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Mary Verklan


This study advances the understanding of essential clinical knowledge skillsets that nurses need to identify and respond to early signs of patient deterioration. The identification of critical thinking and assessment skills that nurses require may support professional practice through improved nursing education curriculum or additions of necessary critical care skillsets. The purpose of this study, which was framed by Benner’s novice-to-expert model, was to identify and measure critical thinking skills that influence a nurse’s ability to detect deterioration in patients and call the rapid response system (RRS). The research questions addressed the relationship between a nurse’s clinical or reasoning skill set and the decision to activate RRS, as measured by INSIGHT Health Professional clinical assessment tool. A multiple regression analysis was conducted to evaluate clinical nurses’ critical thinking and clinical assessment skills. The study evaluated 37 nurses’ expertise in clinical reasoning by measuring 8 indicators of reasoning skills. Among nurse participants in this study, 68% had the clinical ladder designation Clinical Nurse-2 (CN-2), and 16% were designated as Clinical Nurse-1 (CN-1). CN-2 participants were 10 times more likely to call RRS as compared to CN-1 participants, with an odds ratio = 10.83. The findings demonstrated that clinical ladder rank was significant for calling RRS (p = 0.047). The study helped to identify critical factors that affect early recognition of patient decompensation, thereby improving patient safety, and collegial respect and social change through improved nursing clinical skills.

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