Date of Completion


Document Type

Campus Access Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Faculty Advisor

Beth Rowlands

Site Advisor

Priscilla K. Gazarian

Second Reader

Natalie Randolph


Background: A change in respiratory rate is often a critical early sign which can identify changes in hospitalized patient status. Early identification of change allows for quicker intervention, reduces the chance of deterioration due to sepsis, and reduces patients risk for cardiac arrest.

Problem: Respiratory rates should be counted prior to being recorded in patient charts. Respiration rates are often either neglected or inaccurate due to a lack of knowledge and understanding of the importance of respiration rate. Lack of resources such as a watch, clock, or other timing device make it virtually impossible to obtain an accurate recording of patient respirations.

Methods: This quality improvement project introduced a short learning session designed to educate nurses and technicians on the importance of their work and of accurately recording respiratory rates. Nurses and technicians were educated on the value of respiration rates and their usefulness for identifying early change.

Interventions: Each patient room was supplied with a wall clock to be used by the nurses and technicians when counting respiratory rates. Nurses and technicians were encouraged to count respirations for a full sixty seconds before recording the number in the patient chart.

Result: There was a 369% increase in the recording of respiratory rates less than 16 breaths per minute. There was a 78.38% improvement between the last recorded respiratory rate in the electronic health record, being within 4 breaths per minute to the rate recorded at the beginning of the rapid response.


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