Table 2.
Key strategies ED Nurses propose to manage during a pandemic.
| Category | |
|---|---|
| ED-level strategies | |
| Staffing | Increase nursing and medical staffing to meet increased patient volumes |
| Use of overtime rates as incentive, including for non-fulltime staff | |
| Introduction of on-call nursing rosters | |
| Investment in casual nursing pool training and retention | |
| Model of care | Focus on emergency interventions only |
| Non-urgent cares to be completed once transferred to inpatient ward | |
| Triage | Development of clear guidelines for the identification of lower-acuity patients who could be triaged away from ED to community-based care |
| Greater input by medical staff into decisions regarding triaging patients away | |
| Use of point-of-care testing at triage to identify atypical presentations | |
| Increased physical distancing between patients and staff at triage and administration desks | |
| Seperation of pandemic and non-pandemic patients within the ED waiting room | |
| Seperation of pandemic and non-pandemic patients within the ED treatment area | |
| Equipment | Robust supplies of PPE for staff |
| Overhaul of ED cubicle decontamination procedures to improve cleaning turn-around times | |
| Hospital-level strategies | |
| Prevention | Sending medical staff to Aged Residential Care faciltities to assess and treat patients and avoid the need for transport to ED where possible |
| Diversion of stable influenza patients away from ED to alternative clinical areas for assessment to limit disease transmission | |
| Preparation | Expand existing ED physical footprint |
| Increase inpatient admission bed capacity including isolation bed capacity | |
| Plan for rapid, temporary expansion of ED footprint into surrounding non-clinical areas | |
| Response | Establish triggers to signal when ED needs an escalation of resources to manage patient influx e.g. hospital staff redeployment to ED |
| Welfare | Subsidised or free childcare on site |
| Government-level strategies | |
| Legislation | Legal protection for ED staff triaging patients away |
| Welfare | Increased sick leave entitlements |
| Increased domestic leave entitlements for those with family dependents | |
| Immunisation | Expansion of free influenza vaccination programme to family members of healthcare workers living in the same household |
| Mandatory healthcare worker vaccination unless medically contraindicated | |
| Public health | Clear, concise, practical public health advice on self-care to encourage lower-acuity patients to be managed at home by family |
| Community services | Subsidise primary health/general practice visits for the duration of the pandemic |