Developing the Role of the Registered Practical Nurse in the Emergency Department

Abstract

The Niagara Health System as a retirement destination serves the oldest age structure within Ontario with a projected growth of 4%, in the 65 and over age group and is anticipated to grow to 18% of total population between now and 2013. The proportion of seniors living along in Niagara is on average 3-7% above the Ontario average of 26.7%. The demographic of this population presents challenges to the hospital sector to treat elderly clients according to best practice for this age group.

There were a total of 167,710 visits to the Niagara Health System Emergency Departments from April 2003 to March
2004 and the St. Catharine’s General Hospital site of the NHS received 46,757 visits.

In keeping with the opportunity to support nursing expertise and knowledge transfer through mentorship relationships, a fellowship focused on Developing the Role of the Registered Practical Nurse in the Emergency Department Setting” is a perfect fit to advancing nursing practice and patient care in the Niagara Region. A gap was identified in the knowledge of the optimal role for the RPN in the Emergency Department Setting.

When research was done within the NHS, a definite gap was identified in regards to consistent practices for utilization of the RPN in the Emergency Department setting.
Most of our sites did not use the RPN to their full capabilities and some Emergency Departments did not have RPNs working in the department.

The advancement of the RPN role from previous task orientated model could be replaced by a new RPN role utilizing the knowledge and skills of this nursing population to the best of their ability and recreating the positive outcome of improved patient care. The fellowship proposed includes the opportunity research, plan and design an optimal role for the RPN and to develop a sustainability plan to ensure knowledge transferred is put into practice.

The overall goal of this fellowship is to improve RPN knowledge and skill in nursing care by enhancing the role and profile of the RPN. The fellowship will involve collaboration and consultation with Scott Gibson as a Mentor, the team of Regional Educators, the Clinical Manager, the Clinical Staff and the Chief Nursing Officer, who has articulated the needs for advancement of the RPN role.

The fellow will be working across multiple sites in order to access Library Resources, attend meetings and to conduct research and consultations. Time will be spent in the
emergency department, accessing staff input to assess needs and modify the approaches to enhance the RPN role.

Outcomes are anticipated for the fellowship for a number of stakeholders;

• The patient benefits secondary to increased nursing skill and knowledge, can reduce lengths of stay, improve patient education and improve patient safety and satisfaction.

• Fellow outcomes include increased nursing skill and knowledge in care of the emergency as well in leadership, organizational, and facilitation skills.

• The organization has multiple gains as a result of improving RPN knowledge and skill in nursing care in the ER.

• The Niagara Health System will be able to advance efficient and effective care delivery models and celebrate advancement of the RPN role.

Overall the opportunity to complete this fellowship will result in an improvement in the quality of care delivered at the Niagara Health System.

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