Background: The Mental Health Co-response Service (MH-CORE) is an interagency collaboration between the South Australian Ambulance (SAAS) and Mental Health Services, partnering paramedics and emergency mental health nurses to respond to 000 calls in an ambulance. MH-CORE is a sub-specialty service providing early intervention, holistic assessment, and improving accessibility in the pre-hospital setting.

Aim: Previously emergency services have had limited options for responding to psychiatric-related emergencies, resulting in 52.2% of Australian mental health emergency department (ED) presentations arriving via ambulance. Almost doubling the National average of all other ED presentations arriving by comparable means (26.2%).

Intervention: Delivering mental state assessment and intervention previously, exclusive to the emergency department, has improved outcomes in the recovery and flow of patients between agencies and supported up to 82% of patients attended by MH-CORE to avoid emergency department attendance.

Outcome: Patients have previously described hospital attendance as traumatic, punitive, and disempowering when restrictive measures, restraint, or forced interventions are utilised. Patients attended by MH-CORE have remarked that their experience has focused on their healthcare needs, reduced stigma and restored their trust in services.

Conclusion: This new person-centered nursing led model creates a gold standard, reducing the need for involuntary treatment, promoting patient advocacy, and delivering trauma-informed care. Fostering collegial alliances at the coal face of emergency care enables frontline clinical decisions, reduces diagnostic overshadowing and inspires sustainable change by directing individuals to access the right service at the right time.

Background/Introduction: Non-suicidal self-injury (NSSI) is a precise term for self-inflicted injuries that are not intended to cause death. Emergency departments (EDs) are critical intervention sites for people who have self-injured, but emergency nurses report feeling ill-equipped to provide care to this cohort.

Aim/Purpose: Increase knowledge about NSSI in ED, the capacity of emergency nurses to respond therapeutically to people who have self-injured and improve workforce resilience.

Methods/Intervention/Activity: A coaching model of NSSI training will be employed at Royal Perth Hospital ED to upskill nursing staff over six months. Self-report questionnaires conducted prior to training, at completion and one month after completion will measure the effects of training on nurses’ knowledge, attitudes, empathy, confidence, self-compassion and resilience in relation to people who have self-injured.

Results/Outcome: Survey results prior to training indicate many nurses experience burnout, that more empathic, less negative attitudes, and more comfort and knowledge about NSSI are associated with more compassion satisfaction and less burnout. Fewer years of experience were associated with lower confidence and most participants started practising after 2016, which is likely representative of the broader ED workforce post-COVID.

Conclusion/Recommendations: Preliminary results suggest strong potential for clinical coaching to increase knowledge and confidence amongst ED nurses in recognising and responding effectively to NSSI. Training is anticipated to be of particular benefit to the large cohort of less experienced nurses practising in ED, for whom it may be effective at preventing burnout.

A brief overview of Nellcor and Microstream technology

Background/Introduction:
In 2021, I studied a certificate II in AUSLAN at TAFE and it was during my studies that I became more conscious of the lack of AUSLAN interpreters available for those who are deaf and hard of hearing. Therefore, I started the project “Language Legends” at Royal Perth Hospital Emergency Department. This introduced video interpreting services via telehealth through an iPad. In August 2022, a small snapshot audit was conducted which showed that 11.4% of patients who required an interpreter received an interpreter, missing 88.6% of patients who have a recognised language barrier.

Aim/Purpose:
The aim of Language Legends is to improve access and accessibility to those with all language barriers to improve communication.

Methods/Intervention/Activity:
Working alongside telehealth and language services, we created a service that we could use telehealth on an iPad deliver video interpreting to help reduce delays and improve access to interpreters. We found it was difficult though to get 24/7 coverage of this service and was only useful within hours.

Results/Outcome:
A new service is being organised for trial in the Emergency Department which is 24/7 on demand interpreting service. This gives access the department access to approximately 14,000 interpreters within Australia and worldwide. AUSLAN and first nations languages are included in the new service.

Conclusion/Recommendations:
Language Legends is still developing and evolving but has made a difference in the accessibility to interpreters in the Emergency Department and improved patient communication. The new service will make a large difference to accessibility to interpreters.