Educational Needs of Emergency Nurses

Reka Dulandas M.N. (Critical Care & Trauma), Hons.BA (Health Sc),CCRN

Prof Petra Brysiewicz (supervisor) UKZN (School of Nursing)

Purposeofthestudy

To describe the educational needs of

emergency nurses

Significanceofthestudy

1.  Paucity of research in SA on: •  Educational needs

•  Skills/competencies deemed satisfactory for

emergency nurses

2.  Findings may contribute to: •  The development of a core curriculum for

emergency nurses

•  CPD – skills & competencies

Introduction

•  Nurses working in trauma and emergency centres

are usually the first person to interact with the

critically ill or injured patient.

•  These nurses require advanced skills and extensive

clinical knowledge to be able to manage such

patients appropriately.

Introduction

Definitions: Emergency nursing

•  specialty in which nurses’ care for patients during the

emergency or critical period of their illness or injury,

focusing on severity levels and timeous treatment (ENSSA, 2010)

Introduction

Definitions: Emergency Centre

•  accident and emergency (A&E)

•  casualty

•  trauma

•  emergency department

•  emergency unit

•  emergency room

Introduction

Definitions: Emergency Nurse

•  A nurse working in a trauma or emergency centre

providing care to acutely ill or injured patients by means

of a NCP.

•  ENSSA (2010) adds that she/he should have basic,

intermediate and advanced skills.

Introduction

Emergency nursing: What do we know?

•  Fastest growing specialties in the developed world

•  In SA & Sub-Saharan Africa – it’s in its infancy

•  ENSSA – promotes advancement in emergency nursing

through leadership, collaboration, education, practice

development & research

South African Nursing Council

SANC has developed competencies for: •  Occupational health

•  Ophthalmic nursing

•  Orthopaedic nursing

•  Paediatric nursing

•  Nephrology

EMERGENCY NURSING COMES UNDER THE BANNER

OF CRITICAL CARE NURSING

Benner’sTheory:“Novice to expert”

•  Increasing roles and responsibilities for emergency

nurses

•  Emergency nurses to be trained at proficient and expert levels (Wolf et al, 2012)

Methods

•  Design: quantitative survey

•  Settings: 2 private, 2 public hospitals

•  Sample: convenience sampling, target population 163

•  Instrument: self administered questionnaire

•  Data collection: over 4 weeks, 6am – 8am

•  Data analysis: SPSS version 23

•  Validity and reliability: Univ of Michigan

•  Ethics approval: UKZN, hospital ethics committees

Results:demographics

Response rate: 128 (78.5%)

Public Private n(%)

R e g i s t e r e dnurses

45 30 75(59%)

E n r o l l e dnurses

34 19 53(41%)

Total(n) 79(62%) 49(38%) 128(100%)

Results:demographics

YEARSOFEXPERIENCE

0 months<1year

>1year<2years

> 2 years <5years

> than 5years

n(%)

R e g i s t e r e dnurses

11 3 18 42 74(59%)

E n r o l l e dnurses

16 7 17 11 51(41%)

Total(n)27 10 35 53 125(100%)

Competencylevels

Testofcompetencylevels

Category pvalue

Yearsofexperience 0.027

NursedesignaRon 0.001

Hospitalsector 0.052

Results:CompetencylevelsQuesRonnaireitemBasicIntermediateAdvanced

L e a s tcompetent%

Competent%

H i g h l ycompetent%

Abletoassessbreathing:rate,effort,cyanosis 2 28 70

Abletoadministeroxygen:cannula,mask,bag-valve-mask 1 25 74

Able to assess circulaRon: pulses, skin colour, capillary refill, blood

pressure,signsofbleeding

0 27 73

AbletoperformcardiopulmonaryresuscitaRon 11 37 52

AbletoprepareandassistwithendotrachealintubaRon 14 38 48

Abletocontrolhaemorrhage:applytourniquet,fracturesplint,pelvic

wrap

19 34 47

Abletomanageshock:obtain intravenous/ intraosseousaccessand

administerfluids

10 46 44

Abletoprepareandadministerdrugsincardiacarrest 20 38 42

AbletoprepareandadministerthrombolyRcs 38 33 29

Abletoperformcardioversion/defibrillaRon 42 38 20

Able to obtain and interpret echocardiograms: detect arrhythmias

e.g.atrialfibrillaRon

45 39 16

Results:EducaConalneeds-trauma

EducaRonalneeds %

Abdominaltraumae.g.intra-abdominalbleed 79

Paediatricemergencies 79

Orthopaedice.g.fractures,compartmentsyndrome

68

Spinalcordinjuries 75

BurnsandtraumaRcinjuries 69

Headinjuriese.g.intracranialbleeding 75

Results:EducaConalneeds–cardiacEducaRonalneeds %

Stroke 69

AcuteCoronarySyndrome 81

AcuteMyocardialInfarcRons 74

Arrhythmias 76

CardiacMedicaRons 76

DefibrillaRon/Cardioversion 69

Results:EducaConalneeds–shortcourses

EducaRonalneeds %

ABGAnalysis 78

Triage 79

ACLS 83

PALS 80

VenRlators 80

Preferredlearningmethods

Learningmethod %

DemonstraRon 76

Lecture 57

SimulaRon 30

Onlinelearning 6

Distancelearning 5

Barriers&facilitatorstoeducaRonaldevelopment

•  Lack of funding

•  Lack of support from management

•  Limited access to educational institutions.

•  Staffing issues

•  Lack of time

RecommendaCons

•  Similar studies in other provinces on competency levels

and educational needs of emergency nurses.

•  The findings can be used to help develop a core

curriculum for emergency nurses.

Conclusion

•  There are significant deficits in knowledge, skills and

competency levels concerning emergency care.

•  Educational gaps can be rectified through CPD, that

incorporates competency based education on specific

emergency nursing skills.

References

1.  Wolf, L, Brysiewicz, P., et al. 2012. Developing a framework for

emergency nursing practice in Africa. African Journal of Emergency

Medicine, 2:174-181.

2.  Benner, P. 1984. From novice to expert: excellence and power in clinical

nursing practice. Menlo Park: Addison-Wesley.

3.  EMSSA. 2012. The South African Triage Scale. Accessed on 21 April

2014 from http://emssa.org.za/sats/

Thank you!