INTRO TO ER NURSINGAn Overview

Mary Corcoran RN, BSN, MICN

ER NURSINGDEFINING THE SCOPE

The Scope of ER nursing practice includes AssessmentDiagnosisTreatmentEvaluation

ER SCOPE

Resolution of “Emergent” problems may require minimal care, advanced life support, patient and family education, appropriate referral, and knowledge of legal implications

ER SCOPEEmergency nursing is multi

dimensional, requiring knowledge of various body systems, disease processes, and age groups.

It also requires unique knowledge such as triage, and emergency operations preparedness, WMD training, Trauma care, EMS training and the anticipation of unforeseen scenarios.

STANDARDS OF EMERGENCY NURSING PRACTICE

As set by the ENA (Emergency Nurses Agency) the ER nurse will: Initiate accurate and ongoing assessment of

physical, psychological, and social problems Analyze assessment data to identify patient

problems Identifies expected outcomes, based on

assessment, id problems, and cultural diversity Formulates the plan of care, based on

assessment, pt problems, and expected outcomes Evaluates and modifies the plan of care based on

observable pt responses, and attainment of expected outcomes

STANDARDS OF PRACTICETHE ER NURSE WILL: Evaluate the quality and effectiveness of

emergency nursing practice Adhere to established standards of ER nursing

practice including behaviors that characterize professional status

Recognize self-learning needs and is accountable for maximizing professional development

Engages in behaviors and activities that characterize a professional

Provides care based on philosophical and ethical concepts: including reverence for life; respect for the inherent dignity, worth, autonomy, and individuality of each human being; and acknowledging the beliefs of other people

STANDARDS OF ER NURSINGTHE ER NURSE WILL:

Ensures open and timely communication with emergency patients, significant others, and other health care providers through professional collaboration

Recognize, value, and use research and quality improvement findings to enhance the practice of emergency nursing

Collaborates with other health care providers to deliver patient-centered care in a manner consistent with safe, efficient, and cost effective use of resources

COMMUNITY EDUCATION

Emergency nurses are actively involved in community education problems, because they serve to reduce the risk and consequence of disease, illness and injury.

The ultimate outcome is achieved through primary, secondary, and tertiary prevention

COMMUNITY EDUCATIONPRIMARY PREVENTION

Primary prevention attempts to avert disease or injury by reducing risk factor levelseg: child safety seat distribution and education

COMMUNITY EDUCATIONSECONDARY PREVENTION

Secondary prevention aims to detect disease early to control or limit its effects eg: HIV/STD screening for those with risky behavior

COMMUNITY EDUCATIONTERTIARY PREVENTION

Tertiary prevention focuses on treating disease and injury in an effort to reduce disability and preserve functioneg: Referral to treatment programs for substance abuse

CORE MEASURES

What are they?Core measures are items

determined by the accreditation body of the hospital to be vital to improving patient care or outcomes

CORE MEASURES What do I have to do as a nurse?

At your designated facility check with management or your PI department about what your specific core measures are and what is expected of you.

Examples of core measures are:Acute Myocardial Infarction (AMI)Heart FailurePneumoniaPregnancy and related conditionsSurgical infection prevention

PATIENT SAFETY

National Patient Safety Goals (NPSG) are a standard set by the accreditation body, following a systematic review of literature and databases by safety experts and clinicians. ER nurses are responsible for integrating these safety goals into the care they provide.

NATIONAL PATIENT SAFETY GOALS Improve accuracy of patient

identification Improve the effectiveness of

communication among care givers

Improve the safety of using medications

Reduce the risk of health care-associated infections

Encourage patients active involvement in their own care as a pt safety strategy

The organization identifies safety risks inherent in its population

Improve recognition and response to changes in patients condition

Accurately and completely reconcile medications across the continuum of care

Reduce the risk of patient harm resulting from falls

Reduce the risk of influenza and PNA in institutionalized older adults

Reduce risk of surgical fires Prevent health care

associated pressure ulcers (decubitus ulcers)

The organization meets the expectations of the universal protocol

CERTIFICATION OVERVIEW

ECRN- Emergency Communications Nurse MICN- Mobile Intensive Care Nurse TNS- Trauma Nurse Specialist CEN- Certified Emergency Nurse CFRN-Certified Flight Registered Nurse CTRN- Certified Transport Registered Nurse

*all require examination and oversight by issuing body- either state, county, or institution