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Recognition of deteriorating patient
Kids
Adults
Risk Factors/Special Populations
Professional Accountability
100
I am the National Safety & Quality Health Standard that governs the clinical deterioration of patients.
What is NSQHS 9?
100
I am a child with a primary survey as follows.. Airway & Breathing - Increased RR and retractions Circulation - Tachycardia, pale/cool extremities, normal BP, oliguria (<1ml/kg/hr) CNS - change in LOC, irritability, restlessness, lethargy
What is Early clinical signs & symptoms of deterioration?
100
As the nurse today, you are just 'not happy' with your patient Mr Jones, you can't 'quite put your finger on it', but he is worrying you this shift!
What is Intuition or 'nurses instinct'? - Found in the literature to be valuable as this often occurs prior to changes in vital signs, dependent on experience. - Included on most rapid response escalation processes nationally
100
I am the patient who you escalated your clinical deterioration concerns on accepting handover at 2300.
What is poorly designed processes and contributing factors? - timing, culture, inadequately designed escalation processes and response systems, poorly coordinated
100
Specific documentation for framework of recognition of deteriorating patient.
What is a track & trigger tool? e.g specific observation & response charts, systems for escalation processes.
200
I am increasing the frequency of observations on my patient and escalating as per my workplace procedures.
What is recognition of the deteriorating patient?
200
I am a child with a primary survey as follows.. Airway & Breathing - Tachypnoea with effort, diminished breath sounds Circulation - Cyanosis, mottled/Poor perfusion to skin, hypotension CNS - stupor
What is Late signs & symptoms of clinical deterioration?
200
I am your patient and have SOB and a RR of 26bpm.
What is my Escalation process??
200
I am your usual case mix - more acuity and more complex patients
What is Patient related risk factors?
200
I am duty of care, escalation process and documentation
What is Individual professional accountability?
300
I am the response to the before mentioned patient who is requiring more frequent observations & escalation
What is the MET/Code Blue team?
300
I am a child with a primary survey as follows.. Airway & Breathing - gasping, ineffective breathing, no respiratory effort Circulation - Bradycardia, weak, thready pulse with poor perfusion, arrhythmia, asystole CNS - unresponsive, flaccid, tonic posturing
What is Missed the boat! Arrest.
300
My track and trigger observation score is at 8 (Qld Nurses)..
What is Medical Emergency Team time!?
300
I am your usual staff on shift; 1 senior RN, 2 casual/demand staff, 1 agency nurse (7hr shift) & a graduate nurse.
What is Staffing risk factors in the setting of clinical deterioration?
300
I am a nurse with the clinical knowledge and skill that are important to recognising clinical deterioration early. I have the knowledge and experience, and work effectively within my team to appropriately recognise and respond to clinical deterioration.
What is working within individual scope of practice?
400
You: Dr Smith, I am phoning to inform you that your post appendectomy, Patient X, is hypotensive at 90/50. She is dizzy and I would like you to review now please... Dr Smith: Certainly Sister, I will come and review her now.
What is Response to clinical deterioration?
400
I am simulation, workshops, MET/Code Blue teams, patient safety officers, clinical incident reviews, resus committees, clinical resource nurses, safety CNC's
What is Education, training and systems (governance) - Prevention! ?
400
I am your adult patient that is not particularly helpful when you are assessing me.
What is Interview techniques to comprehensively assess a patient? Ideas, tips & tricks, thoughts??
400
I am NESB and have recently moved to SE Qld after 4 years as a displaced person. I am a patient of your hospital.
What is Detecting clinical deterioration in our CALD groups?
400
I want to resolve problems, maintain high standards of care, and to protect patients from harm as a nurse.
What is Professional Accountability?? The concept of being answerable or responsible for one’s actions.
500
I am the Ryan's Rule process
What is Communication with patients & carers? Patients & carers are aware of recognition & response systems in place and can contribute to the process of escalating care...
500
I am Ryan's Rule (QHealth) or Code H (SEISAHS)
What is Ability to allow parental/caregiver escalation processes?
500
You are the nurse caring for Mrs Jones, she has severe pleuritic pain and has had no relief from IV opiods. I have a ICC in situ for drainage of my pleural effusion.
What is Pain is you 6th vital sign!? Include this in your assessment for clinical deterioration. Unresolved pain is most often a worrying sign!
500
I am your nurse tonight, I have been in this unit for 8 months and I am the nurse in charge.
What is Clinical staff risk factors?
500
Ability to analyse information, transform knowledge, logical reasoning, predicting applying standards, have contextual perspective, intellectual integrity and flexibility.
What is Critical thinking? Essential component of professional accountability and quality nursing care.