‘roots to grow and wings to fly’: the introduction of a transition program at the royal hobart...
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doi:10.1016/j.aenj.2011.09.028
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n evaluation of an Early Pregnancy Assessment ClinicEPAC) in one Australian Emergency Department
im Wendt1,∗, Julia Crilly2, Nicole Beatson3
Emergency Department, Gold Coast Hospital & Redlandospital, Weippen Street, Cleveland, Qld. 4163, AustraliaEmergency Department, Gold Coast Hospital & Griffithniversity, 108 Nerang St, Southport, Qld. 4215, AustraliaEmergency Department, Gold Coast Hospital, 108 Nerangt, Southport, Qld. 4215, Australiaeywords: Advanced nursing practice; Pregnancy; Miscar-iage; Emergency department; Nursing; Evaluation
-mail addresses: kim [email protected]. Wendt), Julia [email protected] (J. Crilly),icole [email protected] (N. Beatson).
Background: More than one in five pregnancies endsn miscarriage. Women experiencing complications associ-ted with early pregnancy often present to the Emergencyepartment (ED). The aim of this research was to (i)valuate the structures and processes of an Emergencyepartment Early Pregnancy Assessment Clinic (ED EPAC)nd (ii) evaluate the outcomes of women who presented tohe ED in early stages of pregnancy with complications. TheD EPAC was implemented in order to specifically addresscute needs of women with complications of early preg-ancy.
Methods: This mixed methods study undertaken in 2010ncorporated two parts; Part 1 was a content analysisf semi-structured interviews with 11 key stakehold-rs (health care professionals and patients) of the EDPAC to evaluate its structures and processes. Part 2as an observational cohort study involving the analy-
is of patient level data to describe characteristics andemporal trends of presentations made to the ED, withomplications of early pregnancy over a 6-year period2004—2009).
Findings: Part 1: Structures and processes pertinent tohe ED EPAC included the provision of a private envi-onment situated within the ED, and the provision andommunication of care service between a variety of careroviders located within the hospital and community. Inte-ral to ED EPAC operation was the model by which continuityf care was delivered. That is, as a primarily nurse-ledervice where the clinical nurse has acute care experi-nce coupled with advanced pregnancy related knowledge.art 2: Over the 6 year period 4992 patient presentationsere made to the ED with complications of early preg-ancy. Outcomes that have improved over time include:ime to see a clinician, ED LOS, hospital admission ratend the number of pathology tests ordered per patientresentation. These outcomes were particularly noted tomprove following the implementation of the ED EPACin 2005).
Conclusions: The ED EPAC is a primarily nurse-led modelf care that can be implemented and operated effectivelyrom within an ED to benefit patients and health service
roviders. Minor changes to service delivery for a selectatient group (in this case females presenting to the ED withomplications during early pregnancy <20 weeks gestation)an impact positively on patient and service provider out-omes. The model evaluated may be useful to apply in EDettings elsewhere.
oi:10.1016/j.aenj.2011.09.027
Roots to grow and wings to fly’: The introduction of aransition program at the Royal Hobart Hospital Emer-ency Department
ancy Arnold ∗, Tony Bradley, Kobi Rybak, Alison West
Royal Hobart Hospital, Liverpool Street, Hobart, Tasmania000, Australiaeywords: Graduate; Transition
-mail addresses: [email protected]. Arnold), [email protected] (T. Bradley),[email protected] (K. Rybak),[email protected] (A. West).
Working in an emergency department is a challenge eveno the more experienced nurse and therefore it is essen-ial that effective support is provided to novice nurses.he Royal Hobart Hospital (RHH) Emergency DepartmentED) is committed to the development of its nursing work-orce, which is essential to achieving and delivering goals ofigh quality person centred care. To achieve this objective,structured professional development pathway for novice
urses was developed as they undertook employment in theD for the first time.
In the period from 2009 till present a specific pro-ram has been developed by clinicians in the ED whichas taken into account feedback from graduate nurses andhe broader team. Skill development, confidence and com-etence for graduate nurses is central to the model andas been blended with a support program which aims tonsure delivery of high level care. The aims are furtherupported by a capability ladder which assists both theeam and graduates to understand their role, future devel-pment needs and growth. The program has grown andeveloped from initially supporting two graduates in 2009,o eight currently. This presentation details the develop-ent of the program and the vision that has providedarticipants with the opportunity to embark upon an emer-ency nursing career pathway that articulates with furtherpportunities in the tertiary sector. Outcomes of the pro-ram indicate high satisfaction from graduate nurses andhe ED team, and high levels of retention of nursing gradu-