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External AV Access - SHED

This document provides a summary of best practice in relation to use of external Ambulance Victoria (AV) access to the Adult Acute Assessment Treatment Room and Resus Cubicle 3. The summary has been created to support staff during the Sunshine Hospital Emergency Department Redevelopment transition and early post-move period, and has been endorsed by the ED Leadership Team.

Overview

This QRG provides an overview of external Ambulance Victoria (AV) access to the Adult Acute Assessment Treatment Room and Resus Cubicle 3.

 

Applicability

This QRG is applicable to all clinical and non-clinical staff within the SHED.

 

Responsibility

The SHED Nurse Unit Manager and Medical Directors are responsible for ensuring that all relevant staff are aware of this QRG and are appropriately trained and orientated in effective use of external AV access for the purposes outlined.

 

Guideline/Process Details

Purpose of the Adult Acute Assessment Treatment Room

The three uses of the Adult Acute Assessment Treatment Room are:

 

Purpose of the Class N Isolation with ANTE Room (Resus Cubicle 3)

The three uses of Resus Cubicle 3 are:

  • A space to care for bariatric patients that exceed the size or safe working load (SWL) of other bays. Note the SWL of the overhead tracking hoist in Resus Cubicle 3 is 450kg (other bays are 250kg)
  • A Class N Isolation with anteroom (as per Adult Cubicle 23, SSU Bed 1 and Children Cubicle 1) therefore can occupy priority 1 patients
  • An entry point to the SHED for suspected infectious patients transported by Emergency Services (Ambulance and Police) as per DG-CC2 Emergency Services Patient Triage and Offload in Sunshine Hospital Emergency Department Guideline and Use of Negative Air Flow and Negative Pressure Rooms – SHED QRG.

Figure 1: External Access of Resus Cubicle 3

External Access of The Adult Acute Assessment Treatment Room

For external entry, staff must use their swipe card to open the door from the inside to allow Emergency Services to enter.

The NIC ensures the use of the Adult Acute Assessment Treatment Room is managed within usual nursing ratios.

There is a PPE station outside the internal door to the room. WH staff doff inside the room prior to exiting. AV will doff in their tent located near AV Arrivals.

It is the responsibility of the bedside nurse and the treating doctor to check there are no alerts on EMR or EDIS on violence, behaviours of concern (BOC) infectious diseases as soon as practically possible in the external entry process. If staff find that a patient has a history of violence and aggression, they should engage a security officer for support.

Any concern of deterioration or increasing BOC is escalated accordingly by using the emergency buzzer, or notifying the NIC so the patient can be relocated as required.

It is the responsibility of the bedside nurse to:

  • Complete nursing tasks as allocated by the medical team, or within scope of practice for the nurse initiate (e.g. bloods, X-Rays, ECG, analgesia, medications, urine tests, IVC, wound care)
  • Complete appropriate clinical nursing documentation of all care/treatment provided to the patient on EMR, ORC chart and EDIS
  • Clean and re-stock as appropriate

Once per shift, the Fast Track Nurse will complete safety checks and re-stock the Adult Acute Assessment Treatment Room (refer to the trolley stock checklist for guidance).

 

Pre-notification of an infectious patient process

  1. NIC organises the nursing team to receive the patient (AV Triage Nurse – Resus Nurse)
  2. Associated cubicle to be closed by NIC to ensure we do not exceed the Safe Patient Care Act
  3. Resus Nurse and AV Triage Nurse prepare the room ensuring the negative airflow functionality is active.
  4. The Resus Nurse and the AV Triage Nurse don the appropriate PPE.
  5. The AV triage Clerk dons the appropriate PPE.
  6. AV Triage Nurse and AV Clerk meet the AV crew outside the airlock just next to the entrance to the Adult Acute Assessment Treatment Room or the external access door to Resus Cubicle 3.
  7. The patient is triaged outside the door.
  8. The patient is clerked outside the door.
  9. The clerk returns to the AV corridor
  10. The AV Triage Nurse and one AV crew member enter the Adult Acute Assessment Treatment Room or Resus Bay 3. Access is facilitated by the Resus Nurse.
  11. Handover of patient care is completed between AV and WH in the Adult Acute Assessment Treatment Room or Resus Cubicle 3.
  12. The AV crew exits the Adult Acute Assessment Treatment Room into the AV Bay or Resus Cubicle 3 via the external door.

 

Supporting Documents

Document Governance

Title: External AV Access – SHED
Version: 1.0
Date Published: June, 2021
Date of scheduled review: 01/05/2022
Author:  Approver: 
Fiona Pazsa SHED Leadership Team