Date of Award

Spring 5-1-2020

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


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First Advisor

Leslie Moore

Second Advisor

Sterling Roberts

Third Advisor

Laura Darby


Timely recognition of signs of impending clinical deterioration in acute care hospitalized patients can prevent an unexpected illness from becoming a fatal event. Failure to recognize the precursors of impending doom can have many factors, but the most influential of these is the role of the bedside nurse in detecting the subtle signs of decline. The Modified Early Warning Score (MEWS) has been used successfully to detect clinical deterioration in hospitalized patients, while simulation has been used successfully to provide an environment to test reaction to acute patient decline without harm to actual patients. A translational research project implemented the MEWS tool through an educational intervention that included simulated patient experiences. The aims of this project were to 1) increase awareness of bedside nurses to acute patient deterioration in the rural hospital setting and 2) increase action of bedside nurses to acute patient deterioration in the rural hospital setting. Results indicate that use of the MEWS increases nurses’ use of other deterioration screening tools as well as their knowledge and confidence in responding to a deterioration event. The usefulness of simulation as a method to provide education in post-licensure nurses is also discussed. Finally, the MEWS tool was shown to accurately predict patient deterioration of hospitalized clients if completed consistently. Future research should focus on how to increase usage of deterioration tools to detect acute clinical decline earlier in the deterioration process.

Included in

Nursing Commons