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Thesis (M.P.A.)--University of Hong Kong, 2000. / Includes bibliographical references.

Thesis (M.P.A.)--University of Hong Kong, 2000. / Includes bibliographical references. Also available in print.

This PhD dissertation experimentally characterized the vibration amplitude, frequency, and energy associated with ambulance travel and defined the relationship of the vibration to safety, comfort and care of ambulance patients. Average vertical vibration amplitudes of .46 to 2.55 m/sec2 were recorded in the patient compartment of four ambulances over four road surfaces at three speed settings. Power spectrum analysis of the data revealed that the vibration energy and resulting vertical acceleration forces were concentrated in the .1 to 6 Hz range. Relationships between the measured ambulance vibration and the impact of whole body vibration on human physiology and performance were quantified. It was found that the accelerations measured in the ambulances were in excess of what is considered to be a normal human comfort level. Furthermore, the vibration measured was in a spectrum which could present physical impediments to optimum task performance for the on-board medical team. Phase portrait analysis combined with the power spectrum data revealed the presence of nonlinearities, stochastic fluctuations and time delays inherent in the data. The ambulance vibration data was then used to create a unique analytical model and library of forcing functions corresponding to the vehicles, road surfaces and vehicle speeds that were tested. Using the example of a vibration absorbing force plate fit over an existing ambulance floor, it was demonstrated how the model and forcing functions could be used to develop a control law equation to select parameters for active control of vibration to produce sustainable regions of patient safety, comfort and care.

Thesis (M. Arch.)--University of Hong Kong, 1998. / Includes special report study entitled: Design on slope. Includes bibliographical references.

The Swedish prehospital/ambulance organization has the last decades evolved from a transport organization to a an organization that focus on alleviate and treating acute medical conditions in the field as well as transporting patient to the emergency ward. The ambulance service is developing continually and offers today a high-tech and highly specialized nursing/care. Which in turn demand a higher standard and competence on the care provider. Ambulance mission can vary in priority and magnitude. This in turn demand a high medical competence our capacity. One of the most important task ́s in pre-hospital work is to prioritize and assess the patient status. The medical judgment lies as a foundation for further caring focus and triage. Feedback and patient monitoring from the hospital can be pin pointing the right diagnosis and support the ambulance nurse to decide if the right pre hospital diagnosis was judged. The aim of the study was to describe specialist educated ambulance nurses need of feedback according to the medical judgment and treatment after terminated ambulance mission. The study was performed as a survey investigation with a quantitative descriptive design. Fifteen specialist educated ambulance nurses in two ambulance stations in Halland participated in the study. The majority of the ambulance nurses recognized the need of feedback/patient monitoring and found it difficult to receive information about patient that been transported to the hospital. Personal relationships to certain patient responsible nurses on caring units showed in some cases important to obtain information about patients. To design a plan for a regular feedback according to judgment and treatment after concluding the assessment could serve as a cost efficient education to the ambulance nurses and increase patient assurance. The result could in the future be used to design a action plan for recurring feedback in regard to assessment and treatment after completed mission. In conclusion one can claim that this is a free of charge competence improvement where all parts can be benefiting if we let the ambulance nurse have the opportunity to patient follow up. / Det senaste decenniet har den svenskaambulanssjukvården utvecklats från att vara en transportorganisation till enorganisation som även fokuserar på att lindra och behandla akuta tillstånd.Ambulanssjukvården utvecklas fortlöpande och i dagsläget är det enhögteknologisk och högspecialiserad vård vilken ställer större krav påpersonalens kompetens. Ambulansuppdrag kan variera i prioritet och omfattningvilket ställer krav på en hög medicinsk kompetens. En av de viktigasteuppgifterna inom prehospitalt arbete är att prioritera och bedöma patienterstillstånd. Bedömningen ligger som grund förfortsatt vårdinriktning och prioritering. Återkoppling/patientuppföljningfrån sjukhuset kan innebära att rätt diagnos sätts samt hjälpaambulanssjuksköterskan att avgöra om prehospitalt bedömt tillstånd varitkorrekt. Syftet med studien var att beskriva specialistutbildadeambulanssjuksköterskors behov av återkoppling avseende bedömning och behandlingefter avslutat ambulansuppdrag. Studien genomfördes som en enkätundersökning.Femton specialistutbildade ambulanssjuksköterskor från två ambulansstationer iHalland ingick i studien. Majoriteten av ambulanssjuksköterskorna såg behovetav återkoppling/patientuppföljning samt ansåg att det är svårt att fåinformation om de patienter som lämnats på sjukhuset. Personliga relationertill patient ansvarigsjuksköterska på vårdande enheter visade sig spela en vissroll när det gällde att får information om patienterna. Utformande av enhandlingsplan för regelbunden återkoppling avseende bedömning och behandlingefter avslutat ambulansuppdrag skulle utgöra en relativt kostnadseffektivutbildning för ambulanssjuksköterskor som skulle kunna öka patientsäkerheten.Resultatet kan komma att användas i framtiden för att utforma en handlingsplanför regelbunden återkoppling avseende bedömning och behandling efter avslutat ambulansuppdrag.Avslutningsvis kan påstås att det är gratis kompetenshöjning där alla ärvinnare om ambulanssjuksköterskan får möjlighet till patientuppföljning.

This thesis is an evaluation of an early intervention Employee Assistance Program (EAP) incorporating Critical Incident Stress Management (CISM) operating in the South Australian Ambulance Service (SAAS). The program was developed specifically for SAAS and is known as the Peer Support Program. The program was designed with the intention of mitigating the effects of cumulative and traumatic stress among SAAS personnel. It reflects the philosophy which has underpinned the concept of early intervention, which is to provide emotional first aid and identify individuals who have experienced traumatic stress in the course of performing their duties within the pre-hospital care environment. The program further aims to reduce psychological injuries through the combination of psycho-education incorporating practical coping skills, initial crisis intervention offered by in-house service providers, namely Peer Support Officers (PSOs) and, when needed, psychological intervention offered through referral to mental health professionals (MHPs). / For professional practice, the research shows that a CISM-based EAP is effective when used in its entirety, specifically pre-incident education, peer support selection and training, and confidentiality are key contributors to the success of CISM and CISM-based programs. Practitioners need to ensure that programs are appropriately developed and continually maintained. Researchers and practitioners must also acknowledge the emergency first aid philosophy underlying early intervention. In conclusion, the study demonstrated that a program developed with CISM guidelines can be effective in mitigating the effects of cumulative and traumatic stress among emergency service personnel in SAAS, thus disproving the claim that all such programs are ineffective and/or harmful. Furthermore, the study demonstrates the value of including qualitative evaluation techniques, and demonstrates that insightful data can be obtained through a multi-method approach. This undermines the argument that a quasi-experimental study is the only method suitable for evaluation and it is recommended that further EAP and CISM research focus on comprehensive, mulit-method evaluation. / Thesis (PhD)--University of South Australia, 2006.

Thèse (de maîtrise)--Université Laval, 2007. / Bibliogr.: f. 69-70. Publié aussi en version électronique dans la Collection Mémoires et thèses électroniques.

Thesis (Ph. D.)--University of Hong Kong, 1996. / Includes bibliographical references (leaf 255-265).

Thesis (M.P.A.)--University of Hong Kong, 1999. / Includes bibliographical references.