Dr. John Ross - BETTER CARE SOONER

In September 2009, the Nova Scotia government appointed Dr. John Ross—a 20+ year

veteran emergency physician—as its first provincial advisor on emergency care.  Dr. Ross visited or spoke with staff from every Emergency Department (ED) in the province, speaking with doctors, nurses, paramedics, and other healthcare workers; district health authority management and board members; community health boards; and civic leaders, citizen groups, and patients.

Dr. Ross will discuss the symptoms and diagnosis of a system not working.  The Emergency Department is simply the canary in the coal mine, alerting people to the troubles that are putting the entire health care system at risk.  Finally, he will discuss the treatment—recommendations to make the “patient journey” work the way it should—for patients, of course, and for all who care for them.

Sharron Lyons – THE PERIOD OF PURPLE CRYING

The Period of Purple Crying is based on more than 25 years of child development and research.  It is a concept of Dr. Ronald G. Barr, in conjunction with the National Center on Shaken Baby Syndrome, USA.  New parents often show up in the emergency department with a crying baby with no diagnosed medical problems.  We send them away using terms such as “it’s colic” or “it will go away, buy earplugs”.  This workshop will provide the emergency staff with evidence informed material linking crying with Shaken Baby Syndrome.  Health care staff learns what to say to parents and caregivers and how to help them through this very frustrating period without injury to the infant. 

Sherry Stackhouse – ACLS GUIDELINES

ACLS guideline changes occur approximately every 5 years and those changes are communicated to healthcare providers in a variety of ways.  Many nurses are expected to take ACLS as part of the requirement to work in a particular area.  Nursing has a powerful presence in the dissemination of this information to colleagues.  The content will include all of the changes as well as the particular areas that nursing can take a leadership role in, such as end tidal CO2 monitoring and tracking time to interventions and patient outcomes. 

Landon James – BECOMING “SOCIAL” IN 2012

This session will introduce the use and functionality of social media platforms into the health care arena. 

The advent of social media has swept through many industries and is making its foray into health care.  Many health care professionals are resisting the adoption of social media for a variety of reasons but one of the main reasons appears to be the fear of the unknown.  Twitter, Face book and other social media platforms may, on the surface, appear to be a waste of time that takes away from patient care; on the other hand, some facilities are starting to use them as staffing tools, disaster communications techniques and public health/injury prevention tools.

The session will start from the basics and take participants through some of the potential for these applications to work from the bedside through to leadership positions.  A Smartphone is not required for this session but this is one of those times that we will be texting and tweeting our way through the session so participants will be encouraged to bring it.  A laptop with an Internet connection will be welcome as well.

Lt(N) Dawn Henneberry and Cpl. Brad Casey – TRAUMA IN AFGHANISTAN

This presentation will focus on trauma in Afghanistan both pre-hospital and hospital care. Lt(N) Henneberry and Cpl Casey will demonstrate the similarities and differences between working in Canada and working in war torn areas.    

Lt(N) Henneberry and Cpl Casey will talk about the struggles for medical staff in and out of the field. These struggles can be anything from cultural differences to working on a friend who was severely injured. There are also many internal struggles that as health care providers, they deal with day to day due to the types of trauma they see, the many different countries they work side by side with, and how they deal with their struggles and that of their peers.

Cpl Casey will show what it is like to work in the field, with the lack of medical supports both in supplies and bodies. Their work in the field is an integral part of how we work in the Trauma Bays. The medics work as soldiers first, then as health care providers. 

Lt (N) Henneberry will show the different equipment used in the trauma bays and the procedure that every patient has to go through before coming through the trauma bay doors. Lt (N) Henneberry will also illustrate the differences between working in Afghanistan and here in Nova Scotia which include: massive transfusions, triage, types of transfers, types of teaching, the amount of staff in the trauma bays and the many different injuries seen. After hours not only do they look after traumas, they were the emergency department, which lead to many other issues. Whether they worked in the field or in the Role 3, they worked hard, they laughed, and they met many new friends all around the world.

Carole Rush– “THE GOOD, THE BAD AND THE UGLY”: BEST PRACTICES FOR EMERGENCY CARE OF MINOR BURNS

This workshop will enhance both knowledge & skill related to the emergency care of minor burns by reviewing current literature and best practices. Specific scenarios include scalds, sunburn, frostbite, 'road rash', tar removal, and minor chemical exposures as well as controversial topics such as blister care. Case examples illustrating the consequences of incorrect wound care will be discussed. Participants will learn hands-on information related to cleansing, debridement, and sorting through the multitude of dressing options currently available.

Laura Wilding – ACUTE CONFUSION: A COLLABORATIVE APPROACH TO THE DEVELOPMENT OF A DELIRIUM STRATEGY FOR THE EMERGENCY DEPARTMENT

Delirium is common clinical syndrome in ED patients that is frequently under recognized and under treated. When missed, this medical condition is associated with a significant morbidity and mortality as well as considerably increased caregiver burden and hospital costs.

This presentation will provide an overview of the collaborative approach between the Geriatric Emergency Management (GEM) Nurses and the ED Nurse Educators to developing an implementing a comprehensive delirium strategy for emergency nurses at The Ottawa Hospital. This strategy was developed and implemented in 2011 in order to build capacity and improve patient safety in the ED.

Joanne Bayes and Cheryl Stephens-Lee - Emergency Department Management (EDM) 6.0 Implementation: Steps to SuccSeuss

Technology is advancing at lightning speeds and healthcare organizations have an obligation to their staff, as well as their patients, to remain current with available technology. Electronic Medical Records (EMRs) provide users with the ability to quickly access patient information including clinical findings, dictated consults and patient care notes with a click of a mouse. Markham Stouffville Hospital has taken a tremendous step forward in being a leader in the use of technology by being the first hospital in Canada to implement Meditech 6.0 in all departments.

The goal of this presentation is to discuss the positive outcomes of this conversion using Meditech 6.0, the challenges and barriers that have been encountered and have overcome throughout the journey and to provide other Emergency Departments with valuable information to help ensure their conversion, from paper to electronic, is seamless and successful.

Cathy Dobson – DEVELOPING A DISASTER PLAN FOR THE EMERGENCY DEPARTMENT: KEY COMPONENTS AND CONSIDERATIONS

The purpose of this presentation is to describe the key components and considerations, based on literature, which should be incorporated into developing a Disaster Preparedness Plan for the Emergency Department (ED), whether it is rural or urban. I will present examples from my experience with developing a plan for a large urban ED and a rural Urgent Care Centre, and demonstrate how to incorporate these important elements into a Mass Casualty Disaster Preparedness plan.

Neala Gill and Kathy Harrigan – IMPROVING ACUTE CORONARY SYNDROME CARE: NOVA SCOTIA’S UNIQUE APPROACH TO GETTING GUIDELINES INTO PRACTICE

Cardiovascular Health Nova Scotia (CVHNS) is a provincial program of the Nova Scotia Department of Health and Wellness with a mandate to improve the cardiovascular health and care of Nova Scotians.

CVHNS has been able to implement its own Nova Scotia Guidelines for Acute Coronary Syndromes throughout the province by targeting specific groups and developing tools to put the guidelines into practice.   In 2010, CVHNS focused on implementing the guidelines in emergency departments around the province. Accredited educations sessions were offered and point of care tools were developed to help get the guidelines into practice. 

CVHNS is unique in that we provide ongoing monitoring and reporting of process of care, system and outcomes indicators on all admissions for ACS in the province. Data is used to set provincial and local priorities for improvement.  Work to date and successful quality improvement strategies will be shared with participants.

Janet Calnan – EMERGENCY NURSES NEED TO P.A.R.T.Y.

The P.A.R.T.Y.  program (Prevent Alcohol and Risk Related Trauma in Youth) is an injury prevention program that is delivered throughout the school year to Grade 10 students on Vancouver Island and the Gulf Islands.

P.A.R.T.Y. was developed 20 years ago at Ontario’s Sunnybrook and Women’s Hospital by ED nurses. 

Nurses want to become more active in preventing the untimely deaths of youth due to risk related behaviour and motor vehicle crashes. This program provides information to youth to recognize injury producing situations and preventative measures that can be used to stop trauma.

The purpose of this session will be to share with the audience the basic components of the P.A.R.T.Y   program, how it works in our community and the outcomes that have resulted from VIHA providing this program to the youth of Vancouver Island.

P.A.R.T.Y. fits perfectly within the hospital environment and is a community based prevention initiative.

Mr. Tim Westhead – “SURVIVE & THRIVE WITH HUMOUR” – BOOST WORKPLACE MORALE & REDUCE STRESS

Because of the nature of their job, shifting government legislation, and increasing demands on front-line healthcare workers, issues of morale and personal stress have intensified, becoming significant challenges in their workplace. This presentation will build morale, reduce stress, foster wellness, and create conditions for a healthier lifestyle and worksite for emergency nurses, their co-workers, and their patients.

Emergency nurses will be able to:

List 12 medical benefits with ROI’s from introducing humour and fun to their workplace

Identify 12 employee benefits with ROI’s from introducing humour and fun to their workplace

Explain dozens of no-cost and low-cost methods to increase motivation and lessen stress, while enhancing patient service delivery

Apply practical and useful skills and transferable knowledge that can be immediately implemented to boost morale in their workplace and their personal life

Lindsay Richards – THORACOTOMY: THE NURSING ROLE

This presentation will outline the nursing role during thoracotomy.  Learn about the procedure itself (indications and methods), review the anatomy and discuss the role of the RN in the whole situation. 

While this is a physician driven procedure, not all hospital emergency departments are equipped with readily available operation rooms and cardiac surgeons, making the role of the RN different from institution to institution.  The nature of thoracotomy as being an emergency life saving procedure means that all ED nurses need to have a least a basic understanding of the expectation they may be faced with. 

Landon James – A PRACTICAL GUIDE TO EMERGENCY/DISASTER MANAGEMENT

Emergency Management programs generally have difficulty finding their way into the everyday emergency nurse's world.  We generally think of them as only for use in disasters and then often wonder why smaller incidents don't run smoothly.  The principles of emergency management can be applied to every day operations of hospitals and emergency departments with good results.

Emergency Management is your friend and aside from running “mock Code Orange” drills, there are a lot of easier (and more effective) ways to practice the plan without spending extra money or investing a lot of time. 

Jo-Ann Sawatzky  and Carol Enns – THE MANITOBA EMERGENCY NURSES RETENTION RESEARCH PROJECT: PIONEERING CHANGE & IMPACTING THE FUTURE OF EMERGENCY NURSING

The nursing shortage is reaching crisis proportions in Canada and throughout the industrialized world. This crisis is particularly evident in critical care areas, such as emergency departments (EDs). Nursing shortages have a negative impact on many aspects of health care delivery, including economic and patient outcomes. Although the need for research on ED nursing staffing has been identified as a priority, there has been a paucity of research in this area. Therefore, the primary purpose of our study was to explore and describe the factors that predict the retention of ED nurses. In addition, our goal was to elicit the expressions and experiences regarding influencing and intermediary factors for retention, as well as insights and strategies for retaining ED nurses.

In this presentation, we will discuss the findings related to the relationships between the influencing factors (i.e., organizational climate & personal factors), intermediary factors (i.e., job satisfaction, engagement, compassion satisfaction/fatigue, burnout, & caring), and the outcome of intent to leave.

We anticipate that this research-based evidence will provide insight into the development of innovative strategies for retention and the impetus for pioneering change for ED nurses in Manitoba. Addressing the ED nursing retention issues will ultimately have a favourable impact on our primary goal: optimal patient care. The insights gleaned from this research may also be applicable to other EDs, as well as other areas of nursing within Canada, and beyond.

Carole Rush – “NOT JUST A BUMP ON THE HEAD: AN UPDATED DISCUSSION ON CONCUSSION

Cerebral concussion is the most common form of head injury that occurs in athletes and in the general population. The consequences of brain injury are the same whether the injury results from a motor vehicle collision, a hook to the jaw in boxing, or a head collision in football.     

Most Emergency Departments (EDs) have adopted a standardized approach to treating more severe head trauma.  Many variables exist with the management of milder forms of brain injury.  The majority of these patients are either discharged from the ED/ Urgent Care, or admitted for only 24 hours of observation. They are given little information on the possible short and long-term sequelae of their injury.  Follow-up of these patients is a rare event.

This session will feature highlights from the latest Consensus Statement on Concussion in Sport, published in May 2009, including the pathophysiology of concussion, key assessment points, the controversy over diagnostic imaging (CT scans), recovery challenges, the role of the ED/Urgent Care in discharge information/return to activity guidelines, and possible long term sequelae of repeat concussions.

Nikki Kelly – A FOLLOW-UP PROCESS FOR PATIENTS WHO LEAVE THE EMERGENCY DEPARTMENT WITHOUT BEING SEEN

Patients who come to the ED for medical care and LWBS are becoming a significant concern for overcrowded ED’s. This patient population represents a failure of our system and they are at increased risk for adverse events due to the delay in receiving appropriate and timely medical care. Furthermore, it is unknown if these patients seek alternate medical treatment after they LWBS.

For ED’s throughout Canada, reducing the number of patients who LWBS has become an important indicator of overall performance.  When the Charles V Keating Emergency and Trauma Centre, at the Queen Elizabeth II Health Sciences Centre in Halifax, N.S. opened in June 2009, data tracking the LWBS population was already being collected[1]. A “Target” goal of 5% LWBS (of the total ED patient population) was established and on a monthly basis these performance indicators are reported. In an effort to improve our LWBS rates, our ED developed a comprehensive process to follow-up with patients who LWBS.

Dawn McKevitt – LEGAL ASPECTS

This is an excellent presentation on some of the legal aspects and challenges of emergency nursing.  It involves a brief review of actual tort law and a comprehensive dissection of a recent case that involved a Calgary emergency room.  It is one of the only cases in Canada where nurses have been found negligent almost solely based on deficient documentation.

Debbie Phillips – MENTAL ILLNESS IN EMERGENCY DEPARTMENTS: I CAN CHANGE THE WORLD AND I KNOW YOU CAN TOO

According to the Canadian Mental Health Association, 20% of all Canadians will personally experience mental illness at some point in their lives, yet nurses continue to say they feel ill-equipped to care for patients with psychiatric disorders.  This fact is not at all surprising considering that entry level nurses receive little training to prepare them to care for this population. 

The primary purpose of this presentation is to increase knowledge of mental illness and the skill set of nursing.  The nurse who develops expert communication skills and techniques is better equipped to interact with all patients and family members, not just those with mental illness. 

Susan Kriening, Lisa Sullivan and Andrew Sharpe - A PROCESS IMPROVEMENT JOURNEY: IMPROVING ACCESS TO EMERGENCY CARE

The University Hospital Emergency Department’s journey through process improvement will be described, with the successes highlighted, including the implementation of a See and Treat care model. Lessons learned will then be shared to motivate those considering similar improvement initiatives.

Emergency Department (ED) overcrowding is “one of the most challenging issues currently facing the Canadian health care system”, resulting in “increased patient suffering, prolonged wait time, deteriorating levels of service, and on occasion, a worsened medical condition or even loss of life”. Over the last four years, the Ontario Ministry of Health and Long-term Care have supported initiatives to improve wait times. One such strategy is the Emergency Department Process Improvement Program, a structured program intended to support improvements in ED length of stay metrics. The program builds capacity within hospitals to ensure long term sustainable change through the utilization of LEAN methodologies to reduce waste in the system from the patient’s perspective. The tertiary/quaternary care center London Health Sciences Centre University Hospital Emergency Department had the opportunity to participate in this program in 2011.

This journey to improve emergency care access was tiring yet exhilarating.  It is hoped that the achievements will motivate teams to embark on similar paths of process improvement. Exceptional work has occurred throughout Ontario and many resources have been provided to hospitals to assist with improving access however, there are still many opportunities to consider.

Karen Melon – INSIDE TRIAGE; HOW EFFICIENCY AND “FLOW” DISRUPT CRITICAL PRACTICES

This presentation will offer a thought provoking and critical look at the current trends in restructuring Emergency Care. The content is based on my MN thesis project, an Institutional Ethnography that examines the organization of nurses’ triage work. The conclusions are based on interviews with 14 Emergency nurses, managers, course instructors and Emergency department administrators, and an analysis of the origins of the Canadian Triage and Acuity Scale.

The presentation will also offer a synopsis of the intricate and complex work processes that accomplish the triage and timely treatment of patients. These knowledgeable nursing practices have very little to do with the triage and acuity scales that are taken for granted organizers of triage ‘work’. I will focus on some of the specific ways that emergency care is being redesigned; (LEAN, streaming, Rapid Assessment areas), discuss where these ideas originated and the problems this type of care can create for nurses and patients.

Implications for Practice: This presentation will offer nurses an opportunity to reflect on the negative changes in their own practice brought about by the pressures to reduce wait times. It offers a way to think differently about triage work, what nurses value, and the potential for emergency nurses to ‘talk back’ to the ‘efficiency and flow’ agenda.

Denise Devison and Caroline McGarry – THE CHALLENGES AND REWARDS OF FLIGHT NURSING IN THE CANADIAN ARCTIC

Flight Nursing represents a new set of challenges for the emergency nurse.  Adding the Canadian Arctic into the equation provides a working environment that is truly unique in comparison to flying in the rest of Canada.  The arctic spans thousands of kilometers spread across 4 time zones, offering a beautiful, raw, enormous landscape, equaling 40% of the total Canadian landmass. 

Landon James and Claude Stang – OVERCOMING THE CHALLENGES OF OVERCROWDING

Vancouver General Hospital in Vancouver, BC has undergone a major transformation over the past few years.  These changes have had a profound impact on the overcrowding problem in the Emergency Department.   The presenters will review the strategies used and the accountability framework in place throughout the entire hospital to achieve this goal.  This problem was not solved through Emergency Department redesign alone, but required intense work throughout the entire health spectrum to produce the results.  These changes were driven by a Ministry of Health program that provided financial reward to hospitals that created results which then allowed further investment in new strategies. 

Participants will be able to return to work, translating some of the lessons that delivered results into their facilities.  Leaders will be able to use some of the strategies to convince others that patient flow starts at the exit door and not in the emergency department.

AnnMarie Papa – TRAUMA FOR THE NON-TRAUMA NURSE

This presentation will focus on the overall basic approach to trauma, the rationale for a coordinated approach and the strategies to help the “non” trauma nurse survive!

AnnMarie Papa – ED DELIVERY – NOT IN MY ED

This presentation will focus on the definition of emergency child birth and the characteristics of labour. It will also discuss the care of the infant and mother following birth and a discussion of what equipment is needed.

Karen Melon – THE MINUTES COUNT: SUPPORTING TIMELY REPERFUSION IN STEMI

This presentation will discuss a process improvement project designed and carried out by a small group of nurses to address the delay in obtaining initial ECG’s for patients experiencing ST elevation MI in our department. I will provide an overview of the project including the specific problems we encountered in obtaining initial ECG’s on potential STEMI patients within the current STEMI guidelines, the process improvement design for data collection, analysis, process mapping and plan for improvement, the implementation of a process redesign, practical considerations, the results, success stories and implications for practice.

Jo-Anne O’Brien – IMPROVING DISCHARGE OF SENIORS FROM THE EMERGENCY DEPARTMENT, IMPLEMENTATION AND EVALUATION OF A SENIOR SAFETY ASSESSMENT TOOL

This presentation will describe the process taken to develop, implement and evaluate a senior safety assessment tool for use by ED nurses. This includes a review of the literature and a survey and focus group about Emergency Nurses perceptions of discharging seniors from the ED. The many lessons learned during this process will be shares throughout the presentation.

It is imperative we continue to develop skill and knowledge in order to meet the needs of geriatric patients in the Emergency Department. 

Nancy Connor – WHAT’S BUGGING YOU?  COMMON INFESTATIONS IN THE ED

Five of the most common “bugs” found on patients presenting to the ED are: bedbugs, scabies, lice, pinworms and maggots. Dermatological manifestations such as a rash or profound itching from the offending insect or worm are often the primary rationale for the visit. The “bugs” are not known to cause or transmit any infectious disease other than itself. Patients living with chronic illness or in unclean environments are at greater risk to present with a more serious health complaint secondary to the infestation such as a bacterial infection. The stigma attached to the “bug” can send healthcare providers into a fluster and impose strict unnecessary isolation for the patient and family to prevent further spread of the infestation.  Discussion of the “bugs” life cycle, presentations, diagnoses and treatment options will help dispel some common myths surrounding the care of the individual experiencing an infestation.

Global travel, poverty and an increasing aging population all equate to a higher probability of caring for an individual experiencing an unintentional infestation. It is important for Emergency nurses to be knowledgeable about the various insects and worms to properly care for and educate the patient and their family. Understanding the pathology behind the infestation can help protect the nurse and the other members of the healthcare team.  

Mohamed Toufic El Hussein – GIVE “PEACE” A CHANCE (PHYSIOLOGIC, ENVIRONMENTAL, ADLS/SLEEP, COMMUNICATION AND EDUCATION): A SCIENTIFIC HOLISTIC NURSING APPROACH TO TREAT DELIRIUM 

Delirium is described as an “emerging epidemic” and constitutes a major health challenge due to increasing cost, incidence, mortality and morbidity. The PEACE mnemonic is used to help nurses understand the contributing factors to delirium and the related nursing interventions.  According to Balas (2010) the prevalence of delirium is about 33% among older emergency department patients; with this high prevalence rate and the increased risk of mortality, emergency nurses needs to be vigilant and skilled in detecting delirium early and instigating the proper interventions. The “PEACE” approach is an ideal strategy that if used appropriately can significantly decrease the incidence of delirium and contributes to better outcomes in patients suffering from delirium. Patients nowadays are spending more time in the emergency departments due to shortage of beds and staff members. Educating emergency nurses and providing them with the necessary tools and evidence will ensure best practice and ultimately safer and more competent nursing care.   

Below is the conference schedule.

To register online visit http://events.nena.ca/

 Or you can download the registration form from here

http://images.nena.ca/nena/conference/2012_NENA_Conference.Registration.pdf

The conference schedule and registration is now available online at this link http://events.nena.ca/

The registration form is also available here http://images.nena.ca/nena/conference/2012_NENA_Conference.Registration.pdf

Group rates are available at The Westin Nova Scotian, Halifax, Nova Scotia.

Please refer to this link for more details about the hotel and the availability.
http://www.starwoodmeeting.com/StarGroupsWeb/res?id=1108253932&key=E2F6F

http://www.mtcw.ca/ (Murphy's on the Water Restaurant)     

http://www.mtcw.ca/harbourhopper/ (Harbour Hopper) Transportation

This website is dedicated to the 2012 NENA Conference being held in Halifax, NS, May 3-5th, 2012.

More news is coming soon.