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new Emergency and Trauma Centre in Galle, Sri Lanka.n early 2007 the first team from The Alfred Emergencynd Trauma Centre completed a training program on traumaare and trauma triage. Twelve months later, after furtherraining visits to Sri Lanka addressing other emergency pre-entations, the original team revisited to evaluate the effectf the training program.

Significant improvements where noted in nursing lead-rship, documentation, the use of universal precautions,atient advocacy and department organisation. Critical carenowledge has been a major area of improvement espe-ially with the introduction of invasive and non-invasiveentilation. Improved skills and confidence in utilising newquipment that has been provided as part of the projects apparent and increased enthusiasm in self education andelf governance is also evident. Areas for further educationuch as triage where also identified.

The effects of this nursing education program are evi-ence of the importance of nurses as educators and roleodels within specialities such as emergency nursing in theeveloping world.

oi:10.1016/j.aenj.2008.09.003

ultural diversity: Crossing contextual borders in emer-ency care

armel Stewart

School of Nursing and Social Work, University of Melbourne,IC, Australia

Managing cultural diversity in health care is a challengeacing nurses globally. The issues experienced by migrantopulations in health care transcend clinical, political andocial borders. Australia is one of the most culturally diverseations and the adherence to a Western biomedical modelf health care creates inequalities in health care for migrantopulations. These inequalities occur in health care out-omes, access to, and delivery of care during interactionsetween consumers and health care professionals. Severaltrategies have been introduced, both globally and withinustralia, with little effect on reducing inequality, with lit-le explanation of why they have been ineffective. Thesetrategies include introduction of cultural content in healthrofessional curricula, and government policy and guide-ines.

A grounded theory study currently in progress is exploringhe perceptions of nurses working in emergency depart-ents and consumers from a culturally linguistic and diverse

CALD) background who experience care delivery in emer-ency departments. The aims of the study are to identifylements of the nurse—patient interaction that affect thebility of nurses in emergency departments to provided careeading to positive outcomes for consumers from a CALDackground.

The presentation aims to:

Present the relevance and importance of this area foremergency nurses.Outline the methodology used in the study.Introduce significant areas identified in initial analysis todate.

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Consider potential recommendations emerging from theanalysis and exploration.

oi:10.1016/j.aenj.2008.09.004

nvironmental change and human health: Are we ahreatened species?

ane Mateer

RMIT University, Bundoora, VIC, Australia

In 1993 Anthony Carmichael’s Planetary Overload coinedhe concept of humans as a potentially endangered species.entral to this notion were overpopulation and the impact ofechnology and human consumption demands overreachinghe earth’s capacity to supply, replenish and repair. In worldopulation terms, there appeared little interest in exploringhis concept, perhaps because we have always had cyclesf drought, floods, pestilence and climate change and ashe ‘tragedy of the commons’ demonstrates, we are oftenoathe to consider the impact of our actions on our neigh-ours. In 2008, we have a clearer view of an anthropogenicole in exacerbating changes in the earth’s ecosystems, andhe potential risk of becoming a threatened species: vic-ims of the effects of habitat destruction, overexploitation,isease, pollution, predation, competition with others andimited distribution.

Thus, environmental change threatens the health andecurity of our species. To mitigate this threat and pro-ect our life sustaining systems, we are faced with a dualhallenge. We must underpin technological solutions withfundamental cultural shift in our behaviour. If we do not

lter our interaction with the environment, over demand foramaging technology and expectations of what the earthan provide, technology will be unable to find sustainableolutions for what ultimately threatens our health.

The purpose of this presentation is to review how theain environmental issues may impact on human health andsustainable future and to challenge nurses as individuals

nd a profession, to develop solutions to a sustainable globalnvironment and explore how our practice might need tohange to address new or expanding areas of health concern.

oi:10.1016/j.aenj.2008.09.005

ORKFORCE EDUCATION

hursday 28 August—–Concurrent Session 1

s a consistent approach to education in the ED achiev-ble?

manda Charles

Southern Health is one of the largest hospital networks inictoria, Australia. There are three Emergency DepartmentsED) within the network, of varying acuity, and patient pre-entation numbers more than 128,000 patients annually. The

Ds are staffed by Registered nurses Division 1 and 2 and alsoupport a variety of formal education programs. These pro-rams include post-graduate students studying emergencyursing and novice practitioners undergoing a structured

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3rd National Conference for Emergency Nurses

and supported program. There was also a number of staffemployed in a permanent capacity with a variety of experi-ence and qualifications.

In 2007 the team of emergency nursing educators weregiven the opportunity to apply a consistent approach toemergency nursing education in the EDs. All the EDs hada variety of learning packages and methods to ascertain thenursing staff’s ability to practice within different areas ofthe EDs. The objective was for the educators to modify allof these documents into an agreed and consistent approach.My paper will outline the processes that we followed toimplement and evaluate these documents.

doi:10.1016/j.aenj.2008.09.006

eLearning: 1091 episode of education in 2 months

Matt Luther1,∗, Shane Lenson2

1 Clinical Advisor, Calvary elearning, Calvary Health Care,ACT, Australia2 Administrator, Calvary elearning, Calvary Health Care,ACT, Australia1

Historically, effective and efficient continuing educa-tion for health care professionals has been difficult toachieve. Some of the obstacles identified in achievingdesired outcomes include; increasing workloads, workforcelimitations and budgetary constraints. When these obstaclesare combined with escalating challenges such as; increasingconsumer expectations, contemporary organisational andprofessional mandatory requirements and risk managementprinciples, the provision of a practical learning approachbecomes complex.

Calvary Heath Care ACT, after identifying the aboveissues associated with the provision of continuing education,has developed and implemented an eLearning platform thatprovides a flexible, modern mode of delivery for professionaleducation.

This platform has proven to be a successful tool displayinghigher rates of training compliance than traditional trainingmethods. Participant satisfaction is also higher, attributedto the ease of access, convenience, and the self-directionbenefits provided by eLearning.

eLearning can provide a cost effective education solu-tion as well as a feeling of ownership and corporate pridethrough the use of local area experts providing evidencebased, accessible, flexible and timely training and educa-tional support to their professional colleagues.

The eLearning platform has now been established atother Calvary sites across Australia including a number ofsites in remote or regional areas. This presentation aims tocover the lessons learnt in establishing an eLearning plat-form in regional areas including the benefits that eLearning

can provide, particularly in the critical care and mandatorytraining requirement domains.

The presentation will also provide the key elements forestablishing an eLearning platform, demonstrate the flexi-bility, accessibility and quality training benefits of eLearning

1 ACT@calvary-act.com.au.

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nd provide information and advice in how rural health ser-ices can develop their own eLearning system.

oi:10.1016/j.aenj.2008.09.007

ocs and frocks in mocks

. Dodson1,∗, T. Mountford2,∗, J.P. Acworth3,

. Ellis-Cohen1, S. Keogh4

Nursing Education, Royal Children’s Hospital, Herston,risbane, QLD, AustraliaDept of Emergency Medicine, Royal Children’s Hospital,erston, Brisbane, QLD, AustraliaDepartment of Paediatrics & Child Health, University ofueensland and Dept of Emergency Medicine, Royal Chil-ren’s Hospital, Herston, Brisbane, QLD, AustraliaNursing Research, Royal Children’s Hospital, Herston, Bris-ane, QLD, Australia

Background: The infrequent nature of paediatric medicalmergencies on a ward setting may limit individual exper-ise and increase anxiety for ward staff dealing with theseituations. Simulated paediatric emergency exercises offermethod of teaching and maintaining knowledge and skills

nd can be tailored to address particular knowledge/skilleficits.

Aims: This study examined the effect of a regularcenario-based educational intervention on the knowledge,ractical skills and attitudes of ward-based paediatric nurseshen dealing with severe respiratory, cardiovascular or neu-

ological compromise in paediatric patients.Methods: A pre-test/post-test intervention design was

sed to assess the impact of mock emergency exercises upondentified deficits in paediatric assessment and life supportanagement. Nurses from four clinical areas participated in

n initial attitudes and knowledge questionnaire, pre- andost-intervention testing scenarios. Scenario performanceas scored using a previously validated evaluation tool.

Results: Eighty-seven nurses completed the initial ques-ionnaire. Mean years experience was 3.63 years with 28espondents (32.2%) reporting ≥10 years nursing expe-ience. Most nurses (86.2%) reported lacking confidencen managing paediatric emergency situations. Participantnowledge was less than optimal, with only 8 respon-ents (9%) achieving scores of ≥80%. Testing scenario scoresmproved significantly in the areas receiving regular mockxercises (70 pre—89% post) compared to control areas (75.8re—65.6% post).

Conclusions: Regular ward-based simulation exercisesan improve clinical skills in dealing with paediatricmergency situations. A multi-disciplinary Mock Paediatricedical Emergency Program has been implemented across

ation striving towards a collaborative team approach toaediatric emergency management.

oi:10.1016/j.aenj.2008.09.008