Alleviating pressures in EDs with staffing ratios

Emergency departments (ED) are continuing to see extremely high volumes of patients seeking acute medical care, highlighting how great the need is for nurse-to-patient ratios across NSW. According to the Bureau of Health Information (BHI) report, one in 10 patients who were treated and admitted to hospital during the October to December quarter in 2023 spent more than 19 hours in the ED. The volume of critically unwell patients presenting to EDs grew during the quarter, with a record 6,649 triage category 1 (resuscitation) patients up 7.7% and a record 119,389 triage category 2 (emergency) up 5.3% compared to the previous year. NSW Nurses and Midwives’ Association (NSWNMA) General Secretary, Shaye Candish, said these numbers highlighted the immense strain nurses were under to deliver emergency care. “Ambulance responses were the highest on record, while one in 10 patients spent longer than 10 and a half hours in the ED which is almost three hours more than pre-pandemic levels,” said Ms Candish. “We desperately need our metropolitan and regional hospitals to be staffed with the right number of skilled emergency nurses to alleviate these pressures. This is why the rollout of shift by shift ratios of one nurse to every three treatment spaces can’t begin soon enough, as our ED nurses need workload relief now. “Liverpool, Royal Prince Alfred, Royal North Shore and John Hunter hospitals continue to be the busiest sites across the state. Nepean Hospital saw an 8.2% increase in ED attendances, and St Vincent’s public saw an 8.1% rise. “Regionally, there was an uptick for the quarter in ED patients attending at Coffs Harbour (up 9.6%), Orange (up 5.6%), Forbes (24.5%) and Kurri Kurri (up 24%) compared to 2022 levels.” NSWNMA Assistant General Secretary, Michael Whaites, said staff were going above and beyond to drive down ED and elective surgery wait times, but they were up against intense and challenging work conditions. “There were 59,422 elective surgeries performed, up 9.4% compared to the same quarter the previous year, yet we still had more than 88,000 patients on the waiting list at the end of December,” Mr Whaites said. “The government needs to adequately invest in this skilled workforce, so nurses and midwives stop leaving the profession, because the pay and conditions are simply not worth sticking around for. “We need to make sure the government’s safe staffing policy is rolled out efficiently and in a timely manner across all EDs. But it cannot stop there; nurse-to-patient ratios must be introduced in all wards and specialty areas as soon as possible.” Meanwhile, the BHI’s Emergency Department Patient Survey 2022-23 indicated there’s ongoing challenges and room for improvement when it comes to hospital care. A percentage of patients treated at Blacktown, Mount Druitt, Cessnock, Maitland and Wollongong hospitals rated their overall care significantly lower than the NSW result of 60%.

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