The document provides an overview of the MET Nurse Program at Austin Health, a major tertiary health provider in Melbourne. It describes the roles and responsibilities of MET nurses, which include attending emergency calls, assessing and assisting with deteriorating patients, educating other staff, and working in the ICU. The MET Panel oversees the program and ensures a high quality of care. The program trains ICU nurses to become accredited MET nurses over the course of 6 months through lectures, workshops and supervised calls. So far 75 nurses have graduated from the program, helping to improve outcomes for deteriorating patients across the health service.

1. MET Nurse Program
Michelle Topple
Associate Nurse Unit Manager
MET Panel Chairperson
Department of Intensive Care

2. Austin Health
• Major provider of tertiary health in north eastern Melbourne
• Operates 980 beds across acute, sub-acute and mental
health
– Over 560 acute beds
• State referral service for liver transplantation and spinal
cord injuries

3. Overview of ICU and the MET
• Funded for 20 ICU beds
• 2200 ICU admissions in 2013
• 2300 MET calls in 2013
• >12% of patients having MET calls in 2013 were admitted
to ICU
• 230 nursing staff (75 MET accredited)
• Funded for a MET nurse 24/7
• MET = MET nurse and registrar

4. MET Panel
• Consists of 4 senior nurses
• Formed in September 2011
• Run MET Program
• Provide leadership and accountability for MET nurses
• Works closely with NUM, MET Director and ICNC service to
ensure a quality MET service

5. Roles of the MET nurse
• Attend Emergency calls
– MET and Respond Blue (Austin Tower & ONJCWC)
– Emergency Medical Review (EMR) and Respond Blue calls
(Mental Health Precinct)
• Review patients as requested by ICNC, ICU
registrars, ANUM’s and/or other MET nurse  esp.
after hours

6. Roles of the MET nurse – cont.
• Patient assessment
• Assist with determining the aetiology of the deterioration
• Providing advanced treatment requirements
• Assisting with providing a management plan
• Ensuring appropriate follow-up
• Support and educate ward staff
• Provide transport of patient to an appropriate location
• Report adverse events

7. Roles of the MET nurse – cont.
• Assist MET registrar with reviewing patients
• Assist MET registrar with procedures on patients outside
of the department

8. MET nurse role within the ICU
Responsibilities may include, but are not limited to:
• Checking the MET trolleys and equipment
• Education and support
• General nursing care within the
department

9. Expectations of our MET nurses
• A comprehensive knowledge of Austin Health protocols and
procedures in relation to MET, EMR and Respond Blue calls
Clinical performance
• BSL and ACLS
• Assistance with intubation, insertion of invasive lines &
haemodynamic monitoring
• Preparation and administration of medications required for
resuscitation
• Setting up and administering of NIV
• To have advanced knowledge and assessment skills when
attending to the deteriorating patient

10. Expectations of our MET nurses - cont.
Professional Behaviour
• To communicate effectively with all responding staff in a
respectful, supportive, constructive and non-critical manner
• Display accurate written and/or electronic documentation relating
to the emergency call
• Display a professional manner, promoting collegiality amongst the
multiple care providers
• Maintain a continuous professional development approach and
be reflective of their practice
• To ensure a timely review of patients when referred by the ICNC,
ICU consultant, registrar or previous MET nurse

11. Application criteria for the MET Program
• Min. 3 years Post Graduate experience in a level 3 tertiary
ICU
• March and September intake
• 1 page expression of interest with 1 ICU ANUM as a
referee
• MET Panel assess (in consultation with the NUM)
• 6 months to complete the program
• MET mentor (senior MET nurse)
• Handbook

12. Handbook Competencies
• MET lecture
• MET Behaviour workshop
• MET trolley competency
• 5 MET calls under supervision
• Written Intubation competency
• CPAP/High Flow practical
• 2 verbal scenario’s
• Navigation to remote areas of hospital

13. To Date
• 4 MET programs have been completed
• 8 participants in the first program
• 6 in the following 3 programs
• 1 nurse withdrew from the program
• 1 nurse required an extension
• Currently 75 accredited MET nurses
– 25 of these completed this program
• No March 2014 program to allow new MET nurses more
opportunity to consolidate post program

14. What we have learnt along the way
• 6 participants is the max. per program
• Some ICU nurses are not suited to the MET
• Behaviour & personalities can be difficult to manage
– difficult conversations
• Self directed learning has pro’s and con’s
• Accept to hear all the negatives and less positive feedback
• Good for staff moral, stepping stone for CNS

15. What about the future?
• Continually review and evaluate the MET program
(evaluations post each program)
• Run a MET nurse symposium
• Continue to analyse and review data
• Continue to work towards timely management of the
deteriorating patient to improve outcomes
• Participate in future research activities (MET nurse
role)
• Utilisation of simulation in training MET nurse

16. Questions?