Foresight Training for Nurses

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Foresight Training for Nurses

• Joanna Parker
• Head of Safer Practice

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Aims of the presentation

• Background and introduction to foresight training
  
• The NPSAs foresight training programme for
  nurses
• Foresight in action Interactive workshop

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The 3-bucket model forassessing risky situations
(Reason, 2005)
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2
1
CONTEXT
TASK
SELF
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Preventing something bad from happening

• The neonatal arterial switch operation study
• Risk assessing the task, context and self

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Foresight - scoping study of previous work
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Examples of foresight training

• Non-technical skills training in aviation
• Western Mining Corporation. Take time, take
  charge (Hopkins)
• Metropolitan police hazard awareness training
• ESSOs step back by five programme
• BPs integrity management training.
• Approach to scene training by London Ambulance
  NHS trust
• Situation, Background, Assessment and
  Recommendation (SBAR) (IHI, 2006)

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Learning outcomes
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Learning outcomes - continued
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FORESIGHT TRAINING FOR NURSES STAKEHOLDER
ENGAGEMENT
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Foresight training for nurses

• A foresight training resource for NHS nurses in
  acute, primary care and mental health settings
• Engaged stakeholders to shape the development of
  the training programme in the following ways
• Identifying and developing nursing foresight
  scenarios in primary care, mental health and
  acute settings
• Identifying where foresight training fits with
  existing nursing education and training

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Focus Groups

• 23 June, (primary care), 12 July (acute), 20
  July, (mental health)
• SWOT analysis of foresight training
• Storytelling to identify potential scenarios

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Focus Groups

• 12-19 attendees from a range of jobs
• Concept of foresight resonated with participants
  three buckets model is a useful conceptual
  framework
• Foundations already in place (i.e. Reflection in
  Action, good reporting culture)
• Confusion about near misses foresight will
  address this and raise near miss reporting rates

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Focus group feedback

• Need to engage other professional groups, i.e.
  Phase 2.
• Releasing staff for training and cost involved.
• Importance of linking it to other training- not
  stand alone!
• Need an implementation strategy which considers
  the broader organisational context.

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THE TRAINING PROGRAMME
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TRAINING SCENARIOS

• Unrecognised deterioration / deterioration not
  acted upon
• Blood transfusion
• Management of diabetes in the community
• Obstetrics scenario
• Dual prescription of an anti-psychotic drug
• Nurse prescribing scenario in primary care
• Both video-based and paper-based to ensure
  flexibility

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Four types of scenario

• Spot the difference scenarios
• Reflection in action
• Story-telling
• Garden path scenarios

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Training materials

• Combination of video-based and paper-based
• Multi-media to fit with local circumstances
• Ranging from 20 minutes to 45 minutes
• Based on real-life incidents, as sourced from the
  NPSAs National Reporting and Learning System and
  the nursing focus groups
• Accompanied by a facilitators guide

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What are the benefits?

• Facilitates learning about patient safety risks
  from more experienced nurses.
• Improves nurses ability to recognise and
  intervene at the first symptoms of a problem.
• Raises awareness of patient safety incidents, and
  in particular, near misses.
• This in turn could lead to improved near miss
  reporting rates.

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Implementation

• Foresight training resources will be available at
  www.npsa.nhs.uk and the RCNs Learning Zone from
  June 2007
• An off the shelf, flexible resource
• Designed to fit into mandatory training
  programmes and team handovers
• NPSA is working to raise awareness of the
  training amongst other professional groups

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INTERACTIVE WORKSHOP
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DETERIORATION INCIDENT

• Watch the video
• Think about the unfolding scenario
• Contextualise in terms of the three buckets model

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Media Clip
E\NPSA_SC1_Rough_Cut1.mpg
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The 3-bucket model forassessing risky situations
(Reason, 2005)
3
2
1
CONTEXT
TASK
SELF
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Whats in the buckets?

• Work in small groups
• Discuss what was in the self, context and task
  buckets
• Write one factor down on each post it note
• 20 minutes to discuss as a group
• 15 minutes group feedback

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FURTHER INFORMATION CAN BE FOUND AT
www.npsa.nhs.uk 4 8 Maple Street, London W1T
5HD