The impact of the HIRAID emergency nursing program on patient and hospital outcomes
- Conditions
- Emergency nursingEmergency medicine - Other emergency carePublic Health - Health service research
- Registration Number
- ACTRN12621001456842
- Lead Sponsor
- The University of Sydney
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- All
- Target Recruitment
- 3200
There are six different populations, with key inclusion criteria for this study:
Source 1: Patient’s with clinical deterioration in 72 hours - medical record review:
- Rapid response equal or less than 72 hours post Emergency Department Discharge (EDD)
- Rapid response call
- Admitted via Emergency Department (includes admission to ward via interhospital transfer direct from ED within Southern NSW LHD)
Source 2: Patient presenting to ED with painful conditions:
Clinical records of patients meeting one or more of the study inclusion criteria, and no exclusion criteria, will be reviewed retrospectively.
- Presented to ED and given a triage category 2, 3, 4 or 5; AND
- Presented to the ED with chest pain, abdominal pain, hip or limb pain
Source 3: Patient or carer:
All patients presenting to the ED, meeting study inclusion criteria will be provided with a participant information sheet for the study.
- Patient, or carer of a patient admitted to the ED during study period;
- Patient/ carer over 18 years of age.
Source 4: Staff surveys-nursing:
All nursing staff permanently employed in the EDs/ MPS across each LHD, pre and post implementation, will be invited by their ED/MPS Manager, Medical Director or Research Nurse via email to participate.
Source 5: Staff surveys-medical staff:
All medical staff, employed on a regular basis, will be invited to complete a survey related to medical staff satisfaction related to clinical handover pre and post the intervention.
Source 6: Nursing staff interviews:
All nursing staff employed in the EDs/ MPS across each LHD, during the implementation period will be eligible to participate. Staff who complete the nursing survey post will have the opportunity to indicate their willingness to participate and provide contact details (phone and/ or email) to the researchers.
There are six different populations for this study:
Source 1: Patient’s with clinical deterioration in 72 hours - medical record review:
Exclusion Criteria
- ICU admission prior to call
- Operation prior to call
Source 2: Patient presenting to ED with painful conditions:
- Triage category 1
- Patients receiving a team response in the ED e.g. trauma team response, stroke, etc
Source 3: Patient or carer:
- patient, or carers of patients, at end-of-life care; OR
- triage category 1; OR
- patients/ carers with cognitive impairment (eg. intoxication, dementia).
Source 4: Staff surveys-nursing:
Source 5: Staff surveys-medical staff:
Source 6: Nursing staff interviews:
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Change in patient deterioration within 72 hours of admission via Emergency Department (ED).<br><br><br>[ Audit of records collected retrospectively for each site for up 12 months prior to intervention. ];Change in time to first analgesia in ED (triage time to first dose) for patients presenting with abdominal, hip, limb or chest pain by audit of medical records.<br>[ Audit of medical records from 12 months prior to intervention commencement to 12 months post intervention. ];Patient/carers ED experience assessment using a study-specific survey via 15 minutes follow-up call.<br><br><br>[ Assessed within two weeks of patient discharge and up to three months prior to intervention commencement.]
- Secondary Outcome Measures
Name Time Method Acute treatment costs associated with patient deterioration within 72 hours of admission to ED by reviewing performance and casemix data.<br>[ Audit of records from 12 months prior to intervention commencement to 12 months post-intervention commencement];Pain score to one-hour post analgesia administration, as per pain score documented in the electronic medical record system (10-point VAS). <br>[ Assessed in all patients that fit criteria and whom received analgesia 12 months pre-intervention and then 12- months post-intervention. <br><br>];Nurse and medical officer satisfaction with patient assessment and provision of nursing care using a study-specific 15 minutes nursing and medical staff survey, respectively.[ Nurse and medical officer satisfaction will be measured within 3 months pre-intervention and 6 months post-intervention.]