Recruiting for family presence in CPR

Giles, T.M., de Lacey, S.L. and Muir-Cochrane, E.C. (2015). Coding, constant comparisons and core categories: a worked example for novice constructivist grounded theorists. Advances in Nursing Science,

 

Giles, T., King, L. and De Lacey, S. (2013). The timing of the literature review in grounded theory research: An open mind versus an empty head. Advances in Nursing Science, 36(2) pp. E29-E40.
[10.1097/ANS.0b013e3182902035] [Scopus]

International Emergency Nurses Day

Wednesday 14th October is International Emergency Nurses Day.

The 13th International Conference for Emergency Nurses was held in Brisbane this month. At the conference a number of nurses and emergency departments were acknowledged for their exceptional contribution to emergency care.

  • Emergency Department of the Year: Dandenong Emergency Department, Victoria
  • Emergency Nurse of the Year: Sarah Cornish, Clinical Nurse Educator, Western Health, Victoria
  • Julie Finucane OAM Medal for Leadership in Emergency Nursing: Di Crellin, Nurse Practitioner, Royal Children’s Hospital, Victoria.

The College of Emergency Nursing Australasia (CENA) would like to acknowledge the work of all emergency nurses who dedicate their professional lives to caring for people during times of emergent injury and illness.

Mr Shane Lenson, Executive Director of CENA said that “at hospitals throughout Australasia, nurses are involved in the emergency care of people. Additionally, emergency nurses assist in the care of people in many other contexts such as rural and remote environments. Emergency nurses are an integral part of the overall health service.”

Mr Lenson states “Emergency nursing is a unique and specialised area of clinical practice. The Australian emergency care population comprises people from all age groups, socioeconomic and cultural backgrounds. Emergency nurses provide care of patients which ranges from minimal intervention to life saving, advanced life support.”

Further information:

Mr Jamie Ranse, Associate Executive Director, CENA,

e-mail: national@cena.org.au

Study of Occupational Violence in Australian Emergency Departments

CENA members were invited to participate in a study titled: Study of Occupational Violence in Australian Emergency Departments. The research group have completed the study, highlighting the key aims, findings and project outcomes in the report. The research team at Monash would like to sincerely thank the CENA Board, the Research Committee and the members for their time and valuable input.

You can download a copy of the report  here.

 

The Care of Patients with Advanced Cancer in the Emergency Department

The project has provided useful insights on the perspectives of health professionals involved in the care of people with advanced cancer who present to the emergency department (ED). Our qualitative and quantitative data provided a wealth of rich information which enhanced our understanding of the complex issues that clinicians face when caring for this patient group. Problems with interdisciplinary communication and opportunities for enhanced communication between the patient, caregivers and health professionals has been a major theme, as well as environmental barriers and enablers for care of these patients in the ED. Health professionals have differing and sometimes inaccurate understandings of what palliative care (PC) encompasses and are not always cognisant of the potential benefits, or indeed when referral opportunities may arise. Participants reported many barriers to caring for this vulnerable patient group regarding the ED environment, including lack of space, privacy and staff. Numerous improvements have been suggested by respondents, which may improve care for this patient cohort. A series of manuscripts detailing these findings are currently in different phases of preparation for publication in peer reviewed scientific journals. Communications of recommendations from this project are being disseminated to the field through meetings, presentations to clinicians and newsletters. Given the importance of this research and the momentum that we have gained, this multidisciplinary team has successfully applied for funding from The Victorian Comprehensive Cancer Centre to explore the experience of patients with cancer that have presented to an ED. This will provide an additional valuable dimension to the research already undertaken.

Publications:

Care of the dying patient in the emergency department: findings from a national survey of Australian emergency department clinicians.
Marck CH, Weil J, Lane H, Weiland TJ, Philip J, Boughey M, Jelinek GA.
Intern Med J

http://onlinelibrary.wiley.com/doi/10.1111/imj.12379/abstract

Caught in the middle: Tensions around the emergency department care of people with advanced cancer.
Jelinek GA, Marck CH, Weiland TJ, Philip J, Boughey M, Weil J, Lane H.
Emerg Med Australia 2013;25(2):154-160

http://onlinelibrary.wiley.com/doi/10.1111/1742-6723.12047/abstract

Ideal care and the realities of practice: interdisciplinary relationships in the management of advanced cancer patients in the emergency department. Supportive Care and Cancer
Lane H, Weil J, Jelinek GA, Boughey M, Marck CH, Weiland TJ, Haydon A, Philip J.

http://rd.springer.com/article/10.1007%2Fs00520-013-2054-6

NET Trial Summary and Progress

The Neurotrauma Evidence Translation trial is devoted to developing and trialling a consistent approach to the management of patients with mild TBI in Australian Emergency Departments (EDs). We have completed and published an extensive review of all published guidelines in this area and from this, developed a list of treatment recommendations for the ED management of mild TBI (Tavender 2011). We have also completed one-on-one interviews with ED staff and an audit of practice in two Victorian hospitals to gain a picture of how this environment functions (Tavender 2014). Using the information from our recommendations and the results of the interviews we have designed a strategy for optimising the ED management of mild TBI. A cluster randomised trial has been designed to test this strategy.

The trial has completed recruitment and ethics approval has been finalised for all participating sites. In total 31 emergency departments from around Australia have agreed to participate. All sites have been randomised and roll out of the trial commenced in late June 2014. The results of the trial will not be known until 2015.

http://www.trialsjournal.com/content/15/1/281/abstract

Publications:

Emma J Tavender, MSc; Marije Bosch, PhD, MSc; Sally Green, PhD; Denise O’Connor, PhD; Veronica Pitt, PhD, MSc; Kate Phillips; Peter Bragge, PhD and Russell L Gruen, MBBS, PhD.
Quality and Consistency of Guidelines for the Management of Mild Traumatic Brain Injury in the Emergency Department

Click for more information

Emma J Tavender, Marije Bosch, Russell L Gruen, Sally E Green, Jonathan Knott, Jill J Francis, Susan Michie and Denise A O’Connor.
Understanding Practice: the factors that influence management of mild traumatic brain injury in the emergency department – a qualitative study using the Theoretical Domains Framework

Click for more information

Sally E Green, Marije Bosch, Joanne E McKenzie, Denise A O’Connor, Emma J Tavender, Peter Bragge, Marisa Chau, Veronica Pitt, Jeffrey V Rosenfeld and Russell L Gruen.
Improving the care of people with traumatic brain injury through the Neurotrauma Evidence Translation (NET) program: protocol for a program of research

Click for more information

 

Treat us equally: South Australians with mental illness getting a raw deal

The Royal Australian and New Zealand College of Psychiatrists (RANZCP), the Australasian College for Emergency Medicine (ACEM), and the College of Emergency Nursing Australasia(CENA) have joined together to highlight the plight of Mental Health patients left stranded in Adelaide’s Emergency Departments (EDs).

Every day, doctors and nurses represented by the three Colleges, are appalled by waits for acute mental health beds: leaving patients languishing in EDs for days. Even for the sickest group of patients, those needing Psychiatric Intensive Care Unit beds, waiting for 4 days is common.

“Lengthy ED stays are not tolerated for patients with severe physical illnesses, and should not be tolerated for acutely ill mental health patients who deserve equitable access to hospital beds. This is discriminatory,” RANZCP South Australian Branch Chair Dr Michelle Atchison says.

The chair of the Emergency Psychiatry Advocacy Group, Dr Megan Brooks says: “EDs are designed for the rapid assessment of patients. They are not somewhere that anyone would wish to stay for days on end. In an ED, acutely disturbed mental health patients are subjected to continuous noise and light, constant scrutiny by a guard, and share a toilet and shower with 20-30 other patients. Fundamentally, there is no basic human dignity or privacy. In this completely non-therapeutic environment: physical and pharmacological restraint is often required.

“SA Health mandate that patients with physical illness should move out of the ED to a ward bed within 4 hours. Why is it acceptable that Mental Health patients wait 4 or 5 days?”

College of Emergency Nursing Australasia SA Branch President, Ms Karen Hammad, says the prolonged presence of these very unwell mental health patients places additional strain on already overcrowded EDs and further reduces the ability of the nurses and doctors in EDs to care for all their patients.”

When compared to all other Australian states SA has the lowest number of acute MH beds per head of population for those aged 18-65.

To meet the national average SA requires a further 43 acute beds for patients aged 18-65.

For media queries contact:

Christine Gounder christine.gounder@ranzcp.org or +61 3 9601 4940

Emergency nursing care provided despite problems with Emergency Department access

There has been considerable media attention given to the difficulties of providing care to
patients in overcrowded emergency departments. In particular, concerns have been raised
regarding the increased demands for emergency care services resulting in ambulance
patients being transferred to trolleys in emergency department corridors and perceptions
about the care that they then receive.

The College of Emergency Nursing Australasia (CENA) deems that caring for patients on
trolleys in emergency department corridors and in unapproved treatment spaces is
unacceptable. Hospitals and health services should view the inability to allocate a patient to
staffed, equipped treatment spaces within the emergency department as a serious adverse
event.

CENA reassures the public that specialist emergency nurses assess every patient who
attends the emergency department through the triage process, and that emergency nurses
provide assessment and care to all patients, irrespective of their location within the
emergency department.

“Emergency nurses are committed to providing safe and high quality emergency care, and
typically do so in challenging working conditions. Equity of access to emergency care is
fundamental to emergency nursing. Nursing resources are distributed according to patient
needs, not where the patient happens to be physically located within the emergency
department” said CENA Executive Director, Lee Trenning. “The College and its members
work collaboratively with our medical and paramedic peers to facilitate appropriate care for
patients presenting to emergency department by ambulance, including those patients for
who there is a delay in accessing the emergency department”.

CENA encourages the public to continue to lobby Governments for timely access to
emergency care and for an integrated health system where ambulance, emergency and
inpatient services can provide the best possible care to the communities that they serve

National Health Performance Authority Update Report on Time in Emergency Departments.

The College of Emergency Nursing Australasia (CENA) is pleased to acknowledge the publication of
the National Health Performance Authority’s Update Report Time patients spent in emergency
departments in 2012 and 2013(1).

The Report tracks hospital performance for the percentage of patients leaving emergency
departments within four hours of arrival (known as the National Emergency Access Target). The
findings in the Report reveal there has been marked improvement in the percentage of patients
departing emergency departments within four hours, particularly in major metropolitan hospitals,
and to a lesser extent in major regional hospitals.

The National Emergency Access Target was established in 2011 under the National Partnership
Agreement on Improving Public Hospital Services2. Individual annual targets were established for
each state and territory with a final target of 90 per cent to be achieved by 2015. The College
supports the implementation of the target, as outlined in the Position Statement on the National
Emergency Access Target(3).

CENA congratulates all clinicians contributing to the reform and redesign efforts necessary to
achieve the improvements in access to care through emergency departments. “The improvement in
timely access to emergency departments requires engagement at all levels to achieve change across
the health system and it is positive to see the achievements in many Australian public hospitals” said
CENA Executive Director, Lee Trenning

“However, the College is concerned that the removal of reward funding associated with National
Emergency Access Target, announced earlier this month by the Australian Government in the 2014
Budget, will create a disincentive to further improvement in this area” said Lee Trenning.

Without the resources and incentives allocated to these health reforms, health services will struggle
to meet the growing demand for emergency department services. Meeting this need requires a
focus on improving patient care, through advancing models of care and streamlining the delivery of
timely emergency care.

The College of Emergency Nursing Australasia (CENA) is the peak professional association representing emergency nurses across
Australasia. CENA represents nurses from small regional and rural hospitals through to large metropolitan emergency departments.
CENA urges the Minister for Health Peter Dutton to meet with representatives from CENA and other
professional bodies to discuss ways to lead sustained improvements in access to emergency
departments and acute care.

(1) www.nhpa.gov.au
(2) http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/npa-improvingpublichospitalsagreement/$File/National%20Partnership%20Agreement%20on%20Improving%20Public%20Hospital%20Services.pdf
(3) http://cena.org.au/CENA_Mer/Resources/Position_Statements/CENA_Mer/Resources/Position_Statements.aspx?hkey=54413819-e458-4a2d-942a-7ff17571366fCollege of Emergency Nursing Australasia

ENDS

Released: 29 May 2014
Contact: Lee Trenning
Executive Director- College of Emergency Nursing Australasia
College of Emergency Nursing Australasia
Email: national@cena.org.au
Web: www.cena.org.au
Tel: +61 03 9895 4433

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