Nurse practitioner and clinical nurse consultant roles in the emergency department: Are both roles necessary in a busy regional ED

Nurse practitioner and clinical nurse consultant roles in the emergency department: Are both roles necessary in a busy regional ED
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  6th International Conference for Emergency Nurses 213potential risks worth the perceived clinical benefits for ouremergency clients? Keywords:  Prophylactic metoclopramide; Quality use of medicines; Emergency departmentdoi:10.1016/j.aenj.2007.09.067 Nurse practitioner and clinical nurse consultant roles inthe emergency department: Are both roles necessary ina busy regional ED? Kathleen Tori ∗ , Stuart Turk Bendigo Health, PO Box 126, Bendigo, VIC, Australia This presentation will explore the role of the emergencynurse practitioner (ENP) and clinical nurse consultant (CNC)in a busy regional emergency department (ED) from personaland professional perspectives. There is no doubt that boththe NP and CNC roles have contributed to the body of knowl-edge underpinning the profession of nursing, contributedto changing health care delivery services and reinforcedemphasis on primary care provision. Yet there is a paucityof Australian literature surrounding the newly implementedroles of both NP and the CNC, which is not surprising giventhefactthatthespecialisednursingpositionshaveonlybeenrecently developed compared to our international counter-parts.The introduction of both positions in a busy regionalED occurred within a short time frame in order to meetincreasing demands, including increased client presenta-tions and resources. NP and CNC are two distinct advancedpractice nursing areas that although share similarities areboth quite different. Both roles have had an exciting andpositive effect on the provision of quality care for clientsand increasing the emergency department efficiency, butas with the introduction of new roles into any departmentthere was some degree of trepidation and uncertainty aboutthe implemented roles. Questions arose and included amongothers—–So what’s the difference between the two roles? Areboth roles necessary in meeting client needs? Does the EDneed both roles? Keywords:  Emergency nurse practitioner; Clinical nurseconsultant; Emergency nursingdoi:10.1016/j.aenj.2007.09.068 Nursing management of acute stroke in an emergencydepartment setting Joanne van Berkel 1 , ∗ , Bernice Redley 2 , 31 Barwon Health, Geelong, VIC, Australia 2 Deakin University, Melbourne, VIC, Australia 3 Department of Human Services, VIC, Australia Background:  The National Stroke Foundation providesevidence-based guidelines for the emergency managementofacutestroke,however,itisnotknownifemergencynurseshave adopted these guidelines in their clinical practice. Aim:  The aim of this study was to examine the trajec-tory of nursing management of patients who present to theemergency department with symptoms of acute stroke, andcompare this care against the recommended standards forbest practices. A secondary aim of this study was to exploretherelationshipsbetweencomponentsofemergencynursingcare and specific patient outcomes. Methods:  Recommendations for best practices in strokemanagement were used to develop a specific audit tool. Adescriptive,comparativedesignwasusedtoconductaretro-spective audit of 130 hospital medical records. Comparativeanalysis of the care documented in the medical record with recommendations for best practice was undertaken. Results : Data analysis revealed several elements of nurs-ing care were consistent with best practices, however,several areas of nursing care were identified as target areasfor practice improvement. These related to triage cate-gory, aspirin administration, blood glucose monitoring andswallowing assessment. Analysis revealed significant rela-tionships between two elements of nursing care and theoutcome of patient length of hospital stay. Conclusion:  Findings from this study indicate that sev-eral elements of nursing care meet the standards outlinedby the National Stroke Foundation. However, there is roomfor improvements in some aspects of nursing managementof stroke in the emergency department and this has thepotential to impact on important patient outcomes.doi:10.1016/j.aenj.2007.09.069 Does peripheral intravenous catheter dwell time effectthe development of phlebitis? A randomised control trialin home-based acute care Trish Van Donk Latrobe Regional Hospital, Traralgon, VIC, Australia A study was performed in a regional hospital to inves-tigate the clinical practice of extended intravenous dwelltime in home-based acute care (Hospital in the Home). Hos-pital in the Home (HITH) services commenced in Victoriain the late 1990s. The purpose was to provide acute hospi-tal care to patients in their own home. This research wasperformed to investigate the effects, if any, on extendedintravenous catheter dwell time in the home.The literature identifies numerous variables that mayinfluence the outcomes of research into the effect of periph-eral intravenous dwell time. Overall the literature supportsthe extension of peripheral intravenous catheter dwell timeto 96h or beyond in certain circumstances in the hospitalsetting, which has both economic benefits to health careproviders and reduces trauma, pain and discomfort to thepatients.This research was performed using a quantitative exper-imental design. HITH patients were randomly assigned toa control or experimental group. Informed consent wasobtained from all participants. The control group had theircatheters re-sited routinely between 72 and 96h, whilethe experimental group catheters were left in situ. Themaximum dwell time in this group, in the absence of com-plications varied between 1 and 19 days. Catheters in bothgroups were removed if phlebitis developed or if they wereno longer required, regardless of dwell time. Catheterswere assessed daily for signs of phlebitis, using a phlebitisscale.

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