ABSTRACTS
Development and Evaluation of Training Aimed at Reducing Ambulance On-Scene Times with Suspected Stroke Patients in an English Regional Ambulance ServiceAuthor: Graham McClelland, PhD | | Associate Authors: Emma Burrow, Hayley Stagg, Lisa Shaw, Lisa Shaw, Tracy Finch, Chris Price
Introduction Prehospital stroke care focuses on recognition and rapid transport to specialist care because emergency treatment is time dependent. English ambulance on-scene times (OST) with stroke patients have increased in recent years. Previous analysis of clinical data and interviews with paramedics identified three modifiable behaviors potentially extending OST: advanced clinical assessments (anything beyond FAST), intravenous cannulation, and electrocardiography. Objective To evaluate the impact of an e-learning package aimed at reducing OST. Methods A before (December 1, 2021 to April 13, 2022) and after (August 15, 2022 to March 17, 2023) service evaluation in a regional English ambulance service was performed using routinely collected electronic patient care records on all transported suspected stroke patients. The e-learning was a 30-minute video delivered during a mandatory annual training update (April to August 2022). Potential patients (n = 6,210) were identified from audit data and included 2,393 pre-training (December 1, 2021 to April 13, 2022) and 3,817 post-training (August 15, 2022 to March 17, 2023). Patients were excluded if no OST was recorded or if OST was an outlier (OST > Median OST + [1.5 × IQR]). Outcomes included OST and frequencies of the three targeted behaviors. Descriptive statistics were reported and compared using Mann-Whitney U and chi-square tests. Results A total of 5,839 suspected stroke patients were analyzed: 2,305 pre-training and 3,534 post-training (Table 1). Conclusion The training package was associated with a small, but significant, reduction in OST and two-thirds of targeted behaviors. The demographics and OSTs reported are broadly representative of English prehospital stroke care; however, the OSTremains long compared to international comparators.
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