Publication Date

Spring 2017

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Terea Giannetta

Second Advisor

Rhonda Litt

Third Advisor

Mariana Teel


Nursing education, Correctional nurse, Simulation


The Cycle 4 OIG medical reports published in January 2016 for California Correctional Institution (CCI) noted emergency medical response (EMR) inadequacies. Nursing was specifically called out for EMR care deficits. Chest pain and respiratory distress were amongst the top signs and symptoms identified as having substandard nursing care issues within the report. The cycle 4 OIG medical inspection report gives specific incidences of patient care inadequacies.

As a result of the EMR portion results of the cycle 4 OIG reports, there was a need for improvement planned interventions. The Doctor in Nurse Practice (DNP) project is a quantitative quasi-experimental study used to evaluate the EMR performance of the CCI nursing staff population. The research question being addressed: does simulation-based training increase correctional nursing staff performance during cardiac emergency response scenarios? The design/methodology of the research included 40 nurse participants that were placed into teams of five and given a cardiac EMR scenario simulation training with a pre and post-test associated. There were a total of eight identical simulation sessions that were offered as one session per day. The pre-test was completed before the simulation training and the post-test was given after the simulation scenario. A debrief discussion was conducted at the end of each simulation training team experience. The pre and post-test included critical thinking type questions related to cardiac EMR using primarily close-ended questions and a few open ended questions (Ex. How do you feel about simulation training?) for feedback purposes. During the simulation training, nurses were evaluated on their performance factors of nursing skills, teamwork, critical judgement and inter-relational effective communication.

This research was valuable to improving the EMR performance skills for CCI correctional nurses. The goal is to provide proficient, quality health care, improve patient outcomes, and eventually achieve adequate OIG passing scores for EMR. The data analysis method used for this study was paired sample t-test through software system SPSS version 24. The post-test for the simulation training was using a dependent variable while the pre-test measure would be the covariate. The pre-test would not be considered an outcome. The paired sample t-test measures were assessed for differences in the post-test means after accounting for the pre-test values. The values produced from the paired sample t-test focused on whether the one group had higher means after the simulation training experience showing research significance.

Included in

Other Nursing Commons


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