Admission Avoidance Assessment of vital signs

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Presentation transcript:

Admission Avoidance Assessment of vital signs Improving resident safety across services

Learning Aims to provide refresh on ABCDE focus on important clinical and non-technical skills in care home setting practice skills without risking resident safety explore some of the core issues of care, compassion and a resident centred approach 1 © SaIL Centre 2015

The acutely deteriorating resident (patient) - Aim to co-ordinate, utilise and apply all available resources to optimise resident (patient) safety and outcomes. With a view to avoid hospital admission or escalate a timely transfer Resources include all people involved with their skills, abilities and attitudes, as well as their limitations, in addition to equipment. © SaIL Centre 2015

ABCDE approach for effective assessment Underlying principles Complete initial assessment Breaks down complex situations into more manageable parts Treatment of life threatening problems Provides access to life-saving treatment Establishes common situational awareness among all treatment providers Reassessment Assesses effects of treatment/interventions Call for help early Can buy time to establish a final diagnosis and treatment . 3 © SaIL Centre 2015 3

Role of assessment & how? Q&A – how can we assess the resident © SaIL Centre 2015

Assessment without measurement tools Look, Listen & Feel Are there any problems? What intervention is needed? Airway – Lips to trachea – is it compromised / patent? Breathing – rate, rhythm, depth – is it effortless? Circulation – skin assessment & urine output Disability –conscious level – AVPU, Glucose Exposure- other symptoms / sites © SaIL Centre 2015

© SaIL Centre 2015

Assessment and monitoring: physiological observations Initial assessment if skilled should include at least: Observation of the resident Airway & respiratory rate oxygen saturation/ residents colour heart rate – pulse & cold or clammy skin systolic blood pressure temperature level of consciousness - AVPU fluid balance (if appropriate) Early warning score (hospitals only) Also Capillary refill, blood glucose, ABGs NOTES FOR PRESENTERS: Initial assessment of the patient in Hospital, GP surgery or by a registered nurses should include the above. © SaIL Centre 2015

Assessment and monitoring: physiological observations – score of Zero NEWS (2012) - 7 parameters for hospital use heart rate – 51-90 (resting) respiratory rate – 12-20 breaths systolic blood pressure – 110- 219 level of consciousness – Alert oxygen saturation >/= 96% Temperature – 36.1- 38.0 fluid balance - NA NOTES FOR PRESENTERS: FYI – National early warning score for hospitals – For Info Only Can hide slide depending on audience © SaIL Centre 2015

In summary Use your resident, relative, colleagues © SaIL Centre 2015

Escalation using SBAR S = Situation B = Background A = Assessment R = Recommendation Provides a framework for communication for health care team about a residents/ patient's condition & don’t forget to structure your escalation communication © SaIL Centre 2015

References Thim et al (2012) Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Int J of General Medicine http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273374/pdf/ijgm-5- 117.pdf © SaIL Centre 2015