Paramedic utility in screening patients who present to Emergency Medical Services and who may benefit from an Advance Care Plan: A mixed methods study with explanatory sequential design

Kirby, K.; Liddiard, C.; Pocock, L.; Black, S.; Diaper, A.; Goodwin, L.; Mensah, T.; Proctor, A.; Richards, G.; Taylor, H.; Voss, S.; Benger, J.

Abstract

We used a two-phased mixed methods study with an explanatory sequential design to understand how frequently paramedics attend patients who, on paramedic assessment with the Gold Standards Framework Proactive Identification Guidance, are end-of-life and have advance care planning. We subsequently explored paramedic views on paramedic screening of patients to assess if they are end-of-life and onward referral to their General Practitioner for advance care planning. Paramedics screened and recorded 14.9% of patients as end-of-life and 44.3% of these patients were assessed to have no advance care plan in place. When paramedics screened patients and they did have an advance care plan in place, 36.8% had only a Do Not Attempt Cardiopulmonary Resuscitation. Paramedics found using the Gold Standards Framework Proactive Identification Guidance to screen patients for end-of-life status useful and straightforward and considered themselves well-placed to complete this task. Future research is required to address the practicalities of implementing a paramedic screening and referral tool for end-of-life care that results in the intended outcome of supporting effective advance care planning.

• Journal Article Type: Article
• Acceptance Date: Apr 2, 2024
• Online Publication Date: Apr 16, 2024
• Publication Date: 2024
• Deposit Date: Apr 17, 2024
• Publicly Available Date: May 23, 2024
• Journal: Progress in Palliative Care
• Print ISSN: 0969-9260
• Electronic ISSN: 1743-291X
• Publisher: Maney Publishing
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 3
• Pages: 189-196
• DOI: https://doi.org/10.1080/09699260.2024.2339077
• Keywords: : Emergency Medical Services; Advance Care Planning; Advance Care Plan; End-of-Life; Explanatory sequential design
• Public URL: https://uwe-repository.worktribe.com/output/11902756
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/09699260.2024.2339077