Revision and evaluation of an 'advanced' nursing role in an Australian emergency department

摘要

Background: Extended Practice Nurse roles have been initiated in various forms in many Australian Emergency Departments. Although common, evaluation of these roles is scarce in the literature. Methods: A four phase practice development project was launched to review contemporary models of Extended Practice Nurse, revise an existing Extended Practice Nurse model called the Advanced Clinical Nurse (ACN), develop and standardise a supporting education and accreditation structure, and implement an evaluative framework for the revised ACN model. Results: A standardised education and accreditation structure was implemented, an 8h ACN rostered shift commenced, and a mixed method evaluative framework initiated. Compared to management without an ACN, where an ACN was involved, mean medical management time of limb injuries and mean total length of stay was 42 min and 48 min shorter, respectively. Mean time to analgesia by an ACN was 22 min. Improvement in satisfaction was documented within subacute and waiting room patients. Median 'time to treatment' by an ACN was 6 min. Conclusions: Preliminary evaluation of the revised ACN model indicated practice benefits within early care delivery and patient flow. Continued standardisation of Extended Practice Nurse roles within New South Wales, Australia is necessary. The evaluative framework enabled greater understanding of this ACN role.