P0316 / #1765: CAN A NURSE CONSULTANT SAFELY AND EFFECTIVELY MANAGE REGIONAL CRITICAL CARE REFERRALS?

Abstract

Aims & Objectives: Nurses have trained as “Advanced practitioners (AP)” to deliver some traditional doctor roles in paediatric intensive care (PIC) & PIC transport. Key to staff retention and career longevity, is development andcareer progression. Currently critical care referrals aremedical consultant led. We explored the feasibility of developing Nurse Consultants to deliver consultant-led roles. Methods: AP with >6 years’ experience in PICU and PIC transport post qualification were included. A staged-development plan including AP leading regional referrals with step-wise reduction in immediate consultant supervision (with other safeguards) was produced prospectively with a plan to retrospectively analyse prospectively collected data over 7 months. Assessment plan included: 1. Direct ‘referral handling’ process in terms of quality of advice provided. 2. Indirect impacts such as incident reports, user feedback and peer-review at morbidity and mortality meetings. Results: Three AP’s eligible. 1. 109 calls were collected (53 high dependency level advice and 56 PICU level). Common diagnostic category underlying the referrals were respiratory(33%), followed by cardiovascular (14%), gastro (13%) and neurological (12%). 81% of calls were led by AP, 11% (n=12) needed additional urgent consultant input, 5 – for planned exemptions, 3 -severity of illness and 4 other. Non-urgent consultant advice was needed in 8% (n=7) of cases, 2 logistical and 5 clinical advice 2. No increase of incident reports or concerns raised at MM. Conclusions: The pilot shows feasibility of nurse consultant to safely and effectively deliver traditionally medical consultant led role. Further development process and detailed analysis of the data are on-going.