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sehas a potential at becoming a learning and training centrefor transitional Nurse Practitioners and junior Doctors.

doi:10.1016/j.aenj.2011.09.044

Abstracts

To explore the nursing assessment and initial managementof septic patients in the emergency department

Leanne Horvat1,2,3,∗, Margaret Fry4, Jacqui Fong5, JoannePlowes5

1 Department of Emergency Medicine, St George HospitalSESLHN, Australia2 The University of Newcastle, Australia3 Sydney University, Gray Street, Kogarah NSW 2217,Australia4 Faculty of Nursing, Midwifery and Health University ofTechnology, Sydney, Australia5 Emergency Department, St George Hospital, SESLHN,AustraliaKeywords: Sepsis; Septic shock; Systemic InflammatoryResponse Syndrome (SIRS); Clinical Excellence Commission(CEC); Emergency department (ED); South Eastern SydneyLocal Health Network (SESLHN)

E-mail addresses: Leanne.Horvat@sesiahs.health.nsw.gov.au(L. Horvat), margaret.fry@uts.edu.au (M. Fry),Jacqui.Fong@sesiahs.health.nsw.gov.au (J. Fong),Joanne.Plowes@sesiahs.health.nsw.gov.au (J. Plowes).

Introduction: Sepsis is recognised as one of the lead-ing cause of mortality and morbidity, with high mortalityrates for severe sepsis and septic shock. The emergencydepartment (ED) nurse is often the first person who comesin contact with the septic patient and therefore is in aprime position to make the initial assessment and evalua-tion. It remains unclear though, the barriers to recognisingthe septic patient by nursing staff. To achieve a reductionin sepsis hospital mortality and morbidity rates it is essen-tial that emergency nurse’s knowledge of sepsis assessment,its defining symptoms and initial management are furtherexplored.

The aim of this study is to explore the: (i) preva-lence of patients presenting with infective conditions andillnesses to the emergency department; (ii) relationshipsbetween triage assessment and ‘Time to Antibiotic’ forthe septic patient; and, (iii) understanding of emergencynurses’ behaviour, decision making and confidence in theearly recognition, assessment and management of the septicpatient.

Method: The project is a mixed methods study to facili-tate understanding of nursing assessment and managementof emergency department practices for the septic patient.This presentation will examine the main preliminary findingsof a four (4) phase study which was conducted in a 550 bedtertiary referral hospital with an annual ED presentation rateis over 59,000 (78% adult; 22% paediatric) and an admissionrate of 39%. The ED serves as the regional trauma centre forSouth Eastern Sydney Local Health Network (SESLHN).

Results: Data collection is in progress and preliminarydata will be presented on acceptance of the paper. Datawill include descriptive analysis of a 12 month sepsis auditof ED adult patients (>16 years) that presented with diag-nostic codes related to infection; a three month prospective

exploratory audit for triage-time to antibiotic therapy; andmajor findings of an emergency nurse survey which exploresemergency nurses’ knowledge of sepsis definitions, signs and

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ymptoms and management against evidence based guide-ines.

Conclusion: This project aims to generate new knowledgend provide information and analysis to improve health ser-ice outcomes. Specifically, the new knowledge can assisto promote health, reduce deterioration and support careractices.

oi:10.1016/j.aenj.2011.09.043

utgrowing fast track moving into Urgent Care Centre

milie Russell ∗, Jane Currie, Bronwyn James

Campbelltown Hospital Emergency Department, Therryoad, Campbelltown, NSW 2560, Australiaeywords: Urgent Care Centre; Change management; Modelf care; Nurse Practitioner

-mail addresses: spinningemma@ymail.com (E. Russell),anecurrie@hotmail.com (J. Currie),ronwyn.James@sswahs.nsw.gov.au (B. James).

The aim of this paper is to review the birth and devel-pment of the Urgent Care Centre (UCC) at Campbelltownospital Emergency Department (ED). In December 2010 theast Track model of care was replaced by Department ofealth funded project, the UCC. This was a Sydney wideroject involving metropolitan health networks. The UCCsere implemented to improve patient flow through the ED.

The UCC at Campbelltown Hospital has been locatedithin the ED and is staffed with Nurse Practitioners, Doc-

ors and Advanced Clinical Nurses. The model of care centrespon the patient by staff working as a team and in clinicalollaboration. Patients are triaged to the UCC against spe-ific inclusion and exclusion criteria. The aim of the UCC is torovide rapid assessment, treatment and referral of patientuffering minor injury and illnesses.

Overall the UCC has been a success for patients and staff;owever it has encountered a number of challenges whichhis paper will discuss. One of the most fundamental of thesenvolved the change management in planning and imple-enting the centre, and some of these issues remain to thisay. In addition there has been some discussion and experi-entation as to the inclusion and exclusion of the patientsresenting complaint and this is largely attributed to theubjectivity of the triage process. Preliminary statistics haverovided some unexpected findings and it is clear there istill further development yet to occur.

In its infancy the UCC is providing patients with a goodervice and with the groundwork now complete there isnormous scope for this model of care to mature. It also