Description of Unit
The Adult Emergency Department is a 62-bed unit located on the first floor of the South Campus tower. There are 62 bed spaces that include an 8 bed dedicated chest pain area, 29 core monitored beds,3 triage screening rooms, 6 bed trauma/resuscitation area, 14 bed Rapid Assessment Care area, and a registration area. There is cardiac monitoring system consisting of bedside 58 units and four wireless portable units with cardiac non-invasive blood pressure, and oxygen saturation capabilities wired to a central monitor station staffed by a monitor support tech and a central scope at the nurses’ station. Some bedside monitors will have ETCO2 and 12 lead EKG capabilities. Special patient care requirements include capability to provide invasive monitoring, in-department radiology, ventilator co-management with respiratory therapy, and emergent specialty procedures. The total ED has an average of 250 registered visits per 24 hour shift with annualized visits at 89,000 patients.
The Pediatric Emergency Department is a 13 bed unit located on the first floor of the North Campus tower. There 13 bed spaces with 5 observation beds for pediatric patients. There is a cardiac monitoring system at each bedside with oxygen saturation capabilities wired to a central monitoring system. Some bedside monitors have ETCO2 capabilities. Special patient care requirements include capability to provide invasive monitoring, in-department radiology, ventilator co-management with respiratory therapy, and emergent specialty procedures.
Description of Patient Populations
The Emergency Department exists to provide quality care to residents of Gainesville and the surrounding area, for patients that are acutely ill or injured. The Emergency Department provides assessment, triage screening, diagnosis, and treatment to all age populations that present to the Emergency Department. The ED provides and supports care for Level I trauma patients in coordination with trauma services. The ED is a STEMI (PCI) receiving facility, and a Comprehensive Stroke Center, providing care to both patient populations. If admission to the hospital is necessary, patient care is transferred to the appropriate admission team and service to provide the continuing care needed as an inpatient. The average LOS is 4 hours for discharged patients and 6.5 hours for patients requiring admission.
The most common nursing care activities include the assessment, diagnosis and treatment of; potential or actual altered respiratory function, potential or actual altered cardiac function, potential or actual altered/impaired neurological status, potential fluid and electrolyte imbalance, potential or actual altered body temperature, potential impaired physical mobility, potential or actual altered comfort, potential or actual tissue/skin integrity, and potential or actual infection. Patient and family discharge education related to the patient’s condition and treatment is an essential element in the nursing care provided. Nurses care for all age populations as well as any diagnosis that may present to the department.
Health Care Team
The Medical Directors of the Emergency Department are board certified in Emergency Medicine and Critical Care. The Emergency Department faculty, emergency medicine, pediatric, surgical, and medicine residents provide 24 hour medical care of the Emergency Department. Multidisciplinary comprehensive care of the Emergency Department patients are provided by pre-hospital providers, a hospital based Flight Transport Program, nursing, medicine, social work services, pastoral care, pharmacy, cardiopulmonary services, and other health care providers as indicated by the patient’s health status and identified needs.
Nursing management for the unit includes Registered Nurses in the positions of Nurse Manager, 3 Clinical Nurse Leaders, a non- RN as Administrative Assistant, and a non-RN as an IS Computer Analyst. The unit staff includes Registered Nurses, Critical Care Techs, Monitor Support Techs and Support Techs. Registered Nurses in the Emergency Department meet the basic requirements for the Registered Nurse staff and function in accordance with the unit-based job description, as described in the Hospital Plan for Nursing Care.
Unit requirements for registered nurses in the Emergency Department include completion of the following courses when hired or within 6 months hire to meet Level I verification requirements:
- ACLS provider
- TNCC provider
- ENPC provider
- PALS provider
A department requirement is to attend ESI Triage training within the first year of hire and completion of orientation to triage after a minimum of 6-12 months experience or sooner if previous documented triage experience. An additional departmental requirement is completion of orientation of care of critically ill patients of all ages, and the ability, willingness, and interest to work with the age appropriate and developmental needs of patients.
Critical Care Techs, Monitor Support Techs and Support Techs meet the basic requirements for their positions and functions in accordance with their unit-based job description as described in the Hospital Plan of Nursing Care. Additional unit requirements for Critical Care Tech’s include training in phlebotomy, performing 12 Lead EKG’s, splinting of extremities, foley catheter insertion, patient transport, and a positive attitude toward patient care.