Date of Conferral

2022

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Francisca Farrar

Abstract

Failure to recognize early warning signs of clinical deterioration can cause critical complications and a sentinel event with legal implications. These complications are preventable if nurses have evidence-based guidelines to guide their critical thinking to identify early warning signs. The purpose of this project was to close this gap by developing a Clinical Practice guideline for identifying early warning signs of clinical deterioration for the rehabilitation center. The clinical practice question addressed what evidence supported the development of a clinical guideline for nurses to recognize early warning signs of a deteriorating patient improve the quality of care of patients at risk for deterioration. The adult learning theory was used as a guiding framework. Johns Hopkins Nursing evidence-based practice framework was used to grade the literature for inclusion. The literature was synthesized for development of the guidelines. Six rehabilitation nurses comprised the expert panel and appraised the content of the developed guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) II tool answering a six-domain questionnaire. Descriptive statistics were used to analyze the six questions. The mean score was 97.6%. The final approved guidelines were presented to the stakeholders and end users who approved the guidelines. The guidelines were handed off to the Director of Nursing, who plans to have an in-service on the guidelines. The Clinical Guidelines for Identifying Early Warning Signs of Clinical Deterioration provides an evidence-based guideline to prevent failure to recognize early warning and creates an environment of safety, quality, accountability, positive patient outcomes, and positive social change.

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