Paramedic patient advocacy: a review and discussion

Internet Journal of Allied Health Sciences and Practice Volume 15 | Number 4 Article 8 October 2017 Paramedic patient advocacy: a review and discussion Alan M. Batt Fanshawe College, London, Ontario, Gerard Ward Royal College of Surgeons of Ireland, Dublin, Ireland Joseph J. Acker British Columbia Ambulance Service, BC, Canada Follow this and additional works at: https://nsuworks.nova.edu/ijahsp Part of the Interprofessional Education Commons Recommended Citation Batt AM, Ward G, Acker JJ. Paramedic patient advocacy: a review and discussion. The Internet Journal of Allied Health Sciences and Practice. 2017 Oct 03;15(4), Article 8. This Review Article is brought to you for free and open access by the College of Health Care Sciences at NSUWorks. It has been accepted for inclusion in Internet Journal of Allied Health Sciences and Practice by an authorized editor of NSUWorks. For more information, please contact . Paramedic patient advocacy: a review and discussion Introduction: Patient advocacy is an often encountered term, but one for which no consistent definition exists. Advocacy is a new and developing role of the paramedic that is closely linked to the developing professionalism of paramedicine, along with the expanding role of the paramedic as a healthcare professional in the community. This role however requires exploration and clarification. Methods: A literature search was performed of multiple databases, including MEDLINE, EMBASE, CINAHL and prominent paramedic journals. Results: No published literature investigating the theory or practice of paramedic patient advocacy, the potential conflicts and benefits of this role, or the perceived and actual barriers to advocacy paramedics face was discovered. Conclusion: The following literature review and discussion investigate the concept of paramedic patient advocacy, the contexts in which advocacy may take place, potential barriers, benefits and conflicts. Proposals are also included for areas requiring further research. Author Bio(s) Alan Batt MSc CCP is a critical care paramedic, educator and researcher based in Ontario, Canada. Gerard Ward BSc CCP is a critical care paramedic and a medical student at the Royal College of Surgeons in Ireland, in Dublin, Ireland. Joseph Acker MA EMT-P(cc) is a critical care paramedic, Director of Patient Care Delivery with British Columbia Ambulance Service, Canada and an Adjunct Senior Lecturer in Paramedicine at Charles Sturt University in NSW, Australia. This review article is available in Internet Journal of Allied Health Sciences and Practice: https://nsuworks.nova.edu/ijahsp/vol15/iss4/8 Dedicated to allied health professional practice and education Vol. 15 No. 4 ISSN 1540-580X Paramedic Patient Advocacy: A Review and Discussion Alan M. Batt, MSc CCP 1 Gerard Ward, BSc CCP2 Joseph J. Acker, MA EMT-P(cc)3 1. Fanshawe College 2. Royal College of Surgeons of Ireland 3. British Columbia Ambulance Service Ireland/Canada Abstract Introduction: Patient advocacy is an often encountered term, but one for which no consistent definition exists. Advocacy is a new and developing role of the paramedic that is closely linked to the developing professionalism of paramedicine, along with the expanding role of the paramedic as a healthcare professional in the community. This role however requires exploration and clarification. Methods: A literature search was performed of multiple databases, including MEDLINE, EMBASE, CINAHL and prominent paramedic journals. Results: No published literature investigating the theory or practice of paramedic patient advocacy, the potential conflicts and benefits of this role, or the perceived and actual barriers to advocacy that paramedics face was discovered. Conclusion: The following literature review and discussion investigate the concept of paramedic patient advocacy, the contexts in which advocacy may take place, potential barriers, benefits and conflicts. Proposals are also included for areas requiring further research. Introduction Patient advocacy is a term that is used frequently in healthcare settings, but it is one for which a consistent definition does not seem to exist. The documented definitions however centre on common themes of furthering the best interests, safety and wishes of the patient. A 2005 review identified the complexity of defining advocacy, 1 and seventeen varying definitions were identified within the nursing literature alone. The concept of patient advocacy has been discussed in the nursing literature since the 1970s when the International Council of Nurses included it in their professional codes of conduct and ethics. It has been further refined, most recently in 2012.2 The nurse’s role as a patient advocate is one that is underpinned by nursing ethics, another well researched and documented area of nursing professionalism. The role of ambulance staff and especially that of paramedics has evolved substantially over the past 20 years, including expanded scopes of practice, the beginnings of paramedic-led clinical governance and increased clinical autonomy. In some health care systems being a patient advocate from a paramedic’s perspective means transporting the patient to the hospital safely, and if possible beginning treatment in the prehospital setting. However in recent years in some services, advocating for one’s patient can mean not transporting the patient to a hospital at all. Paramedics in many jurisdictions now have the ability to generate and implement treatment plans for patients with the option to transport, refer or discharge at scene, as deemed appropriate. With this evolution and role expansion has come greater responsibility, including an expanded scope of practice, and an obligation to patients to provide appropriate treatment, transport or discharge advice in the out-of-hospital setting. This has in turn required paramedics to advocate for their patients in both their decision making (for example, treat and discharge) and treatment options (for example, administration of medications). Patient advocacy is a new, developing role of the paramedic that is closely linked to the developing professionalism of paramedicine. Paramedicine, though not formally defined in the existing literature, is the unique domain of education, practice and self-determination of paramedics, which includes traditional emergency response, and evolving non-emergent roles such © The Internet Journal of Allied Health Sciences and Practice, 2017 Paramedic Patient Advocacy: A Review and Discussion 2 as community paramedicine. This evolution can be evidenced through the increasing recognition of paramedics as regulated health professionals in countries such as the United Kingdom, Republic of Ireland, South Africa, Australia (forthcoming) and various provinces within Canada, and consequently, the inclusion of advocacy language in the national codes of ethical conduct of these jurisdictions.3-5 The concept that patients require hea (...truncated)