Category 2 walk-in chest pain patients are at the highest risk in the Emergency Department (ED) waiting room because of an inability to access electrocardiogram (ECG) within recommended timeframes due to lack of resources, including staffing, equipment and treatment space.
Only one waiting nurse is responsible for all waiting patients - acute and ambulatory - which at times can be 30 patients and sometimes up to 60. On Average, only 45% of Category 2 arrivals who self-present are seen and have treatment commenced in time.
Undregraduate students in Nursing (USiN) have limited scope and are taught a set skill, but they are enthusiastic for workplace exposure.
Because registered nurses do a more thorough assessment and work-up, it can be inefficient in the Emergency Department (ED) waiting room to perform an ECG, where the main task is to assess the risk to patients. USiNs take about 10 minutes to complete an ECG, whereas registered nurses can take double that amount of time because of thorough patient history documentation.
In this project, Logan ED have employed USiNs under an 'ECG Technician' type model and new role descriptions were developed to align and compliment other waiting room initiatives. The USiN role was designed to perform ECGs on all Category 2 chest pain patients. Role specific education was developed and commenced as two shifts per day, seven days a week.
