Name: Clinical Deterioration: Identify, Assess, Prevent Seminar
Start: 08 Dec 2021
End: 10 Dec 2021
Location: Mercure Hotel Brisbane

Why Attend

The fact that patients can become very rapidly unwell is a high risk for them as well as the healthcare team. Attend this two-day seminar to sharpen essential skills for early detection of deterioration. Learn about:

Thinking fast not slow in a crisis situation
The first subtle signs of deterioration
How to rapidly assess a deteriorating patient
Recognising life-threatening conditions early, such as sepsis and acute kidney injury
How to recognise acute respiratory failure including basic CXR interpretation
Interpretation of diagnostic tests
“Let me be clear!” communicating concisely and correctly

Don’t miss this essential seminar!

Program

8:30am - Registration and Refreshments

9:00am

Welcome and Introduction to Program

9:15am

What Happens to a Person During an 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.

9:30am

Essential 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 we assess our patients
Vitally important “vital signs” – why some clinical cues are 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

11:00am

Shifting 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. It includes:

The importance and physiology of acid-base balance
Arterial blood gas analysis
Case studies for practice interpretation and management options

12:00pm

Asleep or Unconscious? Assessing Neurological Deterioration

The ability to recognise subtle changes in a person’s 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 Glasgow 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?
What are the common signs and symptoms associated with neurological decline and what may they indicate?
How do you document and report changes?

1:00pm - Lunch and Networking

2:00pm

ST 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. It 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?

3:00pm - Afternoon Tea

3:30pm

Chest 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. It includes:

The different types of chest pain and which 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

4:15pm - Close of Day One of Seminar

9:00am - Commencement of Day Two

9:00am

Recognising 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. It includes:

The difference between ventilation and oxygenation, and why it matters
Respiratory pathophysiology – type I respiratory failure versus type II respiratory failure
The indications for the use of non-invasive ventilation (NIV)
Practical strategies to assist with the introduction and management of NIV

9:45am

Fluid 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 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 do you recognise electrolyte disturbances early?
How can you identify important/life-threatening ECG changes on the rhythm strip?

10:30am - Morning Tea

11:00am

Acute 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
The potential causes and classifications of acute kidney injury
Recognising renal dysfunction and the key to preventing acute renal failure
The management principles of acute renal failure
A look at renal replacement therapies - basic explanation

12:00pm

Recognising Rapid Cardiovascular Deterioration

Pulmonary embolism, tension pneumothorax, and/or pericardial tamponade, are potentially dangerous cardiac conditions that require 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 these three common cardiac causes of clinical deterioration:

The patients considered most at risk
Pathophysiology related to clinical presentation
Identification and outline of early management
Goals of treatment

1:00pm - Lunch and Networking

2:00pm

Sepsis 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. It 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?

3:00pm - Afternoon Tea and Coffee

3:30pm

When 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.

4:00pm - Close of Seminar and Evaluations

Presenters

Joanne Reading

Joanne Reading is a clinical educator within the 42-bed ICU at the Royal Melbourne Hospital, which also services critically ill patients from the Peter MacCallum Cancer Centre and the Royal Women’s Hospital. Joanne holds a critical care graduate certificate and a master of health science with a focus on education. She is also the author of her own nursing education website called 'Blogging for your Noggin'. With a special interest in all things cardiac and respiratory. Joanne is passionate about ensuring that education not only fosters critical thinking but is entertaining in the process!

Need for Program

Growing numbers of high acuity patients are being cared for by a diversity of healthcare workers and across a wide range of clinical settings, not just in acute care units. The more acutely unwell a person is the greater the risk of poor patient outcomes, including increased morbidity and mortality. Rapidly recognising and responding to subtle and obvious changes in a patient’s condition is a high priority of the healthcare team if patient deterioration is to be averted.

Purpose of Program

This seminar assists nurses and other health professionals to sharpen skills and confidence in recognising and managing patients whose clinical condition is deteriorating.

Your learning outcomes

Rapidly respond to and effectively communicate the signs and symptoms that may indicate a patient is deteriorating so as to prevent an adverse event
Correlate clinical assessment findings with pathophysiological processes occurring across body systems in acutely ill patients
Apply a range of appropriate and timely evidence-based nursing interventions when a patient is acutely ill and their condition is deteriorating
Use knowledge of the early signs of sepsis to swiftly implement evidence-based interventions and prevent poor patient outcomes