Abstract

Experiential learning deficits in newly licensed registered nurses (RNs) may extend to deficits in clinical judgment, particularly in recognizing cues of patient deterioration. The purpose of this quantitative, pretest posttest quality improvement project was to determine if and to what degree the implementation of QSEN education with simulation for nurses impacts clinical judgment and frequency of documentation of deterioration parameters in an acute care hospital in southeastern Pennsylvania. Benner's novice to expert theory and Tanner's clinical judgment model supported the framework for this project. Thirty-three nurses in residency participated in a didactic session on the QSEN competencies and an unfolding high-fidelity simulation scenario featuring a deteriorating patient. The Lasater Clinical Judgment Rubric (LCJR) was used to evaluate clinical judgment ability during the simulation. Correlational analysis using Pearson's r with two pairs of data points established a relationship between project interventions and the impact on clinical practice. The first pair included a post-test score completed after simulation and the tallied LCJR score (p = .000, r-value = 1, and the coefficient = .950). The second pair reflected a practice change by correlating an increased frequency of documentation of specific deterioration parameters prior to and after project interventions (p = .000, r-value = 1, and the coefficient = -.510). Based on the findings, the integration of a mandated competency devoted to cue recognition is recommended at the project site.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 27963658; ProQuest document ID: 2406476827. The author still retains copyright.

Notes

Tool(s) Used: Lasater Clinical Judgment Rubric, Benner's Novice to Expert Theory, and Tanner's Clinical Judgment Model

Author Details

Patricia K. Schmehl, DNP, RN

Sigma Membership

Nu Upsilon

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Quantitative Research

Keywords:

Novice Nurses, High-Fidelity Simulation, Quality and Safety Education for Nurses (QSEN)

Advisor

Tabitha Garbart

Second Advisor

Linda Seasholtz

Degree

DNP

Degree Grantor

Grand Canyon University

Degree Year

2019

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2021-09-03

Full Text of Presentation

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