Benjamin Horan1, Hannah Putland1, Emily Cooper1
1Department of Emergency Medicine, Princess Alexandra Hospital
Integrated electronic medical records(iEMR) offer a huge potential for increasing patient medical record accuracy, integration and thus patient care(1), as well as reducing associated clinician worktime(2) and thus provision of cost-effective quality healthcare(3). Despite this potential, a number of barriers to implementation at individual and organizational levels have been identified(3,4), blunting initial enthusiasm for this patient record process. The successful innovative use of iEMR during presentations requiring high acute emergency care (resuscitation) replaced paper documentation including all observations, medications and clinical orders.
Implementation of the Cerner program (https://www.cerner.com) specifically, FirstNet for Emergency presentations, included 60 hours of innovative education and training for ~150 resuscitation competent Emergency department (ED) nurses. This included offline training days, digital practice domains, real-time simulations, and revision of our model of care which included changes in policies and procedures with close collaboration with medical and other ED staff. Optimisation strategies have been implemented to improved documentation and processes. Resuscitation nurses now exclusively chart via computer workstations (mobile or fixed) located in each of the 5 resuscitation bays during episodes of high acuity care. This digital charting enhances patient quality of care by reducing delays in obtaining test results and accessing previous records, enabling medical and nursing staff to access and enter data into the same record simultaneously, ensuring legibility and prompting complete record entries. In the often highly stressed and chaotic space, such a centralized tool appears to enhance patient care staff and patient safety and delivery of timely quality clinical processes. This demonstrates the capacity for ED cultural and procedural change where there is clear organizational and managerial support, and there are clear advantages for patients and staff.
Ben Horan- Ben graduated BN in 2012 and gained a graduate Job at the Princess Alexandra Hospital ED. He completed his EPIQ program and then followed on to complete a Graduate Certificate in Emergency Nursing and also the Trauma Nursing Core Course (TNCC). He has a strong interest in Resuscitation and Trauma nursing. Ben is currently acting in the Associate Nurse Manager Role.
Hannah Putland- Hannah received her BN in 2009. She has worked her way from graduate to Clinical Nurse Consultant in the Princess Alexandra ED. Hannah has her Masters in Emergency Nursing and a Graduate Certificate in Clinical Education. She is currently undertaking a Post Graduate Certificate in Disaster Management and dreams to one day work with the Red Cross in aiding during international crisis.
Emily Cooper- Emily has been an Emergency Nurse for 10 years. She has worked across 2 Metro organisations with most of her time spent at the Princess Alexandra Hospital ED where she works as the Nurse Educator. Emily has completed a Masters of Emergency Nursing. She is currently the Co- Chair of the QLD State wide Emergency Nurse Educators group and is passionate about developing and mentoring staff to achieve their full potential.