Clinical Deterioration - Identify, Assess, Prevent
- : Surry Hills NSW 2010
2 Day Seminar for Nurses
There is a huge potential for patients across any clinical setting to rapidly become unwell. Recent system changes have been rolled out to encourage better management of clinical deterioration. However, your ability to recognise and respond to changes in a patient’s condition early is a high priority if acute illness is to be averted. Attend this two-day seminar to gain knowledge that will help you to feel more confident that your essential assessment skills and early nursing management can detect early cues, and prevent poor patient outcomes. Learn about:
- The power of assessment when your patient is deteriorating
- How to recognise sepsis early
- Warning signs of acute kidney injury
- How to recognise acute respiratory failure including basic CXR interpretation
- Tips for recognising common arrhythmias and electrolyte imbalances
- How to perform a basic interpretation of arterial blood gases
- The power of communication when things don’t go to plan…
Attend this seminar if you are a nurse working in a general clinical setting and want to improve your ability to identify and manage patients whose clinical condition is deteriorating.
Need for Program
Growing numbers of high acuity patients are increasingly being cared for across a wide range of clinical settings, not just in acute care units such as intensive care units. The more acutely unwell a person is, the greater the risk of poor patient outcomes, including increased morbidity and mortality. Nurses are essential to the prevention, early detection and management of developing problems that can increase such morbidity and mortality. The ability to recognise and interpret clinical cues and then implement appropriate, evidence-based interventions in a timely manner has a significant positive impact on patient outcomes. Therefore, nurses must continually increase their knowledge to ensure they are sufficiently educated to care for patients at risk of deterioration and prevent them from becoming acutely unwell.
Purpose of Program
This seminar enables nurses working in general areas to feel more confident in their knowledge and ability to assess and manage patients whose clinical condition is deteriorating.
Your Learning Outcomes
- Relate pathophysiological principles that occur in acutely ill patients to prioritise assessment in a patient who is deteriorating
- Correlate clinical assessment findings with pathophysiological processes occurring across a range of body systems
- Apply a range of appropriate and timely evidence-based nursing interventions for a person who is acutely ill and whose condition is deteriorating
- Recognise and respond to early signs of sepsis by implementing evidence-based interventions and thereby improving patient outcomes
- Schedule Day One
8:30am - Registration and Refreshments
9:00amWelcome and Introduction to Program
9:15amWhat Happens to a Person During Acute Illness?
Acute illness can trigger an array of psychological and physiological responses that have the potential to be either beneficial or harmful. Whilst nurses need to focus their attention on what physiological changes may be occurring, we often forget that beneath this is a person! This brief introductory session considers what happens to not just the body but a person's mind and wellbeing during illness and the nursing implications for this.
9:30amEssential Physical Assessment Skills
Nurses are essential in the early detection of clinical triggers that may suggest a patient is deteriorating or has already become acutely unwell. Appropriate and timely assessment is known to reduce morbidity and mortality, thus improving patient outcomes. This session reviews important assessment considerations, including:
- Why do we assess our patients?
- Vitally important ‘vital signs’ - why are some clinical cues neglected?
- Overview of Australian Commission on Safety and Quality Health Care Standard 9
- Top tips for quick recognition of acute deterioration
- Assessing consciousness
- Assessing perfusion
10:30am - Morning Tea and Coffee
11:00amAsleep or Unconscious? Assessing Neurological Deterioration
The ability to recognise subtle changes in a persons neurological state will enable you to detect signs of deterioration early. The purpose of this session is to take you through the basics of a neurological assessment, including a simplified approach to using the Glascow Coma Scale (GCS). Topics covered include:
- What is a GCS include and what does this tell you?
- What else, other than a person’s GCS should be assessed e.g. limb strength?
- Common signs and symptoms associated with neurological decline and what these may indicate
- How to document and reporting changes
11:45amSepsis and the Significance of Early Recognition
Did you know that sepsis is one of the leading causes of death globally? Preventing mortality related to sepsis begins with early detection and timely interventions. This session uses case scenarios to explain the pathophysiological mechanisms by which sepsis develops. It will look at how you can detect the early warning signs of sepsis. Finally, it will assist you to understand the evidence-based management of this potentially fatal condition across a range of clinical settings. Includes:
- What is the definition of sepsis?
- What is the relationship between infection and sepsis?
- Early recognition - what are the clinical signs? E.g. an increasing SOFA score
- Why is timely intervention so important?
- In a suspected or a known case of sepsis, what are the main nursing management priorities across a range of clinical settings?
1:00pm - Lunch Break and Networking
1:45pmRecognising Respiratory Failure
The respiratory system is often thought of as a difficult system to assess. However, the importance of assessment cannot be underestimated, particularly as problems associated with the respiratory system often result in acute deterioration and may be the cause of a patient becoming acutely unwell. This session will review key anatomical and physiological principles to guide your assessment of respiratory failure. Includes:
- What is the difference between ventilation and oxygenation, and why does this matter?
- Respiratory pathophysiology - Type I respiratory failure versus Type II respiratory failure
2:30pmThe Respiratory System - Case Scenarios - When Things Go Wrong
Building on your knowledge from the previous session, this interactive session uses case studies to highlight how to recognise (including CXR interpretation) and manage the following conditions:
- Acute pulmonary oedema
- Tension pneumothorax
3:15pm - Afternoon Tea and Coffee
3:30pmNon-Invasive Ventilation - For All Nurses
Non-invasive ventilation (NIV) is an important strategy for the management of acute respiratory conditions. NIV isn’t just confined to acute care settings. A wider scope of practice and a desire to manage more acutely ill patients away from acute care settings demands that a basic understanding of NIV is part of every nurse’s tool kit. This session will explain:
- What are the different types of NIV? E.g. continuous positive airway pressure (CPAP) and biphasic positive airway pressure (BiPAP)
- What are the indications for their use?
- Practical strategies to assist with the introduction and management of NIV in your clinical practice
4:15pm - Close of Day One of ProgramDay Two
9:00am - Commencement of Day Two
9:00amChest Pain - What Do I Need to Do?
Acute illness, can originate from or eventually compromise cardiovascular function. Chest pain may be an early indicator of this. So if your patient reports that they have chest pain, what would you do next? How would you assess this individual? Would you be confident in knowing the cause? Would you be able to act on this potential cause of acute illness to prevent a downward spiral of events? This session will leave you feeling much more confident that you can answer these questions. Includes:
- What are the different types of chest pain and which of them are life threatening?
- How to assess and differentiate dangerous cardiac pain from other chest pains
- What to do when your patient reports they have chest pain
- Useful update on the pharmacological and non-pharmacological management of chest pain
9:45amST What? Identifying Important ECG Changes
There are certain ECG changes that may be present in the context of Acute Coronary Syndromes (ACS) that must be correctly identified and reported urgently. This session will use case studies to take a look at some of these important changes, helping you to immediately gain confidence and apply this knowledge to your clinical practice. Includes:
- What ECG changes may indicate a person is experiencing or has experienced chest pain?
- How do you identify ECG changes relating to myocardial ischaemia, injury or infarction and what might this mean?
10:30am - Morning Tea and Coffee
11:00amCardiogenic Shock - When the Heart Fails
Heart failure relating to acute pulmonary oedema; pericarditis and pericardial tamponade, are potentially dangerous cardiac conditions requiring alert and responsive care. Your cardiac assessment skills are vital if you are to recognise these states early to ensure appropriate management occurs and rapid deterioration is prevented. In this session you will review the following considerations for three common types of cardiac failure:
- Which patients are considered most at risk?
- ECG changes
- Goals of treatment
- Pathophysiology related to clinical presentation
- Identification and outline of early management
12:00amAcute Kidney Injury - More Than Just Low Urine Output
Acute onset of kidney injury ranges from mild impairment of function through to acute kidney failure. The incidence increases significantly with progressive severity of the underlying cause. Topics include:
- A brief look at the role of the kidneys
- What are the potential causes and classifications of acute kidney injury?
- Recognising renal dysfunction and the key to preventing acute renal failure
- What are the management principles of acute renal failure?
- A look at renal replacement therapies - basic explanation
12:45pm - Lunch Break and Networking
1:30pmFluid and Electrolyte Balance
Failure to recognise and appropriately treat fluid and electrolyte imbalances can have fatal consequences. Knowledge and understanding of normal physiological processes is essential for accurate patient assessment. This session will refresh your knowledge and assist you to get up to speed. As well, refresh your knowledge of the different types of fluids and their uses. Topics include:
- What are the normal physiological processes of fluid balance?
- What is hypovolaemic shock? How would you recognise it and what might the causes be?
- What intravenous fluids should be used and when?
- How to recognise electrolyte disturbances early
2:15pmShifting the pH - Acid Base Balance
A deviation from acid base balance homeostasis can severely affect any organ in the human body. In this interactive and practical session you will develop a better understanding of this complex topic. Includes:
- Importance and physiology of acid base balance
- Arterial blood gas analysis
- Case studies for practice interpretation and management options
3:00pm - Afternoon Tea and Coffee
3:15pmWhen Things Don’t Go to Plan…
While the purpose of clinical assessment is to prevent deterioration and recognise acute illness early, it is inevitable that some patients will become significantly unwell. This final session of the seminar will examine some of the key communication challenges that can occur when these sticky situations arise. Take away some key practical skills to help you manage your own stress during these situations.
3:45pm - Close of Seminar and Evaluations
Jodie Allen is an experienced Nurse Practitioner and Credentialed Emergency Nurse, currently working on the Sunshine Coast in Queensland. With a career spanning over 30 years, she has worked in multiple clinical settings; from remote Arnhem Land in the NT, to London UK, and rural and metropolitan hospitals throughout Australia. Jodie has extensive clinical experience and skills in emergency, critical care, primary health and rural nursing. A committed advocate with a strong background in nursing education, and a passion for teaching, she provides relevant, evidence-based education activities with a good dose of humour, and some very interesting case studies. Jodie is currently working on a range of projects, including a postgraduate Applied Law (Health Major) at QUT. She is Commissioning Manager for the Sunshine Coast University Hospital Program (due to open in April 2017) and an education/training co-ordinator for Nurse Practitioners at the Sunshine Coast Hospital and Health Service. Additionally, Jodie is a founding member of the National CENA (College of Emergency Nursing Australasia) Credentialing Committee, and the QLD Chapter Education Officer of the Australian College of Nurse Practitioners.