There is a well-established link between shift work, nurse exhaustion and clinical errors. However there is a lack of research focusing specifically on Emergency Departments (ED) and nurse rostering patterns.
ED nurses are at particular risk of fatigue due to the fast-paced and demanding nature of the work environment caring for high acuity patients, increasing the risk of clinical errors and threatening patient safety. Shift work in the ED is an around-the-clock occupation, frequently nurses are required to commence work at 07:00 on the morning following a 21:30 finish, a shift pattern termed a “late/early”. Understanding the impact that this shift pattern may have in adverse clinical events is critical for patient and staff well-being.
This novel project will collect and analyse retrospective data from the ED at Nambour General Hospital to ascertain whether late/earlies are associated with adverse patient outcomes. We will use a logistic regression model to analyse data collected from PRIME (electronic database for clinical incident reporting), TrendCare (online nurse rostering system), EDIS (Emergency Department Information System) and patient medical records. This analysis will allow us to identify any association between clinical incident severity rating, patient outcomes, time of the incident, staff roster patterns and level of nursing experience.
The results of this study will therefore provide significant insights into the relationship between ED nurse shift patterns and adverse clinical events. The outcomes of this research may be used to assist and improve rostering practices, fatigue management, staff well being, and improve patient safety outcomes.READ MORE
Emergency doctors have been shown to exhibit higher levels of psychological distress and burnout than both their medical colleagues and the general population. This study will measure levels of burnout and psychological distress amongst Emergency Registrars before and after the implementation of a clinical debriefing program. It will be ascertained whether there is a difference in the before and after scores and whether the change is statistically significant.READ MORE
Patient flow and access block will be evaluated through comparing time to decision making in the Emergency Department (ED) and Emergency Department length of stay (ED LOS) between patients who have POC and Laboratory BNP testing. Cost effectiveness will be evaluated by reviewing treatment type given, admission rate, ICU admission rate, inpatient length of stay (IP LOS), Emergency Department Length of Stay and 30day readmission rate.
This study will build upon the findings of a similar concurrent study. Both studies demonstrate a poor utility in BNP testing in patients presenting with shortness of breath in reducing Emergency Department length of stay. While this limits the potential for BNP Point of care testing within the ED, the validated Abbott Point of Care BNP cartridge will have the good potential for improving patient care in rural and remote cardiac outpatient locations where current BNP testing results take several days to obtain.READ MORE
The objective of this research was to evaluate the effect of working consecutive night shifts on sleep time, prior wakefulness, perceived levels of fatigue and psychomotor performance in a group of Australian emergency registrars. A prospective observational study with a repeated within-subjects component was conducted. Sleep time was determined using sleep diaries and activity monitors. Subjective fatigue levels and reciprocal reaction times were evaluated before and after day and night shifts.READ MORE