Ambulance ramping predicts poor mental health of paramedics.

OBJECTIVE: Ambulance ramping involves a patient remaining under paramedic care until a hospital emergency department bed becomes available. This study examined whether negative ramping experiences (verbal abuse, physical abuse, compromised patient care, and patient fatality) contribute to relatively high levels of depression, anxiety, stress, and posttraumatic stress disorder (PTSD) in paramedics. METHOD: Ninety Australian paramedics (Mage = 37.68, SD = 10.73; 52.2% male) completed an online survey. RESULTS: Path analysis found that negative ramping experiences were positively associated with symptoms of depression, anxiety, stress, and PTSD. Interactions indicated that negative ramping experiences predicted greater depression, stress, and PTSD among paramedics with higher, but not lower, work-related self-efficacy. All interactions with resilience were nonsignificant. CONCLUSIONS: These findings suggest that policymakers should aim to reduce ambulance ramping, and that future research could fruitfully investigate the mental health benefits of training programs that include strategies to minimize paramedics' feelings of powerlessness, frustration, and self-blame, during ramping. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Evaluation of the B-SAFE campaign to reduce clinically significant warfarin-drug interactions among fee-for-service Medicare beneficiaries.

The objective of this study was to evaluate the effectiveness of a health communication campaign designed to reduce the rate of serious warfarin-related drug interactions. The B-SAFE campaign was conducted in 2009 to educate patients located in a Michigan hospital's service area about the risk of serious adverse drug events associated with warfarin. The rate of warfarin-related drug interactions among Medicare fee-for-service (FFS) patients admitted to the exposed hospital with hemorrhagic complications was compared with the rate of warfarin-related drug interactions among a similar cohort admitted to a control hospital before and after the campaign. The χ(2) test and logistic regression were used to analyze differences. The authors observed a marginally significant decline in the rate of warfarin-related drug interactions (odds ratio [OR] = 0.66; 95% confidence interval [CI] = 0.33-1.29) among FFS Medicare patients admitted for bleeding complications to the hospital targeted by the B-SAFE campaign. The same association was not observed in the control hospital (OR = 1.15; CI = 0.42-3.14). These findings suggest that patient exposure to the B-SAFE campaign may have resulted in a decrease in the rate of clinically significant warfarin-related drug interactions.