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


When did you first introduce the innovation?

Between 12 and 24 months ago

Please describe the innovation you have developed

The ALERT programme is designed 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. The ALERT course, designed by Portsmouth Hospitals NHS Trust, is a nationally recognised multi-disciplinary course aimed at registered clinicians. Many organisations that our students have placements in use the ALERT within their preceptorship programme for newly qualified nurses as well as forming part of the junior doctor induction programme.

Bucks New University is the first university in England to deliver the ALERT programme to pre-registration adult and mental health nursing students and has been evaluated very well by students and clinicians who support our students within clinical practice. The programme is delivered by six senior lecturers that have spent some time in Hillingdon Hospitals Foundation Trust and Portsmouth Hospitals NHS Trust receiving training on how to deliver the ALERT programme locally in the university. The delivery is also supported by expert practitioners from the intensive care unit at Hillingdon Hospital which has greatly enhanced the experience and knowledge for our students.

What prompted you to develop this innovation?

In September 2013 our pre-registration nursing students on the BSc (Hons) Nursing were the first to commence the third year of this programme. This gave an opportunity to bring exciting innovations to a number of modules. One of the adult field nursing skills modules ‘Underpinning Complex Care’ is designed to give the students heightened knowledge in the area of clinical skills around providing clinical care for patients who have acute health care needs both in the hospital and community.

In order to help the students with their learning the ALERT course was introduced into this module. This exciting innovation was developed alongside many of our NHS partners who reported the need for student nurses to be much more engaged with patient assessment and treatment alongside the work around failure to rescue and patient safety that NHS organisations were developing and delivering.

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 nursing students and has been evaluated very well by students and clinicians who support our students within clinical practice.

It gives our students confidence to complete their academic assessments as well as increased confidence and understanding of managing a patient in clinical practice that has complex care needs.

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

The ALERT programme is delivered in one day and comprises of a number of short and snappy presentations, clinical skills based demonstrations and a structured simulated clinical assessment where students can demonstrate their ability to put to practice their new knowledge and skills. Using the A – E (Airway, Breathing, Circulation, Disability and Exposure) assessment technique students can quickly identify and manage life threatening complications as well as learn about the skills required to work within multi-disciplinary teams in order to stop patient deterioration and ensure that evidence based care is delivered safely in a timely fashion.

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

The university has received a lot of positive and powerful feedback regarding the implementation of the ALERT. This has ranged from students telling us about their increased academic knowledge base, their heightened awareness of clinical skills when in clinical practice and positive impact of their student experience. 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.

There was much interest generated at two conferences where national and international delegates were very interested in taking this back to their organisations due to our successes.

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

Student confidence was measured pre- and post-course and the quantitative data indicated that there was a very strong link that students felt more confident to assess and mange the care of a potential deteriorating patient following the completing the ALERT course.

Some examples of feedback are given below:

‘Doing the ALERT course helped me prepare for the exam which I passed. During my placement in A&E I felt confident to work as part of the team with an understanding of what was happening during the A- E assessment.’ (BSc Nursing Student)

‘ALERT has been running for a number of years it is a blended, flexible, multi-disciplinary learning programme which is nationally recognised with a good track record of delivery, so it’s a great programme for Bucks student nurses to be completing.’ (NHS Partner)

‘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 position, the ALERT course has helped them to get the job the want.’ (NHS Partner)

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 two conferences (detailed below).

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 an article regarding these experiences.

The team have been asked to return to a conference to report back further on this innovation.