GP Nurse Liaison Service
The GP Nurse Liaison Service operates from Monday to Friday. It’s an identified link whose aim is to enhance two way communications between the Emergency Department and the community incorporating General Practitioners, Southdoc and the Public Health Nurses.
A high rate of useful information is transferred to the principle carer in the community. This contributes to better knowledge of the outcome of a patients visit to the Emergency Department and enables safe discharge.
In patients with chronic conditions i.e. Diabetes or Asthma it reduces the risk of revisits and readmissions particularly in the elderly. This link with the community also enables the transfer of much needed information comprising of past medical history, regular medication and social history to the acute service where the patient is unknown prior to arrival. All healthcare professions are welcome to use this service.
Academy of Emergency Care
The Emergency Department has developed an Emergency Care Training Academy. Originally targeting sports, the Academy now offers a wide range of courses. These include pre-hospital care for all environments from novice level to specialist Practitioners. We are a PHECC registered training institution and also run ATLS training. Instructor training is a big part of the service, helping people develop networks so that training becomes accessible and cost effective.
Please visit the Academy website for full details: www.aecs.ie
Paul Allan, Training Officer
Emergency Med. Dept.
Cork University Hospital
Tel: +353 (0)21 4920141
Mobile: +353 (0)86 8112281
Clinical Nurse Facilitator
The goal of Clinical Facilitation is to enhance clinical practice by supporting qualified nurses in the delivery of patient care. The role embraces the promotion of continuous practice development, utilising the skills of collaboration, networking and effective relationship building (Thornbury, 1999, McCormack et al, 1999, Manley, 2000).
The department currently has two Clinical Nurse Facilitator posts. One of the positions is permanent and is responsible for organisation and facilitation of ongoing training and education for nursing staff of all grades in the department. The second position (which is vacant at the present time) has responsibilities primarily for the postgraduate students completing the Postgraduate programme in Critical Care Nursing (Emergency Nursing), which are undergoing clinical placements. Both roles overlap significantly at times. The clinical facilitators are involved also in training and education of other disciplines (training of all grades of staff in Major Emergency preparedness in the emergency department) when the need arises. The facilitators in the emergency department are two of four facilitators in C.U.H. (ICU/CCU and theatre, being the other two). Each position is one whole time equivalent, working ‘core hours’. This role has been in existence since 2000.
The Emergency Department is at the forefront of planning for Major Emergencies that may occur. The ED is a major contributor by way of its Emergency Response team to the overall Major Emergency Plan for CUH. The ED emergency response team is regularly involved in training of staff, updating its equipment, testing its plans and attending training courses with all the other principal emergency response agencies.
To establish the framework of response in the event of a major emergency involving the emergency department and Cork University Hospital.
- Definition of Major Emergency
For the purpose of this plan, a major emergency is any event which, usually with little or no warning, causes or threatens death or injury, serious disruption of essential services or damage to property, the environment or infrastructure beyond the normal capabilities of the principal emergency services in the area in which the event occurs, and requiring the activation of specific additional procedures to ensure effective, co-ordinated response.
The ED has developed its own internal Major Emergency Plan which will hopefully be published in the New Year.
Within the emergency department we have our own decontamination unit which can be used to decontaminate patients in the event of a chemical or biological incident occurring in this area. The department has undertaken the training of staff to deal with emergencies of this type and a policy document has been drawn up for the decontamination of a patient with Chemical or biological agent exposure.
The Emergency Department has its own Quality Improvement Team that meets on a regular basis to discuss and implement all aspects of the provision of a quality service in the Emergency department. It would deal with topics like Risk, Accreditation, Audits, Performance Indicators, Patient Information, Policies and Procedures, Training, Incident Reporting and Standards.
Pre Hospital Care
Pre-hospital services provides a medical call-out team to the ambulance service and general practitioners. There are strict guidelines laid down for the request of a call out team. The response also depends on the level of activity in the Department when the medical team is requested. The team comprises of a senior doctor (Consultant /Registrar) and a senior nurse. The consultant will respond from home out of hours. 2008 has seen the introduction of a Rapid Response Vehicle (RRV) to the Cork City Area. This is manned by the Senior Registrar in Emergency Medicine, CUH and we would hope as part of reconfiguration that this work would be expanded to provide a more regular service. The department is very much involved with our colleagues in the ambulance service and is involved in the training of Advanced Paramedics.
Primary Community Continuing Care
Community Intervention Teams
The HSE South established this service to provide additional services in the community, on a 7-day basis, to support General Practitioners and Emergency Departments of acute hospitals in Cork city. This support is the provision of fast-tracked access to Nursing and Home Help services for patients with an acute episode or illness, who have been medically assessed and it has been determined that their care can be managed in their own home, with the additional services of the CIT.
The main focus of the CIT is the prevention of avoidable hospital admissions and the facilitation of early discharge from hospital. This will be done through the provision of immediate supports by the team of Public Health Nurses (PHNs), Registered General Nurses (RGNs) and Home Helps dedicated to the CIT. The team will manage the care of the patient until their care can be transferred back to mainstream community services and the aim is that this will happen within 72 hours.
The Community Intervention Team takes patient referrals from General Practitioners and the staff of the Emergency Departments of acute hospitals in the city. Referrals are accepted between 09:00am and 11.30pm on a 7-day basis.
Criteria for referral
Any patient over 18 years of age living within 10 miles of Cork city.
Have been assessed for an episode of acute illness and discharged home but cannot self-manage and/or requires the provision of non-medical care supports in the home, such as Nursing or Home Help.
They do not need to be in possession of a Medical Card.
All referral phone calls must be followed by a faxed concise medical history from the General Practitioners or Emergency Department staff.
Rapid Response Beds
For patients in the Emergency Department who need short term crisis intervention providing care for an interim period of 24 - 72 hours while the mainstream services are being arranged.
Medical Card holders over 65 years of age.
Patients who do not require acute hospital admission
Patients who need short term crisis intervention only.
Acute Psychiatric History.
Made by the Medical Staff of the Emergency Department Cork University Hospital.
Bed management must be made aware of patients occupying these Rapid Response bed.
Patients can go by family car, or if family is unavailable, in a hospital taxi with a Care Assistant
- Main Waiting/Reception Area
At the entrance to the department there is an extensive waiting area for patients and relatives who are waiting to be called following triage. We also have a separate waiting area for our Paediatric patients which is located inside the main entrance to the treatment areas.
There are two televisions in the waiting area and we also have an electronic notice board with a lot of very valuable information that will be of interest to patients and relatives waiting in the area.
There are Male, Female and wheelchair assessable toilets in the waiting area for patients and relatives.
There are two vending machines located in the waiting area and there is an ATM machine at the front entrance to the department.
- Paedicatric Waiting Area
The department has a separate treatment and waiting area for our paediatric patients which also incorporates a toilet and baby changing facilities.
- Relative Room
At the end of last year we completely refurbished our relatives room which can be used by family and relatives of patients that have passed away or are having treatment for a serious injury or illness. It has been very well received by those that have had reason to use the room and it has provided some comfort for those relatives and family friends that have had to deal with bad news.
- Intrepretation Service
Interpreters can be provided to assist with specific languages/sign languages when needed.