Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Meyer, Kim

Committee Member

Burckardt, Elizabeth

Author's Keywords

patient deterioration; failure to rescue; new graduate nurse; nurse residency; knowledge; confidence


Background: Failure to recognize patient deterioration is a problem in healthcare that can lead to poor patient outcomes. A novice skill level, knowledge gap, and lack of confidence are contributing factors. The nurse is the key individual who should recognize patient deterioration early and intervene appropriately. Setting: The project took place in a 246-bed hospital in Memphis, TN. The hospital is a magnet-recognized, comprehensive, acute care hospital that serves adult residents of the Raleigh-Bartlett area in North Shelby County and the surrounding areas. Purpose: The purpose of this quality improvement (QI) project was to educate new graduate nurses (NGN) who are in their first year of practice to increase their knowledge and confidence in recognizing the signs of patient deterioration and how to intervene appropriately. Methods: Data was collected on the number of MRT calls, the number of MRT calls resulting in the upgrade of patient care, and the number of codes outside the ICU. Pre- and post-intervention, the NGNs completed a basic demographic form, a multiple-choice knowledge questionnaire, and a self-confidence survey. Results: The increased scores of the knowledge assessment and self-confidence survey showed statistical significance. There were no significant changes in MRT calls, calls resulting in an upgrade of care, or codes outside the ICU. Discussion: This QI project supports further studies to increase NGN's knowledge and confidence using didactic education, although it did not affect MRT call rates.