ALERT™ AWARE™ & BEACH™ Network Day Tuesday 21 st October 2014 Holiday Inn, Birmingham 1

Introduction The Team Fire procedures Parking Facilities Mobiles Manuals Evaluation Forms Slides will be on the website 2

Morning Programme Welcome & Introduction Official launch of BEACH™ V ALERT™ in the pre-registration nursing curriculum at Bucks New University Coffee/Tea – Lancaster 1 Foyer Official launch of Obstetric ALERT™ 12.15–12.30 AWARE™ – 1 year on 3

Afternoon Programme Lunch & Networking – Lancaster 1 Foyer ALERT™ Education Outcomes and Impact on Clinical Practice Developing ALERT™ Faculty (with working tea/coffee) Looking forward to Final ‘open’ discussion and themes for next year’s Network Day Evaluation & Close 4

Any Questions? 5

Obstetric ALERT™ Course Nicky Sayer ALERT™ Course Lead 6

Overview Separate course which follows the ALERT principles Pilot stage Manual, Programme and Teaching materials Next steps 7

Manual Familiar but distinctly different 8

Manual – Inside the cover Pages 1-2 Pages Pages Page 48 Pages Pages

Programme Introduction & Case Discussion The ALERT TM System of Assessment COFFEE Faculty Demonstration of The ALERT TM System of Assessment Immediate Assessment and Management of Airway Immediate Assessment and Management of Breathing Immediate Assessment and Management of Circulation The Oliguric Patient 10

Programme The Patient with a Disordered Conscious Level Sepsis Communication and the Deteriorating Patient TEA Scenarios (4 x 20mins) Evaluation & Close 11

Teaching Materials Key changes are:  Obstetric based Case Discussion  Breathless Patient workshop  Sepsis lecture/workshop added  Obstetric based scenarios 12

Case Discussion Page 7 in manual

Case Discussion Key points to note: SIRS and new infection on Day 1 Delayed referral for senior Obstetric and ICU review Poor documentation – e.g. “Full bloods” what was sent? Poor recognition of sepsis by all clinicians including GP, ED and Obstetric staff Sepsis 6 not done

What would make a difference Sepsis Pathway Use of MEOWS and escalation protocols Sepsis awareness and management education Improved documentation standards

Teaching Materials The Breathless Patient is group work using a hand out from the CD Let’s have a go 16

The Breathless Patient CasesPatient HistoryClinical Findings 1 22yr old 24/40. Has a Salbutamol Inhaler. She has had a 3 day history of a cough, increased shortness of breath and wheeze ↑Resp Rate ↓SpO2 Wide spread wheeze ↑Pulse Rate Anxious 2 28yr old 28/40 with a one week history of a cough. She has seen the GP and been prescribed antibiotics ↑Resp Rate ↓SpO2 ↓Air Entry right base ↑Temp ↑Pulse Rate 3 34yr old 34/40 ↑BMI presents complaining of chest pain and increased shortness of breath ↑Resp Rate ↓SpO2 ↓Air Entry right base ↑Temp ↑Pulse Rate 4Severe pre-eclampsia. Post-natally has had ↓urine output despite increased fluid input ↑Resp Rate ↓SpO2 despite increased FiO2 ↑Pulse Rate

The Breathless Patient CaseDiagnosis Treatment and Investigations Complications 1AsthmaOxygen Nebulisers Humidified Oxygen to target SpO2 Steroids Consider antibiotics if infective cause CXR ABG Pneumothorax Severe respiratory failure

The Breathless Patient CaseDiagnosisTreatment and InvestigationsComplications 2PneumoniaOxygen to target SpO2 IV Antibiotics CXR ABG Physiotherapy Sepsis Respiratory failure

The Breathless Patient CaseDiagnosis Treatment and Investigations Complications 3Pulmonary Embolism Oxygen to target SpO2 CXR ECG Anticoagulation Profound hypoxia (refractory to oxygen therapy) Heart failure

The Breathless Patient CaseDiagnosis Treatment and Investigations Complications 4Pulmonary Oedema Oxygen to target SpO2 Seek expert help Profound hypoxia

Sepsis Lecture Learning Objectives Understand the aetiology of sepsis How to recognise sepsis Understand the initial management of sepsis including the sepsis six Understand the importance of early senior involvement

Teaching Materials Scenarios are: Hypovolaemia due to Hyperemesis Gravidarum (Faculty Demo) Eclampsia Hypoglycaemia Sepsis MOH Pulmonary Embolism 23

Scenario’s 24

Next steps Get the feedback from the pilot centres Revise course materials if necessary Roll out Obstetric ALERT Course to all centres 25

Any Questions? 26

Summary Obstetric ALERT™ Course is an exciting addition to the ALERT™ suite of courses for more 27

Developing ALERT™ Faculty Nicky Sayer ALERT™ Course Lead 28

Overview Applicable to all courses What faculty is needed Who to target Train the Trainer Course versus developing your own faculty 29

What faculty is needed A Course Facilitator - ALERT™ Train the Trainer Course or - a Resuscitation Council Instructor or - a senior clinician with a recognised teaching qualification A Course Administrator 30

What faculty is needed Core faculty to deliver sessions, participate in the demo and scenario’s Core Faculty must: – be credible educators with acute clinical experience – have skills in delivering lectures, facilitating workshops and running scenarios 31

Who to target to teach Critical Care Outreach clinicians with known teaching experience Experienced healthcare professionals from an acute background with known teaching experience Practice Educators 32

Who to target to teach Resuscitation Officers Resuscitation Council (UK) ALS/ILS/GIC Instructors ALERT™ candidates who have attended an ALERT™ Train the Trainer Course 33

Train the Trainer Course Updated in February 2013 Aimed at ALERT™ candidates who do not have experience of teaching or a teaching qualification Two centers Portsmouth and North Lincolnshire 34

Train the Trainer Course Programme 35

Developing faculty who don’t need ALERT™ TTT Course Attend or observe an ALERT™ Course Ensure they have a manual and access to the teaching materials pre-course Support from the Course Facilitator for teaching experience as required Feedback using the Lecture and Scenario Evaluation forms from Train the Trainer Course 36

ALERT™ Lecture and Scenario Evaluation Forms 37 Needs further development Effective and competent SET [includes environment] 1.Checks and adjusts layout and equipment 1.Has prepared appropriately to deliver the lecture/workshop and is 2.familiar with the content, case studies and teaching materials 1.Introductions 1.Establishes usefulness and clearly states learning outcomes DIALOGUE 1.Uses visual aids and teaching materials appropriately 1.Uses voice and eye contact appropriately

Developing your own faculty Enter them onto the ALERT Local Faculty Database Will get a certificate Transferable between Trusts This evidence can be used for annual appraisals 38

Any Questions? 39

Summary Sustainability is based on developing your own faculty or utilising the Train the Trainer Course Using credible educators with acute clinical experience will ensure your course maintains it’s integrity 40

Looking forward to 2015 Nicky Sayer ALERT™ Course Lead 41

Introduction ALERT V4 will be the focus Manual will be updated Comprehensive review of teaching materials Group work from Network Days will guide developments Network Day in October

Ideas to be explored Pre & Post Course MCQ Video option for the Faculty Demo Less lectures and develop the sessions to be more workshop and scenario based Increased options for introducing local policies, documents, case studies etc. 43

Ideas to be explored Sepsis Airway as a skill station More scenarios - basic in the morning and more advanced in the afternoon More scenarios to chose from (AAA, Tracheostomy, HAP, Chest Pain) 44

Ideas to be explored Able to tailor-make scenarios to candidates role/speciality More complex scenarios for medical staff Acute Kidney Injury More Human Factors 45

Ideas to be explored Assessment scenario with MCQ so Pass/Fail option for centres Teaching materials on the website Recert Course option – half day 46

Any Questions? 47

Summary ALERT V4 will be the focus Manual will be updated Comprehensive review of teaching materials Network Day in October 2015 will be arranged 48