P9 Development and facilitation of a training course for critical care outreach nurses in a tertiary cardiothoracic centre to aid learning and improve patient outcomes

In 2016 a Critical Care Outreach team was initiated for the post-operative assessment of all cardiothoracic patients stepped down from a busy tertiary intensive care unit (ICU) to the ward. The objectives of the outreach team were to recognise and act on post-operative complications, improve patient outcomes and reduce the number of readmissions to ICU. The outreach team comprises of intensive care nurses but they had no formal training in post-operative patient assessment prior to this initiative. We developed a training course to aid their ability to formally assess patients, deal with complex clinical scenarios and effectively manage common post-operative complications. The outreach course was developed after identifying the team’s learning needs and particular clinical situations they found difficult to manage. The majority of the outreach team had never been formally taught how to examine a patient or had any outreach training prior to transitioning to this post. The course involved small group workshops teaching review of A to E (Airway, Breathing, Circulation, Disability, Exposure) systems, x-ray teaching and simulation scenarios. Detailed feedback forms were collected and results analysed. The feedback from the course was overwhelmingly positive with all candidates rating the course as excellent in content, interest, clinical practice, teamwork, leadership, management and education. The systems workshop teaching was particularly well received and the simulations were ”good and relevant...like scenarios we would normally come across”. After the simulation sessions, 100% of candidates stated that they would feel more confident in managing patients with respiratory failure, arrhythmias and renal failure. All candidates called for further opportunities to engage in simulation and attend a formal cardiac advanced life support course. We found that setting up a one day course for critical care outreach nurses resulted in valuable learning experiences, enhanced confidence in patient assessment and, hopefully, better post-operative ward management of patients and a consequential reduction in morbidity and mortality. The 2007 NICE guidelines regarding recognition and response to acutely ill patients emphasises “the importance of a full clinical assessment, and of tailoring the written monitoring and management plans to the individual patient‘s clinical circumstances”. 1 This is what we set out to achieve in the development of our course and feedback suggests we delivered it. We plan to run this course on an annual basis to keep skills up to date and respond to reported challenges and difficult case scenarios. Reference 1. NICE (National Institute for Health and Care Excellence). Acutely ill adults in hospital: Recognising and responding to deterioration [Online] 2017.