Background: Failure to Rescue (FTR) is an important contributor to patient morbidity and mortality. Despite interventions described in the literature the problem of FTR persists.
Purpose/Specific Aims: This project aimed to determine the effectiveness of an educational intervention on improved performance related to clinical judgment, and situational awareness in critical scenarios.
Methods This project involved a mixed-method pre- and post-assessment quality improvement design with a sample of 21 senior nursing students at a Southern New England Community College. Pre- and post-intervention data was collected using a nine-item, author-developed tool designed to assess students' levels of knowledge and confidence in the areas of the concept of FTR, skill in clinical judgment, and level of situational awareness. Additionally, the Creighton Competency Evaluation Instrument (CCEI) was used during simulations, providing additional quantitative data on student performance. The Debriefing for Meaningful Learning (DML) method was used to extrapolate the reflections and themes post-simulation.
Results: Post-assessment using the Wilcoxon Signed-Rank Test demonstrated a statistically significant increase in understanding of the FTR as well as clinical judgment and situational awareness across four of the nine questions surveyed.
Conclusion: Strategies to foster clinical judgment and situational awareness should be incorporated throughout nursing education in academic and practice settings. High-fidelity simulation appears to be a safe and effective pedagogy for the ongoing development of clinical judgment and decision-making skills.
