Publications by authors named "Charmaine Cunningham"

Background: The Emergency Department(ED) team need to make sense of an ever-changing dynamic environment. The stories people tell about everyday occurrences are central to how sense-making occurs. These stories also contribute to organisational culture, with the frequently told narratives maintaining organisational identity and shaping behaviour.

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Introduction: Vocational learning has been critical in shaping South Africa's workforce, especially for paramedicine. The introduction of the National Qualification Framework (NQF) in 1995 phased out previous short course learning systems and redesigned qualifications within the framework. While recognition of prior learning is well advocated in the NQF, the predominant focus is undergraduate studies.

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Background:  The COVID-19 Pandemic had profound effects on healthcare systems around the world. In South Africa, field hospitals, such as the Mitchell's Plain Field Hospital, managed many COVID patients and deaths, largely without family presence. Communicating with families, preparing them for death and breaking bad news was a challenge for all staff.

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Introduction: Prehospital care in many low- and middle-income countries is underdeveloped and needs strengthening for improved outcomes. Where formal prehospital care systems are under development, integration of a layperson first responder programme may help improve access for those in need. The World Health Organization recently developed the Community First Aid Responder (CFAR) learning program in support of this system, providing that it may require adaptation to be contextually suitable and sustainably implemented at country level.

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Objectives: This project seeks to improve providers' practices and patient outcomes from prehospital (ie, ambulance-based) trauma care in a middle-income country using a novel implementation strategy to introduce a bundled clinical intervention.

Design: We conduct a two-arm, controlled, mixed-methods, hybrid type II study.

Setting: This study was conducted in the Western Cape Government Emergency Medical Services (EMS) system of South Africa.

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Background: Emergency Departments serve as a main entry point for patients into hospitals, and the team, the core of which is formed by doctors and nurses needs to make sense of and respond to the constant flux of information. This requires sense-making, communication, and collaborative operational decision-making. The study's main aim was to explore how collective, interprofessional sense-making occurs in the emergency department.

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Introduction: Volunteering yields valuable benefits to communities, yet globally there is limited published data regarding emergency medical volunteering in communities. Hout Bay Volunteer Emergency Medical Service is thought to be the oldest volunteer ambulance service in Cape Town. The objective of this paper is to quantify the contribution of the community service to the Western Cape Government Health: Emergency Medical Service.

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Introduction: The Ministry of Health - Uganda implemented the World Health Organization's Basic Emergency Care course (BEC) to improve formal emergency care training and address its high burden of acute illness and injury. The BEC is an open-access, in-person, short course that provides comprehensive basic emergency training in low-resource settings. A free, open-access series of pre-course online cases available as downloadable offline files were developed to improve knowledge acquisition and retention.

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Introduction: Patients experiencing traumatic shock are at a higher risk for death and complications. We previously designed a bundle of emergency medical services traumatic shock care ("EMS-TruShoC") for prehospital providers in resource-limited settings. We assess how EMS-TruShoC changes clinical outcomes of critically injured prehospital patients.

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Objectives: Community members are often the first to witness and respond to medical and traumatic emergencies, making them an essential first link to emergency care systems. The Emergency First Aid Responder (EFAR) programme is short course originally developed to help South Africans manage emergencies at the community level, pending arrival of formal care providers. EFAR was implemented in two rural regions of Zambia in 2015, but no changes were originally made to tailor the course to the new setting.

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Background: In Zambia, an increasing burden of acute illness and injury emphasised the necessity of strengthening the national emergency care system.

Objective: The objective of this study was to identify critical interventions necessary to improve the Zambian emergency care system by determining the current pattern of emergency care delivery as experienced by members of the community, identifying the barriers faced when trying to access emergency care and gathering community-generated solutions to improve emergency care in their setting.

Methods: We used a qualitative research methodology to conduct focus groups with community members and healthcare providers in three Zambian provinces.

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Equipment and training for nurses in Africa are scarce but, as this article explains, if aid were targeted at local suppliers of cheap but vital equipment, such as resuscitation manikins, nursing practice would be enhanced and patient outcomes may improve.

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