Commission on Excellence and Innovation in Health

CALHN to be the first to implement HIRAID® to improve the quality of nursing assessment in its emergency department

20 Oct 2023

HIRAID® is now mak­ing its way to South Aus­tralia, with a part­ner­ship formed between the Uni­ver­si­ty of Syd­ney, the CEIH, and par­tic­i­pat­ing Local Health Net­works (LHNs).

HIRAID®, which stands for His­to­ry (includ­ing infec­tion risk), iden­ti­fy red flags, Assess­ment, Inter­ven­tions and Diag­nos­tics, is the only val­i­dat­ed, evi­dence-based frame­work that empow­ers emer­gency nurs­es to sys­tem­at­i­cal­ly assess and man­age Emer­gency Depart­ment (ED) patients after triage. Devel­oped in New South Wales, HIRAID® has been suc­cess­ful­ly imple­ment­ed in rur­al, region­al and met­ro­pol­i­tan EDs in New South Wales and Victoria.

CAL­HN will be the first LHN to imple­ment HIRAID®. Led by the local imple­men­ta­tion team of Daniel Sofia (ED Nurse Con­sul­tant) and Dani Mar­shall and Megan Franken­feld (ED Nurse Edu­ca­tors), CAL­HN are in the final stages of prepa­ra­tion in antic­i­pa­tion of a launch in ear­ly 2024.

South Aus­tralian EDs, like many across Aus­tralia, con­tin­ue to deal with ever-increas­ing demand. EDs also face work­force chal­lenges includ­ing staff short­ages, edu­ca­tion and suc­ces­sion plan­ning for the loss of expe­ri­enced spe­cialised nurs­ing staff.

ED nurs­es oper­ate at the front-line of our health sys­tem. They are the first health pro­fes­sion­al that patients see when attend­ing EDs. ED nurs­es assess and ini­ti­ate care for patients of all ages, with vary­ing degrees of clin­i­cal urgency and sever­i­ty. Accu­rate, high qual­i­ty emer­gency nurs­ing assess­ment is fun­da­men­tal to achiev­ing excel­lent patient outcomes.

Cur­rent­ly, there is no stan­dard­ised emer­gency nurs­ing assess­ment frame­work in use for the thou­sands of emer­gency nurs­es work­ing in South Aus­tralia. Emer­gency nurs­es, like each nurs­ing spe­cial­ty, need spe­cial­ist skills in addi­tion to the foun­da­tion­al skills of reg­is­tered nurs­es, and not all emer­gency nurs­es in South Aus­tralia have spe­cial­ist emer­gency nurs­ing train­ing. There­fore, there is vari­a­tion in the deliv­ery of emer­gency nurs­ing care, with­in the same emer­gency depart­ment, and between emer­gency departments.

Research has demon­strat­ed that HIRAID® improves: the qual­i­ty of patient assess­ment and doc­u­men­ta­tion; recog­ni­tion and response to clin­i­cal dete­ri­o­ra­tion; improved com­mu­ni­ca­tion between nurs­ing and med­ical staff; and nurs­es’ self-effi­ca­cy and lev­els of anx­i­ety. HIRAID® has been shown to reduce the risk and asso­ci­at­ed costs of clin­i­cal ward dete­ri­o­ra­tion asso­ci­at­ed with ED care dur­ing the first 72 hours of admis­sion in patients admit­ted via the ED.

We are now in dis­cus­sions with oth­er LHNs about this fan­tas­tic oppor­tu­ni­ty to imple­ment an evi­dence-based frame­work that deliv­ers improve­ments in patient and sys­tem out­comes. Fur­ther infor­ma­tion about HIRAID® is avail­able via the Uni­ver­si­ty of Syd­ney HIRAID® inter­net page. If you would like to know more and hear how it can be imple­ment­ed in your prac­tice, reach out to us at ceihurgentandemergentcare@​sa.​gov.​au.

Update: We’re thrilled to announce that HIRAID® is now live at CALHN!