Journal article
HIRAID® Emergency Nursing Framework improves documentation for common emergency department presentations: A stepped-wedge cluster randomised control trial
Australasian emergency care, Vol.First online, pp.1-8
25/08/2026
PMID: 42642299
Appears in Recent Faculty of Health Publications
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Abstract
Background: The HIRAID® emergency nursing framework (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) decreases patient deterioration; improves patient and carer experience; and improves nurses’ confidence in patient assessment and communication. In this paper, the effect of HIRAID® on emergency nurses’ documentation is reported.
Methods: Patients presented with chest, abdominal, hip or limb pain, fever or shortness of breath; were triaged to categories 2, 3 or 4, and had emergency department stay > 60 min (n = 884: 441 control and 443 intervention). Data were collected via record audit using the modified D-catch tool and HIRAID® framework.
Results: There were significant increases a structured approach to documentation (77.1% vs 93.5%, p < 0.001), and median accuracy of nursing record structure scores (2.0 vs 3.0, p < 0.001). HIRAID® increased overall quantity (median=2.3 vs 3.0, p < 0.001) and quality (median=2.0 vs 2.5, p < 0.001) scores for initial nursing assessment documentation, and quantity and quality scores for documentation of all HIRAID® elements. The time to documentation from arrival did not change (median=74.5 vs 79.5 min, p = 0.475).
Conclusion: HIRAID® improves emergency nurses’ documentation of: i) initial patient assessment and management; ii) communication with colleagues, patients and families; and iii) plan of care without increasing time to documentation.
Details
- Title
- HIRAID® Emergency Nursing Framework improves documentation for common emergency department presentations: A stepped-wedge cluster randomised control trial
- Creators
- Julie Considine - Deakin UniversityBelinda Kennedy - The University of SydneyMary K. Lam - RMIT UniversityMargaret Fry - Northern Sydney Local Health DistrictMargaret Murphy - The University of SydneyRamon Z. Shaban - The University of SydneyChristina Aggar - Southern Cross UniversityJames A. Hughes - Queensland University of TechnologyHatem Alkhouri - University of New South WalesMichael Dinh - The University of SydneySteven M. McPhail - Queensland University of TechnologyKate Curtis - Wollongong Hospital
- Publication Details
- Australasian emergency care, Vol.First online, pp.1-8
- Publisher
- Elsevier Ltd
- Identifiers
- 991013396821302368
- Copyright
- © 2026 The Author(s).
- Academic Unit
- Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article