We have a ready-made, scalable implementation solution to support sustained use of HRIAID® by emergency nurses working in any setting.
The HIRAID® team at the University of Sydney provides a consultancy and training service that your healthcare facility can access to support implementation.
The HIRAID® team will assess your current practices, protocols, etc and provide solutions on how HIRAID® can be best integrated into specific contexts.
To train staff in HIRAID®, an evidence-informed education program led by Professor Julie Considine has been purposefully designed by educational experts to put structure around many of the things emergency nurses already do drawing on best available evidence regarding patient assessment, risk factors for adverse outcomes, recognising and responding to clinical deterioration, and educational pedagogy to develop deep learning of core concepts and high-order thinking. See the level of expertise in the design here.
To be HIRAID® trained, a nurse must complete the 4hr education program which includes pre-reading, a workbook, eLearning and a face to face workshop. In our study with 1300+ RNs that we showed that nurses are more confident and give better handover. The materials are Australian College of Nursing endorsed and aligned with the CENA Practice Standards
To maintain quality within large facilities, the HIRAID® Instructor Course permits dedicated members of your staff to deliver HIRAID® training in-house. The HIRAID® Instructor Course provides a best practice framework for nurse educators, clinical facilitators, or senior nursing staff to support participants in the development of knowledge, skills, behaviours and professional attributes necessary to apply the HIRAID® framework in clinical practice. Here’s what an instructor course looks like.
To be a HIRAID® certified facility needs to demonstrate that; 80% of their nursing staff have completed the HIRAID® training program; nurses are enabled to document using a HIRAID® template; an organisational policy document encourages the use of HIRAID® and, the HIRAID® training program is incorporated into the emergency orientation/on boarding program
HIRAID® aligns with the Australian Commission for Quality and Safety in Health Care National Safety and Quality Health Service Standards for emergency departments and inpatient wards.
HIRAID® ED:
Curtis, K., Fry, M., Kourouche, S., Kennedy, B., Considine, J., Alkhouri, H., Lam, M., McPhail, S. M., Aggar, C., Hughes, J., Murphy, M., Dinh, M., & Shaban, R. (2023). Implementation evaluation of an evidence-based Emergency Nursing Framework (HIRAID): Study protocol for a step-wedge randomised control trial. BMJ Open, 13(1). https://doi.org/10.1136/bmjopen-2022-067022
HIRAID® Aged Care:
Shaban, R. Z., Curtis, K., Fry, M., McCormack, B., Parker, D., Lam, M. K., Low, L.-F., Jeon, Y.-H., Waters, D., Lindley, R. I., Watson, K., Dunsmore, M., Considine, J., Squillacioti, G., Thompson, L., Smith, A., Begum, M., Dalton, J.-A., Ramsden, C., … Viengkham, C. (2024). Nurse-led framework to improve the safety and quality of residential aged care (HIRAID® aged care): Protocol for a stepped-wedge cluster randomised controlled trial. Trials, 25(1). https://doi.org/10.1186/s13063-024-08585-w
HIRAID® Inpatient:
Curtis K, Considine J, Lam M. K, Wiseman T, McPhail S, Jones T, Mulholland B, Trostian B, Wright K, Kourouche S, Kennedy B, Clements A, Melville G, Ashford B, Brereton C. J, Bartlett A, Wand T, Pettigrew C, Zeitz K, Mitchell R. J, Shetty A, Lingam M, Saddington E, O'Reilly G, Smith S, Watts M, & Shaban R. Z. (in press). Implementation evaluation of an evidence-informed hospital inpatient nursing framework (HIRAID® Inpatient): A protocol for a stepped-wedge cluster RCT. Trials.
EPIC-START:
Curtis, K., Dinh, M. M., Shetty, A., Kourouche, S., Fry, M., Considine, J., Li, L., Lung, T., Shaw, T., Lam, M. K., Murphy, M., Alkhouri, H., Aggar, C., Russell, S. B., Seimon, R. V., Hughes, J. A., Varndell, W., & Shaban, R. Z. (2023). The emergency nurse protocols initiating care—sydney triage to admission risk tool (EPIC-START) trial: Protocol for a stepped wedge implementation trial. Implementation Science Communications, 4(1). https://doi.org/10.1186/s43058-023-00452-0
The nursing system saving lives in emergency departments University of Sydney (2025)
Just the facts. University of Sydney (2023).
Quality and safety in residential aged care to drastically improve thanks to innovative nurse-led program in Western Sydney Local Health District. The Pulse, Western Sydney Local Health District (2023).
Hospital processes come to aged care after trial cuts deterioration in half. Sydney Morning Herald (2022).
From the emergency room to aged care: the potential of HIRAID® in healthcare. University of Sydney (2022).
Professor Ramon Shaban, Western Sydney Local Health District. Bench Side Story (2023).
Winner of the Western Sydney LHD Quality Awards 2022: People and Culture.
HIRAID®
Curtis, K., Hoy, S., Murphy, M., et al. (2009). The emergency nursing assessment process: A structured framework for a systematic approach. Australasian Emergency Nursing Journal, 12(4), 130–136. https://doi.org/10.1016/j.aenj.2009.07.003
Munroe, B., Curtis, K., Considine, J., et al. (2013). The impact structured patient assessment frameworks have on patient care: An integrative review. Journal of Clinical Nursing, 22(21–22), 2991–3005. https://doi.org/10.1111/jocn.12226
Munroe, B., Curtis, K., Murphy, M., et al. (2015). HIRAID: An evidence-informed emergency nursing assessment framework. Australasian Emergency Nursing Journal, 18(2), 83–97. https://doi.org/10.1016/j.aenj.2015.02.001
Munroe, B., Curtis, K., Murphy, M., et al. (2016). A structured framework improves clinical patient assessment and non-technical skills of early career emergency nurses: A pre-post study using full immersion simulation. Journal of Clinical Nursing, 25(15–16), 2262–2274. https://doi.org/10.1111/jocn.13284
Munroe, B., Buckley, T., Curtis, K., et al. (2016). The impact of HIRAID on emergency nurses’ self-efficacy, anxiety and perceived control: A simulated study. International Emergency Nursing, 25, 53–58. https://doi.org/10.1016/j.ienj.2015.08.004
Munroe, B., Curtis, K., Buckley, T., et al. (2018). Optimising implementation of a patient-assessment framework for emergency nurses: A mixed-method study. Journal of Clinical Nursing, 27(1–2), e269–e286. https://doi.org/10.1111/jocn.13932
Curtis, K., Munroe, B., Van, C., et al. (2020). The implementation and usability of HIRAID, a structured approach to emergency nursing assessment. Australasian Emergency Care, 23(1), 62–70. https://doi.org/10.1016/j.auec.2019.10.001
Curtis, K., Munroe, B., Fry, M., et al. (2021). The implementation of an emergency nursing framework (HIRAID) reduces patient deterioration: A multi-centre quasi-experimental study. International Emergency Nursing, 56, 100976. https://doi.org/10.1016/j.ienj.2021.100976
Munroe, B., Curtis, K., Fry, M., et al. (2021). Increasing accuracy in documentation through the application of a structured emergency nursing framework: A multisite quasi-experimental study. Journal of Clinical Nursing, 00, 1–12. https://doi.org/10.1111/jocn.16115
Curtis, K., Sivabalan, P., Bedford, D. S., et al. (2021). Implementation of a structured emergency nursing framework results in significant cost benefit. BMC Health Services Research, 21(1), 1381. https://doi.org/10.1186/s12913-021-07326-y
Curtis, K., Fry, M., Kourouche, S., et al. (2023). Implementation evaluation of an evidence-based emergency nursing framework (HIRAID): Study protocol for a step-wedge randomised control trial. BMJ Open, 13(1), e067022. https://doi.org/10.1136/bmjopen-2022-067022
Curtis, K., Fry, M., Shaban, R. Z., et al. (2023). Emergency nurses’ perceptions of the utility, adaptability and feasibility of the emergency nursing framework HIRAID™ for practice change in US: An exploratory study. International Emergency Nursing, 71, 101377. https://doi.org/10.1016/j.ienj.2023.101377
Curtis, K., Kennedy, B., Considine, J., et al. (2024). Successful and sustained implementation of a behaviour change informed strategy for emergency nurses: A multicentre implementation evaluation. Implementation Science, 19(1), 54. https://doi.org/10.1186/s13012-024-01383-7
Kennedy, B., Curtis, K., Kourouche, S., et al. (2024). Establishing enablers and barriers to implementing the HIRAID® emergency nursing framework in rural emergency departments. Australasian Emergency Care. https://doi.org/10.1016/j.auec.2024.08.002
Curtis, K., Kennedy, B., Considine, J., et al. (2024). Data-driven implementation strategy to optimise clinician behaviour change at scale in complex clinical environments: A multicentre emergency care study. Journal of Advanced Nursing. https://doi.org/10.1111/jan.16461
Kennedy, B., Curtis, K., Kourouche, S., et al. (2024). Development of an evidence-based strategy to implement the HIRAID® emergency nursing framework in rural emergency departments using behaviour change theory. International Emergency Nursing, 77, 101538. https://doi.org/10.1016/j.ienj.2024.101538
Curtis, K., Kennedy, B., Considine, J., et al. (2025). Use of the structured emergency nursing framework HIRAID® improves patient experience: A step-wedge cluster randomised control trial in rural, regional and metropolitan emergency departments. Intensive and Critical Care Nursing, 87, 103948. https://doi.org/10.1016/j.iccn.2025.103948
Considine, J., Kennedy, B., Murphy, M., Fry, M., Shaban, R. Z., & Curtis, K. (2025). Methods and processes to develop and deliver a theory-informed education program for sustained behaviour change in emergency nursing. PLoS ONE, 20(6), e0323115. https://doi.org/10.1371/journal.pone.0323115
Curtis, K., Murphy, M., Lam, M. K., Kennedy, B., Shaban, R. Z., Fry, M., Aggar, C., Hughes, J., Alkhouri, H., Dinh, M., McPhail, S., Waters, D., & Considine, J. (2026). Reducing inpatient deterioration and improving patient safety in emergency departments with a standardised nursing framework: A stepped-wedge cluster randomised controlled trial. International Journal of Nursing Studies, 173, Article 105256. https://doi.org/10.1016/j.ijnurstu.2025.105256
HIRAID® Aged Care:
Shaban, R. Z., Curtis, K., Fry, M., Considine, J., Low, L. F., Watson, K., McCormack, B., Lam, M. K., Dunsmore, M., Jeon, Y. H., & Lindley, R. I. (2025, September 3). Nurse-led innovations for optimising the quality and safety of care for the older person in residential aged care: A warrant for action. Journal of Advanced Nursing. https://doi.org/10.1111/jan.70206
Bock, L., Viengkham, C., Powell, M., Considine, J., Fry, M., Curtis, K., Dalton, J., Watson, K., McCormack, B., Lam, M., Dunsmore, M., Jeon, Y. H., Lindley, R., & Shaban, R. Z. (2025). Registered nurse-led assessments in Australian residential aged care homes: A scoping review. Journal of Advanced Nursing. https://doi.org/10.1111/jan.16916
Shaban, R. Z., Curtis, K., Fry, M., McCormack, B., Parker, D., Lam, M. K., Low, L. F., Jeon, Y. H., Waters, D., Lindley, R. I., & Watson, K. (2024). Nurse-led framework to improve the safety and quality of residential aged care (HIRAID® Aged Care): Protocol for a stepped-wedge cluster randomised controlled trial. Trials, 25(1), 737. https://doi.org/10.1186/s13063-024-08585-w
Fry, M., Curtis, K., Considine, J., Viengkham, C., Watson, K., Dunsmore, M., & Shaban, R. Z. (2025). Using real-time Delphi methods to develop a consensus-based framework to improve nursing assessment in residential aged care. Australasian Journal on Ageing, 44(1), e13387. https://doi.org/10.1111/ajag.13387
Wiseman T, Kourouche S, Jones T, Kennedy B, & Curtis K. (2024) The impact of whole of patient nursing assessment frameworks on hospital inpatients: A scoping literature review. Journal of Advanced Nursing, http://doi: 10.1111/jan.16025
Curtis K, Considine J, Lam M. K, Wiseman T, McPhail S, Jones T, Mulholland B, Trostian B, Wright K, Kourouche S, Kennedy B, Clements A, Melville G, Ashford B, Brereton C. J, Bartlett A, Wand T, Pettigrew C, Zeitz K, Mitchell R. J, Shetty A, Lingam M, Saddington E, O'Reilly G, Smith S, Watts M, & Shaban R. Z. (in press). Implementation evaluation of an evidence-informed hospital inpatient nursing framework (HIRAID® Inpatient): A protocol for a stepped-wedge cluster RCT. Trials.
EPIC-START
Curtis, K., Murphy, M., Kourouche, S., Hughes, D., Casey, L., Gawthorne, J., Berendsen-Russell, S.[SK3] , Couttie, T., Skelly, D., Williams, N., Shaban, R. Z., Fry, M., Kloger, R., Rheinberger, J., Aggar, C., & Considine, J. (2024). Designing a standardised emergency nurse career pathway for rural, regional and metropolitan contexts: A consensus process. Australasian Emergency Care, https://doi.org/10.1016/j.auec.2024.03.002
Curtis, K., Dinh, M.M., Shetty, A. et al. The Emergency nurse Protocols Initiating Care—Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial. Implement Sci Comms 4, 70 (2023). https://doi.org/10.1186/s43058-023-00452-0
Kourouche S, Considine J, Li L, Murphy M, Shaban RZ, Lam MK, et al. Identifying Barriers and Enablers for Nurse-Initiated Care for Designing Implementation at Scale in Australian Emergency Departments: A Mixed Methods Study. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.17693
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