Purpose/Objectives:
The purpose of this project was to improve patient outcomes through an education program to enhance novice nurses' (<1-year clinical experience) ability to recognize clinical changes in patient conditions requiring Rapid Response Team (RRT) notification. A secondary goal was to utilize the situation, background, assessment, recommendation (SBAR) communication tool when initiating the RRT.
Significance:
Novice nurses lack the experience to detect the subtle clinical signs and symptoms exhibited by patients in distress. Research shows that most critical events are preceded by warning signs from an average of 6 to 7 hours.
Background/Rationale:
Nursing staff knowledge regarding clinical criteria necessitating RRT notification and content/process expertise with SBAR was measured using pretests and posttests. Additional measured outcomes included the number of RRT notifications preceding and 3 months following the education sessions.
Description:
Education sessions were implemented for staff registered nurses 2 days per week, 4 sessions per day for 30 to 45 minutes over a 3-month period. Content for education sessions included RRT notification criteria, review of normal vital signs, SBAR content/utilization, and clinical scenarios with question/answer dialogue.
Outcome:
Target outcomes included the number of RRT notifications and descriptive data from residents related to nurse-to-physician verbal communication. Data were collected for 3 months preceding the education session intervention and were compared with outcomes data collected for 3 months postintervention. Data analysis revealed an increase in the number of average monthly RRT notifications from 13 to 22 monthly on 1 unit and from 8 to 13 on another unit. Verbal feedback collected from medical residents by the student clinical nurse specialist during daily rounds reported improved SBAR communication from nursing staff during RRT notification.
Interpretation/Conclusion:
The education sessions were successful in increasing nurses' knowledge on clinical signs warranting activation of the RRT. The SBAR tool enhanced communication quality between physicians and nurses.
Implications for Practice:
Inexperienced nurses are likely to be intimidated and second guess their clinical instincts. It is necessary to provide education and resources that may be used until novice nurses develop accurate clinical judgment and expert intuition.
Section Description
The journal is proud to share the student abstracts accepted for poster presentation at the 2010 National Association of Clinical Nurse Specialists Conference. These abstracts are submitted under a separate, later deadline and therefore did not appear in the journal with the general abstracts. Congratulations to these CNS students and their faculty mentors.