Recognising and managing deterioration - e-Learning for Healthcare
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This programme is in partnership with...
  • Health Education England
  • London Southbank University
  • Bournemouth University_Partnership Logo

About the recognising and managing deterioration programme

Changes to vital signs, behaviour and mental state often occur before a serious event, such as cardiac arrest.

Deterior Patients.pdf >

Being able to recognise and act on these changes are essential skills to improving patient safety and outcomes.

A range of resources are available here to support the workforce and organisations in ensuring staff have the necessary knowledge and skills to recognise and manage deterioration in adult patients. This includes resources on the National Early Warning Score which is endorsed by NHS England and NHS Improvement for use in acute and ambulance settings.

 

Signs of Life - Educational Game

News2

Signs of life is a simulated training resource, where healthcare professionals can practice the care of the deteriorating patient. The game is played out in a hospital ward or nursing home setting. In real time scenarios, players record a patient’s vital signs in a simulated work situation, decide what interventions are required and are given critical feedback on the best clinical decisions to take.

Ufi VocTech Trust  funded the development of the game which has been produced by Desq, staff from Dudley Group NHS Foundation Trust and a former care sector nurse.

Recognising and managing deterioration

The recognising and managing deterioration programme is an e-learning programme developed for a wide variety of health and social care professionals working in clinical environments where adults could physically deteriorate.

The resource is offered at 2 levels (Universal and Advanced) to reflect the participant’s experience and clinical setting.

This resource is structured around the ABCDE assessment tool and allows participants to revise their anatomy and physiology, develop their skills and knowledge in the assessment process to recognise deterioration and manage the findings within the scope of their clinical role.

Resources by settings

Use the links below to find resources relevant to your setting.

Selecting the links will open a new tab in your browser and take you directly to the relevant area of the programme.

  • Primary Care

    NEWS in Primary Care

    Sepsis and NEWS (National Early Warning Score) webinar – supporting the primary care team

    This webinar took place on 17 March 2020, hosted by Alison Tavaré, Primary Care Clinical Lead, West of England Academic Health Science Network.

    The webinar addresses NEWS:

    How it supports the identification and early management of the deteriorating patient

    • Its use in primary care
    • Emerging evidence for community settings
    • How to support the identification of the patients with possible COVID-19, referring to sources of information and data that will offer real time updates on its future treatment.

    Primary Care training package

    A learning resource has been developed on NEWS and its use in a Primary Care setting.
    It also provides supporting evidence, references and resources.
    Case studies are also available to support a learner to consider the use of NEWS in their work area.

    NEWS in Primary Care – All Slides

    This is the full slide deck of NEWS in Primary Care training that contains all sections of the course. This includes an introduction to NEWS and how it can be used in primary care and its effective use between primary and secondary care, evidence of NEWS in the Community, case studies to give a learner examples of how NEWS can be beneficial in treating patients, as well as links to other useful resources and references for further research.

    Using NEWS in the Recognition of Deterioration

    This section of NEWS in Primary care training gives an overview of NEWS. It outlines the measurements of NEWS, how it can be used in primary care, and the benefits of using the same language can improve communication and treatment when transferring patients between primary and secondary care.

    The evidence for NEWS and its use in the community

    This section of NEWS in Primary care training addresses the evidence around NEWS and its use in Community settings, in relation to challenges that NEWS may increase unnecessary referrals to hospital. It addresses how effective it could be for patients with long term conditions and its use in Care Homes. It also features staff opinions of the use of NEWS outside acute settings.

    Case studies of NEWS in Primary Care

    This section of NEWS in Primary care training contains case studies that use real scenarios given by practising GPs, to give the learner practical examples of when NEWS would be used, and offers the learner the chance to consider how they would treat patients in similar situations.

    Topics include:
    1. Identifying a sick patient
    2. Communication between clinicians
    3. Baselines – what is normal for a patient
    4. NEWS and altered behaviour
    6. NEWS and Learning Disability
    7. Instances you would not admit a patient
    8. Using clinical judgement

    Resources

    This section of NEWS in Primary care training contains references for further research. It also lists a range of other learning resources that may be of interest.

    Receptionist training package

    A learning resource for reception staff, composed of training resources and a workbook, has been developed by HEE in collaboration with Hartlepool and Stockton Health, as an introduction for reception staff to address the deteriorating patient.

    Receptionists are commonly the first point of contact for people with acute health needs. This training helps receptionists recognise specific symptoms that may indicate a deteriorating patient, and how they would consider escalating this to a clinician within their service or practice. It particularly focuses on to the symptoms of chest pain, stroke, sudden breathlessness and sepsis.

  • Secondary Care

    Secondary Care training package

    A learning resource has been developed for healthcare staff in secondary care settings, which can be also incorporated into Foundation Year 1 Doctors’ training. This comprises two learning resources:

    1. Using NEWS in the recognition of deterioration

    This covers:

    • The need for a National Early Warning Score (NEWS) and the evidence to support its use
    • Raising awareness and increase understanding of how the National Early Warning Score (NEWS) is used in the recognition and response to deterioration in secondary care settings
    • Understanding the purpose of SBARD as a structured communication tool

    2. Case studies to support effective diagnosis and management of NEWS in relation to deterioration

    This includes case studies on:

    • Anaphylaxis
    • Gastro intestinal bleed
    • Hospital acquired pneumonia
    • Pulmonary Oedema
    • Pulmonary Embolus
    • Urinary tract infection

    Receptionist training package

    A learning resource for reception staff, composed of training resources and a workbook, has been developed by HEE in collaboration with Hartlepool and Stockton Health, as an introduction for reception staff to address the deteriorating patient.

    Receptionists are commonly the first point of contact for people with acute health needs. This training helps receptionists recognise specific symptoms that may indicate a deteriorating patient, and how they would consider escalating this to a clinician within their service or practice. It particularly focuses on to the symptoms of chest pain, stroke, sudden breathlessness and sepsis.

  • Social Care

    Deterioration, NEWS and Sepsis in Care Homes

    Learning resources on Deterioration, NEWS and sepsis designed in particular for care home staff to ensure care home residents receive appropriate, timely medical care. They provide a comprehensive training for non-clinical carers in the community. The training may also be suitable for health care assistants working in other settings and nursing students.

    This is a mainly film-based course that covers:

      • An introduction to NEWS in care home settings and its benefits
      • An introduction to sepsis and serious illness
      • The importance and significance of soft signs
      • An overview of each component part of NEWS and how to measure:
        • Respiratory rate
        • Oxygen saturations
        • Blood pressure
        • Pulse rate
        • Level of alertness
        • Temperature

    Receptionist training package

    A learning resource for reception staff, composed of training resources and a workbook, has been developed by HEE in collaboration with Hartlepool and Stockton Health, as an introduction for reception staff to address the deteriorating patient.

    Receptionists are commonly the first point of contact for people with acute health needs. This training helps receptionists recognise specific symptoms that may indicate a deteriorating patient, and how they would consider escalating this to a clinician within their service or practice. It particularly focuses on to the symptoms of chest pain, stroke, sudden breathlessness and sepsis.

Coming soon

NEWS in Mental Health:

NEWS in Mental Health training resource is currently being written. The training will offer learners an overview of NEWS, as well as specific case studies relevant to staff working in a mental health setting.

NEWS in Ambulance services:

NEWS in Paramedics training resource is currently being written. The training will offer learners an overview of NEWS, as well as specific case studies relevant to staff working in an ambulance service.

Further resources

Further NEWS resources have been referenced within the Sepsis learning materials: https://www.e-lfh.org.uk/programmes/sepsis/

Meet the team

  • Antonio-De-Gregorio

    Antonio De Gregorio

    Programme Coordinator – Antimicrobial Resistance and Sepsis, Health Education England, Population Health and Prevention Team
  • Mohamed Sadak

    Mohamed Sadak

    Clinical Lead and Programme Manager, Antimicrobial Resistance and Sepsis, Health Education England, Population Health and Prevention Team
  • Janet Flint

    Janet Flint

    Programme Lead, Health Education England, Population Health and Prevention Team
  • Dr Chris Carey

    Associate Postgraduate Dean, Health Education England Kent, Surrey, Sussex
  • Dr Sanjiv Ahluwalia

    Dr Sanjiv Ahluwalia

    Postgraduate Dean, Health Education England, North Central and East London
  • Dr Simon Stockley

    Content author Receptionist training package
  • Alison Tavaré

    Dr Alison Tavaré

    Content author, NEWS in Primary Care training & Deterioration, NEWS and Sepsis in Care Homes
  • Sue Maddex

    Sue Maddex

    Senior Lecturer, London South Bank University, Content Author of Recognising and Managing Deterioration
  • Claire Nadaf

    Claire Nadaf

    Senior Lecturer, Bournemouth University, Content Author of Recognising and Managing Deterioration
  • Danielle Fullwood

    Danielle Fullwood

    Senior Nurse; Professional Development, Health Education England, Content author of Secondary Care training package
  • Alan Ryan

    National Programmes Director, Health Education England
  • Clair Guy

    Clair Guy

    Programme Manager, HEE e-Learning for Healthcare
  • Jon Collins

    Jon Collins

    Project Manager, HEE e-Learning for Healthcare
  • Victoria Ward

    Victoria Ward

    Lead Learning Designer, HEE e-Learning for Healthcare
  • Tracy Watkins

    Tracy Watkins

    Learning Designer, HEE e-Learning for Healthcare
  • Jenny Berrisford

    Jenny Berrisford

    Learning Designer, HEE e-Learning for Healthcare
  • e-LfH staff - Rashmi Chavda

    Rashmi Chavda

    Graphic Designer, HEE e-Learning for Healthcare
  • Leanne Hargreaves

    Leanne Hargreaves

    Stakeholder Officer, HEE e-Learning for Healthcare

How to access

Available to all

The News and Deterioration programme is freely available to access here.
Please note your progress and completion of sessions will not be recorded and you will not be able to generate a record of completion. If you require evidence of learning, please register and then log in to access this programme on the e-LfH Hub.

If you already have an account with e-LfH, then you can enrol on to the News and Deterioration programme by logging in to the e-LfH Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My e-Learning section.

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To view the News and Deterioration programme, select the View button below. If you already have an account with e-LfH, you will also be able to login and enrol on the programme from the View button.

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Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the News and Deterioration programme, please contact e-LfH directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact e-LfH directly to express interest.

More information

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