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Identifying Srnas Individual Learning Preferences Utilizing The Vark Learning Inventory Tool, James Eads May 2024

Identifying Srnas Individual Learning Preferences Utilizing The Vark Learning Inventory Tool, James Eads

Doctor of Nursing Practice Projects

Abstract

All graduates of a doctoral anesthesiology program are required to successfully pass the National Certifying Exam (NCE). Since 2011, the national average passage rate has decreased from 89.1% to 84.1% in 2021 (NBCRNA, 2023). Yamaguchi’s 2022 study revealed that students are positively impacted academically when they implement individual learning preferences. The purpose of this project was to identify individual learning preferences for students enrolled in the U.S. Army Nurse Anesthesiology program. The hypothesis was that students who recognize their preferred learning and incorporate preferred learning techniques would result in an increased percentage of passage rate scores for the NCE. …


Diversity In Nurse Anesthesia Education: Understanding The Perspective Of Racial-Ethnic Minority Nurse Anesthesia Students, Lorette Osun, Jeannette Ineza May 2023

Diversity In Nurse Anesthesia Education: Understanding The Perspective Of Racial-Ethnic Minority Nurse Anesthesia Students, Lorette Osun, Jeannette Ineza

Doctor of Nursing Practice Projects

The idea that race is not an issue, everyone is treated fairly, and the denial of racial differences is an act to refute that racism still perpetuates nursing education. Racial-ethnic minority student registered nurse anesthetists (SRNA) face unique challenges in their didactic and clinical training, including microaggressions, discrimination, and bias, all of which white students do not have to face during their educational experiences (Carter & McMillian-Bohler, 2020). Our project sought to highlight the lived experiences of ethnic minority student registered nurse anesthetists in the United States to bring awareness and effectuate change in nurse anesthesia education. Our Qualtrics survey …


Telehealth Integration In Primary Care, Ashley Simons May 2023

Telehealth Integration In Primary Care, Ashley Simons

Doctor of Nursing Practice Projects

Telehealth has been proven to be a useful and integral tool in primary care settings. Carlinville Family Health Care Clinic, a rural health clinic, has the current ability to conduct Telehealth visits but is not currently doing so. They have several programs available that are equipped with Telehealth capabilities. The physicians cite lack of education on these programs and lack of a standard streamlined practice for which program to use or how to use it.

According to the physicians in this practice, along with their patients, the use of Telehealth has multiple advantages. Because visits in this clinical are usually …


Utilizing Gastric Point-Of-Care Ultrasound Assessment For Patients With Questionable Npo Status, Carolina Botero May 2023

Utilizing Gastric Point-Of-Care Ultrasound Assessment For Patients With Questionable Npo Status, Carolina Botero

Doctor of Nursing Practice Projects

Perioperative aspiration is a rare but serious complication with high morbidity and mortality for patients. This event often occurs from anesthetic depression of protective airway reflexes. NPO guidelines are implemented before anesthesia to eliminate the presence of any gastric contents. However, patients with certain comorbidities may still persist with a full stomach before an anesthetic. Patients may complicate matters further by not following NPO instructions, the patient’s NPO status may be unknown, or the timing of surgery may prevent adequate NPO times. In these situations, the anesthesia provider is faced with the difficult decision to alter, delay or potentially cancel …


Advanced Care Planning In Primary Care, Kaylee Beals, Amanda Merriman May 2023

Advanced Care Planning In Primary Care, Kaylee Beals, Amanda Merriman

Doctor of Nursing Practice Projects

In Illinois, the do-not-resuscitate (DNR) form that is legally binding in all healthcare facilities is known as the Practitioner Orders for Life-Sustaining Treatment (POLST) form. The Patient Self-Determination Act (PSDA) of 1991 mandates only certain facilities to discuss advanced care planning (ACP). Primary care offices are not included in this mandate. Therefore, no structured process exists for primary care providers to identify patients who may benefit from ACP discussions. The purpose of this Doctor of Nursing Practice (DNP) project was to initiate conversations about ACP with patients 55 years and older in a primary care office and complete POLST forms …


Development Of Neuraxial Anesthesia Educational Videos For Nurse Anesthesia Students, Mackenzie Schutt, Kaylie Lajeunesse May 2023

Development Of Neuraxial Anesthesia Educational Videos For Nurse Anesthesia Students, Mackenzie Schutt, Kaylie Lajeunesse

Doctor of Nursing Practice Projects

Development of Neuraxial Anesthesia Educational Videos for Nurse Anesthesia Students

Kaylie LaJeunesse, BSN, RN, SRNA & Mackenzie Schutt, BSN, RN, SRNA

Performance and evaluation of anesthetic procedures, specifically neuraxial anesthesia, are core components of nurse anesthesia curriculums. Teaching methods must provide nurse anesthesia students with the proper tools and knowledge to perform skills confidently and proficiently. Traditional teaching methods have fallen short of providing the necessary instruction for optimal student success. Incorporating video-learning resources on neuraxial anesthesia into course curriculums can significantly improve nurse anesthesia practice by better-preparing students for the clinical setting. Video learning increases student engagement and facilitates …


Improving Traumatic Brain Injury Outcomes: Early Identification And Management Of Paroxysmal Sympathetic Hyperactivity, Randi Rockwell May 2023

Improving Traumatic Brain Injury Outcomes: Early Identification And Management Of Paroxysmal Sympathetic Hyperactivity, Randi Rockwell

Doctor of Nursing Practice Projects

Abstract

Background: Paroxysmal sympathetic hyperactivity (PSH) can occur in patients with acutely acquired brain injury and is associated with mortality, poor clinical outcomes, prolonged hospitalizations, physical disability, and increased healthcare costs. The most common cause of PSH syndrome is traumatic brain injury (TBI). Symptoms consist of hyperthermia, diaphoresis, arterial hypertension, tachycardia, tachypnea, and extremity motor dystonic posturing, often in response to evoked stimuli and occurs in 8% to 33% of TBI patients. Critical care nurses are at the forefront of providing direct patient care to TBI patients and are often the first to identify PSH.

Purpose: The objective of this …


Implementation Of A Glidescope Educational Program For Novice Student Registered Nurse Anesthesiologists, Joshua F. Snodgrass, Brian Bendel Apr 2023

Implementation Of A Glidescope Educational Program For Novice Student Registered Nurse Anesthesiologists, Joshua F. Snodgrass, Brian Bendel

Doctor of Nursing Practice Projects

GlideScope Video laryngoscopy carries a higher risk of injury to the pharyngeal cavity than direct laryngoscopy. Verathon is aware of this risk and has developed a proprietary “Four-step method” to mitigate it. This project aimed to reduce injuries related to GlideScope video laryngoscopy by providing first-year nurse anesthesiologists at Southern Illinois University Edwardsville with didactic and simulation education related to GlideScope video laryngoscopy and injury prevention. Didactic education was provided via a pre-recorded PowerPoint presentation. Simulation education was provided with the GlideScope and airway trainer manikins. The participants completed an identical 8-question pre-test and post-test to assess for knowledge gain …


Implementing A Covid 19 Policy For Telehealth, Ashley M. Morello Jan 2023

Implementing A Covid 19 Policy For Telehealth, Ashley M. Morello

Doctor of Nursing Practice Projects

The proposed DNP Project explored the implementation of a COVID-19 telehealth policy to clarify evidence-based practice, promote use of safe medications, and reduce hospitalizations. Providers were recruited from a telehealth organization, educated on current guidelines, and given a pocket card for reference and re-enforcement of training. Data was collected to examine guideline utilization, confidence in treating COVID-19, and efficacy of pocket card. COVID-19 patients also received follow up calls to determine if hospitalization was required post treatment. Chart audits were then completed to review compliance with guidelines. The results indicated both objective and clinical improvement in provider confidence treating COVID-19. …


Improving Handoff Communication In The Emergency Department, Amy Shepherd Jan 2023

Improving Handoff Communication In The Emergency Department, Amy Shepherd

Doctor of Nursing Practice Projects

Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …


Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon Dec 2022

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …


Implementing The Use Of The Emergency Severity Index Triage Tool In Urgent Care, Sakeena Spencer Oct 2022

Implementing The Use Of The Emergency Severity Index Triage Tool In Urgent Care, Sakeena Spencer

Doctor of Nursing Practice Projects

Background: The urgent care sector has quickly grown in the last decade. Patients who visit healthcare facilities seeking treatment for exacerbations of chronic conditions or episodic illnesses such as asthma without scheduled appointments receive healthcare services from Urgent Care Centers (UCC) or Emergency Departments (E.D.s). Upon visiting the UCC, these patients report life-threatening symptoms; hence require immediate medical attention. UCC healthcare workers should distinguish between non-acute and acute patients to prioritize providing healthcare to patients, ensuring they are not at risk for fatal outcomes. Using the Emergency Severity Index (ESI) triage tool while delivering healthcare services to these patients has …


Implementing Antimicrobial Stewardship For Healthcare Providers In An Urgent Care Setting To Reduce Antibiotic Misuse For Respiratory Infections, Ashley Pauldin Jul 2022

Implementing Antimicrobial Stewardship For Healthcare Providers In An Urgent Care Setting To Reduce Antibiotic Misuse For Respiratory Infections, Ashley Pauldin

Doctor of Nursing Practice Projects

Background: Antimicrobial resistance has been identified as a major threat by the World Health Organization (WHO), and antimicrobial stewardship is a key strategy to overcome resistance. A major contributing factor to this crisis is the inappropriate use of antibiotic prescriptions in outpatient settings. Although evidence-based guidelines on appropriate treatment for acute upper respiratory infections (URIs) have been developed, the need for improving provider and patient awareness and knowledge in the urgent care setting is critical.

Purpose: The purpose of the DNP project was to implement antimicrobial stewardship guidelines in the urgent care facility to decrease the misuse of antibiotic prescribing …


Stroke Care: Achieving Recommended Door To Computed Tomography Times In Ambulatory Patients Presenting To The Emergency Department Of A Rural Hospital Through The Application Of American Stroke Association Guidelines, Ricardo Paitz Jul 2022

Stroke Care: Achieving Recommended Door To Computed Tomography Times In Ambulatory Patients Presenting To The Emergency Department Of A Rural Hospital Through The Application Of American Stroke Association Guidelines, Ricardo Paitz

Doctor of Nursing Practice Projects

Background: Time matters in stroke care, and every second counts because the extent of irreversible neuronal damage increases over time (Saver, 2006). Therefore, the American Stroke Association (ASA) recommends a door to computed tomography time of 20 minutes or less for patients presenting with signs of acute ischemic stroke. This time metric in stroke care is often not met, resulting in the delay of care of patients which translates to poorer outcomes, including death and a decreased quality of life in patients who have suffered an acute ischemic stroke (Kamal, Sheng, et al., 2017).

Purpose: The purpose of this DNP …


Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King Jul 2022

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …


Increasing Obesity Education In An Underserved Latino Population, Morgan Lippert, Kelsey Beard May 2022

Increasing Obesity Education In An Underserved Latino Population, Morgan Lippert, Kelsey Beard

Doctor of Nursing Practice Projects

Obesity is a rapidly growing health problem in the United States. Certain populations are at high risk for developing obesity including the Latino population and underserved communities. This Quality Improvement project aimed to develop a more patient centered approach for primary care providers use to deliver obesity education to an at-risk Latino population. The project was completed at a clinic in southern Illinois where the majority of the population is underserved and Spanish speaking. Obesity education tools in both Spanish and English were given to the patients in order to decrease the language barrier and improve patient education and understanding …


Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier Jul 2021

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …


Continuing Education Preferences Amongst Crnas, Jamie Nichting May 2021

Continuing Education Preferences Amongst Crnas, Jamie Nichting

Doctor of Nursing Practice Projects

The Illinois Association of Nurse Anesthetists (IANA) is a professional organization representing Certified Registered Nurse Anesthetists (CRNAs). To ensure compliance with high standards of care in the profession, CRNAs are required to obtain continuing education units (CEUs) for each 4-year certification period. The IANA offers conferences in both fall and spring, however, a loss in attendance and revenue at state meetings concerns the board members as to how state members are complying with the educational requirements to remain certified. It was imperative that the IANA needed to implement new educational opportunities that actively engaged CRNAs resulting in an increase in …


Trauma Informed Care: Paving The Way To Better Patient Outcomes, Sarah Halsey, Amy L. Armstrong May 2020

Trauma Informed Care: Paving The Way To Better Patient Outcomes, Sarah Halsey, Amy L. Armstrong

Doctor of Nursing Practice Projects

Trauma-informed care (TIC) is an approach that enables healthcare clinicians to understand the effects of trauma and create a safer environment. Providers acknowledge the pervasive nature of trauma but lack proper tools and training to implement. It has been suggested that trauma is the prime determinant of health outcomes. Therefore, providing training and cultivating a change towards a trauma-informed organization, has the capability to change health outcomes.

The purpose of this project was to establish a program at SIU Medicine in which new employees are trained on the importance of TIC. Working closely with the Director of Population and Community …


Optimizing Intraprofessional Communication At Patient Handover, Allison Crabtree Jul 2019

Optimizing Intraprofessional Communication At Patient Handover, Allison Crabtree

Doctor of Nursing Practice Projects

This performance improvement project aimed to increase the communication competency of nurses during intraprofessional interactions at patient handover. An educational program focused on optimizing communication among nurses was implemented in a community-based, not-for-profit, rural hospital. The course was designed to incorporate a variety of instructional strategies to meet learner needs. Consistency and standardization of the patient handover process was a central theme. Topics of the course focused on the use of a standardized communication tool, the relationship of communication on patient safety, the importance of clear and effective communication, the role of the nurse as gatekeeper and facilitator of patient-specific …


Online Sexual Health Education With Rural Independent Study Charter School Students, Crystal L. Gardner Msn, Phn, Rn Apr 2019

Online Sexual Health Education With Rural Independent Study Charter School Students, Crystal L. Gardner Msn, Phn, Rn

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) and unwanted pregnancies continue to be public health problems in the United States. Each year there are about 20 million new STIs in the United States with about half of the infections occurring in people 15 to 24 years old (The Centers for Disease Control and Prevention, 2016).

Objectives: The purpose of this descriptive pre- and post-test study was to determine if an online STI prevention program increased knowledge about STIs, STI related resources, and lowered STI risk-taking behaviors in rural northern California students attending an alternative high school.

Methodology: “Positive Prevention PLUS” curriculum and …


Effects Of Teach-Back Method Of Education On Knowledge Of Heart Failure Self-Care Management And Post-Discharge Knowledge Retention, Ama Awuah-Asamoah Msn, Rn, Acnp Apr 2019

Effects Of Teach-Back Method Of Education On Knowledge Of Heart Failure Self-Care Management And Post-Discharge Knowledge Retention, Ama Awuah-Asamoah Msn, Rn, Acnp

Doctor of Nursing Practice Projects

Background: Approximately forty to eighty percent of patient education is immediately forgotten, and about fifty percent of retained information is inaccurate; knowledge is an essential bridge between patient teaching, comprehension and knowledge retention by using the teach- back method (Farris, 2015; Rouse et al., 2016; Stamp et al., 2014).

Objectives: The purpose of this study was to compare teach-back education method versus standard education and care, on knowledge of heart failure (HF) self-care management at discharge and retention of knowledge at three to ten days post discharge.

Methods: A non-probability convenience sampling of 22 HF patients, 65 years and older, …


Peer To Peer Review: Professional Development To Improve Feedback Skills And Self-Efficacy, Brittany H. Gnilka, Dnp, Msn, Rn-Bc Apr 2018

Peer To Peer Review: Professional Development To Improve Feedback Skills And Self-Efficacy, Brittany H. Gnilka, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Peer to peer review is the most essential form of peer review as it encourages nurses to evaluate the quality, safety, and effectiveness of nursing care amongst peers. Poor communication skills for providing feedback during peer review is a barrier identified in the literature, which can be addressed in professional development training.

Objectives: The purpose of this study was to evaluate the effect of communication-focused professional development sessions on the ambulatory care nurses’ perceived self-efficacy to successfully provide meaningful feedback during peer to peer review.

Results: The results showed a statistical significance difference between the mean pre and postGSES …


Effectiveness Of Residency Training Programs For Increasing Confidence And Competence Among New Graduate Nurse Practitioners, Heather Parkhill, Dnp, Msn, Fnp-C Apr 2018

Effectiveness Of Residency Training Programs For Increasing Confidence And Competence Among New Graduate Nurse Practitioners, Heather Parkhill, Dnp, Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Nurse practitioners (NPs) are enrolling in post-graduate residency programs that provide training and mentorship during transition to practice.

Objective: This project explored whether participation in NP residency improved feelings of confidence, competence, preparedness to provide care and job satisfaction among new graduate NPs who completed a residency program compared to new graduate NPs who did not complete a residency program.

Method: This mixed-methods study collected survey data from NPs who attended the 2017 AANP National Conference and two residency programs. A modified Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) (Misener & Cox, 2001) and Hart’s New Nurse Practitioner Preparedness …


Effects Of A Formal Educational Class On The Quality Of Life In Patients Diagnosed With Hypothyroidism, Tahimina Popal, Dnp, Bsn, Msn, Fnp-C Apr 2018

Effects Of A Formal Educational Class On The Quality Of Life In Patients Diagnosed With Hypothyroidism, Tahimina Popal, Dnp, Bsn, Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Hypothyroidism is a chronic disease that requires self-care skills such as healthy diet, exercise, and a daily medication regimen where timing of food intake is essential. Adequate education is essential for patients with hypothyroidism to be able to manage their disease, and to live with the best quality of life possible. Many studies have been conducted to assess the perceived health status of patients with hypothyroidism, but few have examined the effects of a formal educational program on the quality of life.

Objectives: The purpose of this study is to determine if a formal hypothyroidism educational class will improve …


Incorporating Just Culture Principles Into Clinical Learning Experiences, Paula Gendreau, Dnp, Msn, Rn, Cne Apr 2018

Incorporating Just Culture Principles Into Clinical Learning Experiences, Paula Gendreau, Dnp, Msn, Rn, Cne

Doctor of Nursing Practice Projects

Background: Although nursing student’s confidence regarding patient safety is influenced by both clinical faculty and environments in which they learn, faculty seemed to have the most influence in shaping student’s attitudes surrounding a culture of safety. Objectives: To explore and support faculty culture of safety practices that promote meaningful learning experiences for students surrounding patient safety in clinical learning environments.

Methods: An embedded mixed method design was utilized for this pilot study. Quantitative data was collected both pre- and post-semester utilizing an adapted Health Professional Education in Patient Safety Survey, and post-semester qualitative data further expanded on faculty perceptions and …


Measuring Nursing Students’ Perceptions Of Teamwork In A Multiple Patient Simulation, Christine Seaton, Dnp, Msn Apr 2018

Measuring Nursing Students’ Perceptions Of Teamwork In A Multiple Patient Simulation, Christine Seaton, Dnp, Msn

Doctor of Nursing Practice Projects

Background: Simulation based education offers safe, reflective learning opportunities. However, data had not been obtained of nursing students’ perceptions of teamwork performed during Virtual Hospital (VH), a multiple patient simulation.

Objectives: This evaluation gap was addressed using the Agency for Healthcare Research and Quality’s (AHRQ) TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ). The validated survey measures self-reported perceptions of teamwork in communication, mutual support, and situational awareness on a Likert scale from 1 to 5 (AHRQ, 2014).

Methods: A pre-and post, one group design was used to measure perceptions of teamwork. Twenty participants were recruited from students, enrolled in a second-degree undergraduate …


Simulation As Staff Development For Competency In Nursing Care Of Patients With Chest Tubes, Jennifer Dent Jan 2016

Simulation As Staff Development For Competency In Nursing Care Of Patients With Chest Tubes, Jennifer Dent

Doctor of Nursing Practice Projects

There is an estimated 98,000 to 400,000 hospital errors that result in patient harm or death annually (David, Gunnarsson, Waters, Horblyuk and Kaplan, 2013; James 2013). As a member of the health care team nurses coordinate and provide continual care to the hospitalized patient (American Association of Colleges of Nursing, 2011; Parker, 2014). Patient safety is promoted when nurses are competent in their knowledge, skills, attitude, and performance related to evidence-based practice, protocols, and standards of care (; American Nurses Association, n.d; Schroeter, 2009). The purpose of this evidence-based project was to promote patent safety by developing and maintaining competency …


Community Acquired Pneumonia Project, Patricia Heaney Jan 2016

Community Acquired Pneumonia Project, Patricia Heaney

Doctor of Nursing Practice Projects

There is an increasing number of microorganisms that are becoming resistant to antimicrobial medications. This growing number of resistant organism poses a serious health threat, not only in this nation, but throughout the world. The Center for Disease Control and Prevention (CDC) estimates that there are greater than 2 million people who acquire serious infections that are resistant to one or more antimicrobial agents that were made to treat those organisms (CDC, 2013). Streptococcus pneumonia (S. pneumoniae or pneumococcus) is one such organism that has been identified by the CDC (2013) as becoming increasingly resistant to drugs that were once …


Simulation In Assisting Nurses To Better Recognize Early Signs Of Clinical Deterioration Of Patients, Loretta Elder Jan 2015

Simulation In Assisting Nurses To Better Recognize Early Signs Of Clinical Deterioration Of Patients, Loretta Elder

Doctor of Nursing Practice Projects

The need to enhance the knowledge and skills of nurses caring for patients who exhibit signs of clinical deterioration has been validated in the literature. The literature has further supported the registered nurse as the key individual expected to recognize signs of clinical deterioration in the patient. The use of simulation as an effective teaching strategy has been well documented in the literature. The purpose of the project was to use simulation as an educational intervention to increase nurse knowledge, self-confidence, and competency when caring for patients exhibiting signs of clinical deterioration. The findings of this project are supported by …