HIRAID® (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics) is a framework designed to support nurses in assessing and managing patients. It combines all essential elements in delivery of safe, high quality nursing care.
HIRAID® was originally validated in the Emergency setting in the largest ever trial with emergency nurses. Implementation of HIRAID® reduced patient deterioration events through improved nursing assessment, recognition and escalation of clinical deterioration, handover and patient experience.
Building on its success, HIRAID® is being adapted for the Aged Care and Inpatient settings and informed the EPIC-START model of care.
HIRAID® aligns with the Australian Commission for Quality and Safety in Health Care National Safety and Quality Health Service Standards
The complexity, uncertainty and sometimes urgency surrounding emergency nursing practice requires a structured approach.
When a patient first presents to the emergency department (ED), the triage nurse performs a brief assessment and allocates a triage category based on their clinical urgency.
Following triage, the allocated nurse must perform a more comprehensive assessment and commence nursing care. Previously, there was no standardised, validated structure to guide emergency nursing assessment and care post triage.
This has led to unwarranted variation in nursing care, avoidable patient deterioration, poor pain management, poor nursing documentation, human suffering and patient dissatisfaction with emergency care.
HIRAID® addresses these issues by providing emergency nurses with an evidence-based structured approach to emergency nursing care post triage.
HIRAID® provides emergency nurses with an evidence-based structured approach to emergency nursing care post triage.
The framework improves:
“I had been hearing about HIRAID at ICEN conferences for years before my colleagues and I reached out to find out how we could go about implementing HIRAID into EDs in Adelaide. Since that initial contact in 2022, my colleagues and I have met often with the HIRAID team to discuss our implementation plans, get advice about getting executive approval, and give input into our EMR build before finally meeting in Adelaide for HIRAID instructor workshops.
The whole HIRAID team, were super approachable throughout the whole process. They were genuinely excited to hear about each milestone we achieved, and were able to give advice about how to navigate a project like this whilst balancing the constant and overwhelming demands of working within an ED. This advice was realistic and based on their experiences of navigating these exact challenges.
I have been very privileged to be involved with HIRAID instructor workshops for other health networks in South Australia, including regional areas. HIRAID has been a big and challenging journey, but it has been very rewarding to be able to implement evidence-based practice that was created by emergency nurses, for emergency nurses.” – Daniel Sofia, Nurse Unit Manager, Central Adelaide Local Health Network
I believe that the implementation of the HIRAID framework has significantly improved the quality of the nursing team's assessment and management of patients in the ED.
Staff Specialist - Emergency Department, Westmead Hospital
It’s wonderful to see the ED nursing team lead the successful implementation of the HIRAID framework across the emergency departments (ED. The results clearly reflect how this project has supported staff to perform more thorough and quality patient assessments which has supported and improved the patient experience.
Executive Director Nursing and Midwifery, Western Sydney Local Health District
HIRAID nursing notes make it easier to find relevant information from my nursing colleagues. The standardised structure encourages consistency of handover information, and this has improved clinical communication in our ED
Medical Lead - Emergency Department, Southeast Regional Hospital
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