This thesis describes, interprets and 'imagines' grand and constituent metaphors for an organisational culture of a state wide ambulance service and addresses the paucity of research relating to the ambulance industry in Australia.

Thesis (M. P. A.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

This thesis describes, interprets and 'imagines' grand and constituent metaphors for an organisational culture of a state wide ambulance service and addresses the paucity of research relating to the ambulance industry in Australia.

Thesis (M.P.A.)--University of Hong Kong, 2008. / Includes bibliographical references.

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It is commonly accepted that ambulance staff undertake a large amount of lifting and handling in their daily work. Their primary role is to provide pre-hospital care and to transport sick and injured people to hospital. The emergency nature of the job means that ambulance workers have to assist people who are incapable of moving themselves in awkward and potentially hazardous environments. While safer lifting policies have been introduced ambulance workers still lift weights which other healthcare workers can avoid. However since the introduction of manual handling regulations and more recently CEN standards, ambulance services and manufacturers have been trying to find new ways of moving and transferring patients. Ambulance services have purchased new equipment to reduce musculoskeletal risks but there is little scientific evidence to support their purchasing choices. This thesis presents two case studies describing ergonomic equipment evaluations of stretcher loading systems and mobility equipment to provide a scientific basis to support purchasing decisions. Case study one is a comparative analysis of stretcher loading equipment used in UK ambulance services. The study was carried out in two phases. Phase 1 was a field study which used observation and interview methods to identify issues affecting equipment use in a range of environments. Phase 2 was a simulation study which used task simulation to assess the postures adopted during loading and unloading activities with each system. Both phases identified the tail lift as the preferred system to reduce manual handling and improve patient and operator safety. Case study two is a comparative evaluation of mobility equipment. User trials were carried out to evaluate 12 transport chairs and 4 stretchers for Accident and Emergency and Patient Transport Service staff to identify preferred equipment for each team. 16 staff assessed the equipment by conducting task simulations and completing questionnaires for each product. Postures adopted during the tasks were assessed using Rapid Entire Body Assessment. The mechanised stair climber chair was the preferred chair for both teams. The stretcher analysis was inconclusive. This thesis has used two case studies to establish a protocol for field and lab based evaluations of movement and transfer equipment in the future for the ambulance vehicle. A more comprehensive procurement process is recommended to include detailed ergonomic evaluation, ensuring that the end user is fully represented. The thesis concludes that automation is way forward to reduce manual handling risks posed to ambulance workers. The output from case study 1 (tail lift) has been included in the national specification for future Emergency Ambulances in the UK.

Abstract:Ambulance nurses have in their everyday work a varied work environment, the pace of work can quickly shift from being calm and structured to be a severe acute situation.Objective: The aim of the study was to describe how professional nurses in the ambulance operations experience their physical and mental work environment in daily practice.Method: A qualitative interview study with semi structured questions was used. The study group consisted of two women and three men, ages between 27–42 years. The study was carried out on an ambulance station in central Sweden. Based on collected data, a qualitativecontent analysis was performed that resulted in three categories.Results: The result showed that the ambulance nurses regarded that it was a lot of heavy lifting. To manage all heavy lifts, without damaging the own body the participants considered it important to be in good physical and mental shape in order to perform their daily work.Conclusion: Ambulance nurses show great adaptability, comprehension and acceptance in their variant work environment. Support and understanding from colleagues at physical and mentally heavy duties is a very important part of their work and healthy work environment, simultaneously as they describe that they experience deficiencies in different work situations.Keyword: Ambulance, physics, mental, environment. / Sammanfattning:Ambulanssjuksköterskor har i sitt vardagliga arbete en varierad arbetsmiljö, arbetstempot kansnabbt skifta från att vara lugnt och strukturerat till att bli en svår akut händelse. Syfte: Syftet med studien var att beskriva hur yrkesverksamma sjuksköterskor inom ambulansverksamheten upplever sin fysiska och psykiska arbetsmiljö i det dagliga arbetet.Metod: En kvalitativ intervjustudie med semistrukturerade frågor användes. Deltagarantalet i studien uppdelades på två kvinnor och tre män med en ålder mellan 27-42 år. Studien utfördes på en ambulansstation i Mellansverige. Utifrån insamlad data utfördes en innehållsanalys som resulterade i tre huvudkategorier.Resultat: Genomgående i resultatet var att ambulanssjuksköterskorna ansåg att det var mångatunga lyft, för att klara detta utan förslitningar ansåg deltagarna att det var viktigt att vara i fysisk och psykisk bra form för att kunna utföra sitt dagliga arbete. Slutsats: Ambulanssjuksköterskan uppvisar stor anpassningsförmåga, förståelse och acceptans i sin varierande arbetsmiljö. Förståelse och stöd från arbetskamrater vid fysiskt och psykiskt tunga arbetsuppgifter upplevs som en väldigt viktig del för sitt arbete och deras välmående i sin arbetsmiljö, samtidigt som de beskriver att de upplever att det finns brister i olika arbetssituationer. Sökord: Ambulans, fysisk, psykisk, arbetsmiljö.

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