- Email: [email protected]
Australian Triage Process Review project
S42 10. Cooper JG, West RM, Clamp SE, Hassan TB. Does computeraided clinical decision support improve the management of acute abdominal pain? A systematic review. Emerg Med J, in press. 11. Bennett M, for National Nursing & Nursing Education Taskforce. Priorities for nursing and midwifery research in Australia. http://www.nnnet.gov.au/downloads/rec8 m bennett priorities report.pdf; 2006 [retrieved 27.05.11]. 12. Currey J, Considine J, Khaw D. Clinical nurse research consultant: a clinical and academic role to advance practice and the discipline of nursing. J Adv Nurs, in press.
doi:10.1016/j.aenj.2011.09.103 Healing from the Dilly Bag: Lessons to be learned from traditional aboriginal spirituality and healing Bilawara Lee NT Medical Program, Australia The Healing from the Dilly Bag session will offer an opportunity for anyone involved in the medical and healing sector to discuss and explore how western medicine practitioners can work with traditional healers and their methods of spiritual healing. The presentation will set out ways of working with patients through healing the mind, body and spirit in a bicultural medical model, where the best in modern medicine together with what is best in traditional healing can only be better than either one alone. Participants will also have the opportunity to hear words of wisdoms on how to bring spirituality back into their lives. In a time of financial and professionally empowerment, the most important need for spiritual empowerment is often neglected or ignored. doi:10.1016/j.aenj.2011.09.104 Healing from the Dilly Bag Bilawara Lee Flinders NT Medical Program, Australia The Healing from the Dilly Bag session will show how Aboriginal people had their own medicines and healing practices before Europeans arrived and how many of the practices and beliefs continues today. The presentation will set out ways of working with patients through healing the mind, body and spirit in a bicultural medical model, where the best in modern medicine together with what is best in traditional healing can only be better than either one alone. doi:10.1016/j.aenj.2011.09.105 Casting workshop Cheryl Kimber Casting is a satisfying and rewarding skill, integral to the care of people with musculoskeletal injuries or disorders. Casts can quickly relieve pain and distress and make an immediate difference to an individual’s quality of life.
However, if incorrectly applied can dramatically change the outcome of a person’s condition, management and long term functional abilities. This workshop will provide the participants with basic knowledge and principles of casting using synthetic material for specific types of cast/slabs typically used in the emergency department or general practice environment.This study was sponsored by Smith & Nephew. doi:10.1016/j.aenj.2011.09.106 Australian Triage Process Review project Rachel Nash 1,2 1 Royal North Shore Hospital, St Leonards, Sydney 2065, Australia 2 Health Services Performance Improvement Branch, NSW Health, 73 Miller St., North Sydney 2059, Australia Keywords: Emergency Department; Triage; Complexity; Streaming; Education
E-mail address: [email protected]. Aim: The Australian Triage Process Review (ATPR) project reviewed the triage process in Australian Emergency Departments to understand: • Current triage practices and whether alternative triaging models/practices exist nationally and if they are in used in conjunction with, or in place of the ATS. • Streaming into ED models of care that allow for the safe and effective referral of patients to the right model of care within appropriate timeframes. • The need for complexity tools at triage. This progress report of the national review is presented on behalf of the ATPR Project Team which has been coordinated by NSW Health on behalf of the Health Policy Priorities Principal Committee. The recommendations are based on consultation activities, survey results of 87 EDs across Australasia, international literature review, observational studies and 16 ED site visits across Australia carried out as part of the project. Background: Health specialists and government organisations recognised the need to review current Australian triage processes and systems to assess whether practices continue to support the clinical prioritisation of patients, needs of the community, and management of patients presenting for emergency care, and whether the system supports service planning and resource management in ED. Australian EDs face ongoing challenges that affect service delivery and have led to a change in the triage process. Increasing interventions, at triage and in the waiting room, place additional pressure on the role of triage. With the introduction of new ED models of care and increasing patient complexity, there is a need to better understand what happens at triage and what opportunities are available to improve the patient experience. While the Australian Triage Scale was not the major focus of the project, it was inevitable that its role would be considered in a review of the triage process and the project would make recommendations to the Australasian College for Emergency Medicine for consideration in their review.
Abstracts This presentation describes the methodology used and the review’s findings. Outcomes: The key outcome of the ATPR project is a set of recommendations for the future development of triage processes that address the key challenges of: • • • • • • •
facilitation and support streamlining the triage role; streaming and complexity principles; triage education and competency; quality and performance monitoring; improving the patient experience; Australian Triage Scale review; future research opportunities.
doi:10.1016/j.aenj.2011.09.107 i-STAT 1 Analyser training options in the Point of Care environment Michael Ziaras E-mail address: [email protected]. The i-STAT 1 Analyser System offers a broad menu of tests for diagnostic and treatment indicators related to disease management and clinical practice guidelines. Using just two or three drops of blood, the system provides time sensitive tests at the patient bedside in just minutes. Our menu comprises blood gases, lactate, electrolyte and chemistry assays, coagulation, and cardiac markers. This workshop would be suitable for any nursing staff who are currently using Point of Care testing in their working environment; or would like to learn about more effective use of their i-STAT 1 Analyser. In this workshop, participants will learn about, and use, the various training options, which Abbott Point of Care Division make available to nursing staff, for training on the i-STAT 1 Analyser. These options include a web based eLearning Tutorial, suitable for initial overview training; as well as ongoing refresher training on the analyser and assay cartridges. APOC also have Basic Operator and Advanced Operator training guides, available in soft and hard copy; both of which incorporate a hands on approach to training. The workshop will also feature best practice techniques used while running our wide range of assay cartridges; and discuss suitable sample types for these assays. doi:10.1016/j.aenj.2011.09.108 When the crime scene moves to the ED: Caring for the victimized patient Daniel J. Sheridan E-mail address: Sher0126@flinders.edu.au. Every day in accident and emergency departments (EDs) throughout Australasia, patients present to the ED with injuries received as victims of crime or received during the perpetration of a crime. Often in our haste to provide emergency trauma nursing care, we wash away, throw away, or flush away any hope of a successful criminal prosecution. Very few nurses are trained in school or trained on the job the basics of appropriate evidence collection. Every time a victimized presents to the ED, either via ambulance or at the triage desk, the crime scene has also traveled to the
S43 ED. On and many times, in the patient is valuable trace evidence that can and should be collected by the ED nurse while also providing specialized ED nursing care. This session will provide an overview of the principles of evidence collection and preservation and nursing documentation in the medical record. Case histories will be used throughout the presentation. In addition, the presenter will discuss the rapid expansion of ED-based, nurse-run, forensic programs in the United States that provide specialized ED nursing care to patients reporting sexual assault, family and domestic violence and elder abuse. The presenter, Daniel J. Sheridan, PhD, RN, FNE-A, SANEA, FAAN has been an ED/trauma nurse since 1982 and a 28-year member of America’s Emergency Nursing Association. He is a past President of the International Association of Forensic Nurses and an Associate Professor at the Johns Hopkins University School of Nursing in Baltimore, Maryland, USA. In the States, Professor Sheridan is a nationally certified Sexual Assault Nurse Examiner and maintains an active ED practice of conducting forensic nursing examinations on patients reporting sexual assault and domestic violence. Professor Sheridan has over 30 publications on the role of nurses working with victimized patients and has given over 600 invited lectures on forensic nursing topics all over the world. Since February 2011, Professor Sheridan has been a Visiting Scholar at the Flinders University School of Nursing & Midwifery creating a Continuing Professional Development course entitled, ‘‘Fundamentals of Forensic Healthcare: An Online Short Course’’ targeting ED nurses. doi:10.1016/j.aenj.2011.09.109 The role of the coroner Mark Johns E-mail address: [email protected]. Mr Johns will discuss the role of the coroner, the relevant legislation, the nature of an inquest, what factors a coroner might consider in assessing a witness, the nature of evidence in an inquest. Mr Johns will be happy to take questions. doi:10.1016/j.aenj.2011.09.110 Transforming healthcare: Action into safety and satisfaction Mary Salisbury E-mail address: [email protected]. This pithy presentation provides the journey and evidence-base underpinning the critical success factors known to strengthen and ensure the work of high performing, highly reliable, self correcting, self improving teams; team equipped to solve their most critical and difficult problems; to move action into safety and satisfaction for patient and provider alike. doi:10.1016/j.aenj.2011.09.111
doi:10.1016/j.aenj.2011.09.103 Healing from the Dilly Bag: Lessons to be learned from traditional aboriginal spirituality and healing Bilawara Lee NT Medical Program, Australia The Healing from the Dilly Bag session will offer an opportunity for anyone involved in the medical and healing sector to discuss and explore how western medicine practitioners can work with traditional healers and their methods of spiritual healing. The presentation will set out ways of working with patients through healing the mind, body and spirit in a bicultural medical model, where the best in modern medicine together with what is best in traditional healing can only be better than either one alone. Participants will also have the opportunity to hear words of wisdoms on how to bring spirituality back into their lives. In a time of financial and professionally empowerment, the most important need for spiritual empowerment is often neglected or ignored. doi:10.1016/j.aenj.2011.09.104 Healing from the Dilly Bag Bilawara Lee Flinders NT Medical Program, Australia The Healing from the Dilly Bag session will show how Aboriginal people had their own medicines and healing practices before Europeans arrived and how many of the practices and beliefs continues today. The presentation will set out ways of working with patients through healing the mind, body and spirit in a bicultural medical model, where the best in modern medicine together with what is best in traditional healing can only be better than either one alone. doi:10.1016/j.aenj.2011.09.105 Casting workshop Cheryl Kimber Casting is a satisfying and rewarding skill, integral to the care of people with musculoskeletal injuries or disorders. Casts can quickly relieve pain and distress and make an immediate difference to an individual’s quality of life.
However, if incorrectly applied can dramatically change the outcome of a person’s condition, management and long term functional abilities. This workshop will provide the participants with basic knowledge and principles of casting using synthetic material for specific types of cast/slabs typically used in the emergency department or general practice environment.This study was sponsored by Smith & Nephew. doi:10.1016/j.aenj.2011.09.106 Australian Triage Process Review project Rachel Nash 1,2 1 Royal North Shore Hospital, St Leonards, Sydney 2065, Australia 2 Health Services Performance Improvement Branch, NSW Health, 73 Miller St., North Sydney 2059, Australia Keywords: Emergency Department; Triage; Complexity; Streaming; Education
E-mail address: [email protected]. Aim: The Australian Triage Process Review (ATPR) project reviewed the triage process in Australian Emergency Departments to understand: • Current triage practices and whether alternative triaging models/practices exist nationally and if they are in used in conjunction with, or in place of the ATS. • Streaming into ED models of care that allow for the safe and effective referral of patients to the right model of care within appropriate timeframes. • The need for complexity tools at triage. This progress report of the national review is presented on behalf of the ATPR Project Team which has been coordinated by NSW Health on behalf of the Health Policy Priorities Principal Committee. The recommendations are based on consultation activities, survey results of 87 EDs across Australasia, international literature review, observational studies and 16 ED site visits across Australia carried out as part of the project. Background: Health specialists and government organisations recognised the need to review current Australian triage processes and systems to assess whether practices continue to support the clinical prioritisation of patients, needs of the community, and management of patients presenting for emergency care, and whether the system supports service planning and resource management in ED. Australian EDs face ongoing challenges that affect service delivery and have led to a change in the triage process. Increasing interventions, at triage and in the waiting room, place additional pressure on the role of triage. With the introduction of new ED models of care and increasing patient complexity, there is a need to better understand what happens at triage and what opportunities are available to improve the patient experience. While the Australian Triage Scale was not the major focus of the project, it was inevitable that its role would be considered in a review of the triage process and the project would make recommendations to the Australasian College for Emergency Medicine for consideration in their review.
Abstracts This presentation describes the methodology used and the review’s findings. Outcomes: The key outcome of the ATPR project is a set of recommendations for the future development of triage processes that address the key challenges of: • • • • • • •
facilitation and support streamlining the triage role; streaming and complexity principles; triage education and competency; quality and performance monitoring; improving the patient experience; Australian Triage Scale review; future research opportunities.
doi:10.1016/j.aenj.2011.09.107 i-STAT 1 Analyser training options in the Point of Care environment Michael Ziaras E-mail address: [email protected]. The i-STAT 1 Analyser System offers a broad menu of tests for diagnostic and treatment indicators related to disease management and clinical practice guidelines. Using just two or three drops of blood, the system provides time sensitive tests at the patient bedside in just minutes. Our menu comprises blood gases, lactate, electrolyte and chemistry assays, coagulation, and cardiac markers. This workshop would be suitable for any nursing staff who are currently using Point of Care testing in their working environment; or would like to learn about more effective use of their i-STAT 1 Analyser. In this workshop, participants will learn about, and use, the various training options, which Abbott Point of Care Division make available to nursing staff, for training on the i-STAT 1 Analyser. These options include a web based eLearning Tutorial, suitable for initial overview training; as well as ongoing refresher training on the analyser and assay cartridges. APOC also have Basic Operator and Advanced Operator training guides, available in soft and hard copy; both of which incorporate a hands on approach to training. The workshop will also feature best practice techniques used while running our wide range of assay cartridges; and discuss suitable sample types for these assays. doi:10.1016/j.aenj.2011.09.108 When the crime scene moves to the ED: Caring for the victimized patient Daniel J. Sheridan E-mail address: Sher0126@flinders.edu.au. Every day in accident and emergency departments (EDs) throughout Australasia, patients present to the ED with injuries received as victims of crime or received during the perpetration of a crime. Often in our haste to provide emergency trauma nursing care, we wash away, throw away, or flush away any hope of a successful criminal prosecution. Very few nurses are trained in school or trained on the job the basics of appropriate evidence collection. Every time a victimized presents to the ED, either via ambulance or at the triage desk, the crime scene has also traveled to the
S43 ED. On and many times, in the patient is valuable trace evidence that can and should be collected by the ED nurse while also providing specialized ED nursing care. This session will provide an overview of the principles of evidence collection and preservation and nursing documentation in the medical record. Case histories will be used throughout the presentation. In addition, the presenter will discuss the rapid expansion of ED-based, nurse-run, forensic programs in the United States that provide specialized ED nursing care to patients reporting sexual assault, family and domestic violence and elder abuse. The presenter, Daniel J. Sheridan, PhD, RN, FNE-A, SANEA, FAAN has been an ED/trauma nurse since 1982 and a 28-year member of America’s Emergency Nursing Association. He is a past President of the International Association of Forensic Nurses and an Associate Professor at the Johns Hopkins University School of Nursing in Baltimore, Maryland, USA. In the States, Professor Sheridan is a nationally certified Sexual Assault Nurse Examiner and maintains an active ED practice of conducting forensic nursing examinations on patients reporting sexual assault and domestic violence. Professor Sheridan has over 30 publications on the role of nurses working with victimized patients and has given over 600 invited lectures on forensic nursing topics all over the world. Since February 2011, Professor Sheridan has been a Visiting Scholar at the Flinders University School of Nursing & Midwifery creating a Continuing Professional Development course entitled, ‘‘Fundamentals of Forensic Healthcare: An Online Short Course’’ targeting ED nurses. doi:10.1016/j.aenj.2011.09.109 The role of the coroner Mark Johns E-mail address: [email protected]. Mr Johns will discuss the role of the coroner, the relevant legislation, the nature of an inquest, what factors a coroner might consider in assessing a witness, the nature of evidence in an inquest. Mr Johns will be happy to take questions. doi:10.1016/j.aenj.2011.09.110 Transforming healthcare: Action into safety and satisfaction Mary Salisbury E-mail address: [email protected]. This pithy presentation provides the journey and evidence-base underpinning the critical success factors known to strengthen and ensure the work of high performing, highly reliable, self correcting, self improving teams; team equipped to solve their most critical and difficult problems; to move action into safety and satisfaction for patient and provider alike. doi:10.1016/j.aenj.2011.09.111