Emergency Communications Registered Nurse (ECRN) Recognition. Board approval: 3/20/08 Effective: 2/1/09 Supersedes: 3/1/08 Page: 1 of 6

Transcription

1 Emergency Communications Registered Nurse (ECRN) Board approval: 3/20/08 Effective: 2/1/09 Supersedes: 3/1/08 Page: 1 of 6 INCLUDES COMMENTS FROM EMS Coordinator mtg Reference: EMS Rules Section (effective December 20, 2001) I. DEFINITION: An Emergency Communications Registered Nurse or "ECRN" means a registered professional nurse, licensed under the Illinois Nursing and Advanced Practice Nursing Act, who has successfully completed supplemental education in accordance with rules adopted by the Department, and who is approved by an EMS Medical Director to monitor telecommunications from and give voice orders to EMS System personnel, under the authority of the EMS Medial Director and in accordance with System protocols." II. III. POLICY In compliance with the Illinois EMS Act, any nurse independently directing prehospital patient care in the Northwest Community EMS System within the scope of the System SOPs must be recognized as an ECRN. ECRN COURSE A. To be approved as an ECRN, an individual must complete an educational curriculum formulated by an EMS System and approved by IDPH, which consists of at least 40 hours of classroom and practical training for both the adult and pediatric population, including telecommunications, system standing medical orders and the procedures and protocols established by the EMS Medical Director (Section 3.80(c)(1)(B) of the Act). B. ECRN education in the NWC EMSS consists of two parts: 1. Precourse 2. Course & testing C. The NWC EMSS ECRN course is typically held two days a week for six weeks during the late winter/early spring unless additional programs are requested based on System needs. D. Registration process 1. Submit course applications to the NWC EMSS office at least 7 days prior to the first day of class. 2. Course tuition is due in full by the first day of class unless prior arrangements have been made with the Course Coordinator. E. Student eligibility requirements 1. Current unrestricted licensure as a registered professional nurse in Illinois. 2. Employee in good standing at a System hospital with ED orientation completed. 3. Prior completion of an ECG course. The course must include electrophysiology, recognition of dysrhythmias, and their recommended treatment. ACLS certificate is acceptable. 4. Completion of the ECRN needs assessment exam is optional as a needs assessment. F. Course completion criteria 1. Class attendance is strongly encouraged to optimize learning opportunities.

2 Board approval: 3/20/08 Effective: 2/1/09 Supersedes: 3/1/08 Page: 2 of 6 IV. 2. Final exams a. Written exam is composed of 150 multiple-choice items blueprinted to the course objectives. b. Timed 15 strip ECG interpretation exam c. Four simulated runs (cardiac, medical, respiratory, and trauma) d. Students must pass all sections of the exam with scores of 80% or above. Should the nurse score below 80% on one or more exam section(s) they will be allowed up to one month after receiving the exam failure notice to complete a retake exam. They may not retake the written or ECG interpretation exam on the day of initial testing. Allowances may be made for immediate retest of the simulated runs. e. Retests shall be precepted by the EMS Coordinator at the nurse's hospital of employment if within the NWC EMSS. Otherwise, they must be done with the Course Coordinator or her designee. f. Extensions may be granted based on individual circumstances. If the nurse fails to retest within one month and has not been granted an extension, he or she will receive a failing grade for the course. g. If the student fails to meet the criteria for successful completion of the retest, the following options are available: (1) Repeat the course at a later time; or (2) Attend educational offerings addressing the areas of weakness and retest the written and practical exams in their entirety; or (3) Complete the provisions of a corrective action plan agreed to by the student, their employer and the EMS Administrative Director. 3. Interim Status: The nurse will not be authorized to direct prehospital care until all course requirements are successfully achieved. FIELD PRACTICUM Subsequent to passing the ECRN Course or challenge exam, each nurse must ride a minimum of 8 hours on a system-approved ALS vehicle with a System-approved EMT-P Preceptor observing a minimum of one ALS call. If such a call is not completed during the first field assignment, a second shift must be scheduled. The nurse may leave as soon as an ALS call is completed on the second shift. If no calls are completed within the 16 hours, an ALS call will be simulated with the EMS Coordinator that shall satisfy this requirement. Arrangements to ride with the ambulance provider should be made with the EMS Coordinator at the nurse's hospital of employment. Field time must be documented on the System form and be forwarded to the Resource Hospital with the other certification paperwork. V. PROVISIONAL INTERNSHIP A. Upon achievement of all course objectives the nurse shall begin a radio internship that must be done under the direct supervision of an approved ECRN preceptor who must be present throughout each call, approve all orders, and co-sign all Communication Logs documented by the Provisional ECRN.

3 Board approval: 3/20/08 Effective: 2/1/09 Supersedes: 3/1/08 Page: 3 of 6 B. Time requirements: The internship shall be completed as soon as all the objectives for phases I and II are completed. While there is no minimum time frame. The maximum is 12 months from the date of successful course or challenge exam completion unless an extension is granted. C. Assignment of an ECRN preceptor: A primary preceptor selected by the nurse s employer who meets the System s standards for a preceptor shall mentor Provisional ECRNs. Preceptor names shall be forwarded to the EMS Administrative Director. D. Opening a file: The provisional ECRN must make an appointment to meet with their designated EMS Coordinator/designee to open an ECRN file prior to commencing the internship. During this meeting, the EMS Coordinator/Educator will review the provisional internship process and System expectations. A Provisional ECRN Internship Agreement will be signed at that time if not already completed. E. Progress meetings: The provisional ECRN must meet at least twice with the EMS Coordinator/Educator to evaluate the nurse's progress and/or to plan for the next phase of the internship. F. Phases of the internship: The internship is a two phase process with specific objectives to be achieved during each phase. Objectives for each phase are listed on the evaluation forms. Phase I must be successfully completed before advancing to Phase II. The ECRN Preceptor is responsible for validating all competencies achieved prior to the monthly meeting with the EMS Coordinator/Educator. A minimum of eight ALS calls of varying natures must be completed during each phase. Communications Logs must be submitted with the EMS patient care reports and ECG strips. Pediatric calls may be simulated if an actual call of this nature was not completed. NOTE: Supervision by the preceptor is interpreted as approving the provisional ECRN's orders and coaching as necessary, but not taking over the call. Those runs where orders were initiated by someone other than the provisional ECRN DO NOT qualify as acceptable runs. G. COMPLETION OF THE INTERNSHIP 1. When the ECRN preceptor believes that the nurse has satisfactorily achieved all objectives of the internship, the ECRN candidate shall schedule a final meeting with the EMS Coordinator/Educator to complete a cumulative performance appraisal. All must agree that the nurse has demonstrated the skills and knowledge required for recognition as an ECRN. If the team is in agreement, submit the following to the EMS Administrative Director: a. Cover letter from the EMS Coordinator recommending certification. b. Certification check list: Includes the nurse's name, mailing address, the ECRN training site (if not NWCH) and date of course completion. c. Signed IDPH Child Support Statement that must include the nurse s date of birth and social security number. d. Phase One Progress Report; completed and signed. Include the 8 ALS runs with all communication logs, run sheets and ECG strips attached. e. Phase Two Progress Report; completed and signed. Include the 8 ALS runs with all communications logs, run sheets and ECG strips attached. f. Cumulative Performance Appraisal: Completed and signed. g. Field experience form: Completed and signed. h. Policy Manual and SOP Self-Assessments (if a challenge candidate. These documents are completed in class if a NWC EMSS student)

4 Board approval: 3/20/08 Effective: 2/1/09 Supersedes: 3/1/08 Page: 4 of 6 VI. VII. VIII. 2. If the runs are evaluated as unsatisfactory, a corrective action plan shall be developed with further objectives and time frames for the nurse to follow in order to complete the internship. 3. Extensions: If an extension is needed beyond the 12 month period, a written extension request must be submitted by the provisional ECRN to the EMS Administrative Director at least 30 days prior to the expiration of the provisional period. Any nurse who completes the internship after an extension may be required to complete additional examinations which may cover each section of the SOPs. RECOGNITION of ECRN STATUS A. If the runs are evaluated as satisfactory, the nurse will be granted ECRN privileges in the NWC EMSS for a period of four years and the nurse's name will be entered into the System plan as an ECRN. He/she will receive a certificate from the NWCH EMS Office recognizing his/her status as an ECRN. B. Upon system approval, a transaction card and signed child support statement will be submitted to IDPH recommending the ECRN for certification. The nurse will receive a license/certificate from IDPH with an ECRN number and date of expiration. They should provide a copy of this license/certificate to their EMS Coordinator/Educator and maintain the original in a place that allows for easy retrieval if necessary. C. Nurses who successfully complete all certification requirements may use "ECRN" after their licensing title. D. A registry of ECRNs is maintained by the Resource Hospital EMS Office. Changes in name, address, or employer must be reported to the Resource Hospital EMS Office within 20 days of the change so IDPH can be notified within 30 days. Notification may be in person, or by mail, phone, fax, or electronic mail. CHALLENGE PROVISIONS A. Any System nurse meeting the first three course eligibility requirements may challenge the current final written and practical exams of the ECRN Course. They should complete the SOP and Policy Manual Self-assessments prior to challenging the exams. Scores of 80% or above on all sections will exempt the nurse from the didactic portion of the course. The Field Practicum and provisional internship requirements must be completed the same as specified above for ECRN students. B. Scores < 80% on any section of the challenge exam will require the nurse to take the entire ECRN Course. CONTINUING EDUCATION: As a minimum, ECRNs and provisional ECRNs are required to complete eight hours of didactic continuing education per year which relates to their role as an ECRN. This may be achieved in a variety of ways: A. Attending the in-station classes at one of the EMS agencies or complete the class credit questions and then take post-test for that class. B. Attending CE classes adapted from the NWC EMSS monthly CE for ECRNs from two hours to one conducted at the hospital by the hospital EMS Coordinator/educator. C. Completing other CE activities relevant to the topics being offered to field personnel that have received an Illinois EMS site code or approval by a nursing CE accrediting body; completing EMS-related QI, writing EMS-related journal articles, textbook chapters, hospital policies, etc. Hour for hour credit will be awarded up to 25% of their total number of hours for one topic.

5 Board approval: 3/20/08 Effective: 2/1/09 Supersedes: 3/1/08 Page: 5 of 6 D. Completing accredited classes with content that would be relevant to their role as an ECRN: ACLS, PALS, ENPC, PEPP, TNCC, or TNS, etc. Hour for hour credit is granted up to 2 hours for one course as the EMS-related information in all of them is limited. E. Other activities may be approved for ECRN CE by the EMS Administrative Director, such as local conferences and seminars upon submission of a request that shall include the class objectives, brief content description, faculty, and time requested. In the case of a conference, the brochure will suffice for advance approval. To gain CE, the ECRN must submit their CEU certificate after attending the program. IX. Modular exams A. ECRNs may maintain exam emption status by complying with System policy E4. B. Nurses who are not exam exempt, but who complete a minimum of 2 NWC EMSS classes between July and October and 2 classes between January and April with a minimum score of 75% on all four post-tests are eligible to sit for one annual exam in May (80 questions). This may be accomplished by attending a class or completing the credit questions. C. All other ECRNs who are not exam exempt will be required to take a System modular exam two times a year (80 questions each, to ensure that they have maintained competency in System EMS principles. Per long-standing tradition, one test will be offered in November (covering System CE topics from July to October; and the other in May; covering System CE topics from January to April. D. The question bank for these modular exams shall be taken from the CE module post-test banks that are published each month to facilitate preparation for the test. X. ECRNs and Provisional ECRNs must complete all System Mandatory Reviews as specified in System policy unless exempted by the EMS MD/designee. XI. ECRN RECIPROCITY A. ECRNs certified in other EMS Systems petitioning for ECRN privileges in the NWC EMSS shall submit the following documents: 1. ECRN training transcripts: a. Verification that they have successfully completed an MICN/ECRN training program, approved by IDPH. b. Name of Course Coordinator. c. Date of successful completion. A photocopy of a diploma or CEU certificate of completion is sufficient. 2. Photocopy of current IDPH ECRN license. 3. Letter from the EMS MD or EMS System Coordinator attesting to the ECRN's good standing in the former system. 4. Copy of all CE credits accumulated during the current recognition period. 5. Letter from a NWC EMSS hospital verifying employment within the system. This letter should include the nurse s address and birth date and social security number. 6. SOP and Policy Manual self-assessments 7. Entry testing exam forms: NWC EMSS Final written exam and ECG test answer sheets and practical exam forms.

6 Board approval: 3/20/08 Effective: 2/1/09 Supersedes: 3/1/08 Page: 6 of 6 B. On-line medical control internship: Each System hospital is expected to fully orient an ECRN who challenges into the NWC EMSS to the communications equipment in place at that facility and the System Communications policies and procedures for ECRNs. This may take the form of an abbreviated internship or be part of the ED orientation. XII. INACTIVE STATUS - EMS Rules Section d) A. Prior to the expiration of the current approval, the ECRN may request to be placed on inactive status. The request shall be made in writing on a form prescribed by IDPH to the EMS MD. Written materials shall contain the following: 1. Name of individual, 2. Date of approval, 3. Circumstances requiring inactive status, 4. Their original ECRN license, and 5. A statement that recertification requirements have been met by the date of the application for inactive status. B. The EMS MD or their designee will review the request for inactive status and forward to IDPH for consideration and approval. C. For the ECRN to return to active status, the EMS MD must document that the ECRN has been examined (physically and mentally) and found capable of functioning within the EMS System, that the ECRN's knowledge and clinical skills are at the active ECRN level, and that the ECRN has completed any refresher training deemed necessary by the EMS System. If the inactive status was based on a temporary disability, the EMS System shall also verify that the disability has ceased. When all requirements have been met, the EMS MD or their designee shall submit a written request to IDPH requesting reactivation of the ECRN s license. D. During inactive status, the individual shall not function as an ECRN at any level. John M. Ortinau, M.D., FACEP EMS Medical Director Connie J. Mattera, M.S., R.N. EMS Administrative Director