Sharing of Nurse Consultant Role in the Emergency Nursing Service. Josephine Chung NC (Emergency Care), NTEC
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1 Sharing of Nurse Consultant Role in the Emergency Nursing Service Josephine Chung NC (Emergency Care), NTEC
2 Practice Model of Nurse Consultant (Emergency Care) Nurse Consultant Enhance Provision of Emergency Nursing Care Coordinate critical ill patient care Coordinate trauma nursing care Develop transport nursing Cat 1 & 2 (Urgent) Deliverables Enhance Patient Safety and Quality of Care Enable early identification of critically ill patients Achieve international standard of care Ensure safety of critically ill patient during transfer Enhance efficiency of patient flow Deliver protocol driven independent practice Cat 3 (Semi-urgent) Reduce waiting time Reduce patient suffering Share service workload Release ED overcrowding Facilitate fast-track service Cat 4 & 5 (Non-Urgent) Decrease waiting time and LOS Better continuity of care Registration Triage Consultation Discharge Follow-up Patient Journey
3 Working Relationships in the department and cluster Clinical specialty arm: COS/ Consultant Professional arm: cluster GM(N) Direct report COSs/DOMs in EDs in the cluster Nurse Consultant Inter-departmental collaboration in the hospital/cluster Stationed ED (PWH)
4 Working Relationships in the department and cluster Clinical specialty arm: COS/ Consultant Professional arm: cluster GM(N) Direct report COSs in EDs in the cluster Nurse Consultant Inter-departmental collaboration in the hospital/cluster Stationed ED (PWH)
5 Accident & Emergency Department and Trauma Center, PWH Daily patient attendance : About 450 Triage category 4&5: 70% of total attendance
6 With support of Senior Medical Doctors to Provide Service for Minor Injury & Illness Nurse Consultant APNs NC manage new patients & follow-up patients referred by doctors. Provides expert consultation to APNs Ensure quality & safety of the service with medical support Manage patient according department protocol Maintain quality of the service Assist audit process Report the service outcome to COS
7 The service is aim to facilitate fast-track patients with minor injury & illness
8 Developed local clinical guidelines to enhance quality and safety and meet service needs
9 Working Relationships in the department and cluster Clinical specialty arm: COS/ Consultant Professional arm: cluster GM(N) Direct report COSs in EDs in the cluster Nurse Consultant Inter-departmental collaboration in the hospital/cluster Stationed ED (PWH)
10 Collaboration with other NCs/Specialties to established inter-departmental Clinical Guidelines
11 Working Relationships in the department and cluster Clinical specialty arm: COS/ Consultant Professional arm: cluster GM(N) Direct report COSs in AEDs in the cluster Nurse Consultant Other clinical specialties in the hospital/cluster Stationed AED (PWH)
12 Collaboration with EDs & GOPCs in NTEC to standardized wound care feedback system Prepared credentialing of suturing procedure in EDs, NTEC
13 Lead Regular Audit, Evaluation AMI Stroke Triage Care Process Wound Care & Suture Resuscitation Trauma Medication
14 Monitor risks in practice and lead CQI projects to prevent harm to patients CQI on prevent fall & missing CQI on shorten door to needle time to AMI patients
15 Introduce Simulation Training
16 Participate in Training for Advanced Emergency Nursing Practice
17 Adopt Innovative Clinical Practice and Conduct Research
18 Service Outcomes of the Nurse Clinic Collaboration with SMOs, managed around 6000 patients Shortened waiting time & length of stay Evidence shows the service is safe Patients accept the service with appreciation Patients feedback: 感謝縮減輪候時間, 對病人是一個很好的幫助 護士比我自己更關心我的病況, 同事亦提供我日後處理傷口的跟進方法 謝謝! 非常好 對待病人, 態度超好及很友善 謝謝! 繼續努力, 加油! 比起排隊見醫生快很多 服務一流
19 Register Nurse: Doing things well Nurse Specialist: Doing things better Nurse Consultant: Doing better things Maylor 2005
20 Reference: Maylor M. (2005) Differentiating between a consultant nurse and a clinical nurse specialist. British Journal of Nursing. 14 (8), McDougall, T (2005). Child and adolescent mental health service in the UK; nurse consultants. Journal of Child & Adolescent Psychiatric Nursing, 18(2),
21 Thank you for your attention!
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