Role of critical care nurses in disasters

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Presented to students of the University of Canberra – Postgraduate Critical Care Nursing, Canberra, ACT, 11th September.

ROLE OF CRITICAL CARE NURSES IN
DISASTERS

Jamie Ranse www.jamieranse.com
Assistant Professor twitter.com/jamieranse
University of Canberra youtube.com/jamieranse
linkedin.com/in/jamieranse
http://lifelineenergy.org/blog/wp-content/uploads/2011/03/jap-11.jpg

role: in-hospital

• What is your role?
– Little research / literature, therefore anecdotal
– Triage
– Decontamination
– Accommodate surge

surge capacity?
180

160

140
Presentation Frequency

120 Total Influenza Presentations
Mean Influenza Presentations
Mean Total Presentations
100
Mean Total Presentations - Excluding Influenza

80

60

40

20

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INTRODUCTION A major limitation in improving patient care has been the shortage of staff nurses. In the control phase staff patient ratio was 1:3 , 1:4 which affected the delivery of quality care nursing, affecting the patient outcome in terms of infection and mortality rate. It is hypothesized that sudden influx of inexperienced nurses may be detrimental for patient care in the short term especially in absence of structured training & mentorship program in place. AIMS AND OBJECTIVES To assess the effect of new joinees as staff nurses on patient care in neurosurgery ICU using infection rate and mortality rate as the surrogate markers for nursing care. MATERIALS AND METHODS In this retro-prospective study in neurosurgery ICU over 6 months( Oct 2010- Mar 2011), the infection rates (using blood, tracheal & urine culture reports) were calculated for a group of patients. RESULT Hospital Mortality Rate and Gross Infection Rates in terms of tracheal, urine and blood cultures were assessed . severity of head injury was also assessed as it can act as a ditermental factor affecting Hospital mortality rate in control phase 18%, in training phase 16.4 % and final phase 15.3% Gross infection rates: tracheal culture incidence in control phase 62.3%, traning phase 59.3%, final phase 22.3% . in terms of urine culture incidence control phase 48.9%, training phase 34.2%, final phase 12.6% and for blood culture it was 24.9% in control phase, 14.5% in training phase and 4.2 in final phase. CONCLUSION • There is significant decrease in mortality following introduction of 1:1 nursing in neurosurgery ICU. • The severity of head injury was approximately in the same range of all the phases hence it has no significant role to play in the reduction of mortality rate. • Blood infection rate (4.25), tracheal infection rate (22.3%) & urine infection rate (12.6%) in the final phase were significantly lower (p<0.001) than the preceding two phases Structured programs and mentorship plays a vital role in improving the nursing practices . •

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Role of critical care nurses in disasters

1. ROLE OF CRITICAL CARE NURSES IN DISASTERS Jamie Ranse www.jamieranse.com Assistant Professor twitter.com/jamieranse University of Canberra youtube.com/jamieranse linkedin.com/in/jamieranse http://lifelineenergy.org/blog/wp-content/uploads/2011/03/jap-11.jpg

2. definition

3. INTERNATIONAL

4. NATIONAL

5. HEALTH-AFFECTED DISASTER?

6. EDUCATION-PRACTICE MISMATCH

7. WILL YOU ASSIST?

8. role In-h o sp i t al

9. role: in-hospital • What is your role? – Little research / literature, therefore anecdotal – Triage – Decontamination – Accommodate surge

10. surge capacity?

11. surge capacity? 180 160 140 Presentation Frequency 120 Total Influenza Presentations Mean Influenza Presentations Mean Total Presentations 100 Mean Total Presentations - Excluding Influenza 80 60 40 20 0 Sun Tue Thu Tue Thu Sun Mon Thu Sun Tue Thu Sun Tue Thu Fri Fri Fri Fri Sat Mon Sat Sat Mon Sat Mon Fri Wed Wed Wed Wed Wed Day

12. surge capacity?

13. surge capacity?

14. role Ou t-of -h os p ital

15. WHAT WILL YOUR ROLE BE?

16. ROLE OF CRITICAL CARE NURSES IN DISASTERS Jamie Ranse www.jamieranse.com Assistant Professor twitter.com/jamieranse University of Canberra youtube.com/jamieranse linkedin.com/in/jamieranse http://lifelineenergy.org/blog/wp-content/uploads/2011/03/jap-11.jpg

Role of critical care nurses in disasters

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