The interactive Deteriorating Adult Patient Course for Registered Nurses is delivered face-to-face over two days usually in the Comely Bank Centre (CBC, adjacent to the Western General Hospital) or in the PGEC in the Royal Infirmary (RIE).
This course aims to provide and enhance participants’ skills, knowledge and understanding to effectively identify, assess and manage a deteriorating patient in primary and secondary care settings. Due to the variety of clinical settings, this course focuses on introducing a baseline of key issues and application of the A-E approach with timely escalation.
Course content includes:
- ‘Soft signs’ of deterioration
- Structured A-E assessment / management
- NEWS2 – scoring, triggers, escalation – clinical judgment
- SBAR-D – Effective Clinical Handover, Communication
- Neurological assessment (including GCS / 4AT / Delirium)
- Human Factors, effective teamwork
- Frailty & Treatment Escalation Plan (TEP)
- Homoeostasis / Fluid Balance
and covers common causes of deterioration, e.g.:
- Airway- and Breathing-related deterioration
- Acute Kidney Injury (AKI)
- Shock, Sepsis, Major Haemorrhage
- Deterioration of the Diabetic Patient, Stroke, and other neurological / related aspects
Learning modes
- Interactive presentations
- Group discussions
- Scenarios to practice the A-E approach in a safe and supportive learning environment
Intended Audience
We welcome all Registered Nurses caring for adult patients in both primary care and secondary care settings.
Pathways
- RNs practising in Care Levels 1, 2, or 3 acute settings (e.g., MAU, SAU, A & E, Operating Theatres, PACU (Recovery), CCU, HDU, ITU) should attend this course within six months of starting in their clinical area and, once eligible, attend the specialist course relevant for their clinical area (e.g., Critical Care Nursing Level 1, 2 or 3, Cardiology Nursing, DCN/Neurosciences Nursing, Orthopaedic Adult Care-Trauma and Elective)
- For all other RNs in Adult Health, Mental Health and Learning Disability settings, we recommend attending within the first two years (and anytime for a ‘refresher’)
Learning Outcomes
Ability to…
- Identify common causes and risk factors for deterioration
- Apply assessment techniques and tools for the management of the deteriorating patient in the clinical context
- Conduct correct NEWS2 scoring and understand triggered escalation pathways
- Apply the principles of A-E assessment and management
- Recognise how and when to escalate care of the deteriorating patient
- Demonstrate self-awareness of individual learning needs to support safe delivery of care for the deteriorating patient
- Demonstrate an understanding of the management of a deteriorating patient within the participant’s primary or secondary care setting
For more information please contact loth.clinicalskillstraining@nhslothian.scot.nhs.uk.
