Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Carolyn Sipes

Abstract

The goal of healthcare organizations across the world is to provide safe, efficient healthcare for patients and their families. The practice problem for this DNP Project, a staff education project, addressed simulation as a strategy to improve clinical judgment in new graduate nurses. Recent studies have shown that 23% of new nurses do not demonstrate entry-level competency and are not as effective as more experienced nurses when making clinical judgment decisions. This lack of efficacy poses a threat to patient safety. This was based on nurse’s progression through Benner’s five levels of competency and was designed to enhance new graduate nurses’ clinical judgment, particularly related to their ability to care for patients when there is an acute change in their condition. The project’s theoretical framework was based on Tanner's clinical judgment model and the Synergy model. Six new graduate nurses participated in the training and completed the 15-question pre- and posttest. The test included both multiple-choice and true-or-false questions. A quantitative approach was used to determine the learning gained from the project by using Brigham and Women’s learning-gained tool. The data indicated the average learning gained from the training was 28.3%. The participants shared that the simulations helped them reflect on their strengths and weaknesses, and that they would be able to take the learning back to the bedside. A staff education manual was created so that new graduate nurses could follow a standardized method to identify changes in patient’s acuity and provide appropriate care. Increases in clinical judgment contribute to positive social change efforts such as organizational-wide patient safety through high quality care.

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