Context Recent studies identify that sick patients continue to receive sub-optimal care following admission to acute hospitals. "Failure to rescue" is recognised to be one of the largest causes of harm to patients in the acute hospital setting.1,2 These reports acknowledge significant challenges to ensure patient safety in ward areas, and the critical importance of employing and developing professionals with the right knowledge and skills to care for acutely ill ward patients at the point of qualification.3
Methodology An innovative seven day programme at Nottingham University Hospitals NHS Trust delivers a new approach to acute care skills education for Newly Qualified Nurses working on wards. The course incorporates simulation training and utilises simulated patient actors (SPs) to assess essential clinical skills and compassion in care delivery using OSCEs.
Patient involvement in training and assessing the nurse’s ability to deliver effective care when under additional clinical pressure in a simulation setting is seen as integral to the programme.4 Understanding human factors in acute care scenarios ensures staff are fit for purpose and confident in escalating concerns to senior colleagues. Focussed individual support is provided should the candidates fail to achieve the required standard.
Results In February 2013, an Early Warning Scoring Tool (EWS) audit identified that mandated nursing escalation happened in 16% of patients in admission wards. Following introduction of the programme and focussed EWS education, this has improved to 57% in March 2014. Implementation of the sepsis six care bundle for patients admitted to critical care areas has improved to 81%.
Potential impact Investing in education and simulation training for NQNs with tailored support to meet the individual needs of participants, has resulted in positive feedback from participants and clinical managers, reporting attendees greater confidence to address patient safety concerns and escalate care decisions.
Berwick D, (2013). A promise to learn - a commitment to act. Improving the Safety of Patients in England. National Advisory Group on the Safety of Patients in England.
NCEPOD, (2012). Time to intervene A review of patients who underwent cardiopulmonary resuscitation as a result of an in-hospital cardio-respiratory arrest. NCEPOD, London
Willis Report, (2012). Quality with Compassion: the future of nursing education. Report of the Willis Commission on Nursing Education, 2012. Royal College of Nursing
Department of Health, (2012). Compassion In Practice Nursing, Midwifery and Care Staff Our Vision and Strategy. December 2012 HMSO, London
- Category: Course or curriculum evaluation/innovation/integration
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