Table 1 Results of the Delphi rounds
Results of the Delphi rounds On what level of competence advanced level paramedics should have (Advanced level paramedic should be able to… ) | Round 1 | Round 2 mean | Round 2 SD | Round 3 included (mean/SD) | Round 3 ranking (summed values) | ||||
|---|---|---|---|---|---|---|---|---|---|
Very poor | Poor | Intermediate | Very good | Exceptional | |||||
Apply a systematic approach in nursing care of sick and/or injured patients* | 0.0% | 0.0% | 4.6% | 47.7% | 47.7% | 4,53 | 0,55 | 6 | 4th (46) |
Identify symptoms and signs of illness, promote well-being and prevent care related suffering | 0.0% | 0.0% | 6.8% | 61.4% | 31.8% | 4,38 | 0,67 | 14 | (26) |
Adjust the pace of care to sick and/or injured patients | 0.0% | 2.3% | 13.6% | 59.1% | 25.0% | 3,88 | 0,79 | ||
Make use of the patients’ experience and knowledge ensuring that nursing care and treatment are based on the patients’ dignity and rights | 2.3% | 9.3% | 20.9% | 65.2% | 2.3% | 3,65 | 0,66 | ||
Document, evaluate, and report the assignment ensuring patient safety | 0.0% | 0.0% | 2.3% | 45.4% | 52.3% | 4,48 | 0,51 | 10 | 5th (44) |
Organize nursing care to promote the well-being of patients and their close relatives | 0.0% | 0.0% | 15.9% | 75.0% | 9.1% | ||||
Identify infection and carry out infection prevention in nursing care | 0.0% | 0.0% | 18.2% | 65.9% | 15.9% | 3,90 | 0,67 | ||
Adjust information and education to sick and/or injured patients and their related persons | 0.0% | 4.6% | 13.6% | 72.7% | 9.1% | 3,95 | 0,64 | ||
Promote patients’ and families’ involvement in health promotion and self-care | 0.0% | 18.2% | 36.3% | 43.2% | 2.3% | 3,30 | 0,72 | ||
Lead nursing care of deceased patients and their closely related in cooperation with other professions | 2.3% | 22.8% | 31.8% | 38.6% | 4.5% | 3,35 | 0,83 | ||
Identify patients with risk behaviour and interact with optimal care levels | 0.0% | 4.5% | 11.4% | 77.3% | 6.8% | ||||
Identify patients and related relatives suspected of being subjected to abuse or violence and report according to legislation | 0.0% | 0.0% | 9.1% | 72.7% | 18.2% | 4,08 | 0,66 | ||
Identify ethical issues in relation to resource shortage and organize care | 0.0% | 15.9% | 29.6% | 50.0% | 4.5% | 3,30 | 0,61 | ||
Assess the patient’s condition according to ABCDE, carry out investigations, decide and evaluate interventions | 0.0% | 2.3% | 0.0% | 20.9% | 76.8% | 1.(4.72/0.58) | 1st (150) | ||
Interpret values and vital parameters as a basis for decisions for health care interventions | 0.0% | 2.3% | 0.0% | 31.8% | 65.9% | 4,60 | 0,55 | 3 | 2nd (81) |
Independently decide, administer, and evaluate pharmacological treatment based on local guidelines | 0.0% | 4.6% | 4.5% | 61.4% | 29.5% | 4,13 | 0,61 | ||
Make use of medical technical equipment | 0.0% | 2.3% | 4.5% | 40.9% | 52.3% | 4,30 | 0,56 | ||
Carry out and evaluate care and treatment based on care pace during transport | 0.0% | 0.0% | 0.0% | 45.5% | 54.5% | 4,53 | 0,51 | 7 | (20) |
Apply a professional approach with respect to the patient’s home environment | 0.0% | 2.3% | 11.4% | 68.1% | 18.2% | 4,00 | 0,56 | ||
Apply ethical approach in nursing environment at the injury scene and in the public environment | 0.0% | 0.0% | 13.6% | 56.9% | 29.5% | 3,95 | 0,60 | ||
Interact and communicate with representatives of the community and caregivers to ensure good and safe care | 0.0% | 2.3% | 6.8% | 63.6% | 27.3% | 4,18 | 0,59 | ||
Move and transport sick and/or injured patients in a traffic and in a patient safe manner | 0.0% | 2.3% | 0.0% | 36.3% | 61.4% | 4,60 | 0,55 | 4 | (27) |
Make use of and apply information and communication technology | 0.0% | 2.3% | 4.5% | 56.8% | 36.4% | 4,30 | 0,56 | ||
Identify risk environments and create safe care space | 0.0% | 0.0% | 0.0% | 47.7% | 52.3% | 4,48 | 0,55 | 11 | (19) |
Establish preparedness for threats and violent situations | 0.0% | 0.0% | 2.3% | 43.2% | 54.5% | 4,45 | 0,55 | 12 | (5) |
Carry out triage of patients in serious events | 0.0% | 2.3% | 2.3% | 38.6% | 56.8% | 4,49 | 0,60 | 9 | (16) |
Systematically plan and address ill health in connection with CBRNE injuries | 0.0% | 9.1% | 29.5% | 50.0% | 11.4% | 3,55 | 0,71 | ||
Take responsibility for medical leadership, prioritization of care at the injury scene | 0.0% | 15.9% | 18.2% | 50.0% | 15.9% | 3,75 | 0,74 | ||
Carry out triage to the relevant level of care in collaboration senior leaders | 2.3% | 7.0% | 11.6% | 62.8% | 16.3% | 3,83 | 0,71 | ||
Collaborate with rescue service and police in serious event | 0.0% | 2.3% | 4.5% | 50.0% | 43.2% | 4,38 | 0,67 | 15 | (24) |
Initiate exchanges of experience between colleagues as well as lead reflective communication with colleagues | 0.0% | 4.6% | 20.4% | 54.6% | 20.4% | 3,90 | 0,71 | ||
Respect and make use of associates’ knowledge and experience from care and rescue work toward common goal | 0.0% | 0.0% | 7.0% | 60.5% | 32.5% | 4,23 | 0,58 | ||
Contribute to cost-effectiveness and optimal resource utilization in care | 0.0% | 18.3% | 22.7% | 45.4% | 13.6% | 3,43 | 0,81 | ||
Initiate and take responsibility for supervision in nursing care | 0.0% | 6.8% | 11.4% | 75.0% | 6.8% | ||||
Apply an attitude that promotes the profession’s reputation and public confidence | 0.0% | 0.0% | 2.3% | 52.3% | 45.4% | 4,53 | 0,55 | 8 | (25) |
Understand the importance and consequences of following or deviating from treatment guidelines | 0.0% | 2.3% | 0.0% | 31.8% | 65.9% | 4,69 | 0,47 | 2 | 3rd (68) |
Take responsibility for in-depth and continuous supervision of students | 0.0% | 0.0% | 4.6% | 81.8% | 13.6% | ||||
Identify knowledge gaps in ambulance care and contribute to clinical- and patient-related research | 0.0% | 15.9% | 31.8% | 50.0% | 2.3% | 3,33 | 0,62 | ||
Implement evidence-based care | 0.0% | 4.6% | 11.3% | 65.9% | 18.2% | 4,08 | 0,73 | ||
Take responsibility for developing information and communication support for the management of nursing data | 2.3% | 20.4% | 43.2% | 34.1% | 0.0% | 3,05 | 0,78 | ||
Participate in the development of new technology and equipment | 0.0% | 27.2% | 34.1% | 36.4% | 2.3% | 3,08 | 0,66 | ||
Identify shortcomings in relation to safety and contribute to safe and comfortable transportation | 0.0% | 2.3% | 6.8% | 54.5% | 36.4% | 4,30 | 0,65 | ||
Share knowledge of the profession’s responsibilities to other professions, the general public and to patients | 0.0% | 11.4% | 27.3% | 54.5% | 6.8% | 3,53 | 0,78 | ||
New statements formulated based on experts responses that were included in the second round: | |||||||||
Recognizes gaps in their own competence | 4,35 | 0,58 | |||||||
Takes care of their own physical functioning | 4,18 | 0,59 | |||||||
Can utilize their working life and interpersonal skills at their workplace | 4,18 | 0,50 | |||||||
Maintains their own well-being at work | 4,43 | 0,64 | 13 | (17) | |||||
Can handle the ambulance reliably in traffic | 4,55 | 0,50 | 5 | (2) | |||||
Can act as a situation leader in EMS missions | 4,00 | 0,64 | |||||||
Understands the operating principles of the Emergency medical service system | 4,23 | 0,70 |