Graduation Year


Degree Type

Open Access Capstone

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



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Baccalaureate and Graduate Nursing

First Advisor

Donna J. Corley

Department Affiliation

Baccalaureate and Graduate Nursing

Second Advisor

Mary Clements

Department Affiliation

Baccalaureate and Graduate Nursing


Failure to monitor early warning signs of patient deterioration can result in cardiopulmonary arrests and patient death. Implementation of team building programs emphasizing vital sign data, with consistent monitoring and trending have demonstrated positive outcomes in multiple health care environments. This project implemented TeamSTEPPS© education for 23 registered nurse (RN) residents in an acute care medical center. Specific aims included: (a) increased knowledge of team communication techniques; (b) improved attitudes towards vital sign monitoring, especially respiratory rate assessment; and (c) improved attitudes towards early rapid response system activation. The education program included support tools, behavioral-modeling, simulation exercises based on de-identified patient data and debriefing. Paired t-tests evaluated the impact of the intervention on total TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and V-Scale scores. There were statistically significant increases in T-TAQ and V-Scale scores post intervention (1.78 p =.04 and 1.87 p = .04 respectively). Eta square calculation indicated a large effect size for T-TAQ and V-Scale measures. The TeamSTEPPS simulation-enhanced curriculum was successful in improving RN residents’ attitudes toward teamwork, and vital signs monitoring and surveillance practices.



This project would not be possible without the vision, expertise, and guidance of my DNP Project Committee: Dr. Donna Corley (chair) and Dr. Mary Clements. Sincere gratitude is extended to Saint Joseph Hospital in Lexington, Kentucky for support of this project. Heartfelt appreciation is also extended to my mentor, Chris Slaughter, for her unwavering dedication to patient safety. Lastly, I would like to express a personal note of gratitude to my husband, Mark, for his love and encouragement on this journey.

Included in

Nursing Commons