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Roles and Responsibilities - SHED - ANUM – Resus & Behaviour Assessment Unit

Overview

The Mental Health and Resus ANUM or Nurse In Charge will be primarily responsible for the flow of patients between the main department and Behaviour Assessment Unit (BAU), The Hub and Resuscitation Area (Resus), while also supporting, leading and directing nursing staff to provide high quality, patient-centred care.

Primary Role

The facilitation of movement of patients from the Emergency Department to BAU, The Hub and Resus. Overseeing the provision of a high standard of timely care to all patients within the BAU, The Hub and Resus, while also ensuring the safety of all staff, patients and carers. The Mental Health and Resus ANUM will liaise with Consultants/Senior Registrar, Emergency Mental Health (EMH), Inpatient wards, Alcohol and other Drug (AOD) Clinicians and Allied Health teams to ensure safe and timely discharge from BAU and The Hub.

Secondary Roles

  • Lead, support, motivate and direct staff in the provision of high quality, culturally safe, person-centred health care.
  • Supervise employees and act appropriately to manage any behaviour that does not meet policy and procedure, ensuring safe patient care.
  • Delegating the workload to nursing staff appropriately, acknowledging the care requirements of each patients and supporting the nursing staff where needed.
  • Collaborate with the Mental Health Nurse Navigator to identify appropriate patients for care in the BAU and The Hub from within the emergency department (ED), facilitating their timely transfer to the unit.
  • The initiation of mechanical and/or chemical restraint for the purposes of staff and patient safety in line with WH PPG, Duty of Care and the Mental Health Act 2014 (ANUM only).
  • Contact the ED nursing staff to facilitate handover of emergency patients requiring BAU, The Hub or Resus admission, ensuring all necessary documentation present to facilitate safe transfer.
  • Coordinate the admission of patients to the appropriate area within the 4-hour NEAT target.
  • Attend regular department huddles and appropriately escalate issues within BAU, The Hub and Resus to the ED NIC, Access Manager/Bed Coordinator and/or After-Hours Coordinator and the medical teams.
  • Support the ED NIC, by managing the rostering requirements of the department, ensuring an adequate skill mix for each shift.
  • Maintain communication regarding patient departure delays on the bed requests, and liaise with access staff regarding barriers to timely ward transfers.
  • Report clinical and non-clinical incidents via VHIMs.

Primary Workspace

  • Behaviour Assessment Unit
  • ED Department
  • Resuscitation Area
  • AV Triage
  • The Hub

Quality and Safety

  • Ensures the safety of patients and the environment by conducting regular safety checks
  • Ensure care, assessments and observations of each patient in the BAU meets with the Mental Health Act 2014
  • Ensure all patients departing ED to the ward have modified criteria in place (if applicable)
  • Infections precautions are considered and documented for all admissions
  • Any high-risk patients are identified prior to departure (high risk of pressure injuries, falls risk, behavioural specials)

Communication

  • ED ANUM
  • Floor Coordinator
  • ED Consultant
  • ED Duty Consultant or Senior Registrar
  • ED Nurse Unit Manager
  • Access Manager
  • WH Bed Coordinator
  • EMH
  • AOD Clinicians
  • ED Operations Manager
  • Mental Health Nurse Navigator
  • Inpatient psychiatric wards (AMARU, SAAPU etc)

Escalation Plan

Facilitate the management and escalation of any issues that impact on the efficient operations of the Emergency Department via consultation and liaison with:

Internal: Access, Bed Co-ordinators, SHED NUM, Area ANUM’s & Consultants, Ward ANUM’s

External: Ambulance Victoria, Victoria Police & EMH

Methods of Documentation and Reporting

  • EDIS Clinical Notes – all interactions and interventions, including reassessment with vital signs must be recorded in EDIS notes
  • Adult ED Flow Chart
  • Mental health Act paperwork – incl. mechanical restraint observation chart
  • All communication – including delays to access and changes to patient status documented in ‘Bed Request Comments’
  • Text messages via the Floor Coordinator mobile phone

Measures Of Success

  • Zero tolerance for any 24-hour total length of stay breaches within the Emergency Department
  • Achieve a 65% NEAT total for the department
  • Achieve an 80% AV Offload Stretcher time within 40 minutes of arrival
  • Improved access and flow that allows access to resus bays for patients who require high level of Emergency care under a 1:1 nursing model
  • All patients meet compliance under the Mental Health Act 2014 for the use of mechanical restraints
  • All patients leave the ED with COVID screening tools completed, admission notes documented and Interim Orders (4-hour plans)
  • Improved access and flow to ensure Best Care is delivered which directly correlates with an improved patient experience and journey