03 August 2007

The Health Minister, the Director General, the General Managers of Central and southern areas, Emergency Department Nurses from the south east, the Secretary and other officials of the QNU met for an urgent meeting on Tuesday, 31 July to address the growing crisis in emergency departments across Queensland.

The meeting was held after a request from the QNU Secretary and following a meeting of Emergency Nurses from across the state on 16th July 2007.

According to QNU Secretary Gay Hawksworth, on any day of the week there are patients who are waiting in Emergency Departments who require inpatient admission and there are no beds. While the number varies, there can be up to 60 patients waiting. 

“These patients require care, and the Emergency Department does not have space, nor do they have staff to meet these patients’ needs. The wards also do not have the beds to admit due to other pressures and/or competing interests – clearly this is unsafe for all concerned,” said Ms Hawksworth.

“Emergency Departments know how many beds per day are required because they keep those statistics, and Queensland Health has now agreed to fast track a system where beds are allocated or quarantined for Emergency Department admissions,” she said.

Ms Hawksworth said discharge planning will be reviewed in order to address the access block. Nurse initiated discharge and the further roll out of nurse practitioner roles are also to be progressed.

“There is also agreement that a nursing workload management tool will be implemented in Emergency Departments. While some work had commenced on this tool, it had not been progressed – much to the frustration of Emergency Nurses who are not only dealing with emergency patients but also inpatients awaiting beds. Currently there is no allocation of staff for the inpatients waiting for beds,” she said.

“Only in crisis situations, where other admission points have been curtailed, elective surgery postponed, eligible patients discharged or transferred back to the referring hospital, and where the bed situation and the Emergency Department is at breaking point, may an over census bed strategy be implemented. An over census bed strategy would mean each ward may be allocated one additional patient. The QNU has agreed that this strategy should be properly planned before crisis situations arise and should not be used as a general bed management strategy.”

“Clearly this needs a whole of hospital approach with all staff working together and understanding the procedure,” Ms Hawksworth said.

The QNU sees the approach as part of an escalation protocol where the requirements have been worked out and agreed in advance.

“While there has been significant commitment in dealing with the situation, more work needs to be done, particularly around discharge planning and processes and also planning around predictable Emergency Department admissions and not just around elective surgery,” said Ms Hawksworth.

“Queensland Health staff will be hearing directly from Queensland Health management about any new initiatives and QNU will keep members informed on the issue.”

» Link to QNU 3 August 2007 Press Release