Good Example Of Essay On Concerns Of Paramedics In Rural Locations: An Annotated Bibliography

Introduction

With significant numbers of patients residing in rural areas of any general population, the concerns of paramedics regarding their role in the community address a number of topics. The three articles reviewed consider the number of patients transported to hospitals from rural areas, the continuing expansion of paramedic responsibilities, and the role of the paramedic in bridging the gap between rural medical care and primary services.

Article 1.

Reed, B. and Bendall, J. (2015). Rural people’s use of ambulances to reach emergency departments in potentially serious health emergencies: Identifying patterns of use and non-use. Australasian Journal of Paramedicine, [online] 12(1). Available at: http://ajp.paramedics.org/index.php/ajp/article/view/142.
A study conducted in Australia determined that patients in rural areas use emergency medical transportation less than those in urban areas.
The records of 303,909 transports were obtained and de-identified to determine the route of arrival of patients to emergency rooms (ERs), particularly those with high acuity. Quantitative statistical analysis of the data found that patients were 41.5 percent less likely to use an ambulance for transport to an ER and 27.7 percent less likely if the need was serious if they lived in inner regional areas compared with people living in major cities; outer regional areas were 55.1 percent and 27.9 percent less likely respectively. Age was an indicator of use with the elderly using ER transport more often.
The findings were significant for future application in discussing unmet rural needs. Paramedics arriving in emergency transport vehicles are not able to assume their responsibilities if the patients do not utilize the service. Further study is required to determine if cost, availability, or other variables are the reason for the results of the study. This information will impact practice results by showing the reasons for lower ambulance utilization; perhaps community paramedics reduce the need for ambulance transport of rural patients.

Article 2.

Roberts, A., Nimegeer, A., Farmer, J. and Heaney, D. (2014). The experience of community first responders in co-producing rural health care: in the liminal gap between citizen and professional. BMC Health Services Research, 14(1), p.460.
Challenges in access of emergency medical services to rural areas have increased the involvement of first responders. This goal of this study was to evaluate Community First Responders (CFRs) in the role of paramedics in Scotland. They are allowed to administer medications in some instances and to apply resuscitation methods, including CPR and AEDs.
The trained CFR bridges the gap between the time when patient need is first established until the arrival of the Resuscitation Team (RT).
The method used data from two previous studies; one evaluated the use of CFRs in an area 90 minutes from primary medical care and the other researched CFR assistance in urban, suburban, and rural areas. CFR activity data was captured by mixed methods; qualitative methods evaluated data obtained through interviews, focus groups, and assessments by resuscitation team officers.
The findings were that CFRs were able to provide interim medical care more quickly than RTs, especially in rural areas. The role of the CFR can be inhibited by community acceptance.
The information supplied by this study is applicable in the context of the role of the paramedic. Some patients viewed the presence of a CFR as a replacement for the emergency team, while others were hesitant to receive care while waiting for professionals from individuals less qualified. This perception by the public of the CFR is significant in his ability to perform his responsibilities.

Article 3.

Pearson, K., Gale, J. and Shaler, G. (2014). The Evidence for Community Paramedicine in Rural Areas: State and Local Findings and the Role of the State Flex Program. Flex Monitoring Team Briefing Paper No. 34. [online] Office of Rural Health Policy. Available at: http://flexmonitoring.org/wp-content/uploads/2014/03/bp34.pdf [Accessed 12 Apr. 2015].
The study was conducted in the United States by three university teams to determine ways for paramedics in rural areas to reduce the need of patients residing there to come to major cities for care.
The method used was surveys of state officials responsible for emergency medical services, directors of state rural health agencies, and coordinators of the Medicare Rural Hospital Flexibility (Flex) Program with follow-up interviews. In addition, Flex grant applications were reviewed to determine support of rural paramedics and research of appropriate peer-reviewed articles was conducted. By September 2013, thirty-five community paramedicine stakeholders in 17 states had been interviewed.
Healthcare overlaps are an issue for the rural paramedic with a blurring of the lines of responsibility. Recruitment, retention, and reimbursement are issues to be addressed. When there are not capable paramedics in a community, emergency transport significantly increases, especially for non-emergent conditions. Topics that require definitive resolution for a successful rural paramedicine program include education and training, legislative barriers, scope of practice, funding, integration in the healthcare system, data collection, and program evaluation processes.

Conclusion

The success of the paramedic in rural instances is based on a clear definition of his role in the medical team. Proper training, support, and leadership provide a stronger sense of being a part of the healthcare group. By focusing on the strengths of the paramedic and assisting with the weakness of the standing of the paramedic within the team and the community, he or she has the capability of using skills to bring the patient to a level where transport to a primary medical facility is possible. It is necessary for the healthcare community to take the steps required to establish the programs for placing rural paramedics.

Commentary on Academic Skills.

One of the challenges faced in this assignment was finding peer-reviewed, research-based, timely journal articles that were available in their entirety on the internet. Libraries are restricted in the number of periodicals available, and many of the online articles were accessible only with memberships or purchase of the bulk of the article. I would like to see more authors allow their research to be available without charge in order to disseminate their findings. A solution may be to find team members willing to finance a membership personally and then allow the rest of the group to share in researching the articles. The more participants in a study group of this type, the more paid websites would be accessible.