HIRAID: an evidence informed patient safety system improves emergency care: a pre: post study
Tracks
Concurrent Stream 1
| Wednesday, October 16, 2024 |
| 3:30 PM - 3:50 PM |
| Ionic Room |
Overview
Margaret Murphy
Speaker
Associate Professor Margaret Murphy
westmead
HIRAID: an evidence informed patient safety system improves emergency care: a pre: post study
3:30 PM - 3:50 PMAbstract
Background
Assessment of undifferentiated patients, timely interventions, communication, and recognition of deterioration are fundamental to safe and quality emergency care. HIRAID® is an evidence informed nursing framework used by emergency nurses for any patient presentation to assess and manage patients post triage. In 2022, Western Sydney Local Health District (WSLHD) partnered with The University of Sydney to implement HIRAID® into all four Emergency Departments (EDs).
Methods
This study used a pre-post design to assess the impact of HIRAID® on emergency nursing assessment, patient experience, pain management, clinical handover, and clinical deterioration.
Nursing documentation was evaluated using the modified D-catch tool. Patient and/or carer satisfaction with nursing care was measured using the Schmidt's Perceptions of Nursing Care Survey (SPNC) and Australian Hospital Patient Experience Question Set (AHPEQS). They completed a phone interview. Patient deterioration data within 72-hours of ED departure was reviewed to identify incidence of inpatient deterioration related to ED care. Data were analysed using descriptive statistics.
Results
A total 589 (Pre 285, Post 313) patients completed the survey. There was improvement is all categories of the SPNC. Likewise, 10 out of 12 AHPEQS improved. Patient reported being better informed (p 0.006), views listened to (p 0.038), needs met (p 0.0410) and supported when distressed (p 0.011). A total 221 (Pre 111, Post 110) patient records were reviewed. After HIRAID® implementation nursing documentation was completed 43 minutes earlier. HIRAID® documentation template had 100% adoption. There were significant improvements in documentation quality, notably in A-G assessment, identifying red flags, interventions, nursing care plans and communication with family. There was a reduction in patient deterioration associated with emergency nursing care.
Conclusion
The implementation of HIRAID® significantly improved patient safety and experience in WSLHD and should be upscaled.
Assessment of undifferentiated patients, timely interventions, communication, and recognition of deterioration are fundamental to safe and quality emergency care. HIRAID® is an evidence informed nursing framework used by emergency nurses for any patient presentation to assess and manage patients post triage. In 2022, Western Sydney Local Health District (WSLHD) partnered with The University of Sydney to implement HIRAID® into all four Emergency Departments (EDs).
Methods
This study used a pre-post design to assess the impact of HIRAID® on emergency nursing assessment, patient experience, pain management, clinical handover, and clinical deterioration.
Nursing documentation was evaluated using the modified D-catch tool. Patient and/or carer satisfaction with nursing care was measured using the Schmidt's Perceptions of Nursing Care Survey (SPNC) and Australian Hospital Patient Experience Question Set (AHPEQS). They completed a phone interview. Patient deterioration data within 72-hours of ED departure was reviewed to identify incidence of inpatient deterioration related to ED care. Data were analysed using descriptive statistics.
Results
A total 589 (Pre 285, Post 313) patients completed the survey. There was improvement is all categories of the SPNC. Likewise, 10 out of 12 AHPEQS improved. Patient reported being better informed (p 0.006), views listened to (p 0.038), needs met (p 0.0410) and supported when distressed (p 0.011). A total 221 (Pre 111, Post 110) patient records were reviewed. After HIRAID® implementation nursing documentation was completed 43 minutes earlier. HIRAID® documentation template had 100% adoption. There were significant improvements in documentation quality, notably in A-G assessment, identifying red flags, interventions, nursing care plans and communication with family. There was a reduction in patient deterioration associated with emergency nursing care.
Conclusion
The implementation of HIRAID® significantly improved patient safety and experience in WSLHD and should be upscaled.
Biography
Margaret is a clinical nurse consultant at Westmead Hospital and a clinical lecturer at The University of Sydney. She has an extensive clinical background in emergency nursing. She has post graduate qualifications in Critical Care and Mental Health Nursing, Education and Change Management. She has also worked as a principal project officer at the NSW Ministry of Health and has consulted on emergency care in Nepal, Malaysia, Sri Lanka and Bangkok. She is a mother of two daughter and has a keen interest in trail walking and cycling.
She sees herself as a clinician researcher. Being at the coalface is important to Margaret as it facilitates the generation of ideas and enables speedy translation of research evidence into clinical practice. Her PhD study focused on the impact of trauma team training on patients and health service delivery and today she is going to talk about that journey.
