Emergency Nursing
Emergency Nursing
Emergency Nursing
This material may not be reproduced, displayed, modified, or distributed without prior written
permission of the copyright holder.
No other use is permitted without prior written permission of the Saudi Commission for Health
Specialties.
For permission, contact the Saudi Commission for Health Specialties, Riyadh, Kingdom of Saudi Arabia.
Any amendment to this document shall be approved by the Specialty Scientific Council and the
Executive Council of the commission and shall be considered effective from the date of updating the
electronic version of this curriculum published on the commission’s website unless a different
implementation date has been mentioned.
Website: www.scfhs.org.sa
ACKNOWLEDGEMENTS
Throughout the process of writing this program, several individuals have taken time to provide
feedback, enriching the program and its content. We would like to give a special thanks to the Nursing
Scientific Board Members for actively participating in the feedback and contributions to this program.
We also appreciate the Saudi Commission Continuous Training Committee Members for their feedback
and support throughout the development of the emergency diploma program. We would like to offer
an extra special thanks to Drs. Zubair Amin and Sami Al Shammarri for their guidance on modifying this
program.
Finally, we would like to state to all of those who have contributed to the components of this program,
including Ms. Husna AlNasr, that without their insight and assistance, the development of this program
might have been much more difficult.
TABLE OF CONTENTS
INTRODUCTION 1
GENERAL TRAINING REQUIREMENTS 3
PROGRAM OVERVIEW 4
PROGRAM OBJECTIVES 5
ADMISSION REQUIREMENTS 6
PROGRAM REQUIREMENTS 7
TEACHING AND LEARNING METHODS 8
Methods of teaching 8
Clinical practicum 8
Hospital rotations 9
Methods of evaluation 9
Method of assessment 10
MODULES OF FIRST YEAR TRAINING 11
Module I: Foundation of emergency nursing 11
Module II: Foundations of emergency nursing practicum I 12
Module III: Pharmacological management of emergencies 13
Module IV: Pathophysiological changes in emergency nursing 14
Module V: Management of behavioral problems and psychosocial concepts 15
Module VI: Ethics in nursing and dimension of care 16
Module VII: Epidemiology 17
Module VIII: Biostatistics 17
MODULES OF SECOND YEAR TRAINING 19
Module IX: Introduction to research and evidence based practice 19
Module X: Trauma assessment and nursing consideration 19
Module XI: Major trauma and surgical emergencies 20
Module XII: Clinical practicum in emergency nursing II 22
Module XIII: Clinical practicum in emergency nursing III 23
Module XIV: Nursing informatics 23
Module XV: Leadership and management 24
Module XVI: Professional performance 25
ASSESSMENT 26
Continuous evaluation 26
Centralized examinations 26
Promotion examination 26
Final (End-of-program) examinations 27
Certification 27
REFERENCES 28
APPENDICES 30
iv SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
TABLE OF CONTENTS
Appendix A 30
Appendix B 31
Appendix C 32
Appendix D 34
Appendix E 36
Appendix F 37
Appendix G 38
Appendix H 39
Appendix I 40
Appendix J 41
Appendix K 42
Appendix L 42
INTRODUCTION
Emergency care deals with human responses to any trauma or sudden illness that requires immediate
intervention to prevent imminent severe damage or death. Care is provided in any setting to persons
of all ages with actual or perceived alterations in physical or emotional health. Initially, patients may
not have a medical diagnosis. Care is episodic when patients return frequently, primary when it is the
initial option for health or preventive care, or acute when patients need immediate and additional
interventions.
Emergency care is typically sought for serious injuries and acute medical conditions (i.e., heart attack
or stroke). However, excessive delays and overcrowding of emergency departments (EDs) have
become serious problems, thus, causing concern about compromised care.
Time is truly an important factor in the care of emergency and trauma patients. The acuity and
complexity of nursing practice in diverse settings continue to grow. As a result, emergency and trauma
nurses are faced with challenges of varying degrees from practice issues and healthcare system
delivery complexities that effectively and adequately prepare a confident and competent nurse or
nurse specialist. Essential practice patterns in emergency and trauma integrate clinical and non-clinical
practitioners to deliver appropriate, efficient, and effective care to healthcare consumers.
Emergency Nursing is the provision of immediate nursing care to people who have identified their
problem as an emergency or where nursing intervention may prevent an emergency arising. The
emergency nurse accepts (without prior warning) any person requiring healthcare with
undifferentiated and undiagnosed problems originating from social, psychological, physical, spiritual,
or cultural factors. The emergency nurse must lead, initiate, and coordinate patient care. This includes
rapid patient assessment, prioritizing care, appropriate intervention - based on assessment, ongoing
evaluation, and discharge or referral to other sources including discharge education where indicated.
Emergency nurses play a major role in disaster response and have the knowledge and skills to care for
mass casualties to ensure maximum survivability is achieved. An emergency nurse is a medical
professional who specializes in emergency care. This type of nursing focuses on identifying serious
problems in incoming trauma cases and on stabilizing those patients so that they can receive further
medical treatment.
There are number of arenas in which a trauma nurse can work; employment prospects in this field are
generally very good, as these nurses are constantly in demand globally. One of the most common
places for a trauma nurse to work is in an emergency room, processing incoming patients. Nurses can
also work in critical care units, applying their specialized training to patients who may be prone to
experiencing medical emergencies and various crises.
The key requirement for people in this field is the ability to work under pressure. They may be required
to cope with chaotic environments, stressful situations, and catastrophic trauma cases. These nurses
must often contend with cultural and language barriers and they must be able to coordinate with
doctors, other nurses, and healthcare professionals who work together as a team to provide
patient care.
Therefore, this postgraduate diploma in emergency specialty is designed to assist students to exercise
critical thinking skills to anticipate patients’ immediate needs and demands in the emergent and critical
phases of patients’ clinical courses. Furthermore, this post-graduate diploma program prepares
professional nurses to develop abilities to be competent and safe in providing emergency and disaster
nursing care in a variety of high dependence emergency settings.
To minimize this impact, a national or regional multidisciplinary trauma system has to be developed
and implemented. A trauma system is a preplanned, comprehensive, and coordinated regional injury
response network that includes all facilities with the capability to care for the injured. Essential
components of the system include trauma prevention, pre-hospital care, hospital care, rehabilitation,
system administration, trauma care education and training, trauma care evaluation and quality
improvement, and societal participation. Research has documented a significant decrease in morbidity
and mortality from trauma after the implementation of such systems, depending on their efficiency.
The population in Saudi Arabia increased1 from 26 million in 2004 to 29,897,000 million in 2015, with
further growth projected to 45 million by the year 2025. Healthcare facilities are expanding to meet
the demand of the population. This expansion, of course, requires more trained/specialized healthcare
professionals. The Saudi Arabian Red Crescent Society Emergency Medical Services Year-End
Accountability Report (1426 H) indicates the total requests/referrals of critical cases to emergency
rooms in the Eastern Province increased from 1423 H – 1426/1427 H by 46.6%.
Hence, the previous information mandate to develop an emergency program that enables healthcare
professionals and nurses in particular to be trained specifically to care for people in different
emergency situations.
1
Further information can be obtain from Central Department of Statistics and Information via URL:
http://www.cdsi.gov.sa/
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 2
GENERAL TRAINING REQUIREMENTS
1) The trainee shall abide by the training regulations and obligations set by the Saudi
Commission for Health Specialties (SCFHS).
2) Training is a full-time commitment. The trainee shall be enrolled in full-time, continuous
training for the entire duration of the program.
3) Training is to be conducted in institutions accredited for nursing training by the Saudi
Commission for Health Specialties.
4) The training will be comprehensive in the specialties of emergency nursing.
5) The trainee shall be actively involved in patient care with gradual progression of responsibility.
PROGRAM OVERVIEW
The Advanced Nursing Practice Diploma in Emergency program is a module-based one that melds a
comprehensive curriculum of emergency nursing theory and clinical practice. These modules provide
the necessary pathophysiology, assessment frameworks, and nursing theory to enable nurses to serve
a multicultural client base presenting a diverse range of illness and injury from a wide age spectrum.
This program is designed to provide an opportunity for professional nurses to develop a specialized
practice and to upgrade knowledge and clinical competence in the area of emergency and disaster
nursing based on international standards. It is constructed in a form that enables the learner to
understand and apply the necessary knowledge, skills, and attitudes about contemporary nursing
issues, theory, and research to emergency and disaster nursing practice. It also focuses on creating
learning opportunities and exemplar case studies that contribute to quality practice environments.
The program aims at facilitating the learner’s personal and professional growth in emergency and
disaster nursing by enhancing critical thinking skills necessary for making rapid, sound nursing
judgments and demonstration of self-direction in providing immediate emergency care in a variety of
high dependency emergency settings such as pre-hospital, emergency department, burn, and trauma
units. Furthermore, this program will synthesize evidence-based data and theoretical knowledge to
deliver immediate, competent, culturally sensitive care, as well as develop expertise in utilizing human
and material resources to support clinical reasoning.
Upon completion of the program, the learner will earn an Advanced Nursing Practice Diploma in
Emergency. This program is offered under the supervision of the Saudi Commission of Health
Specialties.
PROGRAM OBJECTIVES
Upon completion of the Advanced Nursing Practice Diploma in Adult Emergency Specialty, the learner
will be able to:
1) Provide specialized knowledge and skills to contribute to the development of emergency care.
2) Understand the professional issues influencing emergency nursing and the wider nursing
profession.
3) Apply management principles for acutely ill and traumatized patients, including multiple
casualties in different health settings.
4) Implement a systematic patient assessment.
5) Incorporate advanced life support skills in the management of traumatized ill patients.
6) Understand the implications of hazards and risk potential risk when managing emergencies.
7) Plan for health promotion, prevention of diseases, and recovery from emergency and
disasters.
8) Apply infection control measures when caring for emergency/disaster patients and their
families.
9) Utilize an evidence-based and research-supported approach in evaluating nursing practice
within an emergency department.
10) Manage ethical issues concerning emergency/disaster care of patients and their families in
accordance with Saudi Arabia’s rules and regulations.
11) Apply leadership concepts in emergencies.
12) Apply quality improvement concepts in evaluating emergency nursing care.
ADMISSION REQUIREMENTS
To be eligible to enroll in the program, the applicant must conform to the application requirements of
the Saudi Council of Health Specialties, in addition to the following:
1) Be a graduate with a bachelor of nursing (BSN) degree or equivalent.
2) Have completed the internship year
3) Interview successfully.
4) Have a valid nursing license from the SCFHS.
5) Be prepared to study on full-time basis.
6) Provide a letter from employer allowing participation.
7) Being physically fit.
PROGRAM REQUIREMENTS
In order to obtain an Advanced Practice Clinical Nursing Diploma in Adult Emergency, the candidate
must fulfil the following requirements:
Leaves
1) The trainee is entitled to an annual leave of thirty days in addition to an Eid's leave.
2) Sick leaves, maternity leaves, and exceptional ”emergency” leaves for a period not exceeding
ninety days shall be compensated by an equivalent period of days before the trainee is
awarded the Certificate of Training Completion.
3) Leaves 2 that are not utilized in due time within the year shall not be shifted to the coming
year.
4) Trainee may be granted a special leave for scientific purposes nor exceeding seven days per
training year to attend scientific conferences, seminars, or workshop in the same specialty
provided that trainee presents proof of attending such activities.
2
For further information on leaves, refer to article (6) in Rules of Procedure for Training of Saudi Board
Specialties Booklet, 4th edition. 2012 that can be accessed through URL:
http://www.scfhs.org.sa/en/Reglations/Documents/Rules%20of%20Procedure%20for%20Traini
ng%20of%20Saudi%20Board%20Specialties.pdf
7 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
TEACHING AND LEARNING METHODS
Methods of teaching
This includes the following:
1) Interactive lecture and discussion
2) Computer assisted interactive instructional programs
3) Weekly reading assignments and use of SCFHS digital library3
4) Simulations and clinical skills demonstration
5) Presentations
6) Group discussion of case studies
7) Clinical practicum including theory to precede related clinical assignment (as needed), post
clinical debriefing (one to two per week), and the development of nursing plans of care for
selected patients (Appendix K).
The Advanced Practice Clinical Nursing Diploma in Adult Emergency contains sixteen modules
addressing the education and training of nurses who will provide comprehensive emergency care to
clients. Each one of these modules includes specific competencies. The clinical competencies of the
program are adopted from Mosby’s online nursing skills database and some were modified for this
program. Each trainee will be issued a username and a password to access the Mosby’s Nursing
Consult database. The trainee is expected to perform competency online testing. Results of these tests
will be monitored by the assigned clinical instructor. The assigned clinical instructor, based on the
trainee’s score on the online exam, will schedule the trainee for a competency checklist review in the
nursing skills laboratory. The attached checklist is used as a tool to monitor the competency review for
each trainee.
Clinical practicum
1) Theory to precede related clinical assignment (as needed).
2) Post clinical debriefing sessions will be conducted once or twice per week as needed for
presentation of individual work and development of nursing care plans for selected patients.
3
SCFHS digital library provides Instructor and trainee with access to diverse electronic learning resources that
provide full-text for evidence-based for best practice such as Ovid Medical Collection, Mosby’s Nursing consult,
LexiComp, PubMed Central Journal and UpTodate. Digital library can be browsed through URL:
http://www.scfhs.org.sa/eservices/ELibrary/Pages/default.aspx
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 8
TEACHING AND LEARNING METHODS
Hospital rotations
A significant proportion of problems are frequently encountered in emergencies. Therefore, to
experience the nurse’s role in emergency and disaster nursing, trainees must have an adequate
specialty experience, enabling them to have confidence and competency in terms of assessment and
overall management of common emergency and disaster problems. At the end of the rotation, the
trainee should acquire knowledge, skills, and attitudes and demonstrate core competencies.
Guidelines
1) Hospital rotations in first two years are considered one block and can be completed in any
sequence. Therefore, any rotation can be taken any time during the first two year after
introductory course.
2) Rotations including inpatient setting should be completed in inpatient and emergency
departments.
3) An outpatient department rotation candidate should perform a minimum of 8 clinics per
week.
Content
The core content of knowledge and skills expected for emergencies and disasters should be attained
during appropriate hospital rotations as described for each rotation.
Learning methods
1) Emergency Department and casualties
2) Clinical rounds case discussion
3) Presentations in continuing professional development activities
4) Chart reviews
5) Clinical and topics presentations
6) Self-directed learning and conferences
7) Simulation and workshops
8) Small group discussions
9) Learning with other healthcare professionals (dietician, educator, etc.)
Methods of evaluation
Attendance
Assignments
Clinical evaluation/OSCE
Quizzes
Final examination/Project
Method of assessment
1) Cognition
Multiple choice questions (MCQs) and extended matching items
2) Clinical skills/Patient Management
Portfolio and logbook4
Case-based discussion
4
Instructor and trainee need to refer to electronic logbook, instructions, and log-ins for users through the following
URL:
http://www.scfhs.org.sa/en/MESPS/TrainingProgs/ElectrobookCases/Pages/default.aspx
http://www.scfhs.org.sa/en/MESPS/TrainingProgs/ElectrobookCases/Pages/Instructions.aspx
To view the video tutorial refer to this URL:www.youtube.com/watch?v=ZncCbDhehns
www.scfhs.info/medical/Bmedical/login.php
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 10
MODULES OF FIRST-YEAR TRAINING
Content Outline
1) Emergency room nurse
Scope of practice
Professionalism and ethics
Legal responsibility
Credentialing
Advanced practice role
Professional development
2) Stressors in the emergency care environment
Identifying stressors
Stress coping
Emergency room psychosis
3) Time management in the Emergency Department
Teamwork
Pattern and routine
Acuity index
Triage system5
4) Crisis management
5) Basics of first aid emergency nursing care
6) Stabilization of injuries
7) Pain management and sedation6
8) End-of-life care
Competencies
1) Assessment: Head and Neck
5
The Canadian Triage & Acuity Scale (CTAS) can be accessed through URL:
http://caep.ca/resources/ctas#intro
6
Refer to the universal topic of Medical and Surgical Emergencies for pain management through the
URL:http://www.scfhs.org.sa/en/MESPS/Pages/UniversalTopics.aspx.
11 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
MODULES OF FIRST-YEAR TRAINING
Content Outline
1) Systematic primary and secondary survey
2) Vascular access monitoring
3) Airway management and ventilation
4) Calculate and administer medications safely for care of patients undergoing invasive
procedures
5) Wound management
6) Burn management
7) Cardiopulmonary resuscitation
Competencies
1) Emergency Primary Assessment
2) Emergency Secondary Assessment
3) Code Management
4) Airway Positioning
5) Airway Foreign Object Removal
6) Esophageal Foreign Body Removal
7) Nasal Foreign Body Removal
8) External Defibrillation
9) Aspiration Precautions
10) Blood Pressure (Systolic): Palpation
11) Apical Pulse
12) Pulse Oximetry
13) Pulsus Paradoxus Assessment
14) Cardiac Output Measurement
15) Cardiac Monitor Setup and Lead Placement
16) Oxygen Therapy and Oxygen Delivery
17) Nasal Cannula or Oxygen Mask Application
18) Ventilation: Bag Mask
19) Ventilation: Mouth to Mask
20) Electrocardiogram: 12 Lead
21) Oral Airway Insertion
22) Endotracheal Tube Intubation
23) Endotracheal Tube Intubation: Advanced Practice
24) Endotracheal Tube and Tracheostomy Tube: Oxygen Administration
25) Endotracheal Tube: Skin and Oral Care
26) Laryngeal Mask Airway
27) Tracheostomy Tube: Care and Suctioning
28) Intravenous Therapy: Initiation
29) Venous Cut down
30) External Jugular Venous Access
31) Mechanical Ventilation: Volume and Pressure Modes
32) Nasopharyngeal Airway Insertion
33) Nasopharyngeal Suctioning
34) Burn Wound Care
35) Wound Cleansing and Irrigation of Traumatic Wounds
36) Wound Drainage Evacuation
37) Wound Irrigation
Content Outline
1) Introduction to pharmacology and legal and ethical aspects of drug administration
2) Dosage calculation, administration of IV fluids, and drug incompatibilities in addition to
prescription reading
3) Principles of pharmacokinetics and pharmacodynamics
4) Adverse drug reactions and drug interactions
5) Psychological factors affecting drug therapy
6) Toxicological emergencies pre-hospital
Competencies
1) Medication Administration: Oral
2) Medication Administration: Topical
3) Medication Administration: Nasal Instillation
4) Medication Administration: Nebulized
5) Medication Administration: Rectal Suppositories
6) Medication Administration: Local Infiltration and Topical Agents for Wound Anesthesia
7) Medication Administration: Intradermal Injection and Allergy Skin Testing
8) Medication Administration: Continuous Subcutaneous Infusion
9) Medication Administration: Subcutaneous Injection
10) Medication Administration: Intramuscular Injection
11) Medication Administration: Intermittent Infusion Methods
12) Intravenous Therapy: Regulation of Flow Rate
13) Intravenous Therapy: Solution Change
14) Blood Products Administration
15) Medication Administration: Intravenous Bolus
16) Medication Administration: Mixing Medications in One Syringe
17) Gastric Lavage for Removal of Toxic Substances
18) Streptokinase for Acute Myocardial Infarction
19) Seizure Precautions
Content Outline
1) Introduction to pathophysiology adaptations and alteration in cellular function
2) Body defense mechanisms
3) Inflammation and repair
4) Immunity
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 14
MODULES OF FIRST-YEAR TRAINING
Competencies
1) Alteplase for Acute Ischemic Stroke
2) Alteplase for Acute Myocardial Infarction
3) Alteplase for Pulmonary Embolism
Content Outline
1) Assessment and management of mental health emergencies
Anxiety and panic reaction
Ineffective coping and situational crisis
Depression
Suicidal behavior
2) Therapeutic communication skills
3) Developmental factors in effective coping responses
Stress
Anxiety
Dependency
Responses to loss
4) General systems theory applied to individual and family coping responses
5) Major coping risks associated with physical and or emotional illness
Competencies
1) Seizure Precautions
2) Communication with Anxious Patients
3) Communication with Depressed Patients
4) Life-Sustaining Therapy: Withholding and Withdrawing
5) Symptom Management at End of Life
6) Grief Support for Patients and Family
Content Outline
1) Introduction to moral and legal concepts
2) Credentialing and licensing
3) Autonomy and paternalism
4) Life and death
5) Public health
6) Ethical issues related to emergency situations
Competencies
For competencies, refer to (Appendix L)
Content Outline
1) Definition of epidemiology and health
2) Dynamics of disease transmission
3) Infectious disease epidemiology
4) Measuring the occurrence of disease
5) Assessing the reliability and validity of diagnostic and screening tests
6) Assessing the efficacy of preventive and therapeutic measures through randomized trials
7) Cohort studies
8) Case control and cross-sectional studies
9) Estimating risk determining association
10) Estimating the potential for prevention
11) From association to causation: deriving inferences from epidemiologic studies
12) Bias, confounding, and interaction
13) Roles of genetic and environmental factors in disease causation
14) Ethical and professional issues in epidemiology
Competencies
For competencies, refer to (Appendix L)
5) Provide necessary statistical background for analyzing data and drawing inferences from that
analysis.
6) Discuss logic of hypothesis testing.
Content Outline
1) Descriptive statistics, frequencies, shapes, measures of central tendency
2) Univariate descriptive statistics, measures of variability, range standard deviation scores
within a distribution, Z scores standardized distribution
3) Bivariate descriptive statistics
4) Inferential statistics, probability, sampling distribution, hypothesis testing
5) Power analysis, Types 1 and II errors, level of significance/critical regions, confidence interval,
one-tailed and two-tailed tests, and parametric tests
6) Bivariate inferential statistics, t tests for independent groups, paired t tests (dependent
groups)
7) ANOVA, between versus within groups, nonparametric tests, Chi square test for
independence, bivariate inferential statistics, Pearson r as inferential testing.
Competencies
For competencies, refer to (Appendix L).
(Appendix B)
Content Outline
1) Overview of nursing research
2) Research methodology and process
3) Research designs
4) Data collection and analyses
5) Evidence based research and application
Competencies
For competencies, refer to (Appendix L)
Content Outline
1) Patient history
2) General approaches to physical examination
3) Assessment of treatment modalities’ side effects
4) Assessment of nutritional states, spiritual and behavior changes
5) Pain assessment
6) Comprehensive system assessment (head-to-toe assessment)
7) Adapting assessment to special populations (child, infant, adult…)
8) Document quality of care issues associated with the trauma patient.
Competencies
1) Nurse-Patient Relationship
2) Assessment: General Survey
3) Emergency Primary Assessment
4) Emergency Secondary Assessment
5) Assessment: Orthostatic Vital Signs
6) Assessment: Nutrition Screening
7) Arterial Catheter Radial Insertion: Advanced Practice
8) Arterial Catheter: Blood Sampling
9) Arterial Puncture: Arterial Blood Gas Sampling
10) Arterial Catheter Radial Insertion: Advanced Practice
11) Nursing Report
Content Outline
1) Disasters and disaster nursing
2) Characteristics of disaster nursing
3) Phases of a disaster and nursing’s role during each phase
4) Basis of trauma and management
5) Head trauma and management
6) Spinal trauma and management
7) Thoracic trauma and management
8) Gastrointestinal trauma and management
9) Renal and genitourinary trauma and management
10) Orthopedic and neurovascular trauma and management
11) Burns and management
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 20
MODULES OF SECOND-YEAR TRAINING
7
Refer to Universal Topics/SCFHS Module (4) Medical and Surgical Emergencies.
1) Management of acute chest pain
2) Management of acute breathlessness
3) Management of altered sensorium
4) Management of hypotension and hypertension
5) Management of upper GI bleeding
6) Management of lower GI bleeding
Competencies
1) Ambulation Aids: Measuring and Fitting
2) Automated External Defibrillator (AED)
3) Chest Physiotherapy: Postural Drainage
4) Ear Irrigations
5) Ophthalmic Foreign Body Immobilization
6) Epistaxis: Anterior Packing
7) Epistaxis: Insertion of Balloon Catheters
8) Epistaxis: Posterior Packing
9) Immobilization Devices
10) Lumbar Puncture
11) Ophthalmic Foreign Body Immobilization
12) Spinal Immobilization: Cervical Collar, Backboard, and Vacuum Mattress
13) Cervical Collar: Management
14) Cervical Tongs and Halo Pins: Site Care
15) Cervical Traction Maintenance
16) Skin Traction
17) Splinting: General Principles
18) Splinting: Traction Splints
19) Splinting: Vacuum Splints
20) Restraint Application and Monitoring
21) Thoracentesis
22) Emergency Needle Thoracentesis
23) Chest Tube Insertion
24) Chest Tube Removal
25) Chest Tube: Closed Drainage Systems
26) Paracentesis
27) Preoperative Care
7
Refer to the universal topic of Module (4) Medical and Surgical Emergencies through the
URL:http://www.scfhs.org.sa/en/MESPS/Pages/UniversalTopics.aspx.
21 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
MODULES OF SECOND-YEAR TRAINING
Content Outline
1) The principles of electrocardiogram (ECG) and 12 Leads ECG
2) Nasogastric tube intubation and removal
3) Esophageal bleeding
4) Enteral and parenteral nutrition
5) Blood glucose monitoring technique and self-injection of insulin
6) Catheterization of the urinary bladder
7) Management of patient undergoing supra pubic bladder drainage
8) Application and removal of a cast
9) Glasgow Coma Scale measurement
Competencies
1) Electrocardiogram: 12 Lead
2) Electrocardiogram: Right Precordial and Left Posterior Leads
3) Esophagogastric Tamponade Tube: Insertion and Care
4) Feeding Tube: Verification of Placement
5) Feeding Tubes: PEG, Gastrostomy, and Jejunostomy Care
6) Gastric Lavage for Removal of Toxic Substances
7) Feeding Tube: Medication Administration
8) Fecal Impaction Removal
9) Massive Transfusion
10) Blood Glucose Monitoring
11) Peritoneal Lavage: Diagnostic: Advanced Practice
12) Specimen Collection: Timed Urine Specimen
13) Specimen Collection: Urine from Indwelling Catheter
14) Specimen Collection: Urine Screening for Glucose, Ketones, Protein, Blood, pH, and Specific
Gravity
15) Urinary Catheter: Closed Continuous Irrigation
16) Urinary Catheter: Indwelling Catheter Care
17) Urinary Catheter: Indwelling Catheter Removal
18) Urinary Catheter: Straight and Indwelling Catheter Insertion (Female)
19) Urinary Catheter: Straight and Indwelling Catheter Insertion (Male)
20) Urinary Catheter: Suprapubic Catheter Care
21) Restraint Application and Monitoring
Content Outline
1) Approach to the acute abdomen in pregnancy
2) Management of ectopic pregnancy
3) Postpartum hemorrhage
4) Sepsis during pregnancy
5) Thromboembolism in pregnancy
6) Diabetic ketoacidosis in pregnancy
7) Amniotic fluid embolism
8) Trauma in pregnancy
9) Cardiopulmonary resuscitation in pregnancy
10) Pediatric medical emergency
11) Pediatric resuscitation
12) Pediatric orthopedics
13) Pediatric surgical emergencies
14) Pediatric toxicology
15) Pediatric trauma
Competencies
1) Emergency Primary Assessment
2) Emergency Secondary Assessment
3) Code Management
4) Airway Positioning
5) Airway Foreign Object Removal
6) Esophageal Foreign Body Removal
7) Nasal Foreign Body Removal
8) External Defibrillation
9) Aspiration Precautions
4) Explain the implications of nursing informatics for nursing practice, administration, education,
and research.
5) Demonstrate skills in the acquisition and retrieval of nursing information using health
information systems within the institution and through the Internet and varied electronic
resources.
6) Apply approaches that safeguard data and information integrity while maintaining privacy and
confidentiality
Content Outline
1) Introduction of nursing informatics and overview
2) Nursing informatics goals, standards, and scope of practice
3) Nursing informatics competencies (i.e., computer literacy skills, informatics literacy skills, etc.)
4) Models and theories of informatics
5) Internet, search engines, and electronic databases and resources
6) Selection of health care information systems
7) System implementation, maintenance, and development
8) Data integrity, security, and confidentiality
9) Intranet, extranet, and network integration
10) Information technology in patient education
11) Integrating computers and information technology in nursing education and practice
Competencies
For competencies, refer to (Appendix L)
Content Outlines
1) Organizational structure and culture
2) Application of leadership and management theories
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 24
MODULES OF SECOND-YEAR TRAINING
Competencies
For competencies, refer to (Appendix L)
Content Outline
1) Sources of data for evidence-based practice
2) Education process (teaching and learning principles)
3) Legal issues
4) Ethical issues
5) Patient advocacy
6) Quality assurance
7) Professional development
8) Multidisciplinary collaboration
9) Effective communication
Competencies
For competencies, refer to (Appendix L)
ASSESSMENT
Overall, evaluation and assessment of trainees is performed according to the Saudi Commission
training and examination rules and regulations. Assessment is divided into two parts:
1) Continuous evaluation process
2) Centralized examinations
Continuous evaluation
The main aim of the continuous evaluation process is to evaluate every aspect of the trainees’
performance during their presence at the training center. This process provides objective feedback
obtained from those who are involved in the training process (i.e., preceptors). This process also
involves evaluation of interactive training activities such as case studies and seminars. The following
are the continuous evaluation process components:
1) Feedback from the assigned clinical instructor: this feedback should be obtained and
documented every month and as needed (Appendix D).
2) Feedback from the assigned preceptor: this feedback should be obtained and documented
every month and as needed (Appendix E).
3) Feedback from the assigned head nurse/nurse manager: this feedback should be obtained
every month and as needed (Appendix E).
4) Seminar evaluation: one group seminar will be conducted each training year. Seminar topics
should be selected by the trainee and approved by the assigned clinical instructor and the
program director (Appendix F).
5) Case study evaluation: case study of a patient treated in the clinical setting. Case presentation
is to include: patient’s past medical/surgical history, diagnosis/treatment history, current
medical/surgical diagnosis and nursing diagnosis with appropriate assessment findings, and
current medical/nursing plans of care with identification of optimal outcomes. Presentations
are to be approximately 15 minutes with the trainee facilitating the post-presentation
discussion. The case study evaluation form has to be completed and signed by the clinical
instructor and the trainee (Appendix G).
Centralized examinations
This assessment component includes examinations conducted centrally by the Saudi Commission for
Health Specialties, which are:
1) Promotion Examinations
2) Final Examinations
Promotion examination
This examination is held at the end of first year of the program. Successful completion of the
examination will enable the trainee to enter the second training year of the program. The promotion
examination will consist of a written test. The main objective of this exam is to assess the theoretical
knowledge as well as the critical thinking skills of the trainees regarding the topics and clinical
experiences covered in the first training year. The examination format including number of items,
eligibility, and passing scores will be according to the Saudi Commission Examination Rules and
Regulations available on the Saudi Commission Website; www.scfhs.org.sa.
Certification
Certificate of training completion will only be issued upon the trainee’s successful completion of all
program requirements. Successful completion of all program requirements (including examinations,
competencies, etc.) would result in awarding the trainees the “Emergency Nursing Diploma”
REFERENCES
1) Blanchard, L., 2010. Pathophysiology for Nurses. Delmar, Australia M. Shaw (latest edition).
2) Lippincott Williams & Wilkins. 2005. Pathophysiology: A 2-in-1 reference for nurses.
Philadelphia: Springhouse Publishing.
3) Emergency Nurses Association, 2008. Emergency Nursing Core Curriculum (6th ed.). New York:
Elsevier Saunders.
4) Emergency Nurses Association, 2011. Emergency Nurses Pediatric Course (4th ed.). Emergency
Nurses Association. Available at https://www.ena.org/education/ENPC-
TNCC/enpc/Pages/aboutcourse.aspx. Cited 5/24/16.
5) Emergency Nurses Association and Hammond, B. 2013. Sheehy's Manual of Emergency Care
(7th ed.). St. Louis, MO: Elsevier Mosby.
6) Emergency Nurses Association, Howard, P. K., and Steinmann, R. A., 2010. Sheehy’s
Emergency Nursing Principles and Practices (6th ed.). St. Louis MO: Mosby Elsevier.
7) Estes, M. E. Z., 2013. Health Assessment and Physical Examination (5th ed.). Clifton Park, NY:
Delmar Cengage Learning.
8) Godwin, L., Johnson, M., Potter, P. A., Perry, A. G., and Sorrentino, S. A., 2002. Mosby's
Nursing Skills: Intermediate. St. Louis, Mo: Mosby.
9) Gordis, L., 2014. Epidemiology (5th ed.). New York: W.B. Saunders Co.
10) Gravetter, F., and Wallnau, L., 2010. Essentials of Statistics for the Behavioral Sciences (8th
ed.). Belmont, CA: Thomson Wadsworth.
11) Gregory, J., 1996. Psychosocial Education of Nurses: The Interpersonal Dimension. Aldershot
UK: Avebury.
12) Guido, G.W., 2010. Legal & Ethical Issues in Nursing (4th ed.). Upper Saddle River, NJ: Pearson.
13) Jarvis, C., 2016. Physical Examination and Health Assessment (7th ed.). St. Louis, MO: Elsevier.
14) Cavanaugh, B. M., 2003. Nurse’s Manual of Laboratory and Diagnostic Tests (4th ed.).
Philadelphia: F. A. Davis Co.
15) Kellar, S. P., and Kelvin, E. A. 2012. Munro’s Statistical Methods for Health Care Research (6th
ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
16) McQuillan, K. A., Makic, M. B. F., and Whalen, E., 2009. Trauma Nursing from Resuscitation
through Rehabilitation, (4th ed.). St. Louis MO: Elsevier Saunders.
17) Petrie, A and Sabin, C., 2009. Medical Statistics at a Glance, (3rd ed.). London: Wiley-Blackwell.
18) Barry, P. D., 1996. Psychosocial Nursing: Care of Physically Ill Patients & Their Families, (3rd
ed.). Philadelphia: Lippincott Williams & Wilkins.
19) Polit, D. F. and Beck, C. T., 2005. Study Guide to Accompany Essentials of Nursing Research:
Methods, Appraisal, and Utilization, (6th ed.). Philadelphia: Lippincott Williams & Wilkins.
20) Saudi Commission on Health Specialties, 2016. Saudi Board Family Medicine Curriculum.
Available at
http://www.scfhs.org.sa/MESPS/TrainingProgs/TrainingProgsStatement/Family/Documents/%
D9%83%D8%AA%D9%8A%D8%A8%20%D8%A7%D9%84%D8%A8%D8%B1%D9%86%D8%A7%
D9%85%D8%AC%20-
%20%D8%B7%D8%A8%20%D8%A7%D9%84%D8%A7%D8%B3%D8%B1%D8%A9.pdf. Cited
5/26/16.
21) Saudi Commission on Health Specialties, 1436/2015. Licensing Examinations. Available at
http://www.scfhs.org.sa/en/registration/exams/Pages/default.aspx. Cited 5/26/16.
22) Saudi Commission on Health Specialties, 1436/2015. Oncology Nursing Diploma. Available at:
http://www.scfhs.org.sa/en/MESPS/TrainingProgs/TrainingProgsStatement/OncologyNursing/
Documents/Program%20Booklet.pdf. Cited 05/24/16.
23) Veenema, T. G. (ed.), 2012. Disaster Nursing and Emergency Preparedness for Chemical,
Biological and Radiological Terrorism and Other Hazards. New York: Springer Publishing
Company, Inc.
APPENDICES
Appendix A
st
Didactic and Clinical Rotations (1 Year)
First Year
Courses Duration Theoretical Clinical
384 Hours
Module I: Foundation of 96 Hours (4 days per week)
12 Weeks
Emergency Nursing * (1 day per week) Simulation and workshop, including
ACLS
Module II: Foundation of 384 Hours
96 Hours
Emergency Nursing 12 weeks (4 days per week)
(1 day per week)
Practicum I ER & Casualty
Module III:
48 Hours
Pharmacological 32 Hours
2 Weeks (3 days per week)
Management of (2 days per week)
ER & Casualty
Emergencies *
Module IV:
128 Hours
Pathophysiological 32 Hours
4 weeks (4 days per week)
Management of (1 day per week)
ER & Casualty
Emergencies
Module V: Emergency
128 Hours
Management of Behavioral 32 Hours
4 Weeks (4 days per week)
Problems and (1 day per week)
ER & Casualty
Psychosocial Concepts *
192 Hours
Modules VI: Ethics in
48 Hours (4 days per week)
Nursing & Dimensions of 6 Weeks
(1 day per week) Application of foundations of emergency
Care *
nursing in ER & Casualty
80 Hours
Module VII: Epidemiology * 2 Weeks Application in computer lab and library
(5 days per week)
80 Hours
Module VIII: Biostatistics * 2 Weeks Application in computer lab and library
(5 days per week)
Total 44 Weeks 496 Hours 1,264 Hours
*These modules are didactic modules.
Appendix B
nd
Didactic and Clinical Rotations (2 Year)
Second Year
Courses Duration Theoretical Clinical
96 Hours
Module IX: Introduction (3 days per week)
to Research and 64 Hours Consolidate rotation in the research area of
4 Weeks
Evidence Based (2 days per week) interest and in areas that provide resources
Practice * for nursing research (e.g., nursing
researchers, biostatisticians, librarians, etc.…)
Module X: Trauma 192 Hours
48 hours
Assessment and 6 Weeks (4 days per week)
(1 day per week)
Nursing Consideration ER & Casualty
Module XI: Major 256 Hours
64 Hours
Trauma and Surgical 8 Weeks (4 days per week)
(1 day per week)
Emergencies ER and OR
Module XII: Clinical 256 Hours
64 Hours
Practicum in 8 Weeks (4 days per week)
(1 day per week)
Emergency Nursing II ER and Casualty
Module XIII: Clinical 256 Hours
64 Hours
Practicum in 8 Weeks (4 days per week)
(1 day per week)
Emergency Nursing III ER and Casualty
96 Hours
Module XIV: Nursing 64 Hours (3 days per week)
4 Weeks
Informatics* (2 days per week) Rotations with nursing informatics staff, and/or
working with healthcare informatics systems
128 Hours
Module XV: Leadership 32 Hours
4 Weeks (4 days per week)
and Management* (1 day per week)
Rotations with Nurse Managers
48 Hours
Module XVI:
32 Hours (3 days per week)
Professional 2 Week
(2 days per week) Rotation in the oncology specialty area of
Performance*
interest
Total 44 Weeks 432 Hours 1,328 Hours
*These modules are didactic modules.
Appendix C
Nursing Research Project Guidelines8
Under the guidance of the advisor, the student takes three credit hours for a research project and
submits it to the adviser. A clinical research project, under the supervision of a faculty member,
employs the scientific process in analyzing a clinical problem or issues related to advanced nursing
practice. Emphasis is on a project that has tangible application to the practice setting.
Learning Objectives
At the end of this module, the learner will be able to:
1) Demonstrate ability to collect, analyze, synthesize, and evaluate information.
2) Formulate research questions on problems of clinical significance on advanced nursing
practice.
3) Critically analyze and apply studies pertinent to client care.
4) Interpret research findings and recommendations to clients, agencies, and health care
professionals.
5) Write a scholarly paper in a formal suitable for professional publication.
Pilot Studies
A student may wish to conduct a small-scale study that provides a foundation for future research. This
might include a pilot study (based on a smaller sample or refined methodology), a descriptive survey of
a group targeted for later study, intervention studies, or studies that establish or extend tool reliability
and validity.
Replicated Studies
A student may conduct an exact or approximate (under similar conditions) replication of a study to
extend findings of previous research.
Advisor
For each research project, one faculty member will function as an advisor. This person gives final
approval for the student to register for the course, advises the student during project implementation,
verifies that all requirements for the project and written report have been met, and submits the final
course grade. Graduate faculty will assign faculty members to the role of advisor or readers.
8
Nursing Research Project Guidelines are adopted from the McNeese State University College of Nursing
Graduate Program 2012-2013 through URL:http://www.mcneese.edu/
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 32
APPENDICES
1) Choose an advisor for the project who has expertise or interest in the area of your proposed
clinical research
2) Provide a description of the project, including the following:
Problem statement;
Purpose and objectives of the project; and
Significance of the project.
Evaluation
1) Written Research Report
2) Completion of the clinical research project, as outlined
Grading Criteria
The maximum score for this paper is 100 points. Each item is weighted for its importance in fulfilling
the purposes of the project.
Appendix D
SCFHS Mentor Guidelines
Goals
1) Guide residents towards personal and professional development through continuous
monitoring of progress.
2) Early identification of struggling residents as well as high achievers.
3) Early detection of residents who are at risk of emotional and psychological disturbances.
4) Provide career guidance.
Mentors are also expected to make appropriate and early referral to the Program Director or
Department Head if they discover a problem that would require expertise or resources beyond their
capacity. Examples of such referral might include:
1) Serious academic problems;
2) Progressive deterioration of academic performance;
3) Potential mental or psychological issues;
4) Personal problems interfering with academic duties;
5) Professional misconduct, etc.
As a guideline, each mentor should not have more than 4–6 trainees. As much as possible, the trainees
should come from the first and second years of training. This will create an opportunity for the senior
trainees to work as a guide for the junior trainees.
Appendix E
Advanced Practice Clinical Nursing Diploma in Emergency
Performance Assessment of the Trainee
(To be completed by the Preceptor 9 on completion of the clinical hours required monthly in the
specialty)
9
Appendix E, F and G are adopted from Advanced Practice Clinical Nursing Diploma in Oncology 2014.
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 36
APPENDICES
Appendix F
Advanced Practice Clinical Nursing Diploma in Emergency
Performance Assessment of the Trainee
(To be completed by the Clinical Instructor on completion of the clinical hours required monthly in the
specialty)
Trainee Name:…………………………………………………………………………………………………………………………………..
Signature:_______________________________________Date:________________________________
Appendix G
Advanced Practice Clinical Nursing Diploma in Emergency
Performance Assessment of the Trainee
(To be completed by the Nurse Manager on completion of the clinical hours required monthly in the
specialty)
Signature:___________________________________________Date:___________________________
Appendix H
Assessor name:…………………………………………………………………………………………………………
In-patient Follow-up
Please rate the trainee against what you would expect of a trainee in that year of training
Trainee to complete the reflection of this CBD using Gibbs framework for reflection
Assessor’s Signature:_____________________________________________________________________________________
Trainee’s Signature:______________________________________________________________________________________
Appendix I
Direct Observation Procedure (DOP) Evaluation Form
In- Follow-up
Please rate the trainee against what you would expect of a trainee in that year of training
Theme Unsatisfactory Satisfactory Superior Not Observed
1. Understanding indications, relative
1 2 3 4 5 6 7 8 9 n/o
anatomy, and technique
2. Obtain informed consent 1 2 3 4 5 6 7 8 9 n/o
3. Pre-procedure preparation 1 2 3 4 5 6 7 8 9 n/o
4. Patient safety 1 2 3 4 5 6 7 8 9 n/o
5. Antiseptic technique 1 2 3 4 5 6 7 8 9 n/o
6. Technical ability 1 2 3 4 5 6 7 8 9 n/o
7. Seek help where appropriate 1 2 3 4 5 6 7 8 9 n/o
8. Post-procedure management 1 2 3 4 5 6 7 8 9 n/o
9. Communication skills 1 2 3 4 5 6 7 8 9 n/o
10. Professionalism 1 2 3 4 5 6 7 8 9 n/o
11. Overall clinical judgment 1 2 3 4 5 6 7 8 9 n/o
Strengths:
Trainee to complete the reflection of this DOPS on the back of this form using Gibbs framework for reflection
Assessor’s Signature:_____________________________________________________________________________________
Trainee’s Signature:______________________________________________________________________________________
Appendix J
Conclusion:
Action Plan:
Appendix K
Logbook
NAME:______________________________________________________________________________
YEAR/MODULE: _____________________________________________________________________
Appendix L
Competency List
2) Airway Positioning
3) Alteplase for Acute Ischemic Stroke
7) Apical Pulse
8) Arterial Catheter Insertion (Assisting), Care, and Removal
9) Arterial Catheter Radial Insertion: Advanced Practice
Competency List
Competency List
Competency List
98) Medication Administration: Local Infiltration and Topical Agents for Wound Anesthesia
99) Medication Administration: Mixing Medications in One Syringe
100) Medication Administration: Nasal Instillation
Competency List
118) Paracentesis
119) Patient Positioning: Dyspnea
Competency List
149) Specimen Collection: Urine Screening for Glucose, Ketones, Protein, Blood, pH, and Specific Gravity
Competency List
165) Transfer Technique: Horizontal Transfer of Patients from Bed to Stretcher (Slide Board or Friction-
Reducing Board)
166) Transfer Technique: Using Mechanical Lifting Device
167) Transfusion Reaction