Professional capabilities for registered paramedics

1. Practise in an ethical and professional manner, consistent with relevant legislation and regulatory requirements

• Demonstrate understanding of legal responsibilities and the legal and ethical boundaries of paramedicine practice
• manage personal, mental and physical health to ensure fitness to practice
• follow mandatory and voluntary reporting obligations
• apply the Paramedicine Board of Australia’s Code of conduct to their practice
• provide relevant information to patient/service user and demonstrate appropriate methods to obtain informed consent
• demonstrate knowledge of the Australian healthcare system
• demonstrate understanding of the basic principles underpinning bio-ethics within paramedicine practice
• exercise appropriate levels of autonomy and professional judgement in a variety of paramedicine practice settings

2. Provide each patient/service user with an appropriate level of dignity and care

• Demonstrate understanding of the influence of socio-cultural factors on patient/service user attitudes and behaviour
• display appropriate professional behaviour in patient/service user interactions
• identify and respect appropriate boundaries between patients/service users and health professionals, and
• assess each situation, determine the nature and severity of the problem and apply the required knowledge and experience to provide a response that is in the best interest of the patient/s.

Socio-cultural factors may include those related to cultural and linguistic diversity, age, gender, disability, socio-economic, geographic locations; and identifying as Aboriginal and/or Torres Strait Islander.

Appropriate professional behaviour must include behaviour that:

• respects socio-cultural difference, is empathetic and non-discriminatory, regardless of individuals or groups race, culture, religion, age, gender, sexual preference, physical or mental state, and
• respects, and so far as possible upholds the rights, dignity, values and autonomy of every patient/service user. This includes their role in the diagnostic and therapeutic process and in maintaining health and wellbeing.

3. Assume responsibility, and accept accountability, for professional decisions

• Recognise and respond appropriately to unsafe or unprofessional practice
• integrate organisational directives, policies, procedures and guidelines with professional standards, and
• apply relevant quality frameworks to practice.

4. Advocate on behalf of the patient/service user, when appropriate within the context of the practitioner’s practice as a paramedic

• Demonstrate understanding of the principles of patient/service user advocacy and their application to paramedicine practice, and
• recognise when it may be appropriate to intervene on the patient’s/service user’s behalf

1. Communicate clearly, sensitively and effectively with patient/service user and their family or carers

• Establish rapport with patient/service user to gain understanding of their issues and perspectives, and to encourage their active participation in care and treatment

• communicate with the patient/service user and/or carers to collect and convey information and reach agreement about the purpose of any care and treatment  

• convey knowledge and procedural information in ways that engender trust and confidence and respects patient/service user confidentiality, privacy and dignity

• respond appropriately to patient/service user queries or issues

• use appropriate communication skills to effectively manage avoidance, confusion and confrontation

• identify and effectively manage likely communication barriers, including anxiety and stress, specific to individual patients/service users and/or carers

• make appropriate adjustments to communication style to suit the particular needs of the patient/service user including those from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander people, and

• make provisions to engage third parties, including interpreters, to facilitate effective communication with patients/service users whose first language is not English, wherever possible.

Communication needs may be influenced by English language skills, health literacy, age, health status, culture.

Appropriate adjustments may include the paramedic demonstrating an awareness of the ways that their own culture and experience affect their interpersonal style, and having an awareness of strategies to ensure this does not present an impediment.

Communication techniques must include active listening, use of appropriate language and detail, use of appropriate verbal and non-verbal cues and language, and confirming that the other person has understood.

2. Collaborate with other health practitioners

• Establish and maintain effective and respectful collaborative working relationships as a member of a healthcare team
• demonstrate understanding of professional roles and responsibilities of healthcare team members and other service providers and how they interact with the role of a paramedic
• follow accepted protocols and procedures to provide relevant and timely verbal and written communication
• effectively supervise tasks delegated to other healthcare team members
• consult effectively with relevant healthcare team members and other service providers to facilitate continuity of care, and
• make appropriate referrals to other healthcare team members and other service providers.

Healthcare team members may include registered health practitioners, accredited health professionals, and licensed or unlicensed healthcare workers.

1. Makes informed and reasonable decisions

• Operate within a framework of making informed, evidence-based, reasonable and professional judgements about their practice, with acting in the best interests of their patients as their primary concern, and
• make sensible, practical decisions about their practice, taking account of all relevant information and the best interests of the people who use or are affected by the service that is being provided.

2. Uses clinical reasoning and problem-solving skills to determine clinical judgements and appropriate actions

• Apply critical and reflective thinking to resolve clinical challenges
• demonstrate a logical and systematic approach to problem solving and situation analysis
• analyse and critically evaluate the information collected to make clinical judgments
• recognise that clinical judgements involve consideration of conflicting information and evidence
• formulate a diagnosis informed by the patient assessment and analysis of context and situation, and
• identify the time criticality of treatment and transport.

Critical thinking may include skills in questioning, analysing, synthesising, interpreting, and cognitive reasoning, and the critical appraisal of literature and evidence.

Reflective practice may include self-reflection during and after a clinical challenge or experience. It may involve structured and informal reflection to review and integrate knowledge and findings into practice.

3. Draws on appropriate knowledge and skills in order to make professional judgements

• Select or modify approaches to meet the needs of patients, their relatives and carers, when presented in emergency and urgent situations
• change their practice as needed to take account of new developments, and
• demonstrate a level of skill in the use of information technology appropriate to their practice.

4. Identify ongoing professional learning, development needs and opportunities

• Demonstrate understanding of legal and professional responsibilities to undertake continuing professional development (CPD)
• critically reflect on personal strengths and limitations to identify learning and development required to improve and adapt professional practice
• seek input from others to confirm professional learning and development needs
• plan and implement steps to address professional learning and development needs, and
• maintain records of involvement in both formal and informal professional learning and development activities.

1. Protect and enhance patient/service user safety

• Follow patient/service user identification procedures to confirm the correct match of patient/service user with intended procedure, care and/or treatment
• identify and manage risks associated with patient/service user transfers, and
• identify and manage risk of infection, including during aseptic procedures.

Patient/service user identification procedures must use at least three recognised patient/service user identifiers, and may include procedures for transferring patients/service users from other health professionals. Procedures may be contained in workplace materials, relevant jurisdictions’ materials and the Australian Commission on Safety and Quality in Health Care publications.

Infection control risk management: The registered paramedic must demonstrate understanding of transmission modes of hospital-acquired infections (host, agent and environment); established practices for preventing the transmission including effective hand hygiene; and ability to implement NHMRC infection prevention and control guidelines.

2. Maintain safety of self and others in the work environment

• Demonstrate knowledge of legal responsibilities for health and safety of self and others
• identify safety hazards in the workplace and apply knowledge of responsibilities for notification, and
• use appropriate personal protective clothing and equipment.

Responsibilities for notification of safety hazards may include protocols or instructions, legislation and regulations.

3. Operates effectively within a mobile environment

• Respond to urgent and non-urgent requests for assistance in a low risk manner in accordance with relevant road safety legislation, organisational directives, policies, procedures and guidelines
• utilise appropriate transport platforms taking into account clinical need, time criticality and environmental considerations, and
• cooperate with and utilise the support of other emergency service and rescue organisations to facilitate patient access/egress/extrication in the most effective manner.

4. Maintains records appropriately

• Record information systematically in an accessible and retrievable form
• keep accurate, comprehensive, logical, legible and concise records
• use only accepted terminology in completing patient care records, and
• review, communicate, record and manage patient/service user information accurately, consistent with protocols, procedures and legislative requirements for maintaining patient/service user records.

5. Monitors and reviews the ongoing effectiveness of their practice and modifies it accordingly

• Monitor and evaluate the quality of practice and the value of contributing to the generation of data for quality assurance and improvement programs 
• consider feedback from colleagues and critically reflect on their own paramedicine practice, and 
• make reasoned decisions to initiate, continue, modify or cease care or treatment, or the use of techniques or procedures, and record the decisions and reasoning appropriately.

6. Audits, reflects on and reviews practice

• Demonstrate the principles, application and need for quality control and quality assurance in paramedicine practice 
• demonstrate an awareness of the role of audit and review in quality management, including quality control, quality assurance and the use of appropriate outcome measures 
• maintain an effective audit trail and work towards continual improvement 
• participate in quality assurance programs, where appropriate or required
• reflect on practice and the application of such reflection to their future practice, and
• participate in case conferences and other methods of review.

1. Use patient information management systems appropriately

• Demonstrate knowledge of patient information management systems, and
• ensure correct verification and management of information.

2. Assess and monitor the patient/service user’s capacity to receive care

• Identify factors or conditions that may affect the patient/service user’s behaviour and/or capacity to undergo the procedure
• identify patients/service users most at risk; including pregnant women and the fetus; breast feeding mothers and their children
• identify contraindications and limitations arising from the patient/service user’s capacity to receive care; determine appropriate adjustments to procedures; and, where appropriate, communicate these to the patient/service user
• perform patient/service user assessment and interventions in accordance with legislation, registration standards, codes and guidelines, including gaining informed consent, and
• identify and respond to a patient/service user’s deteriorating condition, or inability to undergo a procedure or treatment, consistent with duty of care and statutory requirements.

Patient/service user’s capacity or behaviour may include pre-existing medical and/or physical and physiological conditions, age, pregnancy, psycho-social, socio-economic, culture, English language skills.

3. Understands the key concepts of the bodies of knowledge which are specifically relevant to paramedicine practice

• Understand the structure, function and pathophysiology of the human body, relevant to their practice, together with knowledge of health, human growth and development, disease, disorder and dysfunction 
• understand the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process 
• understand the theoretical basis of and the variety of approaches to assessment and intervention
• demonstrate applied knowledge of human anatomy and physiology sufficient to understand the nature and effects of injury or illness and to conduct assessment and observation in order to establish patient/service user management strategies
• understand psychological and social factors that influence an individual in health and illness, and
• understand the clinical sciences underpinning paramedic practice, including physiological, pharmacological, behavioural and functional.

4. Conducts appropriate diagnostic or monitoring procedures, treatment, therapy or other actions safely

• Maintain the safety of patients/service users and those involved in their care
• position for safe and effective interventions
• demonstrate applied knowledge of the indications and contra-indications of using specific paramedic interventions including their modifications, and
• modify and adapt practice appropriate to the emergency environment.

5. Demonstrates the requisite knowledge and skills to participate in mass casualty or major Incident situations

• Demonstrate an understanding of the public health model for response to major incidents
• demonstrate applied knowledge of emergency medicine for a mass casualty/major incident event, and
• maintain currency with organisational directives, policies, procedures and guidelines relating to the major incidents.

6. Formulates specific and appropriate patient/service user care and treatment actions

• Adapt practice to meet the needs of different groups distinguished by, for example, physical, psychological, environmental, cultural or socio-economic factors within their authorised scope of practice
• demonstrate sensitivity to the factors which shape lifestyle that may impact on the individual’s health and affect the interaction between the patient/service user and registered paramedic
• utilise knowledge, reasoning and problem-solving skills to determine appropriate judgements and actions, and
• prioritise the care provided to optimise safety and health outcomes for the patient and demonstrate a logical and systematic approach to problem solving.