Evaluating knowledge in acute illness: Critical Care Educational Project

Aim

Clinical knowledge and its application underpins delivery of adult care in our hospitals. Such deficits are well recognised [1, 2]. The Greater Manchester Network assessed clinical knowledge and its application within the trusts in our area.

Method

Eleven hospitals were involved in the design and application of a questionnaire that asked specific questions in relation to applied physiology and care of acutely ill patients.

The questionnaire was distributed to coordinators in 11 hospitals across the network. There were 240 replies (72% response) and they were completed by: nurses n = 134; medical staff n = 42; physiotherapists n = 48; and 24 other/unrecorded. The specialities of those questioned varied with the majority from medical and surgical areas; n = 79 and n = 72, respectively. The questionnaire contained questions relevant to basic and applied physiology (25); and qualitative questions pertinent to their perception of their ability to deal with ill patients

Results

Respiratory system; 16% recognised all the signs of respiratory distress; 22% did not know how much oxygen was in room air; 27% correctly identified factors relevant to the measurement of oxygen saturation. Forty-eight per cent recognised what respiratory rate reflects; 50% failed to recognise the role of supplementary oxygen in an acute asthmatic attack. Forty-two per cent knew when to take a manual pulse. Eighty-seven per cent knew the normal range for potassium; 31% recognised the implications of hypokalaemia and 54% knew what caused hyperkalaemia. Interestingly, even though the questionnaire had areas that required intensive teaching, 71% of the participants said they felt confident in looking after acutely ill patients.

Conclusion

To address this deficit, education and training had commenced in all the trusts surveyed. A central training centre has opened within the network and a shared programme of education has been instituted. The schools of nursing have been approached to look at preregistration training to try to address these issues earlier, and the same is to occur with the other training institutions.