Clinical initiatives nurse

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The primary purpose of the clinical initiatives nurse (CIN) role is to provide nursing care to patients in emergency department (ED) waiting rooms.

The CIN:

  • Maintains an ED nursing presence in the waiting room to facilitate a safe clinical environment
  • Communicates with patients and carers regarding ED processes, waiting times and provision of relevant education on their health issues
  • Assesses patients following triage with a view to:
    • initiate of diagnostics or treatment
    • escalation of care, where required
    • appropriate referral of patients.

Resources for clinicians

Manuals and role description

Presentations

For use by facilitators. They correspond to the chapters of the resource manual.

Videos

These videos are for use throughout the CIN learning process, as referenced in the CIN manuals. They can also be used as standalone videos for self-reflection, group discussion and education.

I'm OK

Family affair

Can't get no satisfaction

CIN rounding group waiting room

CIN rounding individual waiting room

Individual joint videos:

The first five videos were developed by S McCarthy (Prince of Wales Hospital) and F Trede (South Eastern Sydney and Illawarra Area Health Service Diversity Health) in 2005 for ED staff training and is part of the “In Their Shoes” communication training series. Used with permission for the CIN program.

Patient resources

Brochure

Printable brochure explaining the CIN role to patients and carers. Available in English and community languages:

Poster

Printable poster for display in the ED waiting room to explain the CIN role. Available in English and community languages:

Background

The CIN role was originally introduced into major NSW EDs in 2002. The aims for the CIN role in 2002 included:

  • providing education and advice to patients and their family’s whilst waiting to be seen
  • facilitate the reassessment or re-triage processes in the ED waiting room
  • assessing patients and constructing a plan of care for each patient in consultation with a senior emergency medical officer.

In 2009 The Garling Special Commission of Inquiry into Acute Care services added CIN roles into all EDs who had over 25,000 ED presentations in 2007-08. CIN was declared to be a vital position, caring for people waiting in EDs for medical reviews. The report noted that the CIN position was frequently re-deployed during "busy periods" which was the "very time" that it was most needed to "provide close observation of patients in the waiting room and initiation of treatment where required".

In 2010 NSW Health and the Ministerial Taskforce for Emergency Care commissioned a review of the role. All sites that have CIN funding were consulted. ED clinicians decided on the key elements of the role. This resulted in the development of a NSW statewide CIN role.

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