PRF and Treat Relay

We've always found patient report forms (PRFs) one of the most difficult things to train and practice so that the first aiders naturally write excellent paperwork rather than just being just about proficient. It's a topic that everyone assume will be a complete bore and is just a nuisance that gets in the way of the actual treatment. But actually, the concept of PRFs is one that we should embrace and see as a really good thing! Yes, sometimes paperwork can be tedious and (with some paperwork) apparently unnecessary. PRFs are our lifeline when it comes to evidencing what we have actually done, said or found out when dealing with a patient. In that one circumstance where a complaint is made against the first aider, they will be relieved to know that they have written a good quality PRF that provides an accurate and clear representation of what happened and what/why they did whatever they did. But if they aren't in the practice of writing good PRFs, then they have that extra worry even if they have done nothing wrong.

The situation in front of us is self-explanatory to us when we treat. We don't need to tell ourselves that it is really cold and so that is why we moved the patient indoors or that the reason we left the patient on their own for a few more minutes after our arrival was because the man with a knife was walking out of the house. But the person reading the PRF won't know these reasons unless they are written down. We need to give enough information on the PRF to say both what we did and also why we did it. This activity aims to get the first aiders to appreciate the importance of recording their findings on the PRF and how difficult it is (even with a patient in front of us) to understand what has happened before if it hasn't be recorded fully.

When writing this, we've realised that we really do have quite a few 'relay' type activities on the scenario library to help train many different topics! But this is because they are so useful at testing out so many skills. In this case, the repetitive nature and the break up of the natural flow of information in a scenario are utilised. It's pretty similar to the treat-handover-treat-handover article on practicing handovers but instead of a verbal handover, a PRF is used to pass on information.

How the activity works:
You will need a scenario that has quite a bit of information to be gleaned and a reasonable amount of treatment available for the first aiders. The patient could also change over time. If you were treating this scenario, you'd expect all of this information to be on the PRF by the end of the scenario (or shortly after it isn't practical to write it during). Split the group into pairs. Each pair will treat the patient for 2 minutes. After each pair, they will have 1 minute (or 2 if you feel generous) to fill in the details of what they have found out and done on the PRF. The next pair will then have a brief time (which probably needs to get longer as the activity progresses) to read the PRF before continuing treatment. Hopefully, the information and treatment will have been recorded so they will know where they are on the scenario and what is left to do and so can continue treatment. At the end of their treatment time, they then also write on the same PRF. The picture of the scenario is therefore building up on the PRF and (hopefully) the patient is getting treated appropriately. If that sounds confusing, just follow the flow diagram below.

PRF Relay exercise work flow

Practical Tips:
  • It's important that the scenario and patient information gives quite a bit of information or treatment options that can be passed on.
  • Getting the patient to change status part way through the scenario is a good way of testing whether this kind of information will be added to the PRF to show the change.
  • This article assumes that you've already taught them the basic aspects of you PRF and what information should go in which box.
  • Try to get the pairs to go round more than once as this will help them see how much has changed since they last treated and wrote on the PRF.
  • If you need smaller groups, why not run multiple scenarios at the same time?

Comments: Have you tried this idea out? Let us know how it went or give us your top tips to make it work well! If you are logged in, your usename will be assigned to the comment.

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