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The UK Forum for Multi-Professional Critical Care Outreach, 
   Medical Emergency, Acute and Rapid Response Teams

Deteriorating patient management education

  • 07 Jul 2019 21:35
    Message # 7767558

    Hello all. I am interested in hearing how other trusts maintain knowledge and skills of the general nursing workforce regarding identifying and caring for the deteriorating patient. We have a deteriorating patient and resuscitation team who only offer BLS, ILS and ALS. We used to teach the ALERT course but that stopped circa 2003. I am now trying to implement the Level 1 competencies but find there is a massive knowledge gap. Our lead for education unfortunately sees this as knowledge the registered nurse is professionally obligated to maintain hence no teaching is required. I think it is vital to provide a reminder of A-E assessment and the non-technical skills of human factors, communication, leadership, conflict management etc. Interested to hear your thoughts. Thanks!

  • 23 Jul 2019 14:20
    Reply # 7792261 on 7767558

    We run a monthly course similar to the ALERT that one of our consultant intensivists developed - we have a faculty that helps to deliver the course and the CCOT facilitate and teach on the day. It is mandatory that the junior doctors FY1/FY2 attend and we are currently pushing to make it mandatory for qualified nurses as well. In addition we teach a session on the deteriorating patient and use of ABCDE and SBAR for the preceptorship programme as well as teaching the new HCAs on NEWS2 and taking observations and escalating. We have also recently started teaching sessions for individual wards with a month long programme covering ABCDE assessment, fluid management, O2 therapy, NIV (where applicable) AKI etc.

    I think it is short sighted of your lead to have that kind of response if like us you are repeatedly finding patients not being appropriately managed with the basics by ward staff and their failure to recognise and respond to deterioration.. Universities only recently (in our area) have started addressing management of acutely ill adults with specific competencies and when you look at student nurse placements many will have very little if any acute care experience. In fact at this time of year we get inundated with students nurses wanting to spend the day with us in the hope we will sign off their competencies.

    Also one of the recurring themes from all the documents and papers regarding the failures around the deteriorating patient is the need for education in this area.

  • 23 Oct 2019 13:34
    Reply # 8073104 on 7767558

    Hi Lorraine,

    I work in a Dublin hospital and we are looking at setting up a similar programme here. Would you be willing to share the format of the programme you run so that perhaps we could look at setting up something similar in our hospital. Like all hospitals we are finding very junior staff left in charge of short staffed wards.

    Would appreciate any feedback. Kind regards, Siobhan





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