A service improvement project within the Minor Injuries Unit (MIU) at LGI and St James’s is aiming to improve patient flow through the department by expanding the skills of Emergency Nurse Practitioners (ENPs).
The project aims to educate and train ENPs to perform the reduction of wrist fractures and shoulder dislocations. ENPs will be able to perform these procedures in the MIU, reducing patient waiting times, improving staff and patient satisfaction, and reducing pressures on the main Emergency Department (ED).
Finlay Langlands, Lead Advanced Clinical Practitioner for MIU, led on the project. He said: “Wrist fractures requiring reduction often lead to long patient waits in the main Emergency Department, with the average wait around four hours. We looked at the factors involved and found a lack of junior clinician experience with the procedures, a reliance on input from senior colleagues, and the time spent in transferring to resus rather than MIU, were all contributing to long patient waits.”
Finlay looked at what other trusts in the region were doing and discovered ENP staff had been trained to perform these procedures in minor injury units elsewhere.
To kick things off at LTHT, the team held a consultant-led training day in January this year to introduce the techniques required. ENP colleagues were then encouraged to develop a training portfolio throughout the year, after which they will receive consultant sign-off to demonstrate their competence at performing the procedures.
The first ENP to successfully achieve consultant sign-off was Farrah Hussain, who received certification for competence to perform wrist reductions independently in July.
“Farrah is the first ENP in LTHT history to achieve this and it represents a great deal of effort and engagement on her part as well as the rest of the ED team in supporting her to achieve this. It’s the start of what I hope will bring major benefits to the service for both patients and staff.”
Finlay Langlands, Lead Advanced Clinical Practitioner for MIU
Subsequently, ENPs Ellie Graham and Mollie Lunn have also achieved consultant sign off to perform these procedures, which the team hope will have a beneficial impact on reducing patient waits, improving patient flow and the overall patient and staff experience in the Minor Injuries Unit.
Pictured (L-R): Amy Coulson, Senior Sister: Alia Yaqub, ED Consultant; Finlay Langlands, ED ACP; Ellie Graham, Senior ENP; Molly Lunn, Senior ENP.
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