Appropriate levels of staffing are crucial in meeting Emergency Department (ED) patients’ needs and in assuring the quality and safety of the care they receive. The dearth of national and international guidance relating to appropriate staffing for emergency settings prompted the National Emergency Medicine Programme (EMP) with the support of the Office of Nursing and Midwifery Services Director (ONMSD) to initiate the development of a framework for nursing to support workforce planning in Emergency Departments. A framework would also support standardised staffing models and ensure equitable and appropriate staffing for all Emergency Departments (EDs) and Emergency Care Networks (ECNs) in Ireland.
The Emergency Department Nursing Workforce Planning Framework was subsequently developed and published and serves as a guide to support senior ED nurse managers and their team to assess and plan their nursing workforce to meet the needs of their individual services. The framework promotes a consistent, standardised and evidence based approach to workforce planning and provides the tools and resources to support workforce decisions. It can also support the development of competence and confidence amongst nurse managers in making workforce decisions.
The toolkit within the framework serves as a guide to support local nursing teams to assess and plan their nursing workforce to meet the needs of their individual services, in collaboration with local management. Education workshops to support implementation via a train the trainer approach was delivered in Q1 & 2 2017. The workshops were designed to enhance the health professional’s skills in workforce planning within the emergency setting with specific focus on the implementation of the ED Nursing Workforce Planning Framework toolkit in the practice setting. The overall objective of the workshops were to enhance the standard of workforce planning and analysis in practice across emergency healthcare settings nationally and aimed to prepare participants to acquire the knowledge and skills to provide a workforce planning leadership role in their emergency setting and to contribute to the improved workforce planning capability through evidenced based practice
The workshop programme was delivered in units of learning. Each unit of learning aligned to the six sections within the ED Workforce Planning toolkit.
The National Ambulance Patient Handover Protocol was developed collaboratively between the Pre-Hospital Emergency Care Council, the National Ambulance Service, the Emergency Medicine Programme and the Dublin Fire Brigade. The protocol aims to support improvements in patient safety and quality of care by ensuring consistent, structured communication when handing over patients from Ambulance teams to ED teams. It is a quality initiative that offers a structured, yet flexible handover process to enhance patient care. It is a key component of a quality process as the information gathered during this process will inform and benefit the patients’ care pathway through the ED. The handover process is underpinned by the general principles that all members of the multi-disciplinary team contribute positively to patient care and their contribution is both important and valued. Professionalism, courtesy and mutual respect are core components of this principle.
The presentation and live recording of the Training and Information session are available to view on EMNOW: please click HERE
The link to the webstream whch is on the updates page also is found HERE
The link to the presentation which is on the updates page is found HERE
The development of the ICTS was prompted by the triage experiences of front-line Emergency Department (ED) nurses and doctors caring for children and advanced by the Emergency Nursing Interest Group and Working Group of the EMP as a safety and quality improvement initiative. It is used for the prioritisation and assessment of paediatric patients presenting to Emergency Departments. The system supports safer, more effective, timely ED care and reflects the importance of child and family experiences of emergency care.
It also makes a significant contribution to the suite of clinical tools developed by the EMP to drive improvement in the safety, quality and value of emergency care in Ireland. ICTS was piloted and audited in six hospitals across Ireland and will become the national standard for all children who present to Emergency Departments in Ireland.
Dr Áine Carroll, National Director for Clinical Strategy and Programmes Division said: “This important tool is a result of collective input and expert opinions from the National Clinical Programmes and frontline staff in our hospitals. The Irish Children’s Triage System enables a timely response to an identified need within our health care system and I would like to say a big well done to everyone involved in its development.”
ICTS is available for download HERE.
The triage of children in EDs is an established standard of care in international and national practice. However, the triage of children can be difficult compared to adults and additional triage parameters are recommended in ICTS to reflect age-related physiological differences, children’s presenting signs and symptoms, significant paediatric co-morbidities and common Paediatric Emergency Medicine diagnoses.
The outcomes of the Irish Children’s Triage System are:
The National Emergency Medicine Programme (EMP) is one of a number of clinical programmes under the Clinical Strategy and Programmes Directorate (CSPD) of the Health Service Executive (HSE). The aim of the EMP is to improve the safety and quality of patient care in Emergency Departments (EDs) and to reduce waiting times for patients.
The Programme is led by a multidisciplinary working group that includes Consultants in Emergency Medicine, Emergency Nurses, representatives of Pre-hospital Care and Therapy Professions.
The objectives of the National Clinical Programme in Emergency Medicine are to:
For more information and the list of working group members please see HERE.