Implementing the ALERT? (Acute Life Threatening Events Recognition and Treatment) course into the third year adult and mental health field pre-registration nursing curriculum


When did you first introduce the innovation?

Between 12 and 24 months ago

Please describe the innovation you have developed

In September 2011 the newly validated BSc (Hons) programme in Nursing commenced at Bucks New University. This gave academic staff the opportunity to deliver a brand new curriculum to our first degree only cohort.

A number of innovations were introduced throughout the programme to ensure that the student experience was good and that the Bucks Nursing Student stood out positively in their knowledge, skills and professional behaviours within clinical practice.

In September 2013 this first group of students commenced their third and final year of the programme. Within this part of the programme the ALERT (Acute Life Threatening Events Recognition and Treatment) course was introduced. Initially this course was delivered within the adult nursing programme. Due to its success and positive outcomes in was incorporated within the Postgraduate Diploma programme and in February 2015 in the mental health field nursing programme.

What prompted you to develop this innovation?

The ALERT course is a nationally recognised multi-disciplinary course designed by Portsmouth Hospitals NHS Trust. It is aimed to enable healthcare practitioners with a structured system to assess, recognise, manage and escalate the care of a deteriorating patient early in order to prevent further clinical deterioration. Many NHS organisations that our students have placements with use the ALERT course within their preceptorship programme for newly qualified nurses as well as forming part of the junior doctor induction programme.

The development and implementation of the BSc (Hons) nursing curriculum was carried out in conjunction with feedback from students, service users and our NHS partners. The views of clinical experts both from acute hospital services and community services were sought regarding the third year modules where the ALERT course sits. The clinicians said that the wanted student nurses with a broad knowledge and practical ability to assess patients and service users and make rapid decisions regarding their care in order and address and reduce failure to rescue issues and to improve service users physical health.

In your view, what is it about this innovation that makes it different/important?

Bucks New University is the first university in England to deliver the ALERT programme to pre-registration adult field nursing students and we believe that we are the first university nationally to deliver the course to mental health nursing students.

In order to develop our expertise in developing and delivering the ALERT course we have worked very closely with our NHS partners and have an excellent relationship with key people within North West London and nationally around the physical care of service users and working with acute and mental health organisations to address issues around caring for deteriorating patients.

To what extent does your innovation make use of existing approaches, resources or technologies?

The adult and metal health field modules (where the ALERT course is delivered) has a focus on addressing the complex care needs of a physically unwell patient/service users. These modules are predominantly skills based and are designed to give the nursing student hands on experience of managing these patient groups both with the acute and community settings within a safe and supportive simulated learning environment.

Bucks New University has an excellent track record of incorporating simulated learning and assessment within the curricula delivered and has some excellent simulation faculties on the campus. This makes delivering the ALERT course much more realistic and beneficial to the students development and skill base which further enhances their learning experience.

To what degree has this innovation led to changes in education or clinical practice?

Student confidence was measured pre and post the ALERT course and the quantitative data has demonstrated that there was a very strong link around students feeling more confident to assess and manage the care of a potential deteriorating patient following the completing the ALERT course. This has been further supported by feedback given to us from students and the clinicians working alongside the students and their ability to manage and promote physical health and identify deterioration early and successfully.

The success of the ALERT was also recognised as a positive innovation within student feedback. The end of ALERT course evaluations were demonstrated 100% student satisfaction and further supported the increased confidence within the pre and post course measures. The end of module evaluation also featured the ALERT course and students felt that this was appropriately placed and did help support their learning and also their enjoyment of the module.

The National Student Survey results also featured positive student feedback regarding the ALERT course and the 2014/15 results have demonstrated a rise in student satisfaction and experience.

What evidence do you have of the impact of the innovation?

Academics at the university have received positive and powerful feedback regarding the implementation of the ALERT course. This has ranged from students telling us about their increased academic knowledge base and their heightened ability to perform clinical skills when in clinical practice as well as students reporting increased student experience through the National Student Survey and other feedback mechanisms.

Our NHS Partners have also given a lot of feedback regarding the clinical ability of the Bucks student nurse, their future employability and how this innovation has made them stand out from other student nurses. Some examples of feedback are given below:

‘Doing the ALERT course helped me prepare for the exam which I passed. During my final placement I felt confident to work as part of the team with a better understanding of what was happening during the assessment.’ (Adult field BSc Nursing Student).

‘Many of the students have mentioned their ALERT qualification in job applications and discussed it when they have been interviewed for their first band 5 Registered Nurse position, the ALERT course has helped them to get the job they want.’ (NHS Partner).

‘I fully endorse the ALERT course and my experience of it is a positive one. I do not believe that there is any one from my group that has not benefited from attending it ‘ (MH field BSc Nursing Student).

To what degree has the innovation been disseminated in your organisation or elsewhere?

The implementation and success of incorporating the ALERT course into the curriculum has been presented at conferences (detailed below).

Hoddinott, P. (2015) Evaluating the impact of the ALERT™ course into the third year pre-registration nursing curriculum at Bucks New University [Poster Presentation West London Sector Research Symposium for AHPs, Nurses, Midwives and Pharmacists, London, United Kingdom].

Hoddinott, P. McCreary, P. (2015) A proposal to improve the recognition, assessment intervention in the physically deteriorating patient using ALERT™. [Conference Presentation London Association of Mental Health Nursing Practice, London, United Kingdom].

Hoddinott, P. Cox, D. Kellet, P. (2014) Implementing the ALERT™ course into the pre-registration nursing curriculum. [Conference Presentation ALERT Conference, Birmingham, United Kingdom].

Please provide details of any plans you have to disseminate the innovation in the future.

There are plans underway to publish two articles regarding introducing the ALERT course at a pre-registration level. The ALERT course delivery team have been asked to return to the London Association of Mental Health Nursing Practice conference in 2016 to report back further on the innovative delivery of the ALERT within the mental health field nursing programme.

We would also like to further measure the longer term benefits of introducing the ALERT course at a pre-registration level and look at more detailed outcomes regarding patient care with our NHS partners.