Clinical deterioration is a serious physiologic disturbance or a sudden worsening patient condition increasing the risk of morbidity and mortality (Jones et al., 2013). Clinical deterioration compromises hemodynamic stability and produces marked physiological decompensation (Padilla & Mayo, 2017). Patients often exhibit physiological signs several hours or more before decompensation is readily apparent (Andersen et al., 2016; Khanna et al., 2019). The need for early recognition of clinical deterioration has been well-identified and documented (Ashbeck et al., 2021). Increasing time duration from the onset of clinical deterioration to intervention is associated with increased resuscitation and critical care requirements, the presence of end-organ dysfunction, and high mortality (Jones et al., 2013; Padilla & Mayo, 2018; Whebell et al., 2020). Successful recognition and rapid intervention of clinical deterioration require synergistic parity between nurse competence, clinical judgment, and a confident response to improve patient outcomes (Clayton, 2019).

An on-demand asynchronous course of didactic instruction coupled with distance simulation was devised to offer bedside nurse providers readily applicable knowledge and skills to rapidly recognize and appropriately intervene during episodes of patient clinical deterioration. A resource-sparing, low-cost, convenient, low-fidelity virtual case study simulation was designed to provide budget and staff-constrained education departments with an alternative platform of didactic instruction and application of skills direct to the clinical site for in-service training or as a part of a formal education curriculum. A video-streamed 2-hour block of instruction viewed conveniently by learners was envisioned and herein offered to develop deep knowledge, exercise skills, and practice critical thinking responses to patient clinical deterioration.

Date of publication

Spring 4-28-2023

Document Type

DNP Scholarly Project



Persistent identifier


Committee members

Cheryl D. Parker, PhD, RN (faculty mentor), Christine S. Gipson, PhD, RN (industry mentor), Janice Hawes, DNP, RN (committee member), Lauri John, PhD, RN (program director)


Doctor of Nursing Practice

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