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Kurland, Lisa
Publications (10 of 64) Show all publications
Stassen, W., Wallis, L., Castren, M., Vincent-Lambert, C. & Kurland, L. (2019). A Prehospital Randomised Controlled Trial in South Africa: Challenges and Lessons Learnt. African Journal of Emergency Medicine, 9(3), 145-149
Open this publication in new window or tab >>A Prehospital Randomised Controlled Trial in South Africa: Challenges and Lessons Learnt
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2019 (English)In: African Journal of Emergency Medicine, ISSN 2211-419X, Vol. 9, no 3, p. 145-149Article in journal (Refereed) Published
Abstract [en]

The incidence of cardiovascular disease and STEMI is on the rise in sub-Saharan Africa. Timely treatment is essential to reduce mortality. Internationally, prehospital 12 lead ECG telemetry has been proposed to reduce time to reperfusion. Its value in South Africa has not been established. The aim of this study was to determine the effect of prehospital 12 lead ECG telemetry on the PCI-times of STEMI patients in South Africa. A multicentre randomised controlled trial was attempted among adult patients with prehospital 12 lead ECG evidence of STEMI. Due to poor enrolment and small sample sizes, meaningful analyses could not be made. The challenges and lessons learnt from this attempt at Africa's first prehospital RCT are discussed. Challenges associated with conducting this RCT related to the healthcare landscape, resources, training of paramedics, rollout and randomisation, technology, consent and research culture. High quality evidence to guide prehospital emergency care practice is lacking both in Africa and the rest of the world. This is likely due to the difficulties with performing prehospital clinical trials. Every trial will be unique to the test intervention and setting of each study, but by considering some of the challenges and lessons learnt in the attempt at this trial, future studies might experience less difficulty. This may lead to a stronger evidence-base for prehospital emergency care.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
ST-elevation myocardial infarction, South Africa, Telemedicine, Randomised controlled trials, Research methods
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-71586 (URN)10.1016/j.afjem.2019.02.002 (DOI)000484785500008 ()31528533 (PubMedID)2-s2.0-85062322395 (Scopus ID)
Available from: 2019-01-18 Created: 2019-01-18 Last updated: 2019-11-08Bibliographically approved
Sjölin, H., Lindström, V., Hult, H., Ringsted, C. & Kurland, L. (2019). Common core content in education for nurses in ambulance care in Sweden, Finland and Belgium. Nurse Education in Practice, 38, 34-39
Open this publication in new window or tab >>Common core content in education for nurses in ambulance care in Sweden, Finland and Belgium
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2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 38, p. 34-39Article in journal (Refereed) Published
Abstract [en]

There is no consensus regarding the required education content and competence needed for professionals working in the emergency medical services and only a few countries in Europe staff ambulances with registered nurses. This study aimed to identify common core content in Swedish, Finnish and Belgian university curricula in the education on advanced level for registered nurses in ambulance care and to describe the teachers' perception of the necessary content for the profession as a registered nurse in ambulance care.

A deductive research design was used. Three Universities, one from each country; Sweden, Finland and Belgium, participated. Data was generated from curricula and interviews with teachers and analyzed with different approaches of qualitative content analysis.

The results showed commonness with respect to core content; the emphasis was mainly on medical knowledge but the content concerning contextual subjects differed between the three universities.

The teachers, however, aimed for the students' to acquire a broad competence in clinical reasoning by implementing theory into practice, as well as developing the students' personal aptitude and instilling a scientific awareness. The results suggest that it is possible to create a common curriculum for training of RNs for working in ambulance care.

Place, publisher, year, edition, pages
Churchill Livingstone, 2019
Keywords
Ambulance care, Curriculum, Emergency care, Nurse education
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-75628 (URN)10.1016/j.nepr.2019.05.017 (DOI)000481564200006 ()31176241 (PubMedID)2-s2.0-85066978542 (Scopus ID)
Funder
Stockholm County CouncilThe Karolinska Institutet's Research Foundation
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-11-15Bibliographically approved
Murphy, J. P., Rådestad, M., Kurland, L., Jirwe, M., Djalali, A. & Rüter, A. (2019). Emergency department registered nurses' disaster medicine competencies: An exploratory study utilizing a modified Delphi technique. International Emergency Nursing, 43, 84-91
Open this publication in new window or tab >>Emergency department registered nurses' disaster medicine competencies: An exploratory study utilizing a modified Delphi technique
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2019 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 43, p. 84-91Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-70790 (URN)10.1016/j.ienj.2018.11.003 (DOI)000460680600015 ()30528661 (PubMedID)2-s2.0-85057738331 (Scopus ID)
Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2019-06-18Bibliographically approved
Hruska, K., Castrén, M., Banerjee, J., Behringer, W., Bjørnsen, L. P., Cameron, P., . . . Kurland, L. (2019). Template for uniform reporting of emergency department measures, consensus according to the Utstein method. European journal of emergency medicine, 26(6), 417-422
Open this publication in new window or tab >>Template for uniform reporting of emergency department measures, consensus according to the Utstein method
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2019 (English)In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 26, no 6, p. 417-422Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To develop a template for uniform reporting of standardized measuring and describing of care provided in the emergency department (ED).

Methods: An international group of experts in emergency medicine, with broad experience from different clinical settings, met in Utstein, Norway. Through a consensus process, a limited number of measures that would accurately describe an ED were chosen and a template was developed.

Results: The final measures to be reported and their definitions were grouped into six categories: Structure, Staffing and governance, Population, Process times, Hospital and healthcare system and Outcomes. The template for Utstein-style uniform reporting is presented.

Conclusion: The suggested template is intended for use in studies carried out in EDs to improve comparability and knowledge translation.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-71585 (URN)10.1097/MEJ.0000000000000582 (DOI)
Available from: 2019-01-18 Created: 2019-01-18 Last updated: 2019-11-08Bibliographically approved
Ekström, A., Eng-Larsson, F., Isaksson, O., Kurland, L. & Nordberg, M. (2019). The effect of a terrorist attack on emergency department inflow: an observation study using difference-in-differences methodology. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 27(1), Article ID 57.
Open this publication in new window or tab >>The effect of a terrorist attack on emergency department inflow: an observation study using difference-in-differences methodology
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2019 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 27, no 1, article id 57Article in journal (Refereed) Published
Abstract [en]

STUDY OBJECTIVE: The objective of this study was to investigate how the terrorist attack in Stockholm, Sweden affected patient inflow to the general emergency departments (EDs) in close proximity of the attack. The study analyzed if, and to what extent, the attack impacted ED inflow during the following days and weeks.

METHODS: In a retrospective observational study, anonymized aggregated data on ED arrivals (inflow of patients) to all seven of the EDs in the Stockholm County was analyzed using the Difference-in-Differences (DiD) estimator. The control groups were the affected hospitals in the years prior to the terrorist attack. The number of ED visits was retrieved from the Stockholm County Council administrative database.

RESULTS: The study shows a statistically significant reduction in overall ED inflow of 7-9% following the attack. The effect was strongest initially after the attack, and ED inflow regained normal levels within approximately three weeks' time, without any significant rebound effect. The effect on ED inflow also decreased with distance from ground zero, and was not significant further away than 10 km.

CONCLUSION: The results showed that ED inflow was significantly decreased in the weeks immediately following the Stockholm terrorist attack. The reasons for this cannot be fully explained in this observational study. However, the results suggest that some patients actively choose when, where and if they should go to the ED.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Emergency service, Health behavior, Hospital, Patient acceptance of health care, Terrorism
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-74560 (URN)10.1186/s13049-019-0634-2 (DOI)000469057100001 ()31126312 (PubMedID)2-s2.0-85066438903 (Scopus ID)
Funder
Stockholm County Council, LS 2016-1448
Available from: 2019-06-05 Created: 2019-06-05 Last updated: 2019-06-19Bibliographically approved
Celik, D. H., Mencl, F. R., Debacker, M., Kurland, L., Wilber, S. T. & Frey, J. A. (2019). Triage Performance of School Personnel Using the SALT System. Prehospital and Disaster Medicine, 34(4), 401-406
Open this publication in new window or tab >>Triage Performance of School Personnel Using the SALT System
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2019 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 34, no 4, p. 401-406Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim of this study was to determine if school personnel can understand and apply the Sort, Assess, Life-saving interventions, Treat/Transport (SALT) triage methods after a brief training. The investigators predicted that subjects can learn to triage with accuracy similar to that of medically trained personnel, and that subjects can pass an objective-structured clinical exam (OSCE) evaluating hemorrhage control.

Methods: School personnel were eligible to participate in this prospective observational study. Investigators recorded subject demographic information and prior medical experience. Participants received a 30-minute lecture on SALT triage and a brief lecture and demonstration of hemorrhage control and tourniquet application. A test with brief descriptions of mass-casualty victims was administered immediately after training. Participants independently categorized the victims as dead, expectant, immediate, delayed, or minimal. They also completed an OSCE to evaluate hemorrhage control and tourniquet application using a mannequin arm.

Results: Subjects from two schools completed the study. Fifty-nine were from a private school that enrolls early childhood through grade eight, and 45 from a public school that enrolls grades seven and eight (n = 104). The average subject age was 45 years and 68% were female. Approximately 81% were teachers and 87% had prior cardiopulmonary resuscitation (CPR) training. Overall triage accuracy was 79.2% (SD = 10.7%). Ninety-six (92.3%) of the subjects passed the hemorrhage control OSCE.

Conclusions: After two brief lectures and a short demonstration, school personnel were able to triage descriptions of mass-casualty victims with an overall accuracy similar to medically trained personnel, and most were able to apply a tourniquet correctly. Opportunities for future study include integrating high-fidelity simulation and mock disasters, evaluating for knowledge retention, and exploring the study population's baseline knowledge of medical care, among others.

Place, publisher, year, edition, pages
Cambridge University Press, 2019
Keywords
disaster medicine, Emergency Medical Services, mass-casualty incidents, tourniquets, triage
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Identifiers
urn:nbn:se:oru:diva-76562 (URN)10.1017/S1049023X1900462X (DOI)000484297600009 ()31389327 (PubMedID)
Available from: 2019-09-20 Created: 2019-09-20 Last updated: 2019-09-20Bibliographically approved
Holroyd, B. R., Beeson, M. S., Hughes, T., Kurland, L., Sherbino, J., Truesdale, M. & Hersh, W. (2018). Clinical Informatics Competencies in the Emergency Medicine Specialist Training Standards of Five International Jurisdictions. AEM education and training, 2(4), 293-300
Open this publication in new window or tab >>Clinical Informatics Competencies in the Emergency Medicine Specialist Training Standards of Five International Jurisdictions
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2018 (English)In: AEM education and training, ISSN 2472-5390, Vol. 2, no 4, p. 293-300Article in journal (Refereed) Published
Abstract [en]

Background: The field of clinical informatics (CI), and specifically the electronic health record, has been identified as a key facilitator to achieve a sustainable evidence-based health care system for the future. International graduate medical education (GME) programs have been challenged to ensure that their trainees are provided with appropriate skills to deliver effective and efficient health care in an evolving environment.

Objectives: This study explored how international emergency medicine (EM) specialist training standards address competencies and training in relevant areas of CI.

Methods: A list of categories of CI competencies relative to EM was developed following a thematic review of published references documenting CI curriculum and competencies. Publicly available documents outlining core content, curriculum, and competencies from international organizations responsible for specialty GME and/or credentialing in EM for Australasia, Canada, Europe, the United Kingdom, and the United States were identified. These EM training standards were reviewed to identify inclusion of topics related to the relevant categories of CI competencies.

Results: A total of 23 EM curriculum documents were included in the review. Curricula content related to critical appraisal/evidence-based medicine, leadership, quality improvement, and privacy/security were included in all EM curricula. The CI topics related to fundamental computer skills, computerized provider order entry, and patient-centered informatics were only included in the EM curricula documents for the United States and were absent for the other jurisdictions.

Conclusion: There is variation in the CI-related content of the international EM specialty training standards reviewed. Given the increasing importance of CI in the future delivery of health care, organizations responsible for training and credentialing specialist emergency physicians must ensure that their training standards incorporate relevant CI content, thus ensuring that their trainees gain competence in essential aspects of CI.

Place, publisher, year, edition, pages
Wiley-VCH Verlagsgesellschaft, 2018
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-71390 (URN)10.1002/aet2.10118 (DOI)30386839 (PubMedID)
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-01-11Bibliographically approved
Petrino, R., Dryver, E., Brown, R. & Kurland, L. (2018). Collaboration in emergency medical care in Europe: the patient is the winner [Letter to the editor]. European Journal of Anaesthesiology, 35(3), 237-238
Open this publication in new window or tab >>Collaboration in emergency medical care in Europe: the patient is the winner
2018 (English)In: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 35, no 3, p. 237-238Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Blackwell Science Ltd., 2018
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-71584 (URN)10.1097/EJA.0000000000000768 (DOI)000430786800017 ()29381599 (PubMedID)2-s2.0-85042424435 (Scopus ID)
Available from: 2019-01-18 Created: 2019-01-18 Last updated: 2019-01-21Bibliographically approved
Meyer, F. & Kurland, L. (2018). Hög tid att planera undervisning i akutsjukvård på läkarutbildningarna. Läkartidningen, 115, Article ID E34C.
Open this publication in new window or tab >>Hög tid att planera undervisning i akutsjukvård på läkarutbildningarna
2018 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, article id E34CArticle in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2018
National Category
Pedagogy Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-66450 (URN)29583163 (PubMedID)
Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2019-01-22Bibliographically approved
Brink, M., Cronqvist, J., Fagerberg, A., Kurland, L., Lindgren, P., Lipcsey, M., . . . Petersson, J. (2018). Nu gäller Sepsis-3 för definitioner och diagnostiska kriterier [New definition of and diagnostic criteria for sepsis: Swedish use of Sepsis-3]. Läkartidningen, 115(15), 660-667, Article ID E3W9.
Open this publication in new window or tab >>Nu gäller Sepsis-3 för definitioner och diagnostiska kriterier [New definition of and diagnostic criteria for sepsis: Swedish use of Sepsis-3]
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2018 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, no 15, p. 660-667, article id E3W9Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB, 2018
National Category
Medical and Health Sciences Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-64457 (URN)29583161 (PubMedID)2-s2.0-85045451106 (Scopus ID)
Available from: 2018-01-23 Created: 2018-01-23 Last updated: 2018-09-04Bibliographically approved
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