Deteriorating Patient Resources: Dr. Claire Nadaf

Dr. Claire Nadaf, Head of Academic Enterprise and Engagement at Health Sciences University, recently contributed to developing resources aimed at identifying deteriorating patients.

These resources, created in collaboration with a colleague from London South Bank University, have been published on the newly updated E-learning for Healthcare NHS platform. Recognised as a priority, the resources are accessible to over two million users, spanning NHS professionals and those in other healthcare settings, including care homes.

Claire, whose doctoral research focused on recognising the deteriorating patient, said: “We know that there are a proportion of deaths every year that are preventable if recognised at an earlier stage in the patient deterioration.

“The sooner healthcare professionals can recognise deterioration, the easier it is to treat it and manage it. With these new resources, we’re trying to encourage people to recognise those signs early on so that they can undertake a full assessment, initiate the treatment , leading to better patient outcomes.”

Background to the Resources

Claire was originally asked to produce these resources by the NHS in 2020, which were added to the NHS e-learning platform during the COVID pandemic, as there were many issues around patients’ deterioration not being recognised during this time.

In 2024, Claire was asked to review and update the resources for their revamped e-learning platform, as recognising deteriorating patients is a continued priority area for the NHS and healthcare as a whole.

The resources are offered at two levels: a foundational level, designed for individuals requiring basic knowledge, and an advanced level, tailored for registered healthcare professionals seeking more in-depth expertise.

The ABCDE Approach

Claire added: “My research demonstrated that the National Early Warning Score (NEWS), that healthcare professionals use in their decision making in some circumstances has replaced peoples’ own clinical decision-making, and nurses, in particular, have become very reliant on that tool.

“So, the e-learning resource is to encourage healthcare professionals, alongside that very vital tool, to do a more in-depth assessment. Humans don’t operate like machines, so we’re all very different. How one human presents with deterioration will not be the same as someone else.

“Whilst you could use the NEWS tool to pick up textbook cases of deterioration, if you were able to do a wider assessment of a patient then you would notice things that maybe the tool hasn’t picked up.

“The new resources include a recommended way of doing that, the ABCDE assessment tool, where you work through a structured assessment to recognise if there is something that’s not right with the patient at that time.

“The ABCDE approach has historically been used widely by emergency services, such as paramedics, but less widely across other acute and primary care settings. The e-learning resource encourages people to use the ABCDE approach and gives them the knowledge and the skills to be able to do that.”

The wider importance to provide the resources

Dr Claire Nadaf added: “Research is usually presented in a research paper publication or presentation at a conference. By sharing these resources as an open-access resource on the NHS E-learning platform, I am delighted that my research can contribute to the development of healthcare professionals and to the wider good, and for the improvement of healthcare services, by educating the workforce to improve the care of patients and prevent unnecessary deterioration.”