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Flinders Medical Centre (FMC) is a 550 bed tertiary teach-ng hospital with extensive specialist nursing practice areas,pproximating 350 nursing staff requiring annual ALS accred-tation. Currently, this process is managed through externalroviders, with a potential cost to the organisation and stafff $140,000 annually. This innovative strategy aims to main-ain high standards of care by ensuring a critical mass oftaff have core.

ALS knowledge and skills embedded within their every-ay practice, utilising the current financial model of care.his presentation will journey through the introduction of aexible delivery, unit based,

ALS accreditation process that:

Is free to regional nursing staff.Standardises ALS practices and safe patient care acrossspecialty nursing areas.Meets ARC guidelines,4 ACCCN accreditation (pending)and attract 25 Royal College Nursing Australia continuingeducation points.Defines multidisciplinary regional policy and ALSpractice.5

Was developed and is maintained within current work-loads of Education Facilitators and unit based assessors.Promoted development of a new clinical educationalframework.Is fiscally supportive of organisational directives.

eywords: Innovative; Education; ALS accreditation

eferences

1. The Australian College of Critical Care Nurses ALS Guidelines at:http://intra.sahs.sa.gov.au/sahs/directorates/acute services/medicine cardiac critical care/intensive critical care unit fmc/cpr met guidelines for fmc.jsp.

2. The ACORN Standard 2008 NR6 & G, Australian College of Oper-ating Room Nurses Inc at: www.acorn.org.au.

3. The College of Emergency Nurses Australasia Position Statementon Mechanical Ventilation 2.5 at: www.cena.org.au.

4. Australian Resuscitation Council 2006 Guideline 11 and 12 ‘Intro-duction to Advanced Life Support, Australian ResuscitationCouncil Melbourne at: www.resus.org.au.

5. Southern Adelaide Health Service Committee for ResuscitationPosition Statement 2009 Flinders Medical Centre South Aus-tralia.

oi:10.1016/j.aenj.2010.08.257

elping emergency nurses to act sooner: Identifying theeteriorating adult and child. Part two

aul Hudson, Jodie Ekholm, Maree Johnson, Rachel Lang-on

Background: An essential role of nurses working in themergency Department (ED) is the early identification andanagement of an unstable or deteriorating patient. Moni-

oring of the patients’ vital signs forms a pivotal part of theay of an emergency nurse. Much of the research relatingo the use of early warning signs, used to identify dete-ioration in a patient has been based in hospital wards.ery little work has been undertaken in the ED setting. This

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Conference Abstracts

tudy describes the implementation and evaluation processf area wide adult and paediatric observation charts withinDs across the Sydney South Western Area Health ServiceSSWAHS). SSWAHS has a population of 1.42 million, includinghe largest paediatric population within New South Wales.

Quality improvement approach: This project outlineshe redesign and modification of the existing observationharts within ED to incorporate early warning sign triggersdentified by the literature with the use of colours as aisual prompt. The development of the adult and paediatricharts includes unique physiological parameters and signs ofeterioration. These tools are envisaged to heighten nurses’wareness of changes in the patient’s condition and alerthem to the need to seek medication assistance. The projects consistent with the Clinical Excellence Commission (CEC)mplementation of the ‘‘Between the Flags’’ project.

Design and setting: A retrospective medical record audits proposed. Within four EDs within SSWAHS Royal Princelfred, Liverpool, Campbelltown/Camden and Bowral, anudit of 100 patient records before (October—November008) and after the implementation (October—November009) of the adult and paediatric will be undertaken foratients with a triage category of 1—3.

Findings and conclusion.Preliminary findings will be presented.The development of this innovation in ED observation

harts is a key initiative that is envisaged to prompt emer-ency nurses to identify and manage the deterioratingatient in shorter times, reduce the time from triage to doc-or/nurse assessment, provide preliminary data on whichigns and symptoms are acted upon, and enhance docu-entation of management of the seriously ill child andeteriorating adult.

oi:10.1016/j.aenj.2010.08.258

dvanced Practice 1C

bstract for oral paper Clinical Leadership and Practicehange — Nurse practitioner role in pain management forractured femur

eonie Burdack

Emergency Department, Canberra Hospital, Yamba Drive,arran, ACT, Australia

The Australian Nursing and Midwifery Council (ANMC)ational Standards for Nurse Practitioner (2006) identify 3omprehensive and generic competency standards. Theseevolve around dynamic practice; professional efficacy in aramework of enhanced autonomy and accountability; and,linical leadership.

To date much of the evaluation surrounding the Emer-ency NP (ENP) role in Australia has focused predominantlyn quantitative measures based on a fast track role including‘numbers of patients seen’’, ‘‘case-mix’’, ‘‘length-of-tay’’ as well as the positive impact of the role on criteriaike ‘‘time to be seen’’, ‘‘numbers of patients who did not

ait’’.

This presentation explores some alternative measureshat demonstrate how extending the NP role beyond fastrack can positively affect practice change and quality ofare. Specifically the presentation will focus on how the NP