1. Intro to ER Nursing An Overview Mary Corcoran RN, BSN, MICN

2. ER NursingDefining the scope The Scope of ER nursing practice includes Assessment Diagnosis Treatment Evaluation

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

4. ER Scope Emergency 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.

5. 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

6. 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

7. 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

8. 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

9. Community educationprimary prevention Primary prevention attempts to avert disease or injury by reducing risk factor levels eg: child safety seat distribution and education

10. 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

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

12. 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

13. 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 Failure Pneumonia Pregnancy and related conditions Surgical infection prevention

14. 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.

15. 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

16. 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