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Educational Needs of Emergency Nurses
Reka Dulandas M.N. (Critical Care & Trauma), Hons.BA (Health Sc),CCRN
Prof Petra Brysiewicz (supervisor) UKZN (School of Nursing)
Purposeofthestudy
To describe the educational needs of
emergency nurses
Significanceofthestudy
1. Paucity of research in SA on: • Educational needs
• Skills/competencies deemed satisfactory for
emergency nurses
2. Findings may contribute to: • The development of a core curriculum for
emergency nurses
• CPD – skills & competencies
Introduction
• Nurses working in trauma and emergency centres
are usually the first person to interact with the
critically ill or injured patient.
• These nurses require advanced skills and extensive
clinical knowledge to be able to manage such
patients appropriately.
Introduction
Definitions: Emergency nursing
• specialty in which nurses’ care for patients during the
emergency or critical period of their illness or injury,
focusing on severity levels and timeous treatment (ENSSA, 2010)
Introduction
Definitions: Emergency Centre
• accident and emergency (A&E)
• casualty
• trauma
• emergency department
• emergency unit
• emergency room
Introduction
Definitions: Emergency Nurse
• A nurse working in a trauma or emergency centre
providing care to acutely ill or injured patients by means
of a NCP.
• ENSSA (2010) adds that she/he should have basic,
intermediate and advanced skills.
Introduction
Emergency nursing: What do we know?
• Fastest growing specialties in the developed world
• In SA & Sub-Saharan Africa – it’s in its infancy
• ENSSA – promotes advancement in emergency nursing
through leadership, collaboration, education, practice
development & research
South African Nursing Council
SANC has developed competencies for: • Occupational health
• Ophthalmic nursing
• Orthopaedic nursing
• Paediatric nursing
• Nephrology
EMERGENCY NURSING COMES UNDER THE BANNER
OF CRITICAL CARE NURSING
Benner’sTheory:“Novice to expert”
• Increasing roles and responsibilities for emergency
nurses
• Emergency nurses to be trained at proficient and expert levels (Wolf et al, 2012)
Methods
• Design: quantitative survey
• Settings: 2 private, 2 public hospitals
• Sample: convenience sampling, target population 163
• Instrument: self administered questionnaire
• Data collection: over 4 weeks, 6am – 8am
• Data analysis: SPSS version 23
• Validity and reliability: Univ of Michigan
• Ethics approval: UKZN, hospital ethics committees
Results:demographics
Response rate: 128 (78.5%)
Public Private n(%)
R e g i s t e r e dnurses
45 30 75(59%)
E n r o l l e dnurses
34 19 53(41%)
Total(n) 79(62%) 49(38%) 128(100%)
Results:demographics
YEARSOFEXPERIENCE
0 months<1year
>1year<2years
> 2 years <5years
> than 5years
n(%)
R e g i s t e r e dnurses
11 3 18 42 74(59%)
E n r o l l e dnurses
16 7 17 11 51(41%)
Total(n)27 10 35 53 125(100%)
Competencylevels
Testofcompetencylevels
Category pvalue
Yearsofexperience 0.027
NursedesignaRon 0.001
Hospitalsector 0.052
Results:CompetencylevelsQuesRonnaireitemBasicIntermediateAdvanced
L e a s tcompetent%
Competent%
H i g h l ycompetent%
Abletoassessbreathing:rate,effort,cyanosis 2 28 70
Abletoadministeroxygen:cannula,mask,bag-valve-mask 1 25 74
Able to assess circulaRon: pulses, skin colour, capillary refill, blood
pressure,signsofbleeding
0 27 73
AbletoperformcardiopulmonaryresuscitaRon 11 37 52
AbletoprepareandassistwithendotrachealintubaRon 14 38 48
Abletocontrolhaemorrhage:applytourniquet,fracturesplint,pelvic
wrap
19 34 47
Abletomanageshock:obtain intravenous/ intraosseousaccessand
administerfluids
10 46 44
Abletoprepareandadministerdrugsincardiacarrest 20 38 42
AbletoprepareandadministerthrombolyRcs 38 33 29
Abletoperformcardioversion/defibrillaRon 42 38 20
Able to obtain and interpret echocardiograms: detect arrhythmias
e.g.atrialfibrillaRon
45 39 16
Results:EducaConalneeds-trauma
EducaRonalneeds %
Abdominaltraumae.g.intra-abdominalbleed 79
Paediatricemergencies 79
Orthopaedice.g.fractures,compartmentsyndrome
68
Spinalcordinjuries 75
BurnsandtraumaRcinjuries 69
Headinjuriese.g.intracranialbleeding 75
Results:EducaConalneeds–cardiacEducaRonalneeds %
Stroke 69
AcuteCoronarySyndrome 81
AcuteMyocardialInfarcRons 74
Arrhythmias 76
CardiacMedicaRons 76
DefibrillaRon/Cardioversion 69
Results:EducaConalneeds–shortcourses
EducaRonalneeds %
ABGAnalysis 78
Triage 79
ACLS 83
PALS 80
VenRlators 80
Preferredlearningmethods
Learningmethod %
DemonstraRon 76
Lecture 57
SimulaRon 30
Onlinelearning 6
Distancelearning 5
Barriers&facilitatorstoeducaRonaldevelopment
• Lack of funding
• Lack of support from management
• Limited access to educational institutions.
• Staffing issues
• Lack of time
RecommendaCons
• Similar studies in other provinces on competency levels
and educational needs of emergency nurses.
• The findings can be used to help develop a core
curriculum for emergency nurses.
Conclusion
• There are significant deficits in knowledge, skills and
competency levels concerning emergency care.
• Educational gaps can be rectified through CPD, that
incorporates competency based education on specific
emergency nursing skills.
References
1. Wolf, L, Brysiewicz, P., et al. 2012. Developing a framework for
emergency nursing practice in Africa. African Journal of Emergency
Medicine, 2:174-181.
2. Benner, P. 1984. From novice to expert: excellence and power in clinical
nursing practice. Menlo Park: Addison-Wesley.
3. EMSSA. 2012. The South African Triage Scale. Accessed on 21 April
2014 from http://emssa.org.za/sats/
Thank you!