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Experiences of emergency care providers conducting critical care transfers in Gauteng Province, South Africa


A.C.G Senekal
C. Vincent-Lambert

Abstract

Background: Critical care transfer (CCT) involves the movement of high-acuity patients between facilities. Internationally, CCTs are commonly performed  by a dedicated team using specialised vehicles and equipment. These transfers comprise a significant portion of the work of local ambulance services;  however, there is a dearth of literature on current approaches and practices.


Objectives: To investigate and describe the experiences of a sample of  Gauteng Province-based emergency care (EC) providers conducting CCTs.


Methods: A qualitative descriptive design used thematic analysis to gather data  from 14 purposely selected participants during semi-structured focus group discussions, which were recorded and transcribed verbatim. Data were  coded and analysed using ATLAS.ti to generate themes and sub-themes.


Results: The two dominant themes that emerged from the study were that there  is no common understanding or clear definition of a CCT in the local context, and that systemic challenges are experienced. Participants indicated that  their undergraduate training did not sufficiently prepare them to conduct CCTs. Local ambulance services appear to lack a common definition and  understanding of exactly what constitutes a CCT and how this differs from ‘normal’ ambulance operations. Participants felt undervalued and poorly  supported, with several systemic challenges being highlighted.


Conclusions: The absence of a contextually relevant definition of what constitutes a CCT,  coupled with potential curriculum deficits in undergraduate EC programmes, negatively impacts on the experiences of EC providers conducting CCTs.  Acknowledging CCT as an area of specialisation is an important step in addressing some of the frustrations and challenges experienced by EC providers  tasked with conducting such transfers. Further research into formal postgraduate programmes in CCT is recommended. 


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eISSN: 2078-676X
print ISSN: 1562-8264