Pass/Fail Assessment.

This assessment addresses the following Unit Learning Outcomes:

        2. Monitor and interpret physiological and psychosocial data to assess a patient's clinical deterioration

        4. Initiate interventions based on diagnostic results of clinical assessment tools and evaluate your nursing actions

        5. Critically examine everyday nursing practices and the ready use of tools related to the deteriorating patient.

Practical Assessment Explained

Serious adverse advents such as unexpected death and cardiac arrest may follow observable deterioration in a patient’s condition.

This clinical assessment evaluates your knowledge and skills in the early identification of a patient's deteriorating condition and the initiation of prompt and effective action to minimise serious consequences, improve outcomes and lessen the level of intervention required to stabilise patients. The assessment will also assess your knowledge of the pathology of the patient's deteriorating condition, your ability to interpret clinical manifestations and effectively communicate these changes in health to team members including the patient, plus family members.

Task Description

You are required to demonstrate the safe care of a deteriorating patient in a clinical simulation setting. This assessment is undertaken at three skill stations (this structure may vary across different Hospital & Health Services).

You will be required to rotate between three skill stations. At each station a scenario relating to a deteriorating patient will be presented. During the first stage you will have the opportunity to practice skills to recognise and respond to a deteriorating patient. During the next stage, you will be assessed on your ability to safely perform these skills: These skills include:

• Initial nursing management
• verbalising a targeted systematic assessment approach (look, listen and feel ABCDEFG) [this worksheet is available on the Moodle site],
• recording vital signs,
• verbalising escalation concerns using SBAR,
• managing basic airway manoeuvres, adjuncts and oxygen therapy delivery device
• identifying further clinical risk factors and additional investigations that may be required
• selecting and inserting naso/oropharyngeal airway
• demonstrating chin lift, head tilt and manual ventilation techniques
• demonstrating and instructing on the use of nasal prongs, Hudson mask, non-rebreather masks and the HFNP Air Viva
• communicating effectively to patients and/or family members changes in the patient's condition

Task Instructions

Step 1. Familiarise yourself with the relevant policies, procedures and legislation available on the unit Moodle site

Step 2. Familiarise yourself with Standard 8, Recognising and responding to acute deterioration standard (The Australian Commission on Safety and Quality in Health Care, [ACSQH] 2017). Some health care providers are using the first edition of standards so you may also need to review Standard 9, Recognising and responding to clinical deterioration in healthcare, (ACSQH, 2012)

Step 3. Stage 1- practice your skills in recognising and responding to deteriorating patients rotating through three skill stations

Step 4. Stage 2 - demonstrate your ability to recognise and respond to the deteriorating patient including:

• Initial nursing management
• verbalising a targeted systematic assessment approach (look, listen and feel ABCDEFG) [this worksheet is available on the Moodle site],
• recording vital signs,
• verbalising escalation concerns using SBAR,
• managing basic airway manoeuvres, adjuncts and oxygen therapy delivery device
• identifying further clinical risk factors and additional investigations that may be required
• selecting and inserting naso/oropharyngeal airway
• demonstrating chin lift, head tilt and manual ventilation techniques
• demonstrating and instructing on the use of nasal prongs, Hudson mask, non-rebreather masks and the HFNP Air Viva
• communicating effectively to patients and/or family members changes in the patient's condition

Pass/Fail Assessment

This assessment address the following learning outcomes:

        1. Explain clinical parameters that indicate a patient is deteriorating

        3. Communicate effectively with health team and family members to ensure the accurate transfer and escalation of critical information             effectively with health team and family members

Task description

You are required to undertake an oral presentation. This presentation will be based on your interaction in a clinical simulated scenario relating to a deteriorating patient observed in the simulation lab at your workplace. Your target audience for your presentation are your workplace colleagues, peers and nurse educators

Task Instructions

Step 1. Observe clinical simulated scenarios in the simulation lab at your workplace. These scenarios focus on the care of the deteriorating patient. The escalation of care required to meet the needs of the patient; the type of interventions required to ensure the best clinical outcomes for the patient; and the effective communication of the patient’s changing health status.

Step 2. During the simulations you will be provided with clinical information related to the patient. You are expected to assess the patient, record the vital signs, determine and initiate nursing management and decide when to escalate interventions using SBAR. This information will be recorded on an assessment worksheet [found on the Moodle site].

Step 3. Present your findings to the group following each clinical simulation. Some important points to consider while you are watching the simulation, and the kind of information to present to the group include:

        · Critical thinking and problem solving skills required.

        • The necessity of accurate recording of vital signs on the QADDS chart.

        • How effective escalation using SBAR was demonstrated.

        • Importance of effective team work and communication that includes the use of clinically appropriate language to communicate key             signs/symptoms and decision to escalate.

         • Importance of effective communication including using appropriate language with the patient and/or family members.

         • The role of the nurse.