An evidence-based practice project for recognition of clinical deterioration: Utilization of simulation-based education




Bell-Gordon, Charyll
Gigliotti, Elizabeth
Mitchell, Katy

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Sciedu Press


BACKGROUND: As more complex patients are hospitalized, the need for highly skilled and competent nurses to recognize clinical deterioration becomes more apparent. The literature supports the use of simulation-based education to enhance the recognition of clinical deterioration. The purpose of this evidence-based practice project was to utilize simulation as an educational modality to improve the knowledge of registered nurses in the recognition of clinical deterioration among their patients.

METHODS: This evidence-based practice project was conducted from May through June 2013 in a 900-bed facility. Participation was voluntary and included 15 medical-surgical, procedural, and post-anesthesia care unit registered nurses. Simulation-based education was utilized for assessing the recognition, management, and reporting of clinical deterioration by nurses while supporting learning in a safe environment. Each participant managed two simulated patients in deteriorating states. Baseline performance was obtained during the initial simulation scenario by utilizing RAPIDS, a validated tool that evaluates assessment, management, and clinical deterioration reporting. A post-simulation debriefing and education session occurred that included a review of all required critical action elements. Debriefing was followed by a second post-intervention simulated clinical deterioration scenario.

RESULTS: The results indicated statistically significant improvement in mean assessment and management scores when the post-intervention results were compared with baseline [t (14) =2.04, p = .03]. Post-intervention reporting scores were also improved, although this change was not statistically significant.

CONCLUSIONS: Simulation-based education may be an effective strategy for impacting a nurse’s ability to recognize clinical deterioration and thereby allow for timely intervention.


Article originally published in Journal of Nursing Education and Practice, 4(6), 69. English. Published online 2014.


Clinical deterioration, Simulation, Evidence-based practice, Registered nurse, RAPIDS


This is a published version of an article that is available at Recommended citation: Bell-Gordon, C., Gigliotti, E., & Mitchell, K. (2014). An evidence-based practice project for recognition of clinical deterioration: Utilization of simulation-based education. Journal of Nursing Education and Practice, 4(6), 69. This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.