Telephone escalation for worsening infection
RN OSCE practice station

The task

You are the RN on a hospital ward. Yusuf Ali, aged 71, is being treated for a suspected infection and has become more unwell. At 09:00 he was alert, BP 118/70, HR 92, RR 20, SpO2 96% room air and temperature 38.0°C. Assess current urgency, telephone the doctor using ISBAR and document the response. Complete the supplied practice record. Speak to the patient and describe each assessment as you perform it. A second RN is available. The doctor can be telephoned. You have eight minutes; describe and select physical actions in this online exercise.

What this station tests

• Yusuf’s hypotension, confusion and oliguria require MET alongside the doctor call.
• State suspected sepsis with shock and the change from 09:00 explicitly.
• Communicate the penicillin rash before antibiotic decisions.
• Read back real instructions and re-escalate a delayed response.

Sources for the clinical content

• ACSQHC: Communicating for Safety Standard
• ACSQHC: Recognising and Responding to Acute Deterioration Standard
• ACSQHC: Sepsis Clinical Care Standard
• TSANZ position statement: acute oxygen use in adults

An original practice scenario with invented patients. Not an exam question.

Practise next

• Calling from a clinic about sudden breathlessness
• RN handover after a minor head injury
• Shift handover for a resident with acute confusion
• Calling for a child with increasing oxygen needs
• Telephone escalation of a falling neurological score