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DETERIORATING PATIENT EDUCATION

LEARNING PATHWAYS

A guide to target audience identification

August 2015

Deteriorating Patient Education – Learning Pathways. August 2015 Page 2


Contents

...................................................................................................................................................................................1

Contents ....................................................................................................................................................................3

Purpose .....................................................................................................................................................................5

Introduction ...............................................................................................................................................................5

Background ...............................................................................................................................................................5

NSW Health Policy and National Standards ............................................................................................................5

Program Frequency ..................................................................................................................................................6

Data Migration ...........................................................................................................................................................6

Related HETI documents ..........................................................................................................................................6

Learning pathways – Between the Flags Education ................................................................................................7

Adults patients ONLY ............................................................................................................................................8

Nurses ................................................................................................................................................................8

Adults patients ONLY ............................................................................................................................................9

Allied Health Professionals (Group 1 & 2) ........................................................................................................9

Paediatrics patients ONLY ................................................................................................................................. 10

Nurses ............................................................................................................................................................. 10

Paediatrics patients ONLY ................................................................................................................................. 11

Allied Health Professionals (Group 1& 2) ...................................................................................................... 11

Maternity Clients/patients only ........................................................................................................................... 12

Obstetricians, Gynaecologists and Midwives ............................................................................................... 12

Mixed - Adult / Paediatric Patients / Midwifery services .................................................................................... 13

Staff ................................................................................................................................................................. 13

Appendix 1: Learning pathways vs previous education ....................................................................................... 14

Appendix 2: List of current and previous education ............................................................................................. 16

Appendix 3: Course titles and codes .................................................................................................................... 16

Appendix 4: eLearning modules learning objectives ............................................................................................ 17

M1 - Awareness, Charts and Escalation - Tier 1 ........................................................................................... 17

Length: 20 minutes ......................................................................................................................................... 17

M2 – Communication, Teamwork and Documentation - Tier 2 .................................................................... 17

Length: 20 minutes ......................................................................................................................................... 17

M3 – Systematic Assessment – ADULT – Tier 2 ........................................................................................... 17

Length: 15 minutes ......................................................................................................................................... 17

M4 – Case Studies specific to professional groups – ADULT – Tier 2 ......................................................... 17

Neurological Case Studies – ADULT (Medical, Nursing and Allied Health*) ............................................... 17

Length: 10 minutes ......................................................................................................................................... 17

Respiratory Case Studies – ADULT (Medical, Nursing and Allied Health**) ............................................... 17


Length: 10 minutes ......................................................................................................................................... 17

Cardiac Case Studies – ADULT (Medical and Nursing) ............................................................................... 17

Length: 10 minutes ......................................................................................................................................... 17

Renal Case Studies – ADULT (Medical and Nursing) ................................................................................... 17

Length: 10 minutes ......................................................................................................................................... 17

DETECT Junior – PAEDIATRICS (Medical / Nursing) – Package currently available in EDMORE .............. 18

recommended deterioration patient education ................................................................................................. 18

Emergency SEPSIS KILLS program (Medical and Nursing) ......................................................................... 18

Length: 60 minutes ......................................................................................................................................... 18

Inpatient SEPSIS KILLS program (Medical and Nursing) ............................................................................. 18

Length: 60 minutes ......................................................................................................................................... 18

Appendix 5: face-to-face workshops - Tier Two Learning objectives .................................................................. 20

DETECT .......................................................................................................................................................... 20

DETECT Junior ............................................................................................................................................... 20

Allied Health T2T ............................................................................................................................................. 20

CFHN T2T ....................................................................................................................................................... 20


Purpose

This document describes the learning pathways for the mandatory education related to the NSW Clinical

Excellence Commission’s (CEC) deteriorating patient program, Between the Flags. The learning pathways

provide the Local Health Districts and Specialty Networks with practical guidance on the requirements for, and

how to target, staff to complete the Between the Flags education.

Introduction

In January 2010, the CEC introduced a major state-wide system across all hospitals called Between the Flags

(BTF) to improve the early recognition and response to deteriorating patients. BTF is a multi-element safety net

system consisting of, (i) governance standards, (ii) calling criteria incorporated in standard observation charts,

(iii) minimum standards for a clinical emergency response system (CERS), (iv) specially designed education

materials and (v) feedback on performance.

Between the Flags provides a tiered approach to education which includes:

Tier 1 – (‘awareness’) an introduction to the NSW BTF system, the Standard Observation Charts, and

escalation

Tier 2 – (DETECT/DETECT junior) a structured approach to clinical assessment of the patient, the local CERS

escalation protocol and appropriate care to provide while waiting for assistance.

Tier 3 – Training for clinical staff that respond to a Clinical Review or Rapid Response. Members of the Rapid

Response team are required to have advanced clinical and resuscitation skills.

Background

The BTF education was first released in 2010 and focused on clinicians that work with adult patients. This

blended education package included an awareness package, a manual, eLearning modules (available

through Moodle) and a face-to-face workshop (DETECT). The paediatric Between the Flags education

(DETECT Junior) was released in 2013 using the same framework, with the eLearning modules being available

through EDMORE. More recently, the CEC has worked with the LHDs to develop specific face-to-face

workshops for Allied Health Professionals and Child and Family Health Nurses. The BTF education is evolving

and where required is becoming more specific to the clinicians scope of practice and clinical setting.

In 2012 the CEC, in collaboration with HETI, commenced a revision of the adult eLearning modules and the

final revised modules were endorsed by the CEC’s Deteriorating Patient Steering Committee in March 2015.

During this time HETI online was launched and discussions commenced to move the NSW Health EDMORE

eLearning materials (including DETECT Junior) to HETI online. With this in mind and considering feedback

from the LHD/Specialty Networks, the revision of the adult eLearning modules aimed to reduce/eliminate any

duplication while also tailoring the education (where possible) to the clinicians role and responsibilities.

NSW Health Policy and National Standards

NSW Health policy directive PD2013_049 ‘Recognition and Management of Patients who are Clinically

Deteriorating’, mandates that Public Health Organisations must ensure that: all staff are aware of Between the

Flags and know how to activate their local Clinical Emergency Response System and all clinicians providing

direct patient care must complete both Tier 1 and Tier 2 of the BTF education curriculum for their clinical setting

(Adult, Paediatric, Maternal/Newborn Services or mixed).

The Australian Commission on Safety and Quality in Health Care introduced the National Safety and Quality

Health Service Standards in 2013. Section 9.6 of the National Standard 9 Recognising and Responding to

Clinical Deterioration in Acute Health Care requires having a clinical workforce that is able to respond

appropriately when a patient’s condition is deteriorating.


Program Frequency

The Between the Flags eLearning modules are to be completed once only, unless a Local Health District /

Specialty Network make a decision to repeat the education in specific circumstances (i.e. as part of a

professional development plan, remedial education).

All Public Health facilities must establish systems to ensure that there are regular updates of the Between the

Flags face-to-face education for existing staff and the training of new staff.

Data Migration

A large proportion of NSW Health staff have completed the Between the Flags mandatory training

requirements since the original release in 2010. Migration of this information to HETI online is essential in order

to accurately represent the significant investment LHDs have put into this training and to negate unnecessary

duplication.

Appendix 1 describes the courses/workshops that need to be completed by staff in order to meet the training

requirements outlined in the targeting pathways which are based on patient as well as professional groups. A

list of the current and previous courses and eLearning material are available in Appendix 2 and the allocated

course codes are listed in Appendix 3.

Related HETI documents

Mandatory Training Matrix

Guide to Target Audience Identification

Summary Table - Mandatory Training Requirements

Mandatory Education and Training Estimated Completion Time

http://www.heti.nsw.gov.au/Global/ESI/Mandatory%20Training/NSW%20Health%20Mandatory%20Training%20Matrix.xlsxhttp://www.heti.nsw.gov.au/Global/ESI/Mandatory%20Training/Targeted%20Training%20Guide.pdfhttp://www.heti.nsw.gov.au/Global/ESI/Mandatory%20Training/Summary%20Table%20-%20Mandatory%20Training%20Requirements%2009012015.pdfhttp://www.heti.nsw.gov.au/Global/ESI/Mandatory%20Training/Mandatory%20Education%20and%20Training%20%e2%80%93%20Estimated%20Completion%20Times%20Nov%202014.pdf


Learning pathways – Between the Flags Education

The learning pathways identify the mandatory and recommended training/education (eLearning and face-to-

face) based on the following factors

Professional group (Nursing, Medical, Allied Health) including pool/agency and locum staff; and

Patient group (Adults, paediatric, maternity or mixed)

Staff must complete the learning pathways based on the patients/clients that they provide care for. The

learning objectives for the education (eLearning and Face-to-Face) are provided in appendices 4 and 5.

The allocation of a specific pathway to a staff member is dependent on the services provided by the facility.

For example, a large tertiary referral hospital that has adult general medical and surgical wards, maternity

services, an adult intensive care unit, a mixed (adult and paediatric) emergency department, and a paediatric

ward may allocate staff a pathway as below:

Nursing Staff (dependant on areas they cover)

o Adult general medical and surgical wards – ADULT PATIENTS ONLY pathways

o Maternity services – MATERNITY CLIENTS / PATIENTS ONLY pathway

o Adult intensive care unit - ADULT PATIENTS ONLY pathways

o Mixed Emergency Department – ADULT and PAEDIATRIC pathways

o Paediatric wards – PAEDIATRIC PATIENTS ONLY pathways

o Midwives that works in maternity, general wards, ED and paediatric wards - ADULT,

PAEDIATIC and MATERNITY pathway

Allied Health Staff (dependant on areas they cover)

o Only work in adult areas – ADULT PATIENTS ONLY pathways

o If working / plan to work in ED / paediatric ward and adult general wards – ADULT and

PAEDIATRIC pathways

o Only working in paediatric areas - PAEDIATRIC PATIENTS ONLY pathways

Medical staff (dependant on areas they cover / term rotations)

o Only work in adult areas – ADULT PATIENTS ONLY pathways

o If working / plan to work in ED / paediatric ward and adult general wards – ADULT and

PAEDIATRIC pathways

o Only working in paediatric areas - PAEDIATRIC PATIENTS ONLY pathways


ADULTS PATIENTS ONLY

Nurses (Registered or Enrolled) and Medical Staff that work in areas with ONLY Adult patients

*local determination required to identify staff allocated these ANZSCO codes that ONLY work in Adult areas

M3 – Systematic Assessment - Adult

Basic Life Support

(Pre-requisite / conjoint education)

Basic Life Support eLearning

Life Support Assessment Tool

Face-to-Face Training

DETECT

M4 – Case Studies – Adult (This will be a

combined braching module)

NURSING

*254211 – Nurse Educator

*254311 – Nurse Manager

*254414 – Registered Nurse (Community Health)

*254415 – Registered Nurse (Critical Care and Emergency)

*254416 – Registered Nurse (Developmental Disability)

*254417 – Registered Nurse (Disability and Rehabilitation)

254418 – Registered Nurse (Medical)

*254421 – Registered Nurse (Medical Practice)

*254423 – Registered Nurse (Mental Health)

*254423 – Registered Nurse (Perioperative)

*254424 – Registered Nurse (Surgical)

*254499 – Registered Nurse nec

*411411 – Enrolled Nurse

*254411 – Nurse Practitioner

MEDICAL

*252311 – Dental Specialist

*252312 – Dentist

*253111 – General Practitioner

*253112 – Resident Medical Officer

*253211 – Anaesthetist

*253311 – Specialist Physician (General Medicine)

*253312 – Cardiologist

*253313 – Clinical Haematologist

*253314 – Medical Oncologist

*253315 – Endocrinologist

*253316 – Gastroenterologist

*253317 – Intensive care specialist

*253318 – Neurologist

*253322 – Renal Medicine Specialist

*253324 – Thoracic Medicine Specialist

*253399 – Specialist Physician (nec)

*253411 – Psychiatrist

*253511 – Surgeon (General)

*253512 – Cardiothoracic Surgeon

*253513 – Neurosurgeon

*253514 – Orthopaedic Surgeon

*253515 – Otorhinolaryngologist

*253517 – Plastic and Reconstructive Surgeon

*253518 – Urologist

*253521 – Vascular Surgeon

*253912 – Emergency Medicine Specialist

*253914 – Ophthalmologist

*253915 – Pathologist

*253917 – Diagnostic and Interventional Radiologist

*253918 – Radiation Oncologist

253999 – Medical Practitioners (nec)

M1 – Awareness, charts and escalation

M2 – Communication, Teamwork and

Documentation

Recommended deteriorating patient

education on HETI online

Sepsis eLearning

o Inpatient SEPSIS KILLS Program

o Emergency SEPSIS KILLS Program


ADULTS PATIENTS ONLY

Allied Health Professionals (Group 1 & 2) that work in areas with ONLY Adult patients

*local determination required to identify if staff allocated these ANZSCO codes who physically exert patients

1 – ALLIED HEALTH GROUP 1: conduct observation and/or physically exert patients

2 – ALLIED HEALTH GROUP 2: do not conduct observation or physically exert patients



Documentation

Basic Life Support





Allied Health Tier Two Training

*234915 – Exercise Physiologist

*252411 – Occupational Therapist

*252511 – Physiotherapist

*252712 – Speech Pathologist

251111 – Dietician

251211 – Medical Diagnostic Radiographer

251212 – Medical Radiation Therapist

#

251213 – Nuclear Medicine Technologists

251214 – Sonographer

251412 – Orthotists

251211 - Pharmacist



251912 – Orthotists or Prosthetist

#

251999 – Health Diagnostic & Promotion Professional nec

252299 – Complementary Health Therapist (nec)252611 –

Podiatrist

252711 – Audiologist

272112 – Drug and Alcohol counsellor

272114 – Rehabilitation Counsellor

272199 – Counsellor (nec)

272311 – Clinical Psychologist

272312 – Educational Psychologist

272399 – Psychologist (nec)

272511 – Social Worker

272613 – Welfare Worker

411214 – Dental Therapist / Oral Health Therapist

411311 – Diversional Therapist


M4 – Case Studies Adult – Allied health

(This will be a combined branching module)



Sepsis eLearning




PAEDIATRICS PATIENTS ONLY

Nurses (Registered or Enrolled) and Medical Staff that work in areas with ONLY Paediatric patients

*local determination required to identify staff allocated these ANZSCO codes that work only in Paediatrics

NURSING

*254211 – Nurse Educator

*254311 – Nurse Manager

254413 Registered Nurse (Child and Family Health)

*254414 – Registered Nurse (Community Health)

*254415 – Registered Nurse (Critical Care and Emergency)

*254416 – Registered Nurse (Developmental Disability)

*254417 – Registered Nurse (Disability and Rehabilitation)

*254421 – Registered Nurse (Medical Practice)

*254423 – Registered Nurse (Mental Health)

*254423 – Registered Nurse (Perioperative)

254425 – Registered Nurse (Paediatrics)

*254499 – Registered Nurse nec

*411411 – Enrolled Nurse

*411412 – Mothercraft Nurse

*254411 – Nurse Practitioner

MEDICAL

253321 – Paediatrician

*252311 – Dental Specialist

*252312 – Dentist

*253111 – General Practitioner

*253112 – Resident Medical Officer

*253211 – Anaesthetist

*253311 – Specialist Physician (General Medicine)

*253312 – Cardiologist

*253313 – Clinical Haematologist

*253314 – Medical Oncologist

*253315 – Endocrinologist

*253316 – Gastroenterologist

*253317 – Intensive care specialist

*253318 – Neurologist

*253322 – Renal Medicine Specialist

*253324 – Thoracic Medicine Specialist

*253399 – Specialist Physician (nec)

253516 – Paediatric Surgeon

*253411 – Psychiatrist

*253511 – Surgeon (General)

*253512 – Cardiothoracic Surgeon

*253513 – Neurosurgeon

*253514 – Orthopaedic Surgeon

*253515 – Otorhinolaryngologist

*253517 – Plastic and Reconstructive Surgeon

*253518 – Urologist

*253521 – Vascular Surgeon

*253912 – Emergency Medicine Specialist

*253914 – Ophthalmologist

*253915 – Pathologist

*253917 – Diagnostic and Interventional Radiologist

*253918 – Radiation Oncologist



Documentation

DETECT junior eLearning module

(EDMORE)


Basic Life Support




RESUS4Kids (eLearning /practical)


DETECT Junior

Child and Family Health Tier Two

training



Sepsis eLearning



Other training requirements

Neonatal/Newborn recognition of

deterioration.

(not yet developed and/or not available

state wide)


PAEDIATRICS PATIENTS ONLY

Allied Health Professionals (Group 1& 2) that ONLY work with Paediatric patients

*local determination required to identify staff allocated these ANZSCO codes that work only in Paediatrics

Basic Life Support





Allied Health Tier Two Training – Paediatric

slides only.

(Not yet developed)



Documentation

DETECT Junior

Allied Health eLearning

(Not yet developed)

*234915 – Exercise Physiologist


*252511 – Physiotherapist


251111 – Dietician

251211 – Medical Diagnostic Radiographer

251212 – Medical Radiation Therapist

#

251213 – Nuclear Medicine Technologists

251214 – Sonographer

251412 – Orthotists

251211 - Pharmacist



251912 – Orthotists or Prosthetist

#

251999 – Health Diagnostic & Promotion

Professional nec

252299 – Complementary Health Therapist (nec)

252611 – Podiatrist

252711 – Audiologist

272112 – Drug and Alcohol counsellor

272114 – Rehabilitation Counsellor

272199 – Counsellor (nec)

272311 – Clinical Psychologist

272312 – Educational Psychologist

272399 – Psychologist (nec)

272511 – Social Worker

272613 – Welfare Worker

411214 – Dental Therapist / Oral Health

Therapist

411311 – Diversional Therapist


MATERNITY CLIENTS/PATIENTS ONLY

Obstetricians, Gynaecologists and Midwives that ONLY work in Maternity services

254111 – Midwife

253913 – Obstetrician & Gynaecologist



Documentation


Basic Life Support





Fetal Welfare Assessment (F)

Obstetric emergency and Neonatal

resuscitation training (ONT)

Other training requirements

Neonatal/Newborn recognition of

deterioration.

(not yet developed and/or not available

state wide)



Sepsis eLearning




MIXED - ADULT / PAEDIATRIC PATIENTS / MIDWIFERY SERVICES

Staff that work in areas with a mixed patient group or work across areas with different patient groups are

required to complete the training/learning pathways for each patient group (Adult, Paediatric, Maternity).

Modules that are duplicated across the pathways will only need to be completed once.

local determination is required to identify staff allocated these ANZSCO codes that work with a mixed patient group (with

Adult and/or Paediatric and/or Maternity patients)

NURSING

254211 – Nurse Educator

254311 – Nurse Manager

254413 Registered Nurse (Child and Family Health)

254414 – Registered Nurse (Community Health)

254415 – Registered Nurse (Critical Care and Emergency)

254416 – Registered Nurse (Developmental Disability)

254417 – Registered Nurse (Disability and Rehabilitation)

254418 – Registered Nurse (Medical)

254421 – Registered Nurse (Medical Practice)

254423 – Registered Nurse (Mental Health)

254423 – Registered Nurse (Perioperative)

254424 – Registered Nurse (Surgical)

254499 – Registered Nurse nec

411411 – Enrolled Nurse

254411 – Nurse Practitioner

254111 – Midwife

MEDICAL

252311 – Dental Specialist

252312 – Dentist

253111 – General Practitioner

253112 – Resident Medical Officer

253211 – Anaesthetist

253311 – Specialist Physician (General Medicine)

253312 – Cardiologist

253313 – Clinical Haematologist

253314 – Medical Oncologist

253315 – Endocrinologist

253316 – Gastroenterologist

253317 – Intensive care specialist

253318 – Neurologist

253322 – Renal Medicine Specialist

253324 – Thoracic Medicine Specialist

253399 – Specialist Physician (nec)

253411 – Psychiatrist

253511 – Surgeon (General)

253512 – Cardiothoracic Surgeon

253513 – Neurosurgeon

253514 – Orthopaedic Surgeon

253515 – Otorhinolaryngologist

253517 – Plastic and Reconstructive Surgeon

253518 – Urologist

253521 – Vascular Surgeon

253912 – Emergency Medicine Specialist

253914 – Ophthalmologist

253915 – Pathologist

253917 – Diagnostic and Interventional Radiologist

253918 – Radiation Oncologist


253913 – Obstetrician &Gynaecologist

Between the Flags Education – Learning Pathways. July 2015 Page 14

Appendix 1: Learning pathways vs previous education

TARGETING PATHWAYS Staff that have already completed the face-to-face workshops (or been granted RPL) have met

the mandatory training requirements as per PD2013_049 for their learning pathway.

(To attend the face-to-face workshop the participant must provide their eLearning certificate. Therefore if the

below course has been completed it can be assumed that the eLearning has been completed) Patient Group Professional Group

Adult patients ONLY

Nurse DETECT workplace trainer or Super trainer workshop, OR

DETECT workshop Medical Staff

Allied Health (Group 1) DETECT workshop, OR

Allied Health BTF Tier Two Education Face-to-Face workshop Allied Health (Group 2)

Paediatric patients ONLY

Nurse DETECT Junior workplace trainer or Super trainer workshop, OR

DETECT Junior workshop Medical Staff

Allied health (Group 1&2) Allied Health BTF Tier Two Education Face-to-Face workshop

Maternity Clients/Patients ONLY Midwifery & Medical FONT1 OR DETECT workshop

Mixed Patient group

(Adult and/or Paediatric and /or

Maternity)

Nurse

Must complete training for each patient group under their care (as above) Medical Staff

Allied Health (Group 1)

Allied Health (Group 2)

1 Fetal Welfare Assessment (F) Obstetric emergency and Neonatal resuscitation training (ONT)


Page has been left blank


Appendix 2: List of current and previous education

Original ‘Between the Flags’ Education - eLearning

BTF Awareness presentation 2010 (provided locally during orientation)

DETECT eLearning Moodle: 2010 – 2013

DETECT Junior eLearning (EDMORE) 2013 - present

Initial revision to Between the Flags Education (released in 2013 - present)

Deteriorating Patient – Adult eLearning modules via HETI online (Module 1 and 2)

Between the Flags Tier Two Education: DETECT eLearning (Adult) - Moodle module made scorm

compliant to make accessible through HETI online

Current ‘Between the Flags’ face-to-face workshops

DETECT face-to-face (full day/half day) - (2010)

DETECT Junior Face-to-Face workshop (2013)

Allied Health Tier Two Education (2014)

Child & Family Health Network Tier Two Education (2014)

FONT (Midwives ONLY – covers the required Tier Two face-to-face learning outcomes

Appendix 3: Course titles and codes

Course Title Course Code HETI online code

BTF Awareness Training CSK909 39829919 (legacy code CSK979)

DETECT e-Learning (Moodle) CSK910 52884073

DETECT Face-to-Face workshop (half day) CSK911

DETECT Trainer the Trainer CSK926

DETECT Super trainer #

DETECT Junior – eLearning (Part I) CSK973

DETECT Junior – Face-to-face workshop (Part II) CSK974

DETECT Junior – Workplace trainer CSK975

DETECT Junior – Super Trainer CSK976

Child and Family Health Tier Two Education N/A 51576427

Allied Health Tier Two Education OHS969

BTF Tier Two RPL #

Recommended deterioration patient education

Emergency SEPSIS KILLS program CSK998 39941883

Inpatient SEPSIS KILLS program N/A 49389821

#allocated but unable to find in CEC records

N/A new course, code allocated in 2014

BTF Tier Two Education

face-to-face

workshop that have been released state

wide and assigned course

codes


Appendix 4: eLearning modules learning objectives

M1 - Awareness, Charts and Escalation - Tier 1 Length: 20 minutes

Identify the reasons for implementation of the Between the Flags program

Describe the five elements of the BTF program

Describe the features of the NSW Standard Observation Charts

Identify the standard response to observations in the Blue, Yellow and Red Zones

M2 – Communication, Teamwork and Documentation - Tier 2 Length: 20 minutes

Discuss the importance of effective communication and identify barriers to effective communication in the

health care setting

Identify effective use of a systematic communication tool (e.g. ISBAR)

Discuss the importance of teamwork and demonstrate the ability to work effectively within a team

Discuss the important of accurate and timely documentation and the importance of a clearly documented

medical management plan

M3 – Systematic Assessment – ADULT – Tier 2 Length: 15 minutes

Identify what DETECT stands for

Demonstrate a system-based approach to patient assessment (A-G)

Identify patients at particular risk of clinical deterioration (The ‘E’ patient-at-risk categories)

Identify, interpret and evaluate early and late warning signs of deterioration as part of a systematic

approach to assessment

Response to deterioration and apply initial management

M4 – Case Studies specific to professional groups – ADULT – Tier 2

Neurological Case Studies – ADULT (Medical, Nursing and Allied Health*) Length: 10 minutes

Identify and evaluate early and late warning signs of neurological deterioration

Recognise the initial management of neurological deterioration

Report appropriate escalation for neurological deterioration *All Allied Health Professional(Group 2)

Respiratory Case Studies – ADULT (Medical, Nursing and Allied Health**) Length: 10 minutes

Identify and evaluate early and late warning signs of respiratory deterioration

Discuss the initial management of respiratory deterioration

Outline the appropriate escalation for respiratory deterioration **Allied Health Professionals (Group1) that who conduct observations and /or that physically exert patients

Cardiac Case Studies – ADULT (Medical and Nursing) Length: 10 minutes

Identify, interpret and evaluate early and late warning signs as part of a systematic approach to

assessment

Respond to deterioration and apply initial management

Renal Case Studies – ADULT (Medical and Nursing) Length: 10 minutes

State the range for normal urine output

Identify accurate assessment and documentation of urine, urine output and fluid balance

Identify early and late signs of deterioration

Recognise appropriate escalation for renal deterioration


DETECT Junior – PAEDIATRICS (Medical / Nursing) – Package currently available in EDMORE

Introduction

Describe the components of the BTF program and DETECT Junior

List additional paediatric resources

Outline the key differences in anatomy and physiology (A&P) between a child and adult

Define developmental aspects of the different age groups

Apply some helpful tips when assessing children

Length

60

minutes

The DETECT Process

Provide healthcare practitioners with the knowledge, skills and understanding to recognise and

response to early and late warning signs of clinical deterioration in infants and children

Develop a systematic approach to ensure appropriate assessments and timely interventions

and escalation

Improve non-technical skills such as communication, teamwork, decision making and situation

awareness in order to reduce the likelihood of adverse events as a result of human factors

The DETECT Junior Assessment

Quiz to evaluate knowledge after completing the introduction and the DETECT process

modules

Nursing / Medical Case Study 1 and 2

Case study quiz testing knowledge gain in previous modules for each stage of the DETECT

process

RECOMMENDED DETERIORATION PATIENT EDUCATION

Emergency SEPSIS KILLS program (Medical and Nursing) Length: 60 minutes

Inpatient SEPSIS KILLS program (Medical and Nursing) Length: 60 minutes

Recognise that sepsis is a medical emergency.

Identify the risk factors, signs and symptoms of sepsis.

Outline the escalation of the septic patient.

Define the initial management actions for sepsis.

Discuss the requirements for 48 hour sepsis management


Appendix 5: face-to-face workshops - Tier Two Learning objectives

DETECT DETECT

Junior

Allied

Health

T2T

CFHN

T2T

2.1 Communication

2.1.1 Discuss the importance of effective communication

2.1.2 Identify barriers to effective communication in the health care setting

2.1.3 Identify methods for improving communication including specific strategies for telephone

communication

2.1.4 Demonstrate effective communication including use of a systematic communication tool e.g.

ISBAR

2.2 Documentation

2.2.1 Discuss the importance of accurate and timely documentation

2.2.2 Discuss the importance of a clearly documented medical management plan

2.3 Teamwork

2.3.1 Discuss the importance of teamwork

2.3.2 Demonstrate the ability to work effectively within a team

3.1 Perform a systematic patient assessment

3.1.1 Demonstrate the systems based approach to patient assessment.

3.1.2 Identify the differences in approach to patient assessment across the age spectrum within the

paediatric population

3.1.3 Discuss the implications of the anatomical and physiological differences across the age

spectrum within the paediatric populations

3.1.4 Identify the differences in approach to patient assessment between children and adults.


DETECT DETECT

Junior

Allied

Health

T2T

CFHN

T2T

3.1.5 Discuss the implications of the anatomical and physiological differences between children and

adults

3.1.6 Discuss the physiological changes that occur in a woman’s body during pregnancy and how

these will alter common findings (included for non-midwives that work in maternity services and

cannot attend the FONT course)

3.2 Recognise deterioration

3.2.1 Identify, interpret and evaluate early (Yellow Zone Criteria) and late (Red Zone Criteria) warning

signs of deterioration as part of a systematic approach to assessment

3.2.2 Identify patients at particular risk of clinical deterioration

3.3 Respond to deterioration and provide initial management

3.3.1 Provide initial management of deterioration

3.3.2 Discuss the process for escalation of concern in your facility

3.3.3 Identify roles and responsibilities in relation to ongoing management and monitoring of the

patient who has clinically deteriorated

4.1 Preform an assessment

4.1.1 Demonstrate a comprehensive assessment of a patients respiratory status (airway & breathing)

4.1.2 Demonstrate a comprehensive assessment of a patient cardiovascular status

4.1.3 Demonstrate a comprehensive assessment of a patient’s neurological status

4.1.4 Discuss the physiological requirements for maintenance of adequate urine output

4.1.5 State the range for normal urine output

4.1.6 Discuss causes of oliguria and anuria and polyuria

4.1.7 Discuss the investigations that are used to identify and monitor renal function

4.1.8 Demonstrate accurate assessment and documentation of urine, urine output and fluid balance

4.1.9 Demonstrate a comprehensive assessment fluid & electrolyte status for a paediatric patient


DETECT DETECT

Junior

Allied

Health

T2T

CFHN

T2T

4.2 Recognise deterioration

4.2.1 Identify, interpret and evaluate the early & late warning signs of respiratory deterioration

4.2.2 Identify, interpret and evaluate the early & late warning signs of cardiovascular deterioration

4.2.3 Identify, interpret and evaluate the early & late warning signs of neurological deterioration

4.2.4 Identify early and late warning signs of renal deterioration

4.2.5 Identify, interpret and evaluate the early & late warning signs of fluid and electrolyte disturbance

4.3 Respond to deterioration and provide initial management

4.3.1 Provide initial management of respiratory deterioration

4.3.2 Demonstrate appropriate escalation for respiratory deterioration

4.3.3 Provide initial management of cardiovascular deterioration

4.3.4 Demonstrate appropriate escalation for cardiovascular deterioration

4.3.5 Provide initial management of neurological deterioration

4.3.6 Demonstrate appropriate escalation for neurological deterioration

4.3.7 Discuss the initial management of a patient with renal deterioration

4.3.8 Demonstrate appropriate escalation for renal deterioration

4.3.9 Provide initial management of fluid and electrolyte imbalance

4.3.10 Demonstrate appropriate escalation of concern regarding fluid & electrolyte imbalance

5.1 Transport principles

5.1.1 List equipment required for transporting deteriorating patients.

5.1.2 Describe the process for verification that the patient is safe for transport

august 2015 - agency for clinical innovation...august 2015 page 8 adults patients only nurses...

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