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2009 CENA International Conference for Emergency Nursing

the unit of nursing of staff that can be used as a benchmarkfor quality improvement.

Keywords: Emergency; Professional development; Staffeducation; Competency based learning

doi:10.1016/j.aenj.2009.08.068

The emergency nursing experience during the Black Sat-urday Bushfire tragedy: The Alfred hospital response

S. Smith1, P. Liston1, L.E. Niggemeyer2

1 Emergency & Trauma Centre, The Alfred Hospital, Victo-ria, Australia2 Trauma Service, The Alfred Hospital, Victoria, Australia

The Black Saturday Bushfire tragedy, 7th February 2009,was Victoria’s worst natural disaster. The firestorm resultedin the deaths of 174 people, huge property, livestock andforest losses. Over 10,000 personnel were mobilised inthe largest emergency and community response in Victo-rian history. As the event unfolded, the Victorian StateTrauma System was mobilised and a state-based health ser-vice response ensued. The Alfred Hospital is a VictorianState Major Trauma Service and the Victorian State BurnsService. Therefore it was the receiving hospital for majorburns/trauma victims.

Working as clinical nurses in the Emergency Departmentprovided a unique opportunity to observe and participatein the hospital response. This presentation will describe thesalient observations from the experience with a view to shar-ing the most significant insights gained from participating insuch an enormous disaster.

Nursing staff were invited to participate in a reflectionin practice activity where they were asked to write a shortstory (500 words) about their experiences during the first72 h of the incident. Seven senior nurses responded provid-ing 3667 words. A thematic review of these writings wasundertaken to identify common themes. These themes werethen extrapolated into the following five common themes:

1. Horror—–of what was to unfold.2. Dignity and grace—–with which the patients held them-

selves. Patients just accepted everything that was doneto them.

3. Community spirit—–the enormous number of phone callsfrom far and wide (medical and nursing) to offer theirservices.

4. Duration—–The disaster seemed to unfold for days . . .

5. Innovation and creativity—–Unexpected requirement forcreative skills which were needed by the nursing staff.For example, finding ways to get patients’ relatives med-ications when they literally only had the clothes on theirbacks; no wallets, no identification, no Medicare card,no credit card.

This presentation will provide an overview of some of the

key factors associated with the health service response andhow emergency nurses responded to and were affected by,the Black Saturday Bushfire Tragedy of February 2009.

doi:10.1016/j.aenj.2009.08.069

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

aul Hudson, Jodie Ekholm, Maree Johnson, Rachel Langdon

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 early warning signs and identifying patient deterioration,ave been based within hospital wards. Very little work haseen undertaken in the ED setting. This study describes themplementation and evaluation process of area wide adultnd paediatric observation charts within EDs across the Syd-ey South Western Area Health Service (SSWAHS).

Quality improvement approach: This project outlineshe redesign and modification of the existing observationharts within SSWAHS ED. This health are has a populationf 1.42 million and includes the largest paediatric popula-ion within New South Wales. The development of the adultnd paediatric charts includes unique physiological param-ters and signs of deterioration. These tools are envisagedo heighten nurses’ awareness of changes in the patient’sondition and alert them to the need to seek medicationssistance.

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 (May—June 2008) andfter the implementation (May—June 2009) of the adult andaediatric will be undertaken for patients with a triage cat-gory of 1—3.

Findings and conclusion: Preliminary findings will beresented.

The development of this innovation in ED observationharts 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.2009.08.070

new model of care for the discharged emergencyepartment (ED) patient

rances Onions

Redcliffe Hospital, Qld, Australia

In 2007 Redcliffe Emergency Department received fund-ng to improve the discharge process of patients byeveloping a coordinated approach to discharge manage-ent.The aim of the project was to provide relevant informa-

ion for emergency department patients being discharged

ome. Information included:

Self-management requirements.After care instructions.Prescriptions.