Example Guidelines for using the R. E. S. T Algorithm
Rest education area from student training
Background to Algorithm:
The REST algorithm supports the decision making process when considering:
- Reduction of student numbers in a clinical area.
- Maintenance of student numbers but with an improvement action plan in place.
- Allowing the clinical area an agreed period of time without students; and an improvement action plan for a return to the placement circuit.
This process will start with an identified trigger, such as those examples in Appendix 1 that potentially compromises the quality of the student learning experience in placement. This does Not include minor issues thatwould be managed locally.
The REST process requires both Trust and HEI senior management support.
The REST Algorithm Flowchart:
Triggers identified by Student/Client/Manager/Clinician/Academic
Issue is reported to the clinical lead and / or PEM/PEF/ University representative
A REST meeting arranged within 48 hours of the issue being raised
Membership of the REST meeting would usually be:
University Representative / Programme Lead
Trust Education Lead
PEM/ PEF
Borough Lead Nurse
An action plan is agreed and recorded on the REST Action Plan template (See Appendix 2)
The agreed action plan shouldalso be recorded on the relevant Education Audit
An agreed circulation list is identified at the REST meeting and recorded in the Action plan. The circulation list might include, the HEI allocations manager to alert the HEI flagging system, The HEI Practice Advisory Committee or equivalent. Please note these are suggestions and not an exhaustive list.
There are two possible outcomes:
(i)Students remain in the clinical area (possibly with a reduction in the number allocated)
With an action plan in place. This will be monitored for completion.
(ii)The clinical area is rested from supporting students. An action plan is implemented followed by a new education audit undertaken in partnership by the Trust and HEI, before the return to the placement circuit.
Both action plans should have regular reviews and be time limited. Additional REST meetings may need to be convened to support this process.
Appendix 1
REST Triggers*
*This is not an exhaustive list – A number of triggers may occur at the same time
Different organisations may rank triggers differently.
- Manager or Deputy manager not in post
- Indications from soft intelligence – e.g. Student evaluation comments, corroborated with additional information
- Failure to improve on a previous action plan
- Reduction of number of mentors in a team
- A large percentage of nursing team on preceptorship
- Occurrence of a serious untoward incident
- Where levels of incidents exceed the Trust clinical governance targets
- Where student is identified as being at risk from a service user
- Where a nursing student has been admitted as a patient
- Where the CQC indicates standards have not been met
- Where a service review will place staff jobs at risk
- Anecdotal verbal comments from students confirmed by clinical manager/ staff
- Sickness levels of staff or turnover of staff in excess of Trust targets
- High use of Bank or agency staff
- Where Level of service user complaints exceed Trust targets
- Review of student portfolios raises concern of quality of assessment evidence recorded by mentors
- Mentors under investigation reduces level of support available to students
- Clinical lead makes request for non-allocation of students
- A clinical area has received a student whose skill level is poor, despite being passed on their previous placement
These Guidelines have been developed by LAMP. They are an example of what might be considered by Trusts and HEIs. Organisations are welcome to adopt these guidelines and the algorithm to their own management structure. But LAMP should be referenced.
Appendix 2
REST Action Plan Template
Issue / Action / By Whom / Review DateOutcome :
Circulation List