Aim

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.

Task Description

You are required to demonstrate the safe care of a deteriorating patient in a clinical simulation setting. This assessment is undertaken at a skill station(s) (this structure may vary across different Health Services). You may be required to rotate between skill stations. You will have the opportunity to demonstrate, explain and safely perform these skills:

• 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 ISBAR
• managing basic airway manoeuvres, adjuncts and oxygen therapy delivery devices
• 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, bag-valve mask (BVM) and high flow nasal oxygen therapy.

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).

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

Step 4. Stage 2 – demonstrate your ability to recognise and respond safely 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 ISOBAR
• managing basic airway manoeuvres, adjuncts and oxygen therapy delivery devices
• 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, BVM and high flow nasal oxygen therapy.

NURS20170 Patient deterioration in the clinical setting - Assessment One Rubric. 

Students must pass each criterion in each skill/topic to be successful in this assessment. Students may have a second attempt if unsuccessful in the first attempt.

Aim

The aim of this assessment is to provide you with an opportunity to demonstrate your knowledge and understanding of using reflection to self-assess your clinical practice.

Instructions

You will provide an oral report on your participation in your simulation assessment.

Your target audience for your presentation may include your workplace colleagues, peers or unit nursing leaders.

Please follow the steps below to complete this assessment task:

Step 1. Access a validated reflection model (for example, the Gibbs’ Reflective Model, 1988) to reflect on your simulated patient deterioration activity – Assessment One.

Step 2. Structure your presentation in a manner that is logical, and the patient experience and your experience is presented systematically.

Step 3. Apply a validated reflection model and present your reflection in an objective manner to your audience that may include peers, educators and other unit nursing leaders.