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Research Publications (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/216

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    Towards a safer and more efficient neonatal transfer system in South Africa : a qualitative inquiry with advanced life support paramedics
    (Faculty of Health, Engineering and Science, Edith Cowan University, 2021-05-18) Bhagwan, Raisuyah; Ashokcoomar, Pradeep
    Introduction The inter-healthcare transfer of the critically ill neonate is a critical aspect of larger neonatal intensive care, as it influences the safe transport of neonates from the receiving to the referring hospital. It is crucial then that the transfer process be safe and efficient so as not to compromise the already fragile condition of the neonate. The aim of the study was to understand the challenges advanced life support (ALS) paramedics face during neonatal transfers and to understand how the process could be made safer and more efficient. The objectives related to understanding the transfer process, the challenges linked to the critically ill neonate and the difficulties associated with the ambulance vehicle and equipment. Methods Using a qualitative research approach we sought the views of ALS paramedics at the forefront of transfers nationally. In-depth interviews were held with eight paramedics in KwaZulu-Natal and four focus group discussions with ALS paramedics in KwaZuluNatal, Gauteng, Free State and the Western Cape in South Africa. A total of 35 ALS paramedics were involved in these group discussions. Results The study uncovered several challenges that paramedics face related to poor organisational preparation for transfer of the critically ill neonate, and other crucial issues that compromise the transfer such as inadequate or defective equipment. Conclusion There is a need for greater scrutiny of the transfer process and a commitment from stakeholders to begin addressing the challenges confronting the safe transfer of critically ill neonates.
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    The pending loss of advanced life support paramedics in South Africa
    (African Federation for Emergency Medicine, 2012) Govender, Kevin; Grainger, Linda; Naidoo, Raveen; MacDonald, Russell
    Background: In 2008 South Africa (SA) had 1631 registered advanced life support (ALS) paramedics to provide pre-hospital advanced life support care to a population of approxi-mately 50 million. Compared to globally accepted ratios, the number of ALS paramedics in South Africa can be considered as grossly inadequate. This current shortage may be ascribed to migration. However, the extent and nature of this migration, the factors that have contributed to them leaving the country and the existence or effectiveness of implemented strategies that attempt to manage migration of SA ALS paramedic is not known for sure. Methods: The study consisted of a two-phase mixed method descriptive survey. A subset of SA ALS paramedics made up the study population. Quantitative data (Phase One) was obtained from a web-based survey distributed to the accessible population (N = 97). Thereafter, qualitative data (Phase Two) was gathered through in-depth interviews with selected information rich participants (n = 10) also from within the accessible population. Through methodological triangulation, data from Phase One and Phase Two were integrated to obtain an in-depth understanding of South African ALS paramedic migration. In addition, the study investigated whether strategies that attempted to manage migration of SA ALS paramedics existed, and if they did, how effective have they been. Result: Fifty-one of 97 (53%) ALS paramedics responded to the questionnaire in Phase One. Of those, 24 (47.1%) were found to be working inside South Africa, while 27 (52.9%) were working outside South Africa. Working conditions, physical security, and economic considerations were ranked as the top three major factors contributing to the decision or intended decision to migrate. Initiatives to manage the shortage of ALS paramedics in the public sector EMS do exist; however, it appears to be inadequate at its current rate of progress. Conclusion: This study suggests that ALS paramedics in SA are leaving to find work outside the country because of working conditions, physical security, and economic considerations. The current measures to manage migration appear to be ineffective, indicating that new or additional strategies to manage migration of ALS paramedics in SA may be required.