Id:23 Fc-Np3-4 nursing Workforce and Education Challenges to Implementing Extracorporeal Membrane Oxygenation Services in Australia

Background: Extracorporeal membrane oxygenation (ECMO) is a type of mechanical circulatory support that is increasingly utilised for severe cardiorespiratory failure in the intensive care setting (ICU). ECMO is resource-intensive and as a result, the development of ICU-led ECMO teams has provided opportunities for specialist nursing roles and introduced new care delivery models. Aim: To explore the role and responsibilities of a novel extracorporeal life support advanced practice nursing team (ECLS-APNT) in a high-volume EMCO ICU. Methods: Descriptive qualitative design using a combination of semi-structured interviews and confirmatory observation in the clinical ICU setting. Results: Six (n=6) semi-structured interviews and 23.5 hours of direct observation of the ECLS-APNT were conducted. Five themes concerning the roles and responsibilities of the ECLS-APNT were identified from the interviews and direct observation: 1) internal ICU responsibilities such as supporting and educating the bedside nursing team, 2) external responsibilities of working in an ECMO referral ICU such as transports and retrievals, (3) beyond ECMO support and supporting other advanced cardiac support devices such as ventricular assist device and Impella, (4) care transitions from clinical deterioration to weaning, bridge-to-transplant, or end of life care, and (5) governance and service quality enhancement to ensure the provision of a 24/7 service. Conclusion: The ECLS-APNT%27s role and responsibilities are not limited to supporting the high-volume ECMO ICU, but also the external ECMO referrals service. Technological advancements in respiratory and heart failure requires a timely response from the ECLS-APNT throughout the hospital and health system.