Implementation of new guidelines in the prehospital services: a nationwide survey of Norway

Springer Science and Business Media LLC - 2019
Nina Øye Thorvaldsen1,2, Lars Didrik Flingtorp3, Torben Wisborg4,5, Elisabeth Jeppesen1
1Faculty of Health Science, University of Stavanger, Stavanger, Norway
2Emergency Medical Services, Division of Prehospital Services, Oslo University Hospital, Oslo, Norway
3Norwegian National Advisory Unit on Prehospital Emergency Medicine (NAKOS), Oslo, Norway
4Norwegian National Advisory Unit on Trauma, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
5Anesthesia and Critical Care Research Group, Faculty of Health Sciences, University of Tromsø – the Arctic University of Norway, Tromsø, Norway

Tóm tắt

A debate regarding the potential harmful effects of rigid neck collar and backboard usage among prehospital and hospital care providers in Norway provoked the development of an evidence-based guideline. “The Norwegian guideline for the prehospital management of adult trauma patients with potential spinal injury” was developed with rigorous scientific methods and published in 2016. An e-learning course was developed in parallel. The aim of this study is to explore whether emergency medical services personnel in Norway have implemented the guideline, and to what extent the e-learning course was applied during the implementation process. An electronic survey was distributed individually to registered prehospital personnel in Norway 18 months after publication of the guideline. In all, 938 of 5500 (17%) EMS personnel responded to the survey. More than one-half confirmed knowledge of the guideline; among these, 56% claimed that the guideline was implemented in the service they work. Not having responded to trauma cases in real life was the main reason for not having executed the guideline. The e-learning course had been completed by 18% of respondents. Although the guideline has not been authorized or made compulsory by national authorities, one-half of respondents with knowledge of the guideline reported it as implemented. E-learning did not seem to have affected the implementation. The guideline was developed based on perceived needs among care providers, and this probably facilitated implementation of the guideline.

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