https://doi.org/10.4081/scenario.2021.464
Territorial emergency nurses, training and competencies: conceptual analysis
Submitted: 11 April 2021
Accepted: 11 April 2021
Published: 11 April 2021
Accepted: 11 April 2021
Abstract Views: 1502
PDF (Italiano): 435
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The Italian Ambulance System is inhomogeneous: the constitution of the ambulance crew, the criteria for the recruitment and retention of the role differ between organisations. The legislation favours autonomy and professional responsibility, but in spite of this the identity of the territorial emergency nurse is not clear, the requirements for being able to obtain the role differ among the organisations. The aim of the study is therefore to explore the concept of the Territorial Emergency Nurse by identifying their training, knowledge and skills.
Ministero della Salute. Le centrali 118 in Italia. http://www.salute.gov.it/portale/temi/p2_6.jsp?lingua=italiano&id=1051&area=118%20Pronto%20Soccorso&menu=vuoto. Ultimo accesso: 04/07/2020.
Raucci V. Infermieri da soli nelle ambulanze. Ecco Regione per Regione norme ed organizzazione. Infermieristicamente. https://www.infermieristicamente.it/articolo/9945/infermieri-da-soli-nelle-ambulanze--ecco-regione-per-regione-norme-ed-organizzazione/. Ultimo accesso 05/07/2020.
AUSL Romagna. Accordo per la fornitura di prestazioni di attività di soccorso e trasporto infermi in emergenza e programmato tra l’Azienda USL della Romagna ambito di Rimini e Croce Azzurra Riccione srl. Periodo dall’ 1/07/2016 al 30/06/2020. https://amministrazionetrasparente.auslromagna.it/documenti/U00/Contratto_Croce_Azzurra_1-7-16_30-6-202.pdf. Ultimo accesso 07/07/2020.
DGR Puglia 28 giugno 2011, n. 1479 “Nuovo Assetto del Servizio Emergenza Urgenza 118â€.
LR Marche 30 ottobre 1998, n.36 “Sistema di emergenza sanitariaâ€.
DGR Marche 19 novembre 2012, n. 1614 “Legge Regionale 30/10/1998 n. 36 e ss. mm. ii. Approvazione dei Criteri per l’individuazione da parte del Dipartimento di Emergenza competente del personale da destinare alla Centrale Operativa 118â€.
DGR Lombardia 6 luglio 2011, n.1964 “Soccorso Sanitario Extraospedaliero – Aggiornamento DD.G.R. N. VI/37434 DEL 17.7.1998, N. VI/45819 del 22.10.1999, N. VII/16484 del 23.2.2004 E N. VIII/1743 del 18.1. 2006â€.
DGR Veneto 28/3/2000, n. 1179 “art.14 LR 21/89. Modifiche ed integrazioni alla DGRV n. 1229/98â€.
D.A.R. Sicilia 25 marzo 2004, “Linee guida relative alla formazione del personale medico operante nel Servizio urgenza emergenza sanitaria - S.U.E.S. 118.â€.
D.A.R. Sicilia 25 marzo 2009, “Nuove linee guida sul funzionamento del servizio di urgenza-emergenza sanitaria regionale S.U.E.S.-118â€.
D.M. 14 settembre 1994, n. 739 “Regolamento concernente l'individuazione della figura e del relativo profilo professionale dell'infermiereâ€.
L. 26 febbraio 1999, n. 42 “Disposizioni in materia di professioni sanitarieâ€.
L. 10 agosto 2000, n. 251 “Disciplina delle professioni sanitarie infermieristiche, tecniche, della riabilitazione, della prevenzione nonchè della professione ostetricaâ€.
Comitato Centrale FNOPI. Codice Deontologico delle Professioni Infermieristiche. Roma: FNOPI; 2019.
Rodgers BL. Concepts, analysis and the development of nursing knowledge: the evolutionary cycle. J AdvNurs, 1989; 14(4): 330-5.
Hupcey JE, Penrod J. Concept Analysis: Examining the State of the Science. Res Theory NursPract, 2005; 19(2): 197-208.
Tofthagen R, Fagerstrøm LM. Rodgers’ evolutionary concept analysis – a valid method for developing knowledge in nursing science. Scand J Caring Sci, 2010; 24(1): 21-31.
Rodgers B. Concept analysis: an evolutionary view. In Concept Development in Nursing: Foundations, Techniques and Applications, 2nd edn, 2000; 77-101.
Anazodo AN, Murthi SB, Kirsten Frank M, Hu PF, Hartsky L, Cristina Imle P, et al. Assessing trauma care provider judgement in the prediction of need for life-saving interventions. Injury, Int. J. Care Injured, 2015; 46: 791-7.
Anderson NE, Gott, M, Slark J. Grey areas: New Zealand ambulance personnel’s experiences of challenging resuscitation decision-making. Int Emerg Nurs, 2018; 39: 62-7.
Ghiyasvandian S, Khazaei A, Zakerimoghadam M, Salimi R, Afshari A, Mogimbeigi A. Evaluation of Airway Management Proficiency in Pre- Hospital Emergency Setting; a Simulation Study. Emergency. 2018; 6 (1): e58.
Giacchero Vedana KG; Magrini DF; Zanetti ACG; Miasso AI; Borges TL; dos Santos MA. Attitudes toward suicidal behavior and associated factors among nursing professionals: a quantitative study. J Psychiatr Ment Health Nurs. 2017; 24(9-10): 651-9.
Martel J, Oteng R, Mould-Millman NK, Bell SA, Zakariah A, Oduro G, et al. The Development of Sustainable Emergency Care in Ghana: Physician, Nursing and Prehospital Care Training Initiatives. J Emerg Med, 2014; 47(4): 462-8.
Mebazaa A, Yilmaz MB, Levy P, Ponikowski P, Peacock WF, Laribi S, et al. Recommendations on pre-hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine. Eur J Heart Fail, 2015; 17(6): 544-58.
Vedovato CA, Boaventura AP, Araujo IEM, Monteiro MI. Logistics in mobile pre-hospital assistance service from highway concessionaires. J Nurs UFPE On Line, 2015; 9(4): 7213-20.
Yang J, Zhang J, Ou S, Wang N, Wang J. Knowledge of Community General Practitioners and Nurses on Pre-Hospital Stroke Prevention and Treatment in Chongqing, China. PLoS ONE, 2015; 10(9): e0138476.
Abelsson A, Lindwall L. The Prehospital assessment of severe trauma patients` performed by the specialist ambulance nurse in Sweden – a phenomenographic study. Scand J Trauma Resusc Emerg Med, 2012; 18: 20:67.
Abelsson A, Lindwall L, Suserud B, Rystedt I. Ambulance Nurses’ Competence and Perception of Competence in Prehospital Trauma Care. Emerg Med Int, 2018; 2018: 5910342. (a)
Abelsson A, Rystedt I, Suserud B, Lindwall L. Learning High-Energy Trauma Care Through Simulation. Clinical Simulation in Nursing, 2018; 17: 1-6. (b)
Axelsson C, Jiménez-Herrera M, Bång A. How the context of ambulance care influences learning to become a specialist ambulance nurse a Swedish perspective. Nurse Educ Today, 2016; 37: 8-14. (a)
Blomstedt K, Johansson A. The public’s perception of prehospital emergency care in the County of Skane, southern Sweden. Int Emerg Nurs, 2013; 21(2) :136-42.
Bohm K, Lund R, Nordlander J, Vicente V. Ambulance nurse’s experience to relieve pain in patients with addiction problems in Sweden. Int Emerg Nurs, 2019; 46: 100779.
Mazya MV, Berglund A, Ahmed N, von Euler M, Holmin S, Laska A, et al. Implementation of a Prehospital Stroke Triage System Using Symptom Severity and Teleconsultation in the Stockholm Stroke Triage Study. JAMA Neurol, 2020; 77(6): 1-9.
Jan Nilsson J, Johansson S, Nordström G, Wilde-Larsson B. Development and Validation of the Ambulance Nurse Competence Scale. J Emerg Nurs, 2020; 46(1): 34-43.
Rantala A, Ekwall A, Forsberg A. Significant others’ perceptions of being taken seriously by the Swedish Ambulance Service when the patient is assessed as nonurgent. Scand J Caring Sci, 2019.
Wihlborg J, Edgren G, Johansson A, Sivberg B. Reflective and collaborative skills enhances Ambulance nurses’ competence – A study based on qualitative analysis of professional experiences. Int. Emerg. Nurs, 2017; 32: 20-7.
Froutan R, Khankeh HR, Fallahi M, Ahmadi F, Norouzi K. Pre-hospital burn mission as a unique experience: A qualitative study. Burns, 2014; 40(8): 1805-12.
Johansson A, Esbjörnsson M, Nordqvist P, Wiinberg S, Andersson R, Ivarsson B, et al. Technical feasibility and ambulance nurses’ view of a digital telemedicine system in pre-hospital stroke care – A pilot study. Int Emerg Nurs, 2019; 44: 35-40.
Larsson A, Engström A. Swedish ambulance nurses’ experiences of nursing patients suffering cardiac arrest. Int J Nurs Pract, 2013; 19(2): 197-205.
Pahlin T, Mattsson J. Digital Documentation Platforms in Prehospital Care - Do They Support the Nursing Care. Int J High Educ, 2019; 8(1): 84-91.
Sjölin H, Lindström V, Hult H, Ringsted C, Kurland L. What an ambulance nurse needs to know: A content analysis of curricula in the specialist nursing programme in prehospital emergency care. Int Emerg Nurs, 2015; 23(2): 127-32.
Sjölin H, Lindström V, Vicente V, Hult H, Ringsted C, Kurland L. Prehospital emergency nurses’ experiences of care in critical incidents. Int Emerg Nurs, 2020; 51: 100890.
Suryanto, Plummer V, Boyle M. Knowledge, attitude, and practice of ambulance nurses in prehospital care in Malang, Indonesia. Australas Emerg Care, 2018; 21(1): 8-12.
Van Der Eng DM, van Beeck EF, Hoogervorst EM Bierens JJLM. Education, exposure and experience of prehospital teams as quality indicators in regional trauma systems. Eur J Emerg Med, 2016; 23(4): 274-8
Wireklint Sundström B, Holmberg M, Herlitz J, Karlsson T, Andersson H. Possible effects of a course in cardiovascular nursing on prehospital care of patients experiencing suspected acute coronary syndrome: a cluster randomised controlled trial. BMC Nurs, 2016; 15(1): 52.
Benneck JC, Bremer A. Registered nurses’ experiences of near misses in ambulance care – A critical incident technique study. Int Emerg Nurs, 2019; 47: 100776.
Holmberg M, Fagerberg I. The encounter with the unknown: Nurses lived experiences of their responsibility for the care of the patient in the Swedish ambulance service. Int J Qual Stud Health Well-being, 2010; 5(2).
Mohd Said N, Sukonthasarn A, Wangsrikhun S, Chanpransit C. Assessing and Exploring the Competency of Prehospital Emergency Medical Service Personnel in Klang Valley, Malaysia: a Mixed Method Approach. Int Medical J Malaysia, 2014; 13(2): 7-20.
Axelsson C, Herlitz J, Karlsson A, Sjöberg H, Jiménez-Herrera M, et al. The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting. Prehosp Disaster Med, 2016; 31(3): 272-7. (b)
Carlström E, Fredén L. The first single responders in Sweden – Evaluation of a pre-hospital single staffed unit. Int Emerg Nurs, 2017; 32: 15-9.
Imbriaco G, Mostardini M, Erbacci M, Gamberini G, La Notte M, Dal Bosco L, et al. Analisi delle competenze infermieristiche nei servizi di emergenza preospedaliera: i risultati di un'indagine multicentrica italiana. Scenario, 2010; 27 (4): 35-42
Martin AB, Lingg J, Lubin JS. Comparison of Airway Management Methods in Entrapped Patients: A Manikin Study. Prehosp Emerg Care, 2016; 20(5): 657-61.
Johansson A, Esbjörnsson M, Nordqvist P, Wiinberg S, Andersson R. Technical feasibility and ambulance nurses’ view of a digital telemedicine system in pre-hospital stroke care – A pilot study. Int Emerg Nurs, 2019; 44: 35-40.
Rubenson Wahlin R, Lindström V, Ponzer S, Vicente V. Patients with head trauma: A study on initial prehospital assessment and care. Int Emerg Nurs, 2018; 36: 51-55.
Nicolaidou I, Antoniades A, Constantinou R, Marangos C, Kyriacou E, Kyriacou E, et al. A Virtual Emergency Telemedicine Serious Game in Medical Training: A Quantitative, Professional Feedback-Informed Evaluation Study. J Med Internet Res, 2015; 17(6): e150.
Silva JOM, Santos LFS, dos Santos SM, da Silva DP, Santos VS. Preservation of Forensic Evidence by Nurses in a Prehospital Emergency Care Service in Brazil. J Trauma Nurs,2020; 27(1): 58-62.
Stomberg MV, Knudsen K, Stomberg H, Skärsäter I. Symptoms and signs in interpreting Gamma-hydroxybutyrate (GHB) intoxication - an explorative study. Scand J Trauma Resusc Emerg Med, 2014; 22: 27.
Istria J, Bonnel G, Gentile S, Durand A, Feuerstein S, Ratmond JJ, et al. A study comparing care between nurses and doctors in the French prehospital setting: the case of hypoglycemia. J Emerg Nurs, 2013; 39(4): 384-8.
Petracca SM, Graciotti P, Massei P, Mercuri M. Analisi e comparazione tra il modello di emergenza extraospedaliera italiano ed anglosassone. Organizzazione, formazione e ruolo infermieristico. Scenario, 2011; 28 (3): 14-19.
Falk A, Alm A, Lindström V. Has increased nursing competence in the ambulance services impacted on pre-hospital assessment and interventions in severe traumatic brain-injured patients? Scand J Trauma Resusc Emerg Med, 2014; 22: 20.
Nystøyl DS, Hunskaar S, Breidablik HJ, Østerås Ø, Zakariassen E. Treatment, transport, and primary care involvement when helicopter emergency medical services are inaccessible: a retrospective study. Scand J Prim Health Care, 2018; 36(4): 397-405.
Abelsson A, Lundberg L. Trauma Simulation in Prehospital Emergency Care. J Trauma Nurs, 2018; 25(3): 201-4. (c)
De Paola L, Terra VC, Silvado CE, Ghizoni Teive HA, Palmini A. Improving first responders' psychogenic nonepileptic seizures diagnosis accuracy: Development and validation of a 6-item bedside diagnostic tool. Epilepsy Behav, 2016; 54: 40-6.
Aftyka A, Rudnicka-Droz˙E, Rybojad B. A comparison of ambulance responses to incidents of Medical Emergency Teams led by nurses and paramedics––A retrospective single-center study. Int J Nurs Stud, 2014; 51(4): 555-61.
Langdalen H, Abrahamsen EB, Sollid SJM, Sørskår LIK, Abrahamsen HB. A comparative study on the frequency of simulation-based training and assessment of non-technical skills in the Norwegian ground ambulance services and helicopter emergency medical services. BMC Health Serv Res, 2018; 18(1): 509.
Boehringer B, Choate M, Hurwitz S, Tilney PVR, Judge T. Impact of Video Laryngoscopy on Advanced Airway Management by Critical Care Transport Paramedics and Nurses Using the CMAC Pocket Monitor. Biomed Res Int, 2015; 2015: 821302.
Mason R, Latimer A, Vrablik M, Utarnachitt R. Teaching Flight Nurses Ultrasonographic Evaluation of Esophageal Intubation and Pneumothorax. Air Med J, 2019; 38(3): 195-7.
Skube ME, Witthuhn S, Mulier K, Boucher B, Lusczek E, Beilman GJ. Assessment of Prehospital Hemorrhage and Airway Care Using a Simulation Model. J Trauma Acute Care Surg, 2018; 85(1S Suppl 2): S27-S32.
Infinger A, Studnek JR, Hawkins E, Bagwell B, Swanson D. Implementation of prehospital dispatch protocols that triage low-acuity patients to advice-line nurses. Prehosp Emerg Care, 2013; 17(4): 481-5.
Berglund A, Heikkilä K, Bohm K, Schenck-Gustafsson K, von Euler M. Factors facilitating or hampering nurses identification of stroke in emergency calls. J Adv Nurs, 2015; 71(11): 2609-21.
Brink P, Bäck-Pettersson S, Sernert N. Group supervision as a means of developing professional competence within pre-hospital care. Int Emerg Nurs, 2012; 20(2): 76-82.
Eiding H, Kongsgaard UE, Braarud AC. Interhospital transport of critically ill patients: experiences and challenges, a qualitative study. Scand J Trauma Resusc Emerg Med, 2019; 27(1): 27.
Mikkola R, Paavilainen E, Salminen-Tuomaala M, Leikkola P. Out-of-hospital emergency care providers’ work and challenges in a changing care environment. Scand J Caring Sci, 2018; 32(1): 253-60.
Van Schuppen H, Bierens J. Understanding the prehospital physician controversy. Step 1: comparing competencies of ambulance nurses and prehospital physicians. Eur J Emerg Med, 2011; 18(6): 322-7.
Corral Torres E, Hernández-Tejedor A, Suárez Bustamante R, de ElÃas Hernández R, Casado Flórez I, San Juan Linares A. Prognostic value of venous blood analysis at the start of CPR in non-traumatic out-of hospital cardiac arrest: association with ROSC and the neurological outcome. Critical Care, 2020; 24: 60.
Dojmi Di Delupis F, Mancini N, Ruggeri M, Pisanelli P. Perceptions of Emergency Department Triage Nurses About Prehospital Emergency Rescuers in Italy: A Latent Threat to Clinical Handover. J Patient Saf. 2020; 16(1): e34-e38.
Karaa H, Bayira A, Aka A, Akincia M, Uyanik A, et al. Prehospital cardiopulmonary resuscitation: A survey of prehospital providers. J Exp Clin Med, 2015; 32(3): 103-7.
Juliá-Sanchis R, Richart-MartÃnez M, GarcÃa-Aracil N, José-Alcaide L, Piquer-Donat T, Castejón-de la Encina ME. Measuring the levels of burnout syndrome and empathy of Spanish emergency medical service professionals. Australas Emerg Care, 2019; 22(3): 193-9.
Arcos González P, Castro Delgado R, Cuartas Alvarez T, Garijo Gonzalo G, Martinez Monzon C, Pelaez Corres N, et al. The development and features of the Spanish prehospital advanced triage method (META) for mass casualty incidents. Scand J Trauma Resusc Emerg Med, 2016; 24: 63.
Abelsson A, Lindwall L, Suserud B, Rystedt I. Effect of Repeated Simulation on the Quality of Trauma Care. Clin Simul Nurs (2017) 13, 601-8.
De Holanda FL, Castagnari Marra C, Kowal Olm Cunha IC. Evidence of validity of the Competence Scale of Actions of Nurses in Emergencies. Rev. Latino-Am. Enfermagem, 2019; 27: e3128.
Van Schuppen H, Bierens J. Understanding the prehospital physician controversy. Step 2: analysis of on-scene treatment by ambulance nurses and helicopter emergency medical service physicians. Eur J Emerg Med, 2015; 22(6): 384-90.
Mata KSS da, Ribeiro ÃAP, Pereira PSL, Freitas Nascimento MV, Nunes Carvalho GC, Bezerra JMT et al. Obstacle in some pre hospital care: nurses’ perception. J Nurs UFPE online, 2018; 12(8): 2137-45.
Kurola J, Paakkonen H, Kettunen T, Laakso JP, Gorski J, Silvfast T. Feasibility of written instructions in airway management training of laryngeal tube. Scand J Trauma Resusc Emerg Med, 2011; 19: 56.
Ewertsson M, Gustafsson M, Blomberg K, Holmström IK, Allvin R. Use of technical skills and medical devices among new registered nurses: A questionnaire study. Nurse Educ Today, 2015; 35(12) 1169-74.
Pires SM, Monteiro SO, Pereira AM, Stocker JN, De Mascardnhas D, De Melo EM. Non-technical skills assessment scale in nursing: construction, development and validation1. Rev Lat Am Enfermagem, 2018; 26: e3042.
D.LGS 30 dicembre 1992, n. 502 “Riordino della disciplina in materia sanitaria, a norma dell'articolo 1 della legge 23 ottobre 1992, n. 421â€.
D.LGS 19 giugno 1999, n. 229 "Norme per la razionalizzazione del Servizio sanitario nazionale, a norma dell'articolo 1 della legge 30 novembre 1998, n. 419".
Supporting Agencies
How to Cite
De Luca, W., Lucenti, E., Andreucci, A., & Colamaria, N. (2021). Territorial emergency nurses, training and competencies: conceptual analysis. Scenario® - Il Nursing Nella Sopravvivenza, 38(1), 33–42. https://doi.org/10.4081/scenario.2021.464
Copyright (c) 2021 Scenario
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Aniarti has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.