In 2007, the National Patient Safety Agency was able to show that a deteriorating condition in patients is often recognised too late and not quickly enough. This was also shown in a study on child deaths (Child and Maternal Health Study 2008). Emergency situations can occur at any age and in any place, regardless of whether a person has an acute or chronic illness. The number of emergency situations in hospitals, psychiatric and psychosomatic institutions or senior citizens' facilities will increase. Not least, this is happening against the background of demographic development and decreasing length of stay in hospital (Wnent et al. 2013, Mavrogiorgou et al. 2011).

Goals:

• To promote clinical and professional competence and decision-making for correct and appropriate action by nurses. This is especially the case when the condition of patients (children and adults) deteriorates acutely, as early recognition of deterioration is an essential skill for nurses.
• Decision-making and management of situations, e.g. with the help of the ABCDE assessment, are clearly practised in simulations in the programme.
• The teaching-learning programme developed in the RADAR project aims to improve communication skills and documentation skills of nurses.
• This project should lead to better training of nursing students in the future by developing evidence-based simulation scenarios jointly by all project partners, testing them in the programme and then disseminating them.

The project consisted of four phases: Development, implementation, evaluation and publication/dissemination.

In the first phase, the project partners developed a 12-day intensive learning programme for nursing students to promote rapid and expert action in acute situations. This took place through meetings, video conferences, online research, email contacts and telephone calls. The participating countries took on different topics based on their knowledge and competences. Fulda was responsible for the care of people with chronic diseases e.g.: Diabetes Mellitus, for people with acute complications and for emergency care. A deteriorating condition of a patient was simulated in different settings.

The learning objectives for nursing students were:

• Reflect and synthesise their own knowledge,
• cooperate interculturally,
• to develop and apply a positive and fear-free safety culture in the sense of "learning from mistakes",
• assess and maintain patient safety,
• demonstrate adequate professional behaviour.

Implementation: 70 students and about 20 experts/teachers took part in the EU RADAR programme at the University of Salford for the first time in 2013. In the period from 17 - 28 February 2014, Fulda University of Applied Sciences and the Department of Nursing and Health were the hosts and again another 70 students and approx. 25 experts/teachers were able to complete the RADAR programme.

Contents of the programme were:

• Lectures by experts on the topics: Assessment of the Rapidly Deteriorating Patient, Patient with an acute Abdomen, Acute Exacerbation of chronic illness, Child with asthma, Mental Health, Postpartum haemorrhage, Emergency Department Management,
• Seminars and workshops in small groups: Risk assessments in home and inpatient healthcare settings, Case reconstructions.
• Simulations and exercises: Communication according to the SBAR scheme,
• Skill training, demonstration and practice of the ABCDE (Airway, Breathing, Circulation, Disabilities, Exposure) action plan,
• Formative evaluation of learning outcomes in OSCE (Objective structured clinical examination): Simulation of an emergency situation

The third phase of the project consisted of the evaluation of the students' learning outcomes and the publication of the results in reports, presentations and journals.

The universities involved in RADAR took up the relevant topic of "emergency management" and developed a joint teaching-learning programme, which was established at the individual universities as a fixed component in the training of nurses and other health professionals.

A European module, best practice simulations and skills training, exchange for future projects and lifelong learning via internet were developed in the project.

The RADAR project enriched the understanding of nursing in other countries of the European Union and the USA. It enabled intensive exchange with the local culture of the host country and supported international learning experiences for future healthcare and nursing professionals. In addition to clinical competence, patient safety was improved. Students learned to work in multidisciplinary teams.

The RADAR project was unique and novel as students participated in role-plays and situations in simulation labs set up like hospital wards. Practice and theory were optimally linked, as technically controlled simulators were used for practical implementation. Real patients were not exposed to any risks. After the simulation, there was immediate feedback and evaluation of the action and implementation.

Students and teachers/experts from the six countries worked together in this project to promote multifaceted cooperation between colleges and universities. The international exchange of knowledge and skills on care and health programmes was at the heart of the project and was a great benefit for the participating countries. Students and teachers were able to learn about different health care systems and pedagogical approaches to improve patient care in a sustainable way. Participants shared good and tested (learning) procedures and practices and exchanged ideas on appropriate research topics.

The EU Radar programme was inaugurated in October 2014 for the Nursing Times Emergency and Critical Care Awards in London.

Foreword in the 2014 handbook for teachers and students in the RADAR programme

It is a privilege and an honour to welcome delegates from 5 European Union countries, as well as delegates from Winona State University in Minnesota, USA. You are very welcome in our Department of Nursing and Health Sciences, and hope you enjoy the beautiful Baroque City of Fulda.

We hope and believe that the next 12 days will be a period of intensive learning with each other and from each other. It is a unique opportunity to come together in this constellation, which gives you the opportunity to get to know other cultures, other languages, and different approaches to teaching and learning. You will have the opportunity to participate in practical workshops, seminars, presentations and master classes that will help you to develop confidence and clinical competence in recognising the clinical signs of deterioration in patients. Our aim is enabling you to react appropriately when you encounter such patients.

Patient safety has gained enormously in importance during the past 10 years. All over the world legislation has been introduced to ensure that patients are treated in a safe and competent way. The program offered to you during the next 12 days will make a contribution to your clinical competence, and will thereby make a small, but important contribution to improving the safety of patients worldwide. You will have the opportunity to learn and practice in a safe environment, where you will have the opportunity to make mistakes and be guided by your lecturers on how to avoid such mistakes in future.

Although the main focus is on learning, we also hope that you will have the opportunity to meet with some of our students and learn more about the German Culture. We hope that you will find interesting activities during your free time, and be able to participate in some of the student activities in Fulda.

We are very happy that you gave us the opportunity to share our facilities with you. It is a great privilege to welcome you at the Fulda University of Applied Sciences. We hope that you will take many impressions with you, and see the program offered here as one of your steps towards your own personal life-long learning process.

Prof. Dr. Stefan Greß - Dean of the Department of Nursing and Health Sciences

Contact:

Prof. Dr. Johannes Keogh
Fulda University of Applied Sciences

Further information on the homepage of RADAR and the Department of PG

Michaela Miertová, Martina Lepiešová (2013): Innovative teaching methods in the professional training of nurses - simulation education. MEFANET Journal 2013; 1(2): 55-60 http://mj.mefanet.cz/mj-02130925