Nurses create innovative emergency unit for children

Nursing Children and Young People Conference hears about service that relieves pressure on hospital's emergency department.

A nurse-led emergency unit is helping to ensure that children receive timely and appropriate care in the north-west of England.

Andrea Spyropoulos, clinical strategist for the new Alder Hey building, praises nurses for
their ‘amazing job’ on creating the emergency unit. Picture: Neil O’Connor

The unit at Alder Hey Children's Hospital in Liverpool is used to triage and treat children with minor illnesses, as well as relieving pressure on the main emergency department (ED).

Most children who use the service are seen and discharged within four hours. Those who need further care are admitted and moved from the ward within 24 hours.

The service was the brainchild of emergency nurses who were concerned about pressures on the hospital’s ED. The unit was created when Alder Hey opened a new site next to its original building in 2015.

Twist of fate

Speaking at the Nursing Children and Young People Conference 2017, held at Alder Hey last week, clinical strategist and project manager for the new building Andrea Spyropoulos, who is also a former RCN president, said the unit only came about by chance.



A bespoke neonatal unit had been built on the new site, and was being prepared for use, when a report into the death of a child at the old building recommended that neonatal wards have separate cubicles.

The new unit had two, four-bedded wards alongside individual rooms, and so was deemed unfit for purpose before it had even opened.

Building work was complete and there was no way of installing new plumbing, so Ms Spyropoulos said planners faced an expensive headache.

But in stepped a team of nurses, who said that if the neonatal unit had to be moved, they had a perfect use for the existing space.

Nurses take the lead

‘Our emergency nurses said we can run an independent, nurse-led emergency service,’ Ms Spyropoulos told the conference. 

‘The unit is right on top of A&E and we get lots of children coming to Alder Hey. Their parents bring them in because they are anxious or they have got minor problems, or they need a nurse and not a doctor – and they can be triaged and sent to the new emergency unit.

‘The nurses have done an amazing job. They were very aware that their practice was under pressure in the ED.

‘It did cost us a lot to convert the unit, but we’ve recouped that money in the time that we’ve been open, in terms of through-put and turnaround, and putting the right child in the right unit, with the right people.’

Ms Spyropoulos said it proved that designing a new hospital was an ‘phenomenal’ opportunity for everybody to get across their ideas, including those who may not be team leaders.

She added that their example reminded planners that they have to be flexible, and must remember that healthcare demands change and that a hospital building has to be future-proof.

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