title: Caring for older people in prehospital emergency care: can nurses make a difference?
abstract: OBJECTIVE
  The aim of this paper is to explore older people's experiences in prehospital emergency care, and identify benefits and difficulties associated with developing a nurse-led ambulance service. Data were collected at sites in Sweden and Norway. Focus group interviews were conducted to enable the collection of data from paramedics, ambulance nurses and nursing students, while individual interviews were utilized to gather data from older people.
  
  
  BACKGROUND
  There is little research on the quality of care older people over 65 years old receive in prehospital emergency care. Older people often present with multiple pathology and diverse needs that nurses are well equipped to deal with, but presently there is no clearly defined role for nurses in prehospital emergency care in the United Kingdom, although other countries such as Sweden and Norway are developing an ambulance nurse role.
  
  
  CONCLUSIONS
  If the multiple needs of older people were addressed in the prehospital field, a reduction in readmissions and increased functional ability might be achieved. Comprehensive training is required for ambulance staff to enable them to meet such needs. While nurses have a great foundation for this care, additional specialist ambulance training is required alongside a need for education on older people's needs and attitudes to older people.
  
  
  CONCLUSIONS
  The introduction of ambulance nurses will result in role differentiation between paramedics and ambulance nurses, which has the potential for creating role conflict. To ensure a smooth transition appropriate training and education for nurses and paramedics should be provided. The end result is a potentially greatly enhanced ambulance care provision, enabling high quality care to all patients.
authors.affiliation: Institute of Nursing Research and School of Nursing, University of Ulster, Magee Campus, Derry, UK. v.melby@ulster.ac.uk
authors.forename: Vidar
authors.initials: V
authors.lastname: Melby
authors.forename: Assumpta
authors.initials: A
authors.lastname: Ryan
mesh_terms: D000328:Adult; D000368:Aged / Q000523:psychology; D000552:Ambulances / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000523:psychology; D016529:Emergency Nursing / Q000193:education / Q000458:organization & administration*; D017144:Focus Groups; D005851:Geriatric Nursing / Q000193:education / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008875:Middle Aged; D020380:Needs Assessment; D009664:Norway; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology; D016730:Program Development; D036301:Qualitative Research; D013338:Students, Nursing / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden