Date of Award

Summer 2022

Document Type

Project – Full Written

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Gayle Casterline


Quick recognition and response to clinical deterioration have a significant impact on patient mortality and outcomes. Nurses’ confidence in their ability to recognize signs and symptoms of deterioration and activate rapid response teams (RRT) is vital in preventing code blues and transfers to a higher level of care. The objective of this project was to determine the effect of an educational intervention on nurse acknowledgment of the deterioration index score and nurse confidence in intervening to improve patient outcomes by alerting the Rapid Response Team (RRT) within two months for adult patients on a medical-surgical unit. Findings from the project revealed nurses’ confidence improved in recognizing and responding, and assessing for clinical deterioration, but did not improve nurse confidence in intervening and evaluating interventions. The deterioration index (DI) score best practice advisory (BPA) acknowledgment did not improve post-educational intervention as nurses dismissed 100% of the BPAs. Rapid response team calls slightly improved by 10% post-intervention than pre-intervention with slightly less patients requiring transfer to a higher level of care. Staffing shortages and years of experience may have influenced the nurse’s ability to effectively recognize and respond to clinical changes. Without proper training and support nurses’ confidence in recognizing and responding to deterioration may be delayed, resulting in unwanted patient outcomes. Although this project did not produce the intended outcomes, it did identify an opportunity to improve internal training and enhance the current process.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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Nursing Commons