Numerous countries in the world have chosen to allow district nurses to prescribe drugs to streamline the primary care process. This qualitative, systematic literature study aimed to examine district nurses’ experience of prescribing within primary care. The search followed the PRISMA-P search strategy, and the quality assessment of the nine articles was completed using the review template for assessing studies with qualitative methodology, using GRADE CERQual. The databases CINAHL, Pubmed, PsycINFO, and Scopus were used. The result shows that district nurses experience prescribing as crucial for being able to meet patient needs through holistic and person-centered care. Being able to sufficiently and efficiently meet patient needs contributed to increased job satisfaction and professional pride in district nurses. However, district nurses need more collegial support and training in prescribing. The additional burden that the ability to prescribe poses needs to be addressed to prevent limitations in the prescription rights of district nurses. Through an extended prescription right, district nurses can contribute to a more efficient care system that can meet future demand for healthcare services in primary care. 

Background: Caring for patients in the end-of-life is an emotionally and physically challenging task. Therefore, undergraduate nursing students (UNS) need opportunities to learn to care for the dying patient. This study aimed to describe UNS' experiences of caring for patients at end-of-life. Methods: Interviews with 16 UNS in their last semester of nursing education were conducted. Data were analyzed with a phenomenological approach. Results: The UNS created a professional relationship with the dying patient. It meant that when the patient was unable to speak for themselves, the UNS could still meet his/her wishes and needs. The UNS believed they could take responsibility for the patient who was no longer able to take responsibility for themselves. Meeting with the patient's family could be experienced with anxiousness but was dependent on the personal chemistry between the patient's family and the UNS. Conclusion: The UNS creates a relationship with the patient and their family. To be knowledgeable about the patient's physical and psychosocial needs means that the UNS can support the patient in the end-of-life phase. Being close to the patient and the family results in an intensity of emotions in the care situation. The UNS can receive support from their colleagues during processing their emotions and creating an experience from their encounters with patients in end-of-life care.

Purpose: The purpose of this paper is to investigate the effects of the intervention of low-dose, high-frequency cardiopulmonary resuscitation (CPR) training with feedback for firefighters for one month. Design/methodology/approach: The study had a quantitative approach. Data were collected through an intervention by means of simulation. The data collection consisted of a pre- and post-assessment of 38 firefighter’s CPR performance. Findings: There was a statistically significant improvement from pre- to post-assessment regarding participants’ compression rates. Compression depth increased statistically significantly to average 2 mm too deep in the group. Recoil decreased in the group with an average of 1 mm for the better. There was a statistically significant improvement in participants’ ventilation volume from pre- to post-assessment. Originality/value: Prehospital staff such as firefighters, police, and ambulance perform CPR under less than optimal circumstances. It is therefore of the utmost importance that these professionals are trained in the best possible way. The result of this study shows that low-dose, high-frequency CPR training with an average of six training sessions per month improves ventilation volume, compression depth, rate, and recoil. This study concludes that objective feedback during training enhances the firefighters’ CPR skills which in turn also could be applied to police and ambulance CPR training.

Introduction. We focus on trauma care conducted in the context of a simulated traumatic event. This is in this study defined as a four-meter fall onto a hard surface, resulting in severe injuries to extremities in the form of bilateral open femur fractures, an open tibia fracture, and a closed pelvic fracture, all fractures bleeding extensively. Methods. The simulated trauma care competence of 63 ambulance nurses in prehospital emergency care was quantitatively evaluated along with their perception of their sufficiency. Data was collected by means of simulated trauma care and a questionnaire. Results. Life-saving interventions were not consistently performed. Time to perform interventions could be considered long due to the life-threatening situation. In comparison, the ambulance nurses' perception of the sufficiency of their theoretical and practical knowledge and skills for trauma care scored high. In contrast, the perception of having sufficient ethical training for trauma care scored low. Discussion. This study suggests there is no guarantee that the ambulance nurses' perception of theoretical and practical knowledge and skill level corresponds with their performed knowledge and skill. The ambulance nurses rated themselves having sufficient theoretical and practical knowledge and skills while the score of trauma care can be considered quite low.

Introduction The prognosis of survival for a person suffering from cardiac arrest increases when a layperson performs cardiopulmonary resuscitation (CPR) on-site. In Sweden, providing CPR training to people working in public places is considered a social benefit. Objective The aim of this study was to investigate the effect of a 3-hour CPR intervention for electricians. Methods Data were collected through an intervention by means of simulation and consisted of a pre-and post-assessment of the participants’ CPR performance. Results The results show a statistically significant improvement in ventilation (41%) and quality of compression (36%). Conclusion With short rehearsal training, the layperson can significantly improve the quality of CPR given. In a situation of cardiac arrest, this can be crucial for the patient’s survival and continued quality of life.

Simulation provides the opportunity to learn how to care for patients in complexsituations, such as when patients are exposed to high-energy trauma such as motor vehicle accidents.The aim of the study was to describe nurses’ perceptions of high-energy trauma care through simulationin prehospital emergency care. The study had a qualitative design. Interviews were conductedwith 20 nurses after performing a simulated training series. Data were analyzed using a phenomenographicmethod. The result indicates that simulation establishes, corrects, and confirms knowledge andskills related to trauma care in prehosp ital emergency settings. Trauma knowledge is readily availablein memory and can be quickly retrieved in a future trauma situation.

Background: Simulation participants are not dependent on learning during an actual clinical situation. This allows for a learning environment that can be constructed to meet the knowledge and experience needs of the participant. Simulations in a prehospital emergency are an ideal way to address these needs without risking patient safety. Method: Nurses in prehospital emergency care (n = 63) participated in simulation interventions. During the simulation, the performed trauma care was assessed in two groups of participants with different frequency of simulation. Results: Several statistically significant differences and clinical improvements were found within and between the groups. Differences were noted in specific assessments, examinations, care actions, and time from assessment to action. Conclusion: The result suggested that repeated simulation may contribute to a clinical improvement in trauma care, and more frequent simulation may led to even greater improvements. (c) 2017 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc.

Introduction: Simulation creates the possibility to experience acute situations during nursing education which cannot easily be achieved in clinical settings. Aim: To describe how nursing students learn acute care of patients through simulation exercises, based on observation and debriefing. Design: The study was designed as an observational study inspired by an ethnographic approach.MethodData was collected through observations and interviews. Data was analyzed using an interpretive qualitative content analysis.Results: Nursing students created space for reflection when needed. There was a positive learning situation when suitable patient scenarios were presented. Observations and discussions with peers gave the students opportunities to identify their own need for knowledge, while also identifying existing knowledge. Reflections could confirm or reject their preparedness for clinical practice. The importance of working in a structured manner in acute care situations became apparent. However, negative feedback to peers was avoided, which led to a loss of learning opportunity.Conclusion: High fidelity simulation training as a method plays an important part in the nursing students' learning. The teacher also plays a key role by asking difficult questions and guiding students towards accurate knowledge. This makes it possible for the students to close knowledge gaps, leading to improved patient safety.

Den prehospitala akutsjukvården är ett komplext kunskapsfält som innebär att vårdaren skall kunna bemöta patient och närstående, bedöma skada, sjukdom och den aktuella situationen samt avgöra vilka vårdåtgärder som skall prioriteras.

Patientens lidande kan lindras genom att vårdaren tränar färdigheter i ett prehospitalt kontext. Detta främjar en god och säker vård samt stärker patientens möjligheter till överlevnad.

Resultatet visar på behovet av simulering inom prehospital akutsjukvård. Med simulering lär sig vårdaren att hantera realistiska, dynamiska och komplexa vårdsituationer, vilket skapar kunskaper, färdigheter och erfarenheter av omhändertagande av patient drabbad av högenergitrauma. Simuleringens utformning och miljö skapar förutsättningar för lärandet vilket framkommer i interventionsstudien.

Utifrån resultatet i föreliggande forskning utvecklas en modell för lärande med hjälp av simulering.

The overall aim of the research was to deepen the understanding of learning through simulation in prehospital emergency care.

Method: In this research, qualitative and quantitative methods are used as well as integrative literature studies (I, II). Qualitative data from the interview studies (III, V) were analyzed by phenomenographic methodology. Quantitative data from the intervention study (IV) were analyzed using descriptive and analytical statistics.

Results: Research on simulation and learning within the prehospital trauma care context is relatively rare (I). Simulation of realistic scenarios where the caregivers are exposed to stress contributes to strengthen caregiver knowledge, skills and experience (II). Caregivers request simulation opportunities regarding critical and emergency situations (III). They describe that learning through regular simulation provides in-depth knowledge and skills in the care of a patient exposed to high-energy trauma (V). Interventions with repeated simulation opportunities related to the care of the patient exposed to high-energy trauma give some improvement in care provided at the site of the accident (IV).

Conclusion: Through simulation, the caregivers develop knowledge and skills and receive enhanced confidence in the care of an injured and sick patient. The research suggests several areas with potential for improvement with regard to the care of patients exposed to high-energy trauma. A model has been developed for systematic trauma simulation.

BACKGROUND: Ethics and dignity in prehospital emergency care are important due to vulnerability and suffering. Patients can lose control of their body and encounter unfamiliar faces in an emergency situation.

OBJECTIVE: To describe what specialist ambulance nurse students experienced as preserved and humiliated dignity in prehospital emergency care.

RESEARCH DESIGN: The study had a qualitative approach.

METHOD: Data were collected by Flanagan's critical incident technique. The participants were 26 specialist ambulance nurse students who described two critical incidents of preserved and humiliated dignity, from prehospital emergency care. Data consist of 52 critical incidents and were analyzed with interpretive content analysis.

ETHICAL CONSIDERATIONS: The study followed the ethical principles in accordance with the Declaration of Helsinki.

FINDINGS: The result showed how human dignity in prehospital emergency care can be preserved by the ambulance nurse being there for the patient. The ambulance nurses meet the patient in the patient's world and make professional decisions. The ambulance nurse respects the patient's will and protects the patient's body from the gaze of others. Humiliated dignity was described through the ambulance nurse abandoning the patient and by healthcare professionals failing, disrespecting, and ignoring the patient.

DISCUSSION: It is a unique situation when a nurse meets a patient face to face in a critical life or death moment. The discussion describes courage and the ethical vision to see another human.

CONCLUSION: Dignity was preserved when the ambulance nurse showed respect and protected the patient in prehospital emergency care. The ambulance nurse students' ethical obligation results in the courage to see when a patient's dignity is in jeopardy of being humiliated. Humiliated dignity occurs when patients are ignored and left unprotected. This ethical dilemma affects the ambulance nurse students badly due to the fact that the morals and attitudes of ambulance nurses are reflected in their actions toward the patient.