The care of patients with advanced cancer in the emergency department – exploring opportunities to improve care

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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,


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.


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

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

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.

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.


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

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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

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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

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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 or +61 3 9601 4940