The attitudes of paramedics to different forms of coercive measures
DOI:
https://doi.org/10.14528/snr.2017.51.2.129Keywords:
special coercive measures, straitjacket, nurses, emergency unitAbstract
Introduction: Coercive measures are often used in prehospital environments. The purpose of the research was to determine their frequency and the attitudes of paramedics towards them. Methods: The questionnaire was completed by 178 paramedics. All segments of the questionnaire have shown suitable reliability (Cronbach alpha > 0.8). Data was represented with descriptive statistics, T test, ANOVA test and Pearson correlation with considering statistical significance (p < 00.5). Results: 165 paramedics (92.7 %) have been involved in coercive measure interventions. Women paramedics feel less safe than men (t = 3.243, p = 0.03) and are more supportive of police intervention (t = −0.572, p =0.03). The most used coercive measure is restraining with police handcuffs (x = 3.30, s = 1.15). Aggression of patients directed at others (x = 4.22, s = 0.86), aggression directed at themselves (x = 4.23, s = 0.76) and agitation (x = 3.23, s = 0.98) are seen as the most justifiable causes for the use of coercive measures. Paramedics believe that they need more knowledge about this subject (x = 3.90, s = 1.01). Discussion and conclusion: Paramedics mention similar reasons for using coercive measures to the ones mentioned by hospital employees in previous research. However, the opinion of the paramedics about using these measures is negative and they only agree with using coercive measures in the case of patients with aggressive behaviour. They feel endangered at their job. They need training and education on the use of coercive measures.Downloads
Metrics
References
Avguštin Avčin, B., 2012. Obravnava psihiatričnih nujnih stanj. In: R. Vajd & M. Gričar, eds. Urgentna medicina: izbrana poglavja 2012, Portorož. 13.–16. junij 2012. Ljubljana: Slovensko združenje za urgentno medicino, pp. 228–230
Balantič, M., 2012. Fizično oviranje pacientov v klinični praksi. In: B. Bregar & J. Peterka Novak, eds. Posebni varovalni ukrepi v teoriji in praksi, Zbornik predavanj z recenzijo, Ljubljana, 11. april 2012. Ljubljana: Zbornica zdravstvene in babiške nege, Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, pp. 39–46.
Bigham, B.L., Jensen, J.L., Tavares, W., Drennan, I.R., Saleem, H., Dainty, K.N., et al., 2014. Paramedic self-reported exposure to violence in the emergency medical services (EMS) workplace: a mixed-methods cross-sectional survey. Prehospital emergency care, 18(4), pp. 489–494. https://doi.org/10.3109/10903127.2014.912703 PMid:24830544
Booth, J.S., 2015. Four - point restraint. Available at: http://emedicine.medscape.com/article/1941454-overview [15. 1. 2016].
Boyle, M., Koritsas, S., Coles, J. & Stanley, J., 2007. A pilot study of workplace violence towards paramedics. Available at: http://emj.bmj.com/content/24/11/760.full.pdf+html [11. 7. 2015].
Bregar, B. & Možgan, B., 2012. Posebni varovalni ukrepi – primerjava s tujino. In: B. Bregar & J. Peterka Novak, eds. Posebni varovalni ukrepi v teoriji in praksi, zbornik predavanj z recenzijo, Ljubljana, 11. april 2012. Ljubljana: Zbornica zdravstvene in babiške nege, Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, pp. 13–21.
Cencič, M., 2009. Kako poteka pedagoško raziskovanje: primer empirične neeksperimentalne raziskave. Ljubljana: Zavod RS za šolstvo, p. 49.
Cheney, P.R., Gosset, L., Fullerton-Gleason, L., Weiss, S.J., Ernst, A.A. & Sklar, D., 2006. Relationship of restraint use, patient injury, and assaults on EMS personnel. Prehospital Emergency Care, 10(2), str. 207–212. https://doi.org/10.1080/10903120500541050 PMid: 16531378
Čander, D. & Virtič, F., 2009. Posredovanje ekip NMP ob dogodkih s prisotnim nasiljem – sodelovanje s policijo. In: A. Posavec, ed. Izvajanje nujne medicinske pomoči in transport v izrednih razmerah: zbornik predavanj, Ig, 23. oktober 2009. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, Sekcija reševalcev v zdravstvu, pp. 51–59.
Danieli, A,. 2008. Nujna stanja v psihiatriji. In: U. Ahčan, D. Slabe & R. Šutanovac, eds. Prva pomoč: priročnik za bolničarje. Ljubljana: Rdeči križ Slovenije, pp. 211–215.
Erbay, H., 2016. Some ethical issues in prehospital emergency medicine. Turkish journal of emergency medicine, 14(4), pp. 193–198. https://doi.org/10.5505/1304.7361.2014.32656 PMCid: PMC4909960
Gosak, S., 2011. Uporaba posebnih varovalnih ukrepov v socialno varstvenem zavodu: diplomsko delo. Maribor: Univerza v Mariboru, Fakulteta za zdravstvene vede.
Gabrovec, B., & Lobnikar B., 2014. Organizational model of ensuring safety and quality of treatment of aggressive psychiatric patients in mental health nursing in Slovenia. Obzornik zdravstvene nege, 48(4), pp. 286–293. https://dx.doi.org/10.14528/snr.2014.48.4.33
Gabrovec, B., Eržen I. & Lobnikar B., 2014. The prevalence and the nature of violence directed at the medical staff in psychiatric health care in Slovenia. HealthMed, 8(2), pp. 228–234.
Gabrovec, B., 2015. The prevalence of violence directed at paramedic services personnel. Obzornik zdravstvene nege, 49(4), pp. 284–294. https://dx.doi.org/10.14528/snr.2015.49.4.60
Gabrovec, B., & Lobnikar B., 2015. The analysis of the role of an institution in providing safety and quality in psychiatric health care. Anadolu psikiyatri dergisi, 16(6), pp. 420–425.
Gabrovec, B., & Eržen I., 2016. Prevalence of violence towards nursing staff in Slovenian nursing homes. Zdravstveno varstvo, 55(3), pp. 212–217. https://doi.org/10.1515/sjph-2016-0027 PMid:27703541 PMCid:PMC5031071
Gelkopf, M., Roffe, Z., Behrbalk, P., Melamed, Y., Werbloff, N. & Bleich, A., 2009. Attitudes, opinions, behaviours, and emotions of the nursing staff toward patient restraint. Issues in mental health nursing, 30(12), pp. 758–763. https://doi.org/10.3109/01612840903159777 PMid:19916810
Hagen, T.M., 2013. Preventing violence against EMS. Journal of Emergency Medical Services. Available at: http://www.jems.com/articles/print/volume-38/issue-12/administration-and-leadership/preventing-violence-againstems.html [15. 1. 2016].
Happel, B. & Koehn, S., 2010. Attitudes to the use of seclusion: has contemporary mental health policy made a difference. Journal of clinical nursing, 9(21–22), pp. 3208–3217. https://doi.org/10.1111/j.1365-2702.2010.03286.x PMid: 21040022
Hyland, S., Watts, J. & Fry, M., 2016. Rates of workplace aggression in the emergency department and nurses' perceptions of this challenging behaviour: a multimethod study. Australasian emergency nursing journal, 19(3), pp. 143–148. https://doi.org/10.1016/j.aenj.2016.05.002 PMid: 27259588
Isenberg, D.L. & Jacobs. D., 2015. Prehospital Agitation and Sedation Trial (PhAST): a randomized control trial of Intramusculae Haloperidol versus intramuscular Midazolam for the sedation of the agitated or violent patient in the Prehospital Environment. Prehospital and Disaster Medicine, 30(5), pp. 491–495. https://doi.org/10.1017/S1049023X15004999 PMid: 26323511
Jeriček Klanšček, H., 2009. Spremna beseda. In: H. Jeriček Klanšček, M. Zorko, M. Bajt & S. Roškar, eds. Duševno zdravje v Sloveniji. Ljubljana: Inštitut za varovanje zdravja Republike Slovenije, p. 1.
Kelbič, A. & Fekonja, Z., 2015. Prisotnost fenomena nasilja nad zaposlenimi v nujni medicinski pomoči. In: R. Vajd & M. Gričar, eds. Urgentna medicina: izbrana poglavja. Portorož, 18.–20. junij 2015. Ljubljana: Slovensko združenje za urgentno medicino, pp. 304–306.
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije, 2014. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Kokalj, A., Rus Prelog, P. & Novak Šarotar, B., 2015. Obravnava samomorilnega pacienta. In: R. Vajd & M. Gričar, eds. Urgentna medicina: izbrana poglavja 2015. Portorož, 18.–20. junij 2015. Ljubljana: Slovensko združenje za urgentno medicino, pp. 134–136.
Migon, M.N., Coutinho, E.S., Huf, G., Adams, C.E., Cunha, G.M. & Allen, M.H., 2008. Factors associated with the use of physical restraints for agitated patients in psychiatric emergency rooms. General hospital psychiatry, 30(3), pp. 263–268. https://doi.org/10.1016/j.genhosppsych.2007.12.005 PMid: 18433659
Možgan, B., 2009. Posebni varovalni ukrepi. In: P. Pregelj & R. Kobentar, eds. Zdravstvena nega in zdravljenje motenj v duševnem zdravju. Ljubljana: Psihiatrična klinika Ljubljana, Rokus Klett, pp. 439–443.
Naka, S., 2012. Uporaba fizičnega oviranja na oddelku splošne bolnišnice. In: B. Bregar & J. Peterka Novak, eds. Posebni varovalni ukrepi v teoriji in praksi, Zbornik predavanj z recenzijo, Ljubljana, 11. april 2012. Ljubljana: Zbornica zdravstvene in babiške nege, Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, pp. 29–32.
Pourshaikhian, M., Abolghasem Gorji, H., Aryankhesal, A., Khorasani-Zavareh, D. & Barati, A., 2016. A systematic literature review: workplace violence against emergency medical services personnel. Archives of trauma research, 5(1), art. ID e28734. https://doi.org/10.5812/atr.28734 PMCid: PMC4860284
Prestor, J., 2013. Komunikacija s pacienti in svojci na njihovem domu. In: R. Vajd & M. Gričar, eds. Urgentna medicina: izbrana poglavja 2013, Portorož, 13.–15. junij 2013. Ljubljana: Slovensko združenje za urgentno medicino, pp. 319–322.
Rant, B. & Bregar, B., 2014. Razumevanje odnosa reševalcev do pacientov, ki so samomorilno ogroženi. Obzornik zdravstvene nege, 48(3), pp. 177–194. https://dx.doi.org/10.14528/snr.2014.48.3.24
Richmond, J.S., Berlin, J.S., Fishkind, A.B., Holloman G.H., Zeller, S.L., Wilson, M.P., et al., 2012. Verbal de-escalation of the agitated patient: consensus statement of the American Association for Emergency Psychiatry project BETA de-escalation workgroup. Western Journal of Emergency Medicine, 13(1), pp.17–25. https://doi.org/10.5811/westjem.2011.9.6864 PMid: PMC3298202
Raboch, J., Kalisová, L., Nawka, A., Kitzlerová, E., Onchev, G., Karastergiou. A., et al., 2010. Use of coercive measures during involuntary hospitalization: findings from ten European countries. Psychiatric service, 61(10), pp. 1012–1017. https://doi.org/10.1176/ps.2010.61.10.1012 PMid:20889640
Szarpak, L., Kurowski A. & Szlachta, T., 2013. Knowledge and compliance use of coercive means in paramedics work. Military Pharmacy and Medicine, 6(2), pp. 41–46. Available at: http://mil-pharm-med.pl/2013/2-6/8.pdf [11.7. 2015]
World Medical Association, 2013. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), pp. 2191–2194. Available at: http://www.wma.net/en/20activities/10ethics/10helsinki/DoH-Oct2013-JAMA.pdf [1. 9. 2016].
Zakon o duševnem zdravju (ZDZdr), 2008. Uradni list Republike Slovenije št. 77.
Zakon o pacientovih pravicah (ZPacP), 2008. Uradni list Republike Slovenije št.15.
Downloads
Published
How to Cite
Issue
Section
License
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.