Improving PreHospital Emergency Maternal and Child Care: A Modern Approach to EMS

描述（由申请人提供）：孕妇院前护理的研究严重不足。虽然儿童院前护理得到了更好的研究，但儿科文献缺乏基于人群的现实世界对院前儿童护理的看法。拟议的研究将缩小这些知识上的差距，并采取适合需求的教育战略，解决已确定的有问题的护理交付领域

DESCRIPTION (provided by applicant): The prehospital care of pregnant women is severely understudied. While the prehospital care of children is better studied, the pediatric literature lacks a population-based real-world perspective of care delivered to children in the prehospital setting. The proposed research will close those gaps in knowledge and move to address identified areas of problematic delivery of care with an educational strategy tailored to the needs of Emergency Medical Services (EMS) providers and their work environment and schedules. The proposed project falls in line with AHRQ's mission to make a safer and higher quality healthcare environment for priority populations. The project will target EMS care of pregnant and pediatric patients in the prehospital environment. AHRQ's mission and the objective of the proposed study will be accomplished through three Specific Aims: 1. Assess current knowledge level of emergency medical services (EMS) providers in North Carolina for children and pregnant women; 2. Develop web-based educational content to address identified knowledge gaps and deploy a two-pronged educational intervention designed to improve the care of children and pregnant women in the prehospital environment; and 3. Evaluate changes in knowledge and service delivery for children and pregnant women within the study population. The proposed study is a stepped wedge randomized trial design involving four rural and four urban North Carolina counties. The eight counties will be randomized, one rural and one urban, to four blocks. This five-year project will include five main components, including web- based courses for Continuing Education Credits, prescriptive learning, mobile simulation labs, yearly knowledge tests, and analysis of patient data from a statewide prehospital database. EMS deficits in knowledge and skills will be measured using the knowledge and simulation skills tests and the results will inform the conditions and topics discussed in the web-based courses and mobile simulations labs received by EMS. The long-term objective of this study is to improve the patient care provided to pregnant and pediatric patients by EMS in North Carolina. Using these educational methods (individualized assigned course requirements via prescription learning, web-based continuing education courses, and mobile patient simulation labs), testing methods (yearly knowledge tests and skills tests), and data collection and comparisons (results of knowledge tests, results of skills tests, and prehospital patient care data), changes in EMS knowledge and skills will be assessed.