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Intro to ER Nursing <br />An Overview<br />Mary Corcoran RN, BSN, MICN<br />

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ER NursingDefining the scope <br />The Scope of ER nursing practice includes <br />Assessment<br />Diagnosis<br />Treatment<br />Evaluation<br />

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ER Scope <br />Resolution of “Emergent” problems may require minimal care, advanced life support, patient and family education, appropriate referral, and knowledge of legal implications<br />

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ER Scope<br />Emergency nursing is multi dimensional, requiring knowledge of various body systems, disease processes, and age groups.<br />It also requires unique knowledge such as triage, and emergency operations preparedness, WMD training, Trauma care, EMS training and the anticipation of unforeseen scenarios. <br />

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Standards of emergency nursing practice <br />As set by the ENA (Emergency Nurses Agency) the ER nurse will:<br />Initiate accurate and ongoing assessment of physical, psychological, and social problems<br />Analyze assessment data to identify patient problems<br />Identifies expected outcomes, based on assessment, id problems, and cultural diversity<br />Formulates the plan of care, based on assessment, pt problems, and expected outcomes<br />Evaluates and modifies the plan of care based on observable pt responses, and attainment of expected outcomes<br />

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Standards of practicethe er nurse will:<br />Evaluate the quality and effectiveness of emergency nursing practice<br />Adhere to established standards of ER nursing practice including behaviors that characterize professional status<br />Recognize self-learning needs and is accountable for maximizing professional development<br />Engages in behaviors and activities that characterize a professional<br />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<br />

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Standards of er nursingthe er nurse will:<br />Ensures open and timely communication with emergency patients, significant others, and other health care providers through professional collaboration<br />Recognize, value, and use research and quality improvement findings to enhance the practice of emergency nursing<br />Collaborates with other health care providers to deliver patient-centered care in a manner consistent with safe, efficient, and cost effective use of resources<br />

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Community education<br />Emergency nurses are actively involved in community education problems, because they serve to reduce the risk and consequence of disease, illness and injury. <br />The ultimate outcome is achieved through primary, secondary, and tertiary prevention<br />

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Community educationprimary prevention<br />Primary prevention attempts to avert disease or injury by reducing risk factor levels<br />eg: child safety seat distribution and education<br />

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

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Community educationtertiary prevention<br />Tertiary prevention focuses on treating disease and injury in an effort to reduce disability and preserve function<br />eg: Referral to treatment programs for substance abuse<br />

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Core measures<br />What are they?<br />Core measures are items determined by the accreditation body of the hospital to be vital to improving patient care or outcomes<br />

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Core measures<br />What do I have to do as a nurse?<br />At your designated facility check with management or your PI department about what your specific core measures are and what is expected of you.<br />Examples of core measures are:<br />Acute Myocardial Infarction (AMI)<br />Heart Failure<br />Pneumonia<br />Pregnancy and related conditions<br />Surgical infection prevention<br />

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Patient Safety <br />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.<br />

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National Patient Safety Goals<br />Improve accuracy of patient identification<br />Improve the effectiveness of communication among care givers<br />Improve the safety of using medications<br />Reduce the risk of health care-associated infections<br />Encourage patients active involvement in their own care as a pt safety strategy<br />The organization identifies safety risks inherent in its population<br />Improve recognition and response to changes in patients condition<br />Accurately and completely reconcile medications across the continuum of care<br />Reduce the risk of patient harm resulting from falls<br />Reduce the risk of influenza and PNA in institutionalized older adults<br />Reduce risk of surgical fires<br />Prevent health care associated pressure ulcers (decubitus ulcers)<br />The organization meets the expectations of the universal protocol<br />

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Certification overview<br />ECRN- Emergency Communications Nurse<br />MICN- Mobile Intensive Care Nurse<br />TNS- Trauma Nurse Specialist<br />CEN- Certified Emergency Nurse<br />CFRN-Certified Flight Registered Nurse<br />CTRN- Certified Transport Registered Nurse<br />*all require examination and oversight by issuing body- either state, county, or institution<br />