Adverse Event Management Training

There are a number of resources available for staff involved in Adverse Event Management

1.     E-Learning Modules

1.1.  Adverse Event Reporting

Course Aim: To ensure NHS Lothian staff understand the importance of reporting adverse events and near misses for future learning and service improvement, in compliance with the NHS Lothian Adverse Events Management Operational Policy and Procedure.

Who should complete this module?

All NHS Lothian staff

What is covered:

·       What is an adverse event

·       The types of adverse events that should be reported

·       How to report and adverse event accurately using DATIX

·       Why we need to report adverse events and near misses

To access course on LearnPro

Select relevant job family under NHS Lothian Core Mandatory section, Select topic Complete once only, Select course module Lothian: Health and Safety and then Launch Health and Safety (Section 3 is the Adverse Event Reporting E-learning module)

1.2.  Datix – A guide to Adverse Event Management

Course Aim: To ensure relevant NHS Lothian staff can manage, review, identify and share learning from adverse events using Datix, in compliance with the NHS Lothian Adverse Events Management Operational Policy and Procedure.

Who should complete this module?

Anyone with responsibility for managing and reviewing adverse events in their ward/team/service e.g. Charge Nurses, Department Manager, Clinical Nurse Managers and Consultants.

What is covered?

·       Your role as a manager – ‘How to Review an Adverse Event’

·       How to get information, data for improvement and assurance from Datix

o   Running reports

o   Datix Dashboards

·       The importance of learning from adverse events, making service improvements and feeding back to staff

To access course on LearnPro

Available within the CPD section (you will be prompted to first complete the Adverse Event Reporting e-learning module)

2.     Workshops/Training Sessions (delivered virtually and in person)

2.1.  SAE Management

Course Aim: To explore why we review Significant Adverse Events (SAEs), how we do it and to provide an overview of current processes in NHS Lothian for the management and learning from SAEs

Who should attend?

Anyone with responsibility for facilitating a SAE Review for major harm or death because of their supervisory/managerial role e.g. Charge Nurses, Department Managers, Clinical Nurse Managers and Consultants.

What is covered?

·       Describe the process of managing and reviewing adverse events

·       Define terms

·       The different types of reviews

·       Describe processes for involving people in SAE reviews, including application of organisational Duty of Candour

·       Key steps in conducting an SAE review

·       Identify resources/support required to help teams to carry out reviews

·       Recommendations and Improvement Planning

2.2.  SAE Review Training

Course Aim: To increase understanding of the theory underpinning a Significant Adverse Event (SAE) review and provide the necessary skills to undertake an effective SAE review for major harm or death. 

Who should attend?

Anyone with responsibility for facilitating a SAE Review for major harm or death because of their supervisory/managerial role e.g. Charge Nurses, Department Managers, Clinical Nurse Managers and Consultants.   People attending should soon be expected to be involved in an SAE review.

Requirements

·       Prior to attending this course, please ensure you have completed the two Datix training modules on Adverse Event Reporting and Adverse Event Management.

·       Have support from line manager to attend training

What is covered?

·       What is an adverse event, what is an SAE and why review

·       What is the role of the managers commissioning the review? 

·       Key steps in conducting an SAE review

·       Systems thinking

·       Explore the role of human factors in adverse events

·       Involving people in SAE reviews

·       Recommendations and report writing

2.3.  Specific Processes

2.3.1.     Falls / Pressure Ulcers

2.3.2.     Local Case Reviews (Mental Health & Substance Use)

Course Aim: To describe the process of managing and reviewing falls and pressure ulcers with significant harm and local case reviews for mental health and substance use adverse events with major harm and death.

Who should attend?

Anyone with responsibility for facilitating a SAE Review for major harm or death because of their supervisory/managerial role e.g. Charge Nurses, Department Managers, Clinical Nurse Managers and Consultants.

Requirements

·       Prior to attending this course, please ensure you have completed the two Datix training modules on Adverse Event Reporting and Adverse Event Management.

·       Have support from line manager to attend training

What is covered?

·       Identifying the key steps in conducting a Fall & PU SAE and a Local Case Review

·       Identifying resources/support required

3.     Other online training available via Turas

3.1.  Duty of Candor

Course Aim: To help understand what the Duty of Candor provisions means for you.

Who should complete this module?

All staff involved with communicating with patients and families following an adverse event

What is covered?

·       Explain the Duty of Candour provisions within the Act, and how and when this affects your practice

·       Identify incidents of unexpected or unintended harm, and explain how the Duty of Candour procedure should be applied

·       Describe the effective elements of making an apology to, and/or meeting with, the people affected by the incident

·       Outline monitoring and reporting requirements

·       Identify what lessons could be learned and shared by you and your organisation to support improvements in the quality of care

·       Explain how you can support implementation of the Duty of Candour

·       Explain where to go for further sources of support

Click here to access module

3.2.  Compassionate communication skills training course

NES is offering compassionate communication skills training focused on how to include patients and family in adverse event reviews. Participants attend three online half-day sessions covering a mix of interactional skills, theory, and practical strategies for inspiring effective communication and one peer support session. Cohort 5 & 6 completed in February 2024.

Next training will take place August/September 2024.

For more information, please email nes.personcentredcare@nhs.scot

3.3.  Human Factors Hub

Human Factors/Ergonomics (Safety Science) for Patient Safety Level 1

Human Factors / Ergonomics e-Learning module produced by Loughborough University.

Learning Outcomes:
Discuss the use of Human Factors as a way of thinking about everyday work and how it relates to health and social care. Think about how Human Factors can improve the performance and well-being of people (patients and staff), teams and organisations by design and an integrated systems approach. Plan to use Human Factors to help with your safety challenges.

Type: eLearning

Audience: General audience

Click here to access module

3.4.  Safety Learning Reviews - Systems Thinking for Safety Investigation

Click here to access webinar