Summary This paper reports the findings of a survey of UK consultant nurses in emergency care. The purpose of the survey was to elicit information regarding level of preparation for the consultant nurse role, the use of formal competency frameworks, current clinical scope of practice and perspectives on future preparation for the role. A semi-structured questionnaire was emailed to consultant nurses in emergency care. Respondents had an average of only 2 years in post and for 24% of respondents this was their second post as a consultant nurse. The survey identified that three quarters of the respondents had no specific preparation for the consultant nurse role. The remainder had varying levels of preparation ranging from brief induction to 6-month clinical training. It could be argued that this diversity of preparation is a reflection of the lack of clarity regarding the consultant nurse role and the ill-defined organisational frameworks within which some consultant nurse posts were established. With the exception of the expert practice domain and clinical leadership, the majority of respondents felt under prepared for one or more elements of the consultant nurse role. Clinically their scope of practice ranged from managing patients with minor illness or injury, to leading resuscitation teams. There was great

Preparing nurses to recognize the signs and symptoms of a deteriorating patient and to provide appropriate initial interventions is essential. Hospital-based in situ simulation education is an effective evidence-based method that supports adult learning in a safe environment. The purpose of this article is to discuss the development, implementation, and evaluation of an in situ simulation program and the positive impact on nurses’ confidence level in the recognition and initiation of interventions for a deteriorating patient.

Transitions of care between settings and clinicians are a time of vulnerability for patients, and can result in fragmented care, medication errors, avoidable readmissions, and patient/nurse dissatisfaction. Through the use of technology and a structured face-to-face handoff, the patient and family can be engaged in the transition across settings. The purpose of this project was to determine the feasibility and effectiveness of videoconference handoffs between inpatient, case management, and home care nurses, and the patients/families during transitions of care from hospital to home care. Videoconferences were conducted for 2 months with patients transitioning from two pediatric inpatient units to the hospital-based home care agency. The nurses and patient/family connected through a secure cloud-based videoconferencing platform. Participants discussed the patient's status, safety concerns, ongoing plan of care, what the patient/family could expect at home, and the coordination of equipment/supply needs and postdischarge visits. Videoconference handoffs (n = 10) were found to be feasible and address gaps in communication, coordination of care, and patient/family engagement during transitions from hospital to home care. Postpilot, nurses agreed the videoconference handoffs should continue with minimal modifications.