title: Paramedics' perceptions of their role in providing pre-hospital thrombolytic treatment: qualitative study.
abstract: BACKGROUND
  The majority of ambulance services in England provide pre-hospital thrombolysis, following publication of the National Service Framework for Coronary Heart Disease. A meta-analysis has confirmed the effectiveness of pre-hospital administration in terms of all-cause mortality reduction and time saved. Little is known however, about how paramedics perceive their role in thrombolytic administration.
  
  
  OBJECTIVE
  To describe ambulance paramedics' perceptions of their role in delivering thrombolytic treatment in the pre-hospital setting.
  
  
  METHODS
  Twenty paramedics, based in one rural ambulance service in the South West of England participated in focus group interviews.
  
  
  RESULTS
  Five key themes emerged: Perceptions of drivers for change; duty of care; perceptions of professional image; role expansion; and preparedness for practice.
  
  
  CONCLUSIONS
  Paramedics' perceptions of their role in pre-hospital thrombolysis were mixed, encompassing professional and political issues including lack of ownership of the emerging national strategy, desire for national certification and financial reward. For successful development and implementation of new strategies within the ambulance service early engagement of paramedics and other staff is essential.
authors.affiliation: Faculty of Health and Social Care, University of the West of England, Glenside Campus, Bristol, BS16 1DD, UK. helen3.cox@uwe.ac.uk
authors.forename: Helen
authors.initials: H
authors.lastname: Cox
authors.forename: John W
authors.initials: JW
authors.lastname: Albarran
authors.forename: Tom
authors.initials: T
authors.lastname: Quinn
authors.forename: Kathrine
authors.initials: K
authors.lastname: Shears
mesh_terms: D001291:Attitude of Health Personnel; D002568:Certification; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D004739:England / Q000453:epidemiology; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D015404:Nursing Methodology Research; D017009:Professional Autonomy; D024382:Professional Role / Q000523:psychology*; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration; D020377:Self Efficacy; D012938:Social Perception; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors