Reference Number
Version
N/A
4
Name of responsible (ratifying) committee PHT Resuscitation Committee
Date ratified 02 October 2015
Document Manager (job title)
Date issued
Review date
Electronic location
Related Procedural Documents
Key Words (to aid with searching)
Resuscitation Officer
15 December 2015
01 October 2017 (unless guidelines change)
Corporate Clinical Guidelines
Cardiopulmonary Resuscitation Policy
Generic Competency Framework for Registered and
Unregistered Practitioners
Cascade training; basic life support; resuscitation; elearning; eMOT’s; anaphylaxis; trainer; cardiopulmonary; CPR; Competency
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 1 of 12

CONTENTS
QUICK REFERENCE GUIDE ...................................................................................................... 3
1.
INTRODUCTION ......................................................................................................................... 4
2.
PURPOSE ................................................................................................................................... 4
3.
SCOPE ........................................................................................................................................ 4
4.
DEFINITIONS .............................................................................................................................. 5
5.
DUTIES AND RESPONSIBILITIES .............................................................................................. 5
6.
PROCESS ................................................................................................................................... 7
7.
TRAINING REQUIREMENTS ...................................................................................................... 8
8.
REFERENCES AND ASSOCIATED DOCUMENTATION ............................................................ 8
9.
MONITORING COMPLIANCE WITH, AND THE EFFECTIVENESS OF, PROCEDURAL
DOCUMENTS .............................................................................................................................. 9
10. EQUALITY IMPACT STATEMENT
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 2 of 12

This Guideline must be followed in full to ensure effective Cascade Resuscitation Training is carried out by appropriately trained Cascade Trainers.
For quick reference the guide below is a summary of actions required. This does not negate the need for staff to be aware of and follow the detail of the guideline.
1. The Cascade Resuscitation Training Guideline was formulated to ensure that quality and standards are protected by ensuring that resuscitation training is carried out in a consistent manner.
2. The Resuscitation Dept will keep a record of all training carried out by cascade trainers using the Electronic Staff Record system.
3. Cascade resuscitation training will provide another means of staff achieving their essential skills requirements.
4. The type of training carried out and the clinical areas covered depends on the speciality and experience of the cascade trainer.
5. Prospective cascade trainers will be required to observe training carried out by a
Resuscitation Officer and in turn the Resuscitation Officer will observe the Cascade
Trainer undertaking their own training session.
6. Each Cascade Trainer will be allocated a link Resuscitation Officer. The Resuscitation
Officer will provide advice, support and feedback and inform the cascade trainer of any changes to local or national guidelines/policies.
7. Cascade Trainers will provide the Resuscitation Department with details of all training sessions and attendance records.
8. The Resuscitation Department will keep a log of current cascade resuscitation trainers.
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 3 of 12

The Resuscitation Council document, Standards for Clinical Practice and Training (updated
2013) states that all clinical staff should receive annual resuscitation training appropriate for their level of responsibility. At a local level, the Cardiopulmonary Resuscitation policy
(Clinical Policies) also states that all clinical staff should have annual resuscitation training.
The Resuscitation Department may delegate this responsibility to other appropriately trained personnel. The Cascade Resuscitation Training Guideline was formulated to ensure that quality and standards are protected by ensuring that training is carried out in a consistent manner and in accordance with current national and Trust resuscitation guidelines/policies
The purpose of this guideline is:

To ensure that cascade resuscitation training is carried out by appropriately trained personnel

To protect and maintain the quality and standards of resuscitation training

To ensure the content and method of training is consistent and in accordance with current national and Trust guidelines/policies

To enable the Resuscitation Department to keep an accurate record of training delivered

To enhance access to training for clinical staff
The following types of training can be carried out as cascade training

Adult Basic Life Support (2 hour classroom)

Paediatric Basic Life Support (Infant and Child) (1 hour classroom)

Newborn Life Support (1 hour classroom)

Anaphylaxis (1 hour classroom)

Adult BLS Part 2 (skills assessment) within 3 months of Part 1 (online module). This is a 15min individual face to face skills assessment
The following clinical areas can carry out cascade training (as appropriate for their patient group)

Department of Critical Care

Cardiac Care Unit

Emergency Department

Theatres

Paediatric Department

Newborn Unit

Maternity Department

Other clinical areas as agreed on an individual basis with the Resuscitation
Department
‘In the event of an infection outbreak, flu pandemic or major incident, the Trust recognises that it may not be possible to adhere to all aspects of this document. In such circumstances, staff should take advice from their manager and all possible action must be taken to maintain ongoi ng patient and staff safety’
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 4 of 12

For the purposes of resuscitation, the following definitions apply:

Adult - From puberty onwards

Paediatric - Includes infant and child

Infant - 0-1 years of age

Child - 1 year to puberty

Neonate - For the purpose of this guideline a neonate is any infant cared for within the
Maternity Unit or Neonatal Intensive Care Unit regardless of age. For other areas within the organisation the neonate is a baby below 29 days of age.

BLS - Basic Life Support

ALS - Advanced Life Support

EPLS - European Paediatric Life Support

APLS - Advanced Paediatric Life Support

NLS - Newborn Life Support

Adult BLS Part 1 & 2 - Two parts, Part 1 is an E-learning package with a minimum pass mark of 75%, Part 2 is a 15 minute 15min individual face to face skills assessment of BLS skills within 3 months of Part 1.
Chief Executive
The Chief Executive has ultimate responsibility for Corporate Governance; including ensuring processes are in place to support good procedural document management.
Trust Board
The Trust Board members have overall responsibility for ensuring that, through good procedural document management, the organisation complies with all legal, statutory and good practice requirements.
Governance and Quality Committee for PHT
The Governance and Quality Committee members are responsible for ensuring that appropriate action is taken to ensure all procedural documents are in date for PHT. To fulfil this responsibility the Committee will receive annual reports from the PHT Resuscitation
Committee.
The PHT Resuscitation Committee
The PHT Resuscitation Committee members are responsible for ensuring that:
This procedural document is in place and for providing assurance to the Governance and
Quality Committee through the provision of an annual report, including any necessary recommendations to address identified deficits. The Committee members will also supply advice to the author of this procedural document, as required;
Appropriate approval is given, and the appropriate author identified, for the development of any new, or the revision of this policy;
An appropriate author is assigned responsibility for development of this policy and they follow the Policy for the Development and Management of Procedural Documents;
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 5 of 12

Procedural documents referred to them are assessed against the standards set out in the
Policy for the Development and Management of Procedural Documents and document authors are advised accordingly;
Consultation with appropriate stakeholders has occurred and a consensus view reached;
The procedural document is technically accurate and in line with evidence based best practice;
An accurate record is kept of discussion and approval of the procedural documented is recorded in the minutes of the meeting. These minutes must be available upon request;
Processes to enable an audit of compliance with the procedural document are detailed in the document;
Ratified Trust procedural documents are forwarded to the Trust Policy Officer (TPO), together with required accompanying documentation as per Policy for the Development and
Management of Procedural Documents.
The Resuscitation Department Staff
The Resuscitation Officers are responsible for ensuring that:
Resuscitation training delivered adheres to the current Resuscitation Council (UK) guidelines and incorporates current PHT VitalPAC Early Warning Scoring System (ViEWS) processes for the identification of at risk patients, including the systems for summoning help, and DNACPR decision making;
Cascade trainers are provided with appropriate training and support to undertake the role and that cascade trainers have their sessions reviewed annually.
They sign off the relevant Competency Statements to at least level 3 for Cascade Trainers.
Cascade Trainers are aware of Infection control practices with regard to cleaning and maintenance of manikins.
The Resuscitation Administration staff are responsible for ensuring that:
The attendance records returned by the Cascade Training staff are entered onto ESR.
The Resus Admin Team are kept informed of the status of current Cascade Resuscitation
Trainers so that they keep the log up to date.
PHT Cascade Resuscitation Training Staff
All Cascade Resuscitation Trainers are responsible for ensuring that they:
Remain in date with their own resuscitation training. ILS, ALS, APLS and EPLS Instructors automatically remain in date for the relevant type of training for as long as they have current
Instructor Status and keep the Resuscitation Admin Team informed of courses they teach on outside of PHT.
Cooperate and comply with the implementation of this guideline;
Inform the Resuscitation Department of training dates and return attendance records to the
Resuscitation Department.
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 6 of 12

When carrying out e-MOT assessments, the Cascade Trainer must make efforts to ensure the candidate has successfully completed part 1 within 3 months of undertaking part 2 of the assessment.
Raise any queries about implementation of this guideline with their link Resuscitation
Officer. These queries should then be discussed at the appropriate forum and then documented in the relevant minutes. This will either be with the Resuscitation Manager,
Resuscitation Link Network meeting, the PHT Resuscitation Committee or at the Trust
Governance and Quality Committee;
Cascade Trainers deemed to be competent to at least level 3 in the skill they are teaching, should then sign the relevant Competency Statements to the appropriate level for their candidates. See the Generic Competency Framework for Registered and Unregistered
Practitioners (N&M Policies)
A Resuscitation Officer will observe the Cascade Trainer carrying out a relevant cascade training session annually.
Keep their link Resuscitation Officer informed of updates to their Cascade Resuscitation
Trainer status so that the Cascade Resuscitation log can be kept up to date.
.
Staff interested in becoming a cascade trainer should contact the resuscitation department.
A Resuscitation Officer will then ensure that they possess the relevant experience/skills.
Each cascade trainer will have a link Resuscitation Officer allocated to them.
If the prospective cascade trainer intends to provide full BLS and/or anaphylaxis sessions, they must observe a minimum of two classroom based BLS or anaphylaxis sessions as appropriate (1 session for current ALS/EPLS/APLS Instructors) by different Resuscitation
Officers.
If the prospective cascade resuscitation trainer is going to be doing BLS e-MOT Part 2 assessments then they must observe a minimum of one classroom based BLS and then one
BLS e-MOT Part 2 assessment session, instead of the 2 classroom sessions stated above.
They will use the relevant lesson plan as guidance and the prospective cascade resuscitation trainer will maintain their own record of this contact.
For their records, the link RO will also be informed that these two observations have occurred.
The cascade trainer will then be observed providing a relevant training session. The
Resuscitation Officer will provide advice, support and feedback. On an annual basis, a
Resuscitation Officer will observe and peer review the cascade trainer providing a training session.
The Resuscitation Officer will inform the cascade trainer of any changes to national or local guidelines/polices which affect the training
If a candidate does not achieve the learning objectives stated in the relevant lesson plan, the Resuscitation Departments Record Form for this purpose should be completed and actioned. (Form available on intranet or from Resuscitation Dept)
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 7 of 12

All cascade training that has been delivered must be recorded on a registration form which must then be returned to the Resus Admin Team so that the training can be recorded onto
ESR
A log of current cascade resuscitation trainers will be maintained on the Resuscitation
Department intranet site – General – Cascade Training. It is the current cascade resuscitation trainer s and link RO’s responsibility to keep the Resuscitation Admin team up to date on who should be on this log.
All relevant documentation is available on the intranet or from the resuscitation department
Cascade trainers must hold a relevant teaching qualification e.g. E.N.B 998/C&G
730/PGCE/BTEC in Education and Training
Cascade trainers must be deemed competent in relevant type of training by the
Resuscitation Officer (RO) on an annual basis. They will be signed off to Level 3 of the relevant Competency Statement.
Trainers must observe a minimum of two BLS sessions (1 session for current
ALS/EPLS/APLS Instructors) by different RO’s.
Trainers must read and demonstrate an understanding of the appropriate lesson plan
(available from Resuscitation Dept or Intranet) and current relevant Trust policies and adhere to these in their training sessions.
Trainers must demonstrate an understanding of infection control precautions, and maintenance of manikins
On an annual basis, a Resuscitation Officer will observe and peer review the cascade trainer providing a BLS/MOT/Anaphylaxis session as appropriate.
1.
Resuscitation Council (UK) (Updated 2013) CPR Standards for Clinical Practice and
Training. http://www.resus.org.uk/pages/standard.htm
2.
Current PHT Cardiopulmonary Resuscitation Including Anaphylaxis & Defibrillation
Policy. Cardiopulmanary Resuscitation Policy Including Anaphylaxis & Defibrillation
3. Current Generic Competency Framework for Registered and Unregistered Practitioners.
Generic Competency Framework
ASSOCIATED DOCUMENTATION / REFERENCES (including related policies and procedures) .
The following documents are stored in the Cascade Training Folder can be found on the intranet. Go to Departments – Resuscitation – General – Cascade Training for the most recent versions Cascade Training Documents

Adult Basic Life Support Lesson Plan
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 8 of 12


Paediatric Basic Life Support Lesson Plan

Newborn Life Support Lesson Plan

Peer Observation of Teaching Session Feedback Pro Forma

Best Practice Evaluation Form

Record Form for Candidates Who Do Not achieve Learning Objectives

Flow Chart for Candidates Who Do Not achieve Learning Objectives

Training Registration Form
Obtained from the Resuscitation Department

Cascade Adult Basic Life Support Certificate of Attendance

Cascade Paediatric Basic Life Support Certificate of Attendance

Newborn Life Support Certificate
Compliance and effectiveness will be monitored by;
Annually a Resuscitation Officer will observe and peer review the cascade trainer providing a training session
Ensuring the cascade trainer adheres to the lesson plan through use of peer reviews.
Candidate led course evaluations to be carried out on 10% of training sessions provided by the cascade Trainer.
Portsmouth Hospitals NHS Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds.
This guideline has been assessed accordingly
Our values are the core of what Portsmouth Hospitals NHS Trust is and what we cherish.
They are beliefs that manifest in the behaviours our employees display in the workplace.
Our Values were developed after listening to our staff. They bring the Trust closer to its vision to be the best hospital, providing the best care by the best people and ensure that our patients are at the centre of all we do.
We are committed to promoting a culture founded on these values which form the ‘heart’ of our Trust:
Respect and dignity
Quality of care
Working together
No waste
This policy should be read and implemented with the Trust Values in mind at all times.
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 9 of 12

To be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval for service and policy changes/amendments.
Stage 1 - Screening
Title of Procedural Document: Cascade Resuscitation Training Guideline
Date of assessment 9/10/2015 Responsible
Department
Resuscitation Committee
Bev Stockwell Job Title Resuscitation Officer Name of person completing assessment
Does the policy/function affect one group less or more favourably than another on the basis of :

Age

Disability
Learning disability; physical disability; sensory impairment and/or mental health problems e.g. dementia

Ethnic Origin (including gypsies and travellers)

Gender reassignment

Pregnancy or Maternity

Race

Sex

Religion and Belief

Sexual Orientation
If the answer to all of the above questions is NO, the EIA is complete. If YES, a full impact assessment is required: go on to stage 2, page 2
Yes/No
No
No
No
No
No
No
No
No
No
Comments
More Information can be found be following the link below www.legislation.gov.uk/ukpga/2010/15/contents
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 10 of 12

Stage 2
– Full Impact Assessment
What is the impact Level of
Impact
Mitigating Actions
(what needs to be done to minimise / remove the impact)
Responsible
Officer
Monitoring of Actions
The monitoring of actions to mitigate any impact will be undertaken at the appropriate level
Specialty Procedural Document: Specialty Governance Committee
Clinical Service Centre Procedural Document: Clinical Service Centre Governance Committee
Corporate Procedural Document: Relevant Corporate Committee
All actions will be further monitored as part of reporting schedule to the Equality and Diversity
Committee
Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 11 of 12

Cascade Resuscitation Training Guideline
Version: 4
Issue Date: 15 December 2015
Review Date: 01 October 2017 (unless requirements change) Page 12 of 12