMS professionals was associ- ated with increased odds of sickness absence, turnover inten- tions, and occupational injury. Nevertheless, causality cannot be inferred from these cross-sectional data. Continuing Education Improves Performance on the International Paramedic Registry Cognitive Exam in Latin-American Countries Author: Jamie Flores, MD Associate authors: Alejandro Gomez, MD, José Palma, PhD Introduction—Latin-American countries have varying educa- tional processes for medical care professionals. A review of the literature revealed the common types of continuing education included repetitive task training and face-to-face programs. The International Paramedic Registry (IPR) cognitive exam provides data to understand the level of knowledge in all areas of pre- hospital medicine throughout Latin America. Objective—To understand if CE is the variable that differenti- ates the results of the IPR cognitive exam. Methods—A total of 507 participants attempted the IPR cognitive exam in Spanish. A subsample of 183 (36.23%) from Mexico, Colombia, and Panama was considered for analysis (list- wise deletion was used to remove cases with incomplete data). CE was defined as any education post-graduation. Results—The mean score of the IPR test was 56.72% (SD=8.4), stratifying data by level of education. An ANOVA test showed a nonsignificant difference between level of educa- tion and IPR test global score (p=0.236). Analyzing by area of knowledge, the data show a significant difference in the pediatric area score (p=0.013) between providers who graduated with a bachelor's degree or three years of university education. In the analysis of CE hours, 50.3% had fewer than 100 hours, 26.8% 100–500 hours, 12.6% 500–1,000 hours, 2.7% 1,000—1,500 hours, 2.7% 1,500—2,000 hours, and 4.9 % 2,000 hours or more. The data of students receiving fewer than 1,000 hours of CE represented 89.6% of the sample. An ANOVA test showed a significant difference between CE hours and score in IPR test (p=0.019). A post-hoc Tukey test located an improvement in IPR scores among the group having 100–500 hours (p=0.022) of CE. Conclusion—This study showed no significant difference between level of CE and IPR exam score. Providers with fewer than 500 hours of lifetime CE performed significantly better on an international cognitive exam. More research is needed to determine the amount and types of education of EMS providers in Latin America. The Eects of Cellular Coverage on Patient Survival in the Rural Setting Author: Emma Hand, EMT-B Associate authors: Jackson D. Déziel, PhD, MPA, NRP Introduction—Cellular coverage is an essential element that contributes to the success of communication among patients, emergency dispatch centers, and first responders. Coverage is

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