New competency framework for emergency nurses.

A competency framework for emergency nurses and those wanting a career in the role has been launched in an effort to aid recruitment and retention.

How nurses are preparing for the revalidation process.

As the profession's new system of revalidation goes live, this article brings together the experiences of emergency nurses from revalidation pilot sites in England, Scotland, Wales and Northern Ireland. A total of 19 sites across the UK, including hospital trusts, tested the process between 2014 and 2015. This gave these trusts the opportunity to prepare their staff and help them to get revalidation ready ahead of the official roll-out. This article aims to help nurses working in emergency departments better understand the process and offers tips for dealing with process issues which are pertinent to them.

Patient safety fears follow staffing guideline decision.

A DECISION to halt development of a guideline for safe nurse staffing in urgent and emergency care settings could have major implications for services this winter, experts have warned.

The trauma report nurse: a trauma triage process improvement project.

INTRODUCTION: Accurate trauma triage is imperative to facilitate appropriate resource mobilization for severely injured trauma patients. A critical window of opportunity exists to prevent secondary injury or death. Timely assessment with a multidisciplinary trauma team is essential to facilitate rapid diagnosis and treatment. However, consistent and accurate trauma triage proved daunting at our institution, resulting in instances of undertriage. METHODS: A process improvement strategy aimed at improving trauma triage accuracy was implemented. An innovative role, the trauma report nurse (TRN), was created and became the trauma nurse expert. The TRN was responsible for assigning a trauma triage level to all incoming adult and pediatric trauma patients. In parallel, improvements were made to the prehospital report format, increasing standardization and clarifying hand-off verbiage. RESULTS: Undertriage rates dropped from 14% to 4.8%. Qualitative data demonstrated acceptance and support of the TRN role among physicians, nurses and nursing and ancillary staff. DISCUSSION: Designating trauma triage to an ED registered nurse proved to reduce undertriage rates. By providing staff education, infrastructure improvements, and leadership support, the role continues to thrive, resulting in improved care for severely injured trauma patients.

Designing a standardised emergency nurse career pathway for use across rural, regional and metropolitan New South Wales, Australia: A consensus process.

BACKGROUND: Emergency nurses are the first clinicians to see patients in the ED; their practice is fundamental to patient safety. To reduce clinical variation and increase the safety and quality of emergency nursing care, we developed a standardised consensus-based emergency nurse career pathway for use across Australian rural, regional, and metropolitan New South Wales (NSW) emergency departments. METHODS: An analysis of career pathways from six health services, the College for Emergency Nursing Australasia, and NSW Ministry of Health was conducted. Using a consensus process, a 15-member expert panel developed the pathway and determined the education needs for pathway progression over six face-to-face meetings from May to August 2023. RESULTS: An eight-step pathway outlining nurse progression through models of care related to different ED clinical areas with a minimum 172 h protected face-to-face and 8 h online education is required to progress from novice to expert. Progression corresponds with increasing levels of complexity, decision making and clinical skills, aligned with Benner's novice to expert theory. CONCLUSION: A standardised career pathway with minimum 180 h would enable a consistent approach to emergency nursing training and enable nurses to work to their full scope of practice. This will facilitate transferability of emergency nursing skills across jurisdictions.

Can emergency nurses' triage skills be improved by online learning? Results of an experiment.

INTRODUCTION: Emergency nurses deal with increasing complexity of patients. In 2003 there were over 14 million ED visits in Canada. The Canadian Triage and Acuity Scale (CTAS) is a 5-level system used by ED triage nurses to classify patients. There is a need for standardized training for all triage systems. In an effort to improve access to CTAS training, a 6-week Web-based CTAS workshop was developed. We determined the impact of Web learning on the accuracy of the triage skills of registered nurses (RNs). METHODS: An experimental method was used in which 132 RNs were randomized to an intervention group (n = 65) or control group (n = 67). All RNs received exactly the same content and learning activities. The experimental group differed from the control group in 3 ways: a mandatory tutorial, awarding of marks for online discussion, and completion of a workplace project. Data were collected using standard instruments, chart audit, and interviews. RESULTS: The Web course provided a standardized and effective educational experience that enhanced emergency nurses' triage accuracy. The mandatory online tutorial, online discussion, and workplace project increased the RNs' preparation for online learning, and these educational methods were successful in transferring triage learning to practice. DISCUSSION: Web learning can help professionals maintain competency and support professional practice. Further research is needed to provide evidence for best practices in E-learning for RNs. The accuracy of the RN's triage assessment impacts patient health, hospital accreditation, and funding.

How safe staffing can improve emergency nursing: time to cut the Gordian knot.

The phrase 'cut the Gordian knot' describes a bold and direct solution to a complicated problem. Nursing presence has been defined as nurses' ability to pay attention to patients and make them feel that their needs have been considered. In the emergency department (ED), nursing presence can be adversely affected by factors such as fatigue, workplace bullying, moral distress and inadequate staffing levels, which could lead to suboptimal patient outcomes and compromise the goals of nursing. Nursing presence is also important for nurses' job satisfaction and therefore for staff retention. This article explores the combined effects of fatigue, workplace bullying, moral distress and inadequate staffing levels on emergency nurses. To cut the Gordian knot it also provides recommendations for mitigating these issues in EDs through safe staffing decisions that consider patient acuity and skill mix.

Violence towards emergency nurses: A narrative review of theories and frameworks.

INTRODUCTION: Workplace Violence in the health environment is a growing issue worldwide. Emergency department have been identified asa high-risk setting for Workplace Violence and emergency nurses are most exposed to this phenomenon. To address workplace violence in the ED effectively, it is critical to understand frameworks established in the literature to assist in development of appropriate interventions and corrective measures. An overview of available theories of violence towards emergency nurses in the literature is presented herein in the format of a narrative review. METHODS: A search of international literature on WPV theories was conducted in three databases: PubMed, CINAHL, Scopus, and Proquest Central. Articles concerning theories that have direct implications for patient-related violence (client-on-worker Type 2 Violence) in the emergency department were sought. RESULTS: Four hundred and fifty-nine articles were found. Applying established inclusion and exclusion criteria, fourteen of these were included in the review. In the international literature there are 24 theories and frameworks pertaining to violence towards nurses in the emergency department which describe different intervention strategies based on these. DISCUSSION: Both the theories on violence developed by nurses and those derived from other disciplines are complex and many key elements are invariably intertwined. Understanding such theories might be useful to manage violence towards emergency nurses with greater effectiveness.

Review of the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies.

The International Council of Nurses (ICN; Geneva, Switzerland) and the World Association for Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) joined together in 2014 to review the use of the ICN Framework of Disaster Nursing Competencies. The existing ICN Framework (version 1.10; dated 2009) formed the starting point for this review. The key target audiences for this process were members of the disaster nursing community concerned with pre-service education for professional nursing and the continuing education of practicing professional nurses. To minimize risk in the disaster nursing practice, competencies have been identified as the foundation of evidence-based practice and standard development. A Steering Committee was established by the WADEM Nursing Section to discuss how to initiate a review of the ICN Framework of Disaster Nursing Competencies. The Steering Committee then worked via email to develop a survey to send out to disaster/emergency groups that may have nurse members who work/respond in disasters. Thirty-five invitations were sent out with 20 responses (57%) received. Ninety-five percent of respondents knew of the ICN Framework of Disaster Nursing Competencies, with the majority accessing these competencies via the Internet. The majority of those who responded said that they make use of the ICN Framework of Disaster Nursing Competencies with the most common use being for educational purposes. Education was done at a local, national, and international level. The competencies were held in high esteem and valued by these organizations as the cornerstone of their disaster education, and also were used for the continued professional development of disaster nursing. However, respondents stated that five years on from their development, the competencies also should include the psychosocial elements of nurses caring for themselves and their colleagues. Additionally, further studies should explore if there are other areas related to the disaster nursing practice (in addition to psychosocial concerns) that may be missing or not fully developed. Finally, the authors of this report recommend that future research explore how the ICN Framework of Disaster Nursing Competencies do or do not assist in maintaining best practices in this field and improve outcomes for victims of disaster. Hutton A , Veenema TG , Gebbie K . Review of the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies. Prehosp Disaster Med. 2016;31(6):680-683.

Expert evidence: do you have all the facts?

As a practising expert witness, or an accident and emergency nurse considering the move into the challenging world of litigation, do you have all the facts about expert evidence to hand? What is your role in the proceedings? When could you be sued for the advice you give? Should you ever accept a case on a no-win, no-fee basis?