Research has become the primary guide of all health care and patient care decisions. Given the fact that most EMS practices have largely been based on in-hospital procedures, it is now time to develop EMS practices that are based on our unique prehospital environment. The RPPEO recognizes the importance of prehospital research and is committed to supporting initiatives in this field.
Are you interested in learning more about prehospital research? In gaining a better understanding of research methods and analyses? Understanding how research could affect practice in paramedine? If yes to all, then you’ll want to register to listen or download episodes of Journal Club Podcasts. Click here to see a list of podcasts and blog sites that focus on preshospital care, emergency medicine and medical education.
A Prospective Evaluation of the Safety and Effectiveness of a Provincial Prehospital Trauma Bypass Guideline for Adult Major Trauma Patients in Eastern Ontario
In Ontario, guidelines have been developed to allow paramedics to transport an injured person directly to a trauma hospital, bypassing closer hospitals en route. Our study will determine how effective these guidelines are in identifying patients who require care at a trauma hospital and in reducing the time required to get them there. We will also determine how often patients deteriorate during the bypass process and support another study that will obtain paramedics opinions on how to improve the guidelines.
- Co-Principal Investigators: K. Smaggus (RPPEO) & C. Evans (Queen’s University)
- Funding: Northern Ontario Academic Health Science Centers Funding Plan
- Question or comments? Email Shannon Leduc
PHASE 1: PLANNING YOUR RESEARCH
FORMULATE THE RESEARCH QUESTION:
Where do Ideas for Research come from?
Your interests and experience! Research is time consuming so it is best to begin with a topic that fascinates you. Think of your clinical experience and ask yourself:
- Why are things done this way?
- What is the process from which this situation arose?
- What would happen if…?
Literature: JEMS articles can be helpful in alerting researchers to clinical trends or issues of clinical importance. Published research reports may suggest problem areas, identify limitations and recommend future research topics.
A research question should address the FINER criteria:
- Feasible (in terms of time, money, expertise, scope, etc.)
- Novel (confirms, refutes or extends previous research)
A research question should address the PICO criteria:
- Population of interest (what specific patient population are you interested in?)
- Intervention being studied (if applicable)
- Comparison group
- Outcome of interest (what do you intend to measure, accomplish, improve or effect?)
PICO criteria are useful to use in the development of a specific research question. Quite often, timing is added to denote the period of time over which a study is conducted. For more information on well-built clinical questions using PICO, click on the following link: https://healthlinks.washington.edu/ebp/pico.html
Example of a Research Question:
"What is the effect of an information and emotional support intervention (I) on the anxiety levels (O) of spouses of ICU patients (P) in the first 72 hours post admission? [C: spouses of ICU patients that do not receive support intervention]"
A research question should contain a stem word (what, when, where, how, why).
PERFORM A LITERATURE REVIEW
It’s necessary to learn as much as possible about the status quo of current procedures relating to the research topic and to review existing practice guidelines or protocols.
DESIGN THE STUDY METHODS
- Select the design
- Determine the sample
- Select the measures
- Plan statistical analyses
- Design procedures
- Get feedback from your colleagues!
- Research Methods – Knowledge Base is a comprehensive web-based textbook that covers the entire research process including: sampling, measurement, research design and data analysis.
OBTAIN ETHICS APPROVAL
When humans are used as study participants, care must be exercised in ensuring that the rights of those humans are protected. Research Ethics Boards (REBs) ensure that ethical guidelines are met and followed in research activities.
- Ottawa Hospital Research Ethics Board (OHREB)
- OHREB sample consent & information sheet
APPLY FOR FUNDING
Guidebook for New Principal Investigators – CIHR
PHASE 2: CONDUCTING THE RESEARCH
- Collect the Data
- Analyze the Data
PHASE 3: DISSEMINATING THE RESEARCH
Prepare Manuscript for Publication
Last fall, a survey was distributed during CMEs to over 1200 paramedics in our region, as part of a study entitled, "Identifying Barriers to Self-Reporting Near Misses, Adverse Events and Patient Care Variances by Paramedics". The 98.6% response rate has yielded a lot of data which is currently being analyzed. An abstract will be prepared for submission Fall 2013.