Madisonville Community College

The need to enhance the knowledge and skills of nurses caring for patients exhibiting signs of clinical deterioration has been documented. 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. The purpose of this 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. A significant improvement in nurse knowledge and self-confidence was shown after a simulation-based educational intervention. Competency evaluation during the simulation-based intervention provided information to help nurses when caring for deteriorating patients. Nursing professional development practitioners can use the information from this project in planning educational interventions for staff nurses.

In 1989 Peabody Coal Company began a comprehensive inventory program on roughly 2000 acres of reclaimed land in various stages of reforestation.Although the information gathered was intended for in-house accurate maps and records created.

Madisonville, Ky. From the Division of Plastic and Hand Surgery at the Trover Clinic and the Department of Surgery (Plastic and Reconstructive) at the University of Louisville. Received for publication August 10, 1993; revised July 22, 1994. Division of Plastic and Hand Surgery Trover Clinic 200 Clinic Drive Madisonville, Ky. 42431–1665