Now that the long-awaited new Emergency Medical Treatment and Labor Act (EMTALA) rule has been published, rumors about changes in the law are abounding in many EDs. For that reason, this is an excellent time to review what is required by EMTALA, says Pamela Rowse, RN, ED assistant nurse manager at St. Rose Dominican Hospital-Rose de Lima Campus in Henderson, NV.
"The changes in the rule are welcomed, but we feel that we should continue our strict observance of all the old EMTALA regulations" that remain in effect, says Shawn Keenan, director of the ED and float pool at Monongalia General Hospital in Morgantown, WV. "Relaxing our vigilance over this complicated law may allow for some subtle aberrations that could lead to a violation."
At St. Rose Dominican Hospital, the following steps will be taken to inform ED nurses of the changes in EMTALA:
- Educational materials will be updated.
- A self-study packet will be created and distributed to all ED staff, with an acknowledgement page to be signed and returned for their education files.
- The changes will be addressed in detail at staff meetings and mandatory charge nurse meetings.
To ensure EMTALA compliance in your ED, do the following:
• Discuss real-life EMTALA cases at staff meetings.
At staff meetings, ED nurses learn about EMTALA requirements by reviewing actual events, says Rowse. "At least half of our staff meetings address a component of the law," she says. "Using real-life events reinforces a concept that might otherwise be difficult to understand." For example, if a case occurred involving a patient being given inappropriate information at triage, the EMTALA implications would be reviewed, says Rowse. "Cases are discussed from the perspective of how to do it better next time," she says. Patient transfers also are routinely reviewed at meetings. "When we have been faced with an EMTALA violation from another provider, we review how to deal with that immediate situation and how to notify management for follow-up," says Rowse.
• Give nurses an annual EMTALA test.
Every ED nurse is required to participate in an annual ED Skills Day, which includes EMTALA education, says Rowse. "We offer them every six months for two full days to allow everyone to find a time to fit them into their schedule," she says. Before the skills day, nurses are given self-study packets with a written exam. (See EMTALA quiz.) The completed packets are returned to ED nurses for review, with any errors addressed, says Rowse. "It’s a very positive experience for nurses, and as managers, we are able to assess where additional focused information needs to be disseminated," she adds.
For more information on educating staff on the revised regulations, contact:
• Pamela Rowse, RN, Assistant Nurse Manager, Emergency Department, St. Rose Dominican Hospital-Rose de Lima Campus, 102 E. Lake Mead Drive, Henderson, NV 89015. Telephone: (702) 616-4600. Fax: (702) 616-4604. E-mail: firstname.lastname@example.org.