Background: Some nurses do not have the skills necessary to evaluate general ICU patient condition and the meaning of laboratory data adequately. This can influence nursing care quality and patient safety. Between October 16th and 29th, 2009, this project employed a checklist to evaluate nursing assessment accuracy in medical and surgical ICUs. The unexpectedly low accuracy rate of two-thirds (63.4 percent) was caused by factors including poor nursing assessment cognizance, lack of experience performing nursing assessments, nursing assessment skills taught only to experienced nursing staff, and a lack of nursing assessment guidelines.Purpose: This project was designed to improve nursing assessment cognizance and accuracy among nursing staffResolution: The authors: 1. Established formal nursing assessment guidelines; 2. made a CD-ROM to introduce nursing assessment basics; and 3. employed lectures and simulation exercises to teach nursing assessment skills.Results: Nursing assessment accuracy improved significantly to 85.8 percent and actual nursing assessment cognizance scores ranged between 68.7 and 83.1.Conclusions: This project effectively improved nursing assessment accuracy and may be considered and referenced by relevant medical organizations.