Improving recognition of early clinical decline: Determining reliability and validity of the Garvey clinical warning curves.

BACKGROUND: New graduate nurses have difficulty recognizing and managing the early signs of clinical decline, resulting in a Failure to Rescue (FTR) event and preventable patient death. To address this gap, Garvey developed a series of Clinical Warning Curves as an instructional tool for new graduate nurses in an academic medical center. The Garvey Clinical Warning Curve models depict the progression of clinical changes in six body systems that occur before cardiac arrest. AIMS: The purpose of this study was to establish the content validity, reliability, and usability of the Garvey Clinical Warning Curves among healthcare experts and new-graduate nurses. METHODS: The current study was a cross-sectional, observational, validation survey design. Content experts used the content validity index (CVI) to evaluate the Curves. RESULTS: All but the temperature curves were rated as "acceptable" (CVI >0.60) for relevance, clarity, and ambiguity. The new graduate nurses who reviewed the case studies and placed patients onto the Clinical Warning Curves did so similarly, generating high intraclass correlation (ICC) scores. The usability survey components measured the perceptions of acceptability, appropriateness, and feasibility for the use of the six Clinical Warning Curves in practice settings. All components of the Curves had an average score of 4.0 or greater except for the level of complexity which scored 3.88. LINKING EVIDENCE TO ACTION: The Garvey Clinical Warning Curves emerged as valid and reliable tools that aid new graduate nurses in recognizing subtle signs of clinical decline. Because timely recognition and communication of clinical decline are key to preventing FTR events and avoiding patient deaths, it would be beneficial to provide the Clinical Warning Curves as a bedside resource for new graduate nurses during their orientation to the unit or within a nurse residency program.

Failure to Rescue: The Nurse's Impact.

Failure to rescue is a major cause of mortality in acute care settings. Several factors contribute to this problem, and nurses hold a significant key to addressing the issue. Using bell curves to analyze patient assessment data enables nurses to recognize indicators of impending crisis and act expediently to safeguard the health of the patient.

Collaborative and Interprofessional Educational Program to Maintain Trauma-Focused Education During the COVID-19 Pandemic.

Failure to rescue is prevalent among patients with traumatic injury who are admitted to medical-surgical units. These units are traditionally staffed by new graduate nurses who require mentorship and ongoing continuing education. The coronavirus disease 2019 (COVID-19) pandemic prompted nurse educators to develop and implement new methods of providing routine and just-in-time education in the hospital setting. This article describes a trauma-focused educational program with live sessions and online educational activities created with survey software. [J Contin Educ Nurs. 2023;54(6):275-280.].

Rising to the COVID-19 Challenge: Creating a Remote Experiential Simulation.

This article will describe the creation and implementation of a remote learning failure to rescue (FTR) class with remote experiential simulation technology into a nurse residency program. The COVID-19 pandemic impacted traditional delivery methods for education within nurse residency programs. Following is the background of this hospital's nurse residency program and FTR curriculum and a description of the creation and implementation of a remote FTR class using internally developed remote experiential simulation technology.