Designing a standardised emergency nurse career pathway for use across rural, regional and metropolitan New South Wales, Australia: A consensus process.

BACKGROUND: Emergency nurses are the first clinicians to see patients in the ED; their practice is fundamental to patient safety. To reduce clinical variation and increase the safety and quality of emergency nursing care, we developed a standardised consensus-based emergency nurse career pathway for use across Australian rural, regional, and metropolitan New South Wales (NSW) emergency departments. METHODS: An analysis of career pathways from six health services, the College for Emergency Nursing Australasia, and NSW Ministry of Health was conducted. Using a consensus process, a 15-member expert panel developed the pathway and determined the education needs for pathway progression over six face-to-face meetings from May to August 2023. RESULTS: An eight-step pathway outlining nurse progression through models of care related to different ED clinical areas with a minimum 172 h protected face-to-face and 8 h online education is required to progress from novice to expert. Progression corresponds with increasing levels of complexity, decision making and clinical skills, aligned with Benner's novice to expert theory. CONCLUSION: A standardised career pathway with minimum 180 h would enable a consistent approach to emergency nursing training and enable nurses to work to their full scope of practice. This will facilitate transferability of emergency nursing skills across jurisdictions.

Rice bodies in a shoulder bursa: a cadaveric and histologic case report.

INTRODUCTION: The subacromial/subdeltoid bursa can develop inflammation and effusion related to autoimmune, infectious, and musculoskeletal disorders. Rice bodies, or loose bodies within bursa, have been described as an uncommon complication of bursitis and have been the subject of case studies over a number of years. However, they have not been described in anatomical or physical therapy-related literature. METHODS: A donor body dissected for a physical therapy anatomy course was found to have an enlarged subacromial/subdeltoid bursa. This bursa, along with the biceps brachii tendon sheath, and the subscapularis muscle bursa, were filled with numerous rice-like bodies. The bursal wall was well developed and thickened. Tissue specimens were obtained of the suspected rice bodies, the subacromial/subdeltoid bursal wall, and the biceps brachii tendon sheath. The tissue was embedded, sectioned, and processed with hematoxylin and eosin or Masson's Trichrome staining for blinded histologic assessment. RESULTS: The tissue samples from within the bursa were identified as tissue similar to that in prior descriptions of rice bodies. Tissue samples from the bursal wall and tendon sheath were identified as similar to synovial membranes. CONCLUSIONS: Rice bodies found within the cadaveric body were similar histologically to those described in rheumatology, radiology, and orthopedic literature. Anatomists teaching future health-care providers and practicing physical therapists should be familiar with rice bodies as a potential finding in cadavers, and patients.

Assessment of computer workstations for compliance with ergonomic guidelines: A field study.

BACKGROUND: Computer workstation use is a risk factor for the development of musculoskeletal disorders. Governmental guidelines have been developed as a resource for workstation set-up to minimize this risk. The degree of worksite compliance with guidelines has not been examined. OBJECTIVE: The purpose of this study was to examine workstations using the VDT Workstation Checklist to determine compliance, and potential modifications. METHODS: Subjects were recruited from a variety of work settings in Erie, PA. Workstations were assessed with the worker present, using the VDT Workstation Checklist. Adjustments and recommendations were made as appropriate. RESULTS: Of the 60 workstations examined, 48%did not receive a passing score. All but one were correctable to an acceptable level with minimal low-cost modifications. The recommendation for wrist rests (43%), changes in monitor height (30%) or position (27%) and reposition of the keyboard (13.3%) and mouse (13.3%) were the most frequent modifications. Ten (16.7%) workstations did not require modification. CONCLUSIONS: Almost half of workstations reviewed were not in compliance with current guidelines, however almost all (98%) could be brought into compliance with simple modifications. Office workers need guidance in setting up workspace and adjusting ergonomic equipment to provide comfortable and safe work settings and minimize musculoskeletal symptoms.