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A new model of care to support emergency nurses has proven successful in the Illawarra and will now be rolled out across 30 hospitals nationally.

Wollongong Hospital ED nurse and internationally renowned trauma nursing researcher, Professor Kate Curtis, worked with the University of Sydney to develop the model, which aims to improve the safety and quality of emergency nursing care.

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“Emergency nursing is like no other – we look after neonates to octogenarians in the same shift, we start without a patient diagnosis or plan, often when people are incredibly distressed”, Professor Curtis told HealthTimes.

“We might resuscitate or provide end of life care to different patients in the space of an hour in a hectic, often over-crowded department under threat of physical and verbal abuse while wearing additional personal protective gear during pandemics.”

“It is challenging, fun, I learn something new every day, and work with the most amazing, intelligent and compassionate group of nursing, medical, allied health and support staff.”

As an experienced emergency RN, Professor Curtis knows that “emergency nursing is more than A, B, C”.

"When patients come in, you don't always know what's wrong straight away - they might not be able to communicate properly for instance because they're so unwell.”

"So emergency nurses need to know what questions to ask, what signs to look out for, so treatment can start as soon as possible", she said. 

"We're sometimes the only clinician a patient sees until a doctor comes several hours later, so it's important nurses have a systematic approach to assessing them and managing their care.

"Yet at the moment there's no consistent, evidence-based approach across Australia for emergency nurses to assess patients."

That’s why Professor Curtis developed the HIRAID model for optimal emergency care delivery.

“HIRAID” which stands for History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment, is the only comprehensive assessment framework that can be applied to all patients in the emergency setting. Its application is not dependent on context, clinical skill level or resources.

It has been formally evaluated in the Australian emergency care environment with the results demonstrating its acceptability, feasibility and practicality.

Nurses who already use this instrument report it to be a useful, easy to use assessment and documentation tool that provides clinical consistency.

The majority of respondents in a multicentre evaluation believed HIRAID is reflective of their responsibilities as emergency nurses. Holistically, HIRAID is viewed by medical officers as an improvement from previous clinical handover tools

“Nurses like it – it really summarises what we do as emergency nurses already, but provides a consistent way to teach new emergency nurses and reduces variation”, Professor Curtis explained.

"In the Illawarra we tested and validated this consistent way for emergency nurses to assess their patients, and it had good outcomes," Professor Curtis said.

"So much so that the Chief Nurse of Australia and the Australian Commission on Quality, Health and Safety want to support us in implementing and evaluating this emergency nursing model in 32 other emergency departments across Australia."

"It's all about patient safety, and the Illawarra is really leading the way for the rest of the country."

HIRAID isn’t about telling nurses how to do their jobs – it’s about providing a structured framework to teach junior nurses. Ultimately, HIRAID is designed to support nurses in providing optimal care within a challenging and unique environment.

It has been announced that Professor Curtis’ project is to receive $1.5 million in the current round of National Health and Medical Research Council's Partnership Project grants.

The 10 successful projects have also received funding from partners including hospitals, state governments, services and patient representative bodies.


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Charlotte Mitchell

Charlotte is a published journalist and editor, with 10 years of experience in developing high-quality content for national and international publications.

With an academic background in both science and communications, she specialises in medical and science writing. Charlotte is passionate about creating engaging, evidence-based content that equips the community with important information on issues around healthcare, medicine and research.

Over the years, she has partnered with organisations including the Medical Journal of Australia, Cancer Council NSW, Bupa, the Australasian Medical Publishing Company, Dementia Australia, MDA National, pharmaceutical companies, and state and federal government agencies, to produce high-impact news and clinical content  for different audiences.