Impact of a one-day inter-professional course (ALERT) on attitudes and confidence in managing critically ill adult patients.

Anecdotal evidence suggests that anxiety and lack of confidence in managing acutely ill patients adversely affects performance. We evaluated the impact of attending an ALERT course on the confidence levels and attitudes of healthcare staff in relation to the recognition and management of acutely ill patients. A questionnaire, which examined knowledge, experience, confidence and teamwork, was distributed to participants prior to commencing an ALERT course. One hundred and thirty-one respondents agreed to participate in a follow-up questionnaire 6 weeks after completing the course. Respondents reported significantly more knowledge (pre 5.47+/-1.69, post 7.37+/-1.22; p < 0.01) in recognising a critically ill patient after attending an ALERT course. Mean scores for respondents' confidence in their ability to recognise a critically ill patient (pre 6.04; post 7.71; t = 11.74; p < 0.01), keep such a patient alive (pre 5.70; post 7.30; t = 10.01; p < 0.01) and remember all the life-saving measures (pre 5.60; post 7.32; t = 11.71; p < 0.01) were increased. Fewer respondents were very worried about being responsible for a critically ill patient (pre 13; post 2; chi2 = 8.55; p < 0.003). There was a significant increase in the number of respondents indicating that they would use a system of assessment for acute illness (pre 23; post 37; chi2 = 4.25; p = 0.035). More staff said that they would approach a registrar or a consultant for help (chi2 = 3.29, n = 131, p < 0.05; chi2 = 7.51, n = 131, p < 0.01). There was a significant improvement in attendees' confidence in working in an interdisciplinary team when caring for critically ill patients (pre 40.66; post 42.91; t = 2.32; p = 0.05). We conclude that attending an ALERT course has beneficial effects on the confidence levels and attitudes of healthcare staff in relation to the recognition and management of acutely ill patients.