Transport of Critically Ill Patients —
Training activity: 4

Details

Perform pre-use equipment checks

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• Power supplies and oxygen supply
• Calculation of resources required for the total process
• Previous use and continued application
• Consumables

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

What does success look like?

• Identify what is expected of you in relation to completing thorough and accurate checks on all identified equipment to ensure it is functional, safe, and ready for use.
• Consider how the learning outcomes apply, specifically in relation to preparing all equipment for continuous use and curriculum considerations on assessing technical requirements. What constitutes a complete check for different equipment types (e.g., ventilator, monitor, pumps)?
• Discuss with your training officer to gain clarity of what is expected of you in relation to the local protocols or checklists used for pre-use equipment checks for transfer.

What is your prior experience of this activity?

• Think about what you already know about checking specific pieces of transport equipment (e.g., checking battery levels, calibration dates, basic functionality).
• Consider possible challenges you might face during the activity, such as discovering faulty equipment, missing components, or time constraints.
• Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if you need to escalate equipment issues to engineering, senior staff, or substitute equipment.
• Acknowledge how you feel about performing these checks – confident in your ability to spot issues?

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as efficiently performing checks under time pressure or identifying subtle signs of equipment malfunction.
• Identify the specific insights you hope to gain into the critical safety features of different equipment or common issues encountered during checks.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of missing a crucial check or finding an issue you didn’t know how to address.
• Identify important information you need to consider before embarking on the activity, such as access to the necessary checklists, manuals, or guidelines for performing the checks.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst performing checks to ensure equipment is functional and ready?
• Are you encountering situations such as:
• Equipment not functioning correctly (e.g., a pump fails the self-test) or showing potential issues (e.g., low battery level) that were not anticipated?
• A required consumable or accessory is discovered to be missing or near expiry, challenging the readiness checklist?

How are you reacting to the unexpected development?

• How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to equipment checks by immediately initiating troubleshooting steps for a malfunctioning pump?
• Consider the steps you are taking in the moment, such as:
• Immediately substituting the faulty equipment with a designated spare or seeking technical support to resolve an equipment issue discovered during the check
• How are you feeling in that moment? For instance, are you finding it difficult to troubleshoot minor issues found during the check? Is it affecting your confidence in ensuring the room meets safety standards?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully resolving the logistical issue by implementing an approved alternative equipment setup yourself? Or are you needing support because the identified safety issue requires senior technical review before the equipment can be deemed safe for transfer?
• What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for troubleshooting equipment setup issues? Or gaining insight into the importance of detailed checks as you perform them?

On action

What happened?

• Begin by summarising the key steps you took when performing the pre-use checks for the equipment intended for transfer.
• Consider specific events, actions, or interactions which felt important, such as finding an issue with a critical device (e.g., monitor calibration) that required intervention, or meticulously checking the battery life of all transport pumps.
• Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately initiating troubleshooting steps for a pump failure found during the self-test.
• How did you feel during this experience, e.g., focused on the technical task or anxious about the limited time to resolve the fault?

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding the importance and specifics of performing equipment checks. What strengths did you demonstrate, e.g., thoroughness in reviewing the checklist documentation?
• What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the location of the spare power supply for the portable ventilator?
• Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in ensuring all equipment is prepared for continuous use?
• Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding the escalation process for equipment failure that could affect patient safety.

What will you take from the experience moving forward?

• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving the efficiency and documentation of your pre-use check process.
• What will you do differently next time you approach performing equipment checks, for instance, by proactively checking the service tag and maintenance log for the transport ventilator?
• Do you need to practise any aspect of the activity further, such as troubleshooting common technical issues or checking particular pieces of equipment?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences of performing equipment checks on a wider range of technical devices or identifying different types of equipment failures since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how an instance where a subsequent transfer required a critical infusion pump failed its self-test forced you to re-evaluate the depth and rigour of your initial pre-use checking routine during your first attempt at this training activity.
• Considering what you understand about quality control, process adherence, and equipment failure modes now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your systematic process adherence for pre-use equipment checks based on further learning and experiences? For example, how you proactively reviewed and integrated standard operating procedures (SOPs) for specific equipment checks, especially battery charge levels, based on further learning.
• Has discussing challenges of equipment checks or specific equipment issues or the impact of undetected malfunctions leading to transfer disruption with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about an incident relating to equipment failure highlighted the necessity of meticulous adherence to the preparation process.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent equipment check and technical troubleshooting experiences, contributed to your overall confidence and competence in quality control, attention to detail, and process adherence during equipment checks, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated ability in systematic equipment checking now enables you to demonstrate functional equipment set up for transport during a DOPS assessment.
• How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to ensuring equipment readiness and performing technical checks? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from the Training Officer or Technical Specialist immediately when an identified safety issue requires senior technical review before the equipment can be deemed safe for transfer.
• Looking holistically at your training journey, how has this initial equipment check experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to preparing all equipment for continuous use? For example, how this foundational experience has supported your development in managing equipment troubleshooting during transfers.

Relevant learning outcomes

#	Outcome
# 3	Outcome Prepare all equipment for continuous use during the transfer of critically ill patients.