Paediatric Assessment Skills Course: Developing an educational programme to support implementation of new nursing roles at Birmingham Children’s Hospital NHSFT Heather Steele Educational Practitioner

Course Development: Driven by the need to develop new nursing roles to support EWTD and HAN implementation in April 2008 Commitment from consultants/ ANPs

Vision: To provide an opportunity for experienced nurses to develop ‘advanced’ knowledge, skills and attitudes to enhance the quality of care delivered to CYP in an acute healthcare setting Flexible approach to skills acquisition

Course development: Aimed at Band 6 Practitioners and above Masters level critical analysis Interactive approach to skills development Competencies available in a PAS Skills Passport Use of an apprenticeship model of learning with experienced Clinical Supervisors

Course Delivery: Implementation of a 3-day Course in January 2008 with 4 courses Course extended to 5 days Successful RCN accreditation at the beginning of 2009

Interactive Approach: The more you learn, the more you know, The more you know, the more you forget The more you forget, the less you know So……… why learn?

PAS Course Structure: Pre course Revision Workbook Day 1: Introduction to history taking/ documentation Recognition of the sick child Critical thinking and clinical decision making Assessment of the respiratory/ ENT systems

PAS Course Structure: Day 2: Assessment of the CVS/ ECG interpretation Blood gas analysis Assessment of the neurological system Abdominal assessment

PAS Course Structure: Day 3: Clinical assessment of fluid balance and shock Assessment of the skin Assessment of the febrile child Initiatives supporting practice development/ quality

PAS Course Structure: Day 4: Workshops practising history taking skills and examination skills Use of simulation to ‘put it all together’ Implications of advancing practice and accountability

PAS Course Structure: Day 5: Spent practising skills with a Clinical Supervisor in a clinical area of choice H = History E = Examination L = Logical deduction P = Plan of management “Look and you should see. Ask and you should be answered!”

Thinking about Critical Thinking: The difference between child-like thinking and adult thinking and between the expert/ non-expert approaches

PAS Course Attendance: Course completed by 11 cohorts to date 125 nurses and 1 AHP Mainly internal plus 16 external participants

PAS Course Attendance: Also pleased to have been joined by 6 senior nurses from Queen Elizabeth Hospital in Blantyre, Malawi

PAS Course Evaluation: Feedback overwhelmingly positive, with specific comments highlighting the excellent use of speakers and resources “I found it an excellent course, completely relevant to my job role” “PAS was pivotal to help me approach examining children” “ Excellent course, I feel I have learnt many new skills and theory which I can apply to my everyday practice”

Measuring Impact: Evidence of positive impact on skills acquisition and service development Majority of participants (91.4%) report enhanced skills post course completion 72% using skills in a clinical role and 8% in an educational role

Skills Acquisition: History taking (66.6%) Assessment of the sick child (97.2%) Respiratory examination (60.6%) Assessment of the skin (100%) Blood gas interpretation (50%) Review of CXRs (52.9%) ‘For me the practising skills is still in progress as I get to do it on a daily/weekly basis. It is a work in progress so I still don’t have the final competencies signed yet. I have started doing pre-admission clinic for cardiac catheter patients so am using the majority of what I learnt during the course during these clinics. The only skill I am not practicing and don’t think I will is neurological limb tone assessment.’ I found it an excellent course, completely relevant to my job role’.

Developments in 2011: Submission of reflection for course completion Accreditation with local university, alongside a portfolio of clinical modules to develop an ENP role Continuing educational innovation!

Impact of the PAS Course at BCH NHSFT: Improved individual knowledge and skills Evidence of improved quality care and patient safety Development of new nursing roles Innovation in clinical practice

Thank You