Paul Hudson

Paul Hudson

Paul Hudson is the Project Officer, Between the Flags at the NSW Clinical Excellence Commission (CEC), which aim to improve the recognition and management of deteriorating patients across the NSW Public Health System.  Prior to joining the CEC Paul spent over 10 years working as a registered nurse  in a variety of roles including Emergency Clinical Nurse Consultant, Nurse Education and Nurse Manager. These roles provided the experience in policy and clinical practice guideline development, education, project manager, research and quality improvement.   Paul has completed his master in Emergency Nursing and has authored the articles on advanced nursing practice and early recognition and management of deteriorating patients.

 

The Psychology of Influence

Peter Anthony

Influence begins with every breath you take, and every conversation you make. This is particularly crucial in emergency and critical care environments where every communication moment is crucial. Mindful communication not only gives you more influence, but increases your compassion too – not just for your patients but for yourself. You will learn from the latest research how to create more influence through more mindfulness. The key topics we will discuss in emergency nursing environments will be:

  • Mindful influence moment by moment
  • What Mindset to master to encourage two way communication
  • Keys to conversational influence

 


Biography:

Peter Anthony is a Director at Thriive where he helps health professionals develop their influencing skills to achieve patient outcomes. He was formerly Associate Director of Executive Education at Australian Catholic University.He has a Masters in Communication and has run workshops on influence and positive coaching in 12 countries over 16 years. His book ‘Influence People’ describes a six step approach to having a collaborative conversation that leaves both people better off. Peter has developed a specialty in helping nurses achieve patient outcomes by using practical approaches from the positive psychology toolkit.
In Peter’s plenary session – The Psychology of Influence – He will highlight the latest learnings from positive psychology for emergency nurses with a focus on how to deal with stress and influence patients.

Brooke Parsons

“Brooke is just beginning her  nursing profession with just over three years experience, two in her special interest Emergency.

Currently Brooke works full time at Wollongong Hospital and is simultaneously studying Masters in Emergency Nursing.

Brooke moved from a rural NSW to Wollongong six years ago. She loves the beach & has a keen interest in fitness & travel.

Rapid rule out of acute coronary syndrome (ACS)

Erin O’Callaghan1, Marianne Griffen1

1 Emergency Clinical Care Network, Melbourne VIC

Assessment of risk is part of the chest pain assessment process within Emergency Departments. In 2016, the National Heart Foundation and Cardiac Society released guidelines advising that selected patients requiring rule out of Acute Coronary Syndrome in the Emergency Department can have a shorter assessment process. This project aimed to provide Emergency Departments across Victoria with guidance about how to combine clinical risk stratification, ECG and troponin testing; along with structure on how to guide patient management in a clear clinical pathway documentation process.

Background: The Emergency Care Clinical Network actively engages with emergency clinicians in creating and building sustainable improvements and innovation in the delivery of emergency care in Victoria. A key focus is to enhance the use of evidence-based care to reduce variation in clinical practise and improve patient care. Within this project: patients were considered eligible for the rapid rule out pathway if they had no high risk features, a modified TIMI score of 0 or 1, depending on the troponin assay used and a normal or unchanged ECG. Implementation of rapid rule out Acute Coronary Syndrome pathway for eligible patients would be in parallel with ‘standard’ practice for other patients.

Results: In 2016, a similar project was conducted; the median change in length of stay for the rapid rule out group over nine months was 96 minutes. The median change in length of stay was 58 minutes. This year the project aims to build on those, with results due November 2017.

Findings: The rapid rule out pathway reduced the average length of stay for patients in the Emergency Department using evidence based practice to guide clinicians. Extended benefits included clear discharge planning and patient education which improved patient centred care.

Summary: Implementation of the rapid rule out pathway in the Emergency Department enhances patient care by reducing variation in clinical practice based on evidence resulting in reduced length of stay and improved patient centred care.


Biography:

 Erin O’Callaghan is an Emergency Clinical Nurse Specialist and Associate Nurse Unit Manager. She works at a large tertiary Emergency Department (ED) and concurrently a smaller private ED in Melbourne. Erin also holds the position of  a Teaching Associate with Monash University.  Erin has a Master of Nursing (emergency). As part of this, Erin completed a research thesis titled ‘Compassion Fatigue in Emergency Nurses’ in 2015.  Erin has experience in homeless youth outreach and mental health case management. 
 
 
Erin is currently on secondment to Safer Care Victoria the Victorian Department of Health and Human Services, working within the Emergency Clinical Care Network (part of Safer Care Victoria). As a Senior Project Officer/ Nursing advisor. Erin’s role is to implement sustainable and innovative evidence based projects that reduce variation in clinical practice and improve quality of care across Victorian Emergency Departments.

Ian Miller

Ian Miller has worked in an Emergency Department in Canberra for the last 34 years.
He has practiced in a diverse range of positions including  a clinical development nurse, a clinical nurse consultant, and an eHealth project manager. But of all the roles he has undertaken he is most proud of being a bedside clinical nurse.

Ian began writing online back around 2000 with a website called impactEDnurse.com. He now writes a blog over at theNursePath.blog as well as:

Curating online content he hopes might be of professional interest to others.

Strategically tracking inter-hospital pillow movements….

and mostly,  being deeply inspired by other nurses across his social media feeds.
Ian lives with his partner Kelly and their dog Juno.

Injury management skills (binders, splints, HFNP, eFast, xray)

Join us to hear about the science behind these and other interventions, and get hands on experience in this interactive workshop

Interventions that will be covered are some of those that can be lifesaving in all types of emergency environments: rural, regional, pre-hospital, during transport and in the major trauma centre

We will discuss the purpose of each of the following and learn to use correctly

  • pelvic binder (purpose and correct placement)
  • the CT6 traction splint
  • eFAST
  • chest and pelvis xrays
  • Quikclot
  • highflow nasal cannulae
  • soft (foam) and philadelphia collars

Facilitators: Alex Tzannes, Rochelle Cummins

Rochelle has worked in ED for almost 10 years, 8 of which have been at SGH. For the past 5 years she has worked in the ED educator roles and currently is acting in the CNC role. She works closely with the Trauma service at SGH and have a passion for providing high quality patient care to all patient’s in the ED.

Anna O’Hare

I began my career in an inner city hospital, at the Royal Liverpool, UK were I progressed to Senior Sister/Clinical Manager completing my BSc (Hons) in Specialist Practice: Emergency Care.  I have dedicated my career to A&E and ‘I am passionate about providing excellent Emergency Care to the Illawarra Community’.

Mum of Quadruplets, Wife, Emergency Nurse Manger with 17 years of Emergency Nursing experience in the UK and Australia. A Kids Sports Cheerleader, fitness addict, beach bum and lonely planet global explorer!’

My family and I emigrated to Australia in 2013 for a change in life style. I took a role at Wollongong Hospital Emergency Department of which I am now the Nurse Manager. My vision is to manage and lead the ED team to continue to raise standards and improve our patients’ experience.

Emma Bosker

Emma Bosker is a mother of 7 children and speaks from the perspective of parent of a child using the emergency services.

She has a background in Occupational Therapy and Family Psychotherapy. She has worked in various mental health settings as an Occupational Therapist and furthered her skills as a therapist with a Postgraduate Diploma in Systemic Psychotherapy.

This led her into working with children, adolescents and families in the Public Health, Private and Charity Sectors.

She is currently a full time mother bringing up her children and is looking forward to reigniting her career once her youngest is at school.

She will talk you through the story of the accident, and subsequent care received, sharing the experiences of her son’s  journey to recovery.

The trends and characteristics of older people presenting with mental health or drug and alcohol conditions to four emergency departments

Prof. Margaret Fry1,2, Mr Steven Kay2, Dr Rosalind Elliott1,2

1University Of Technology Sydney, Broadway, Australia, 2Northern Sydney Local Health District, St Leonards, Australia

Introduction: The incidence of older people with mental health and/or drug and alcohol conditions is on the rise.  It has been estimated that older people with mental health and/or drug and alcohol conditions will double by 2020.  Emergency Departments (ED) need to be alert to the needs of this cohort. Therefore, the aim of this study was to explore trends and characteristics of older people with mental health and/or drug and alcohol conditions presenting to ED.

Methods: A 12 month retrospective medical record audit was conducted of presentations by older people (aged 65 years and over) with mental health and/or drug and alcohol conditions. The study was conducted in four Sydney EDs; one university tertiary referral hospital and three district Hospitals.

Results: There were 40,093 presentations during the study period; 2.3% (n=900) were related to mental health or drug and alcohol related conditions. The majority were female (n=471, 52.3%) with a mean age of 79 years and more than half arrived by ambulance. Diagnoses related to cognitive impairment (n=234, 26%), affective disorders (n=233, 26.0%), chronic mental health conditions (n=91, 10.1%) and aggression (n=86, 9.6%). Alcohol related (n=120, 13.3%) conditions or medication overdose (n=81, 9.0%) were more common than suicide related presentations (n=55, 6.1%). There was no documentation of completed suicide. Sixty-three per cent were admitted as an inpatient, with a seen by time of 36 minutes (mean) and a length of stay of 6 hours 21 minutes (mean).

Conclusion: Given our ageing population, early recognition and appropriate assessment will assist in better outcomes and management, reduce disease burden and improve overall quality of life for older people of this patient group.


Biography:

Professor Fry is Director of Research and Practice Development for Northern Sydney Local Health District and holds a Professorial Chair position with the University of Technology Sydney. Professor Fry has a strong emergency care background, has held CNC positions and is an authorised Nurse Practitioner (NSW). Professor Fry has extensive senior nursing experience and a proven research track with 118 peer reviewed publications and over $2.2million in grant, research tenders and or scholarship funding. Her program of research has led to significant state and national practice change. She was awarded Australasian emergency nurse of the year in 2005 and St George Hospital nurse of the year in 2001 and was a finalist in 2014 Nursing Excellence Awards for ‘Innovation in Research”. Professor Fry has also been awarded NSW Heath Care awards for innovative research making a difference for practice.

Implementation, evaluation and refinement of an intervention to improve blunt chest injury management

Prof. Kate Curtis1,2,6, Dr Connie Van1, A/Prof Stephen Asha2,5, Dr Mary Lam3, Dr Annalise Unsworth2, Dr Louise Atkin5, Dr Madison Reynolds6

1Sydney Nursing School, Sydney, Australia, 2St George Clinical School, Faculty of Medicine, University of New South Wales, High Street, , Kensington, Australia, 3Faculty of Health Psychology, Health Information Management, Genetic/Bioinformatics. University of Technology, Sydney, Australia, 4Centre for Behaviour Change, University College London, London, England, 5Emergency Department, St George Hospital, Kogarah, Australia, 6Trauma Service, St George Hospital, Kogarah, Australia

Failure to treat even one rib fracture early with sufficient analgesia, physiotherapy and respiratory support can lead to pneumonia, respiratory failure and/or death. Introduction of an early notification protocol for isolated blunt chest injured patients (ChIP) in our major trauma centre initiated consistent, multidisciplinary, tailored patient care that reduced the odds of patients developing pneumonia by 56%. The overall uptake of the protocol however was poor (68%) and factors which hindered or helped activation unknown.

Objectives:

– To determine factors influencing protocol uptake

– Identify evidence informed interventions to improve protocol use

– Re-implement and evaluate protocol compliance

Methods: Two methods were used in this mixed methods study conducted from 2012-2016.

1) Review of 603 linked trauma registry and medical records to identify any patient characteristics influencing protocol activation, and

2) Survey of 99 hospital staff to identify implementation barriers and facilitators. The survey was mapped to the Theoretical Domains Framework (TDF), known to impact clinician behaviour change.

Quantitative data were analysed using descriptive statistics, qualitative data coded in NVivo10.  Interventions to change target behaviours were sourced from the Behaviour Change Technique Taxonomy in consultation with stakeholders.

Principle findings: Eligible patients who did not receive ChIP were not different in demographic or clinical characteristics to those that did. Fifteen facilitators and 10 barriers were identified by staff. Seven interventions were selected to address target behaviours including modelling, training, persuasion and social influence. A multifaceted relaunch strategy, including video, targeted the motivation of activators and responders and the empowerment of nursing staff. In the 4 months post relaunch, uptake improved to 91% (p=.001).

Conclusions: Behaviour change theory may be used to improve clinical protocol implementation in the ED context. Newly implemented clinical protocols should incorporate clinician behaviour change assessment, strategy and interventions.


Biography:

Kate has been an emergency and trauma nurse clinician since 1994 and is Professor of Trauma and Emergency Nursing at the University of Sydney, where she leads the Paediatric Critical Injury Research Program. She is an honorary Professorial Fellow at the George Institute for Global Health and in 2011 was awarded the Frank McDermott Award for research completed and published in the last 10 years judged to have led to the greatest improvements in care of severely injured patients in Australia and NZ. Kate’s translational research program continues to focus on improving the way we deliver care to patients and their families and she is the world’s most published author in the field of Trauma and Emergency Nursing. Kate is also on the Editorial Board of the Australasian Journal of Emergency Nursing and a Fellow of the College of Emergency Nursing Australasia.

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