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Capstone Project Change Proposal ESSAY

Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment

Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.

Improving a Fall Prevention Program in a Clinical Environment

Falls are very important and preventing these falls are the most important goal and plan for every patient’s safety that encounters healthcare settings. There are many ways in preventing falls such as new trainings, new bed alarm tones and even hourly rounding. Daily improving to bedside reporting is another suggestion this field of study. Failing to increase measures in implementing change can lead to death and or longer hospitalization stays. Detecting problems early and adjusting to change will help with improvement of falls. Patients will build confidence and a trusting relationship that will help secure a solid foundation for the healthcare setting.

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Background

University of Louisville Hospital is a Level Trauma 1 Center in the state and nearby surrounding states. Admissions records over 3,000 patients a year and half of them are from outside of the county. Decreasing patients falls is the most important. In order to promote this proposition we need to set up teams that are willing to work together and communicate. University of Louisville hospital has had a total of 45 falls this year from January thru May. According to research, falls have been around for over 50 plus years. Incident reports are avoided when these happen the best thing is adverse events. Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment. Healthcare facilities need to make sure they understand the interventions and not focus on the quantity of falls which is very important. Inpatient fall rates range from 1.7 to 25 falls per 1,000 patient days, depending on the care area, with geropsychiatric patients having the highest risk (NCBI, 2007). Falls inpatient has increased in some facilities. The facility that I am employed at fall cases have decreased through interventions and hourly rounding. Falls may never be fixed but we can all work together to decrease the chances and give the proper teachings.

Problem Statement

        According to research falls have been around for over 50 plus years.  Incident reports are avoided when these happen the best thing is adverse events. Falls in hospital are associated with excess financial and opportunity costs (Oxford Academic, 2008).  The majority of falls in healthcare facilities are patients over 70 years of age and the youth between 18-39 years of age. Falls inpatient has increased in some facilities and this is why interventions are needed. Falls can be very costly towards everyone’s pockets and also their health.  Prolonged hospital and even injuries such as fractures and death can occur if proper precautions are not in place. Liabilities can also occur which can cost the hospital more funds than actually receiving to improve better care.   Consequently, various hospitals falls, prevention programs have been implemented in the last decades (BMC Health Services Research, 2006). Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment. Fall cases have decrease over time at the facility that I am employed at and this was all through hourly rounding and building a rapport with you patients.  We as a team can always help fix the issues at hand, falls may never be completely solved but they can be decreased through teamwork and dedication. Falls may never be fixed but we can all work together to decrease the chances and survival rates through proper teachings and statistical facts.

Change Proposal

        In order to promote safety and prevent falls within all healthcare facilities the plan of care that promotes, reassurance, full assessment and communication. The purpose to change fall prevention strategies in our facility is to decrease falls and provide advance care through evidence based research. The proper education and research will introduce more expected outcomes. There will be some challenges and barriers that may interfere with this intervention.  There will be multiple ways that this research will be used in order to be successful.  Encouraging engagement and participation will affect the quality improvement process such as implementing small scale demonstrations which are less difficult to manage. Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment. Small-scale demonstrations or small tests of change also allow you to refine the new processes, demonstrate their impact on practices and outcomes, and build increased support by stakeholders (AHRQ, 2017). It is important to understand that many changes will be made along the way and learning from these experiences will help with adding change to any obstacles that take place.

PICOT

PICOT is used to help people clarify answers for any problems they may encounter. This will be used in research and evidence based practices that can be used and implemented on a daily basis. The P in PICOT stands for the population or specific cohort that is included in the study. The I in PICOT stand for the interventions that are used for in treatments during this study. The C in PICOT stands for the comparison in the study of research. The O in PICOT stands for the objectives in the research study. The T stands for the time frame which is not always included in the Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment study.

The inpatient population such as the sick and elderly (P) for the study of prevention in falls in an inpatient setting. The intervention (I) for this study and intervention of falls is the revision of the post debriefing forms and training for bedside report along with hourly rounding. The comparison (C) in this study is to reduce the risk for falls such as hourly rounding and improved training for staff. The outcome (O) for this study is to reduce falls in an inpatient facility. The time frame (T) in this study would be decreasing of falls over a three to six month period.

Literature Search

        Falls can be related to intrinsic and extrinsic factors. Intrinsic factors are disorders, mental problems anything that is preventable through health. Extrinsic factors are made up of environmental things such as spills, rugs, and cluttered areas. All falls are important and it’s even more important to understand the causes.  Morse falls scale is very important and our hospital uses this scale for every patient that is admitted to the hospital. Medical errors are another way falls can occur.  Nurses or even ancillary staff may forget to give a patient a call light and patient may have to use the restroom and attempt to get up and fall. Making sure that the patient has worked with physical therapy and communication has been documented and transcribed accurately. Identifying those at risk allows targeted assessment and intervention such as a review of medications and environmental modifications (BMC Medicine, 2004). Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.

Falls can be very costly towards everyone’s pockets and also their health. Prolonged hospital and even injuries such as fractures and death can occur if proper precautions are not in place. Liabilities can also occur which can cost the hospital more funds than actually receiving to improve better care. Consequently, various hospitals falls, prevention programs have been implemented in the last decades (BMC Health Services Research, 2006). Coming up with reasoning to why a person fall is the leading answer to the problem. Every patient is different and their reasons are going to be different as well so making sure that the proper assessment is given then falls should be prevented.

Literature Evaluation

Information that was collected from journals and articles to help promote fall preventions in an inpatient facility has been very beneficial. There are so many issues that can relate to falls such as bad lightening, shoes are not flat, irregular eye exams and even clothing that’s not fitting appropriately can help with falls. Understanding the causes of falls is very important and factual. The older population tends to have a higher risk for falls then that of the youth population. Falls also occur often among older people in hospital and the sickly ill patients. Our hospital uses the Morse Falls scale to assess every patient that is admitted into our doors which is part of a detail assessment of the patient. Medical errors are another way falls can occur which is caused by either shortage of nurses, work overload or even lack of education. Nurses or even ancillary staff may have times where they may not give the patient a call light and then the patient may attempt to get up and fall which can lead to death or even broken bones. It’s also relevant that patients have worked with ancillary staff such as physical therapy and other therapies that play a role in activities of daily living. Communication is very important and vital information that has to be documented and transcribed accurately; if not, then many errors can occur. There are many suggestions such as bed alarming sounds changing and a new call light sound becoming more distinct giving that familiar sound to focus on the patient. Orienting the patient through assessments every 2-4 hours throughout shift depending on level of consciousness will help with fall preventions. Fall rates will decrease in our inpatient medical surgical and progressive care units. Focusing on post fall forms will help after the revision take place and orienting all staff new and old will help with the these goals of safety and reliability. Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment. Coming up with reasoning to why a person fall is the leading answer to the problem. Every patient is different and their reasons are going to be different as well so making sure that the proper assessment is given then falls should be prevented.

Patient engagement is another suggestion if it’s going to prevent falls in the future. Introducing safety huddles have been suggested to reduce fall in hospitals which helps with communication and knowing each patient. Intentional rounding will help with patients that are at higher risk of falling. Falls inpatient has increased in some facilities. The facility that I am employed at fall cases have decreased through interventions and hourly rounding. Falls may never be fixed but we can all work together to decrease the chances and give the proper teachings. Falls seem to be one of the most major problems in older adults. In the United States one in three people aged 65 or more living in the community fall at least once a year (BMJ, 2006). Research and clinical programs in hospital fall prevention should pay more attention to study design and the nature of interventions (Wiley Online Library, 2015). Research will be very beneficial to the hospital and the elderly population. Collecting all information on the patient will help with eliminating falls. Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.

Nursing Theory

Nursing theories are very important when implementing evidence base practices. There will be two change theories that will be factored in this healthcare setting. Model and role model theory has it’s concept from Piaget’s Theory of Cognitive Development. Erickson’s theory helps nurses care for their patients by recognizing each individual’s uniqueness, and focusing on the individual patient’s needs (Nursing Theory, 2016). It is also a self-care method of nursing, which means it is based on the patient’s perceptions of the environment, and adapts based on individual stressors for that patient (Nursing Theory, 2016). Understanding the patient in order to maintain safety measures will help reach goals and also allow the patient to feel secure.

        Next theory that can help with the improvement of this research will be the novice to expert theory.  Patricia Benner developed a concept known as “From Novice to Expert.” This concept explains that nurses develop skills and an understanding of patient care over time from a combination of a strong educational foundation and personal experiences (Nursing Theory, 2016).  She was based off of clinical experience through learning the patient over time. This Theory had five levels novice, advance beginners, competent, proficient, and expert. Different levels of skills will show the changes that need to take place in the healthcare facilities (Nursing Theory, 2016).  Both theories are both beneficial in learning the patient’s cognitive skills and also building a confidence in each individual allowing them to heal and be safe. Changes are instilled in both theories and depending on the changes in the future. Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.

Implementation

        Medicines have side effects understanding these effects and communicating with your doctor along with the nurse the feelings that you are experiencing will help prevent any cases of falls.  Nurse need to make sure that the call light is in reach and they give the proper teaching of what medicine they are giving their patient along with an understanding.  Routine rounding is very important in the hospital which can be shared amongst the nurse and nursing assistant.  Blood pressure medications are one of the most serious falls because of the dizziness that it can cause.  Making sure the patient has proper footwear can also prevent falls, non skid socks and even slippers will help. Making sure the patient has a bed alarm under the patients and patients are aware of the call light being in reach. Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.

Collecting all information on the patient will help with eliminating falls. We as nurses need to make sure that patients with the need for assistance devices need to be close to the nurse station and teachings on falls every hour when rounding. Patient that are on many prescriptions need to understand that side effects can really cause falls and that’s not good. Bring the entire team together and communicate will help with fall preventions. Making sure that a checklist is in place will help with less falls and more awareness. The Morse falls scale will help with understanding the risk of falls per patient. Making sure you understand the goal and also include everyone in the plan with an open mind will help with the benefits of the research project. Educational presentations would be presented to the healthcare and ancillary staff. This would be to help staff get a clearer perspective and also more education on fall preventions. A revision of the post fall briefing form adding more detail information will be applied to help with teamwork.

Potential Barriers

        Changes brought to the surface will be one of the most difficult challenges on the units at work. This will have a big impact on the implementation strategies.  Lacking structural guidelines and trainings can prevent falls from decreasing. Communication lacking between therapist and staff on each individualized patient can also prevent a change from occurring. Considering time is another barrier that can occur with falls and patient’s timing, how often they’re getting up and the time they’re falling. Physicians will not look at this situation as important as diagnosis which is another barrier that can prevent changes to occur. Interference of parents and visitors can also be a hindrance of growth within the plan of care of the patient. Some older people considered using assistive devices, such as walking frames, as a stigma, because they believe that using such aids is a sign of weakness and reflects a change in one’s self image (BMJ Open, 2015). One HCP perceived that older people normalized falls and consider them to be part of the normal ageing process. He felt that older people disregarded falls because they believed they were inevitable in old age (BMJ Open, 2015). Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment. Living situations outside of the facility is another barrier that can occur which the design of the house and the inadequate space for assistive devices.  Admitting weaknesses and balance issues is another difficult task to get through, patients tend to be in denial of any issues they may be having. We as nurses and healthcare staff need to make sure that we have the knowledge and skills in managing falls in order to deliver a safe environment.

References

O., D., P., A., G., L., . . . G. (2008, October 01). Systematic review and meta-analysis of studies

using the STRATIFY tool for prediction of falls in hospital patients: How well does it work? | Age and Ageing | Oxford Academic. Retrieved from https://academic.oup.com/ageing/article/37/6/621/40889

Section 4: Ways to Approach the Quality Improvement Process. (2015, November 16). Retrieved from https://www.ahrq.gov/cahps/quality-improvement/improvement-guide/4-approach-qi-process/index.html Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.

Bühler, H., Geest, S. D., & Milisen, K. (2006, June 07). Falls and consequent injuries in

hospitalized patients: Effects of an interdisciplinary falls prevention program. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-6-69

Papaioannou, A., Parkinson, W., Cook, R., Ferko, N., Coker, E., & Adachi, J. D. (2004, January

21). Prediction of falls using a risk assessment tool in the acute care setting. Retrieved from https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-2-1

Oliver, D. (2007, January 11). Strategies to prevent falls and fractures in hospitals and care

homes and effect of cognitive impairment: Systematic review and meta-analyses. Retrieved from https://www.bmj.com/content/334/7584/82

Oliver, D., Hopper, A., & Seed, P. (2015, April 27). Do Hospital Fall Prevention Programs

Work? A Systematic Review. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1532-5415.2000.tb03883.x

“Patricia Benner Novice to Expert – Nursing Theorist.” Biographies of Nursing Theorists and Their Work – Nursing Theory, 2016, nursing-theory.org/nursing-theorists/Patricia-Benner.php.

“Helen Erickson – Nursing Theorist.” Environmental Theory – Nursing Theory, 2016, www.nursing-theory.org/nursing-theorists/Helen-C-Erickson.php.

Loganathan, Annaletchumy, et al. “Barriers Faced by Healthcare Professionals When Managing Falls in Older People in Kuala Lumpur, Malaysia: a Qualitative Study.” BMJ Open, British Medical Journal Publishing Group, 1 Nov. 2015, bmjopen.bmj.com/content/5/11/e008460. Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.

Professional Capstone and Practicum
Details This is a writing-intensive course. The
professional capstone practicum project offers
students the opportunity to propose a resolution
to an issue or problem significant to nursing
practice within a clinical environment. Students
identify, design, and propose an evidence-based
solution within a health care organization with
guidance from faculty and a preceptor in the
field. The proposal must reflect synthesis and
integration of course content and professional
practice. Development of the capstone project
is guided by the baccalaureate program student
learning outcomes. Practice immersion hours: 100.
Prerequisites: NRS-430V, NRS-429VN, NRS-434VN,
NRS-427VN, NRS-433V, PHI-413V, NRS-451VN,
NRS-410V, and NRS-440VN.
Credit Hours 6.0
PreRequisites NRS-430V, NRS-429VN, NRS-434VN, NRS-427VN,
NRS-433V, PHI-413V, NRS-451VN, NRS-410V, and
NRS-440VN
coRequisites None
Course Add-Ons Additional Material
Other
Optional: Publication Manual of the American
Psychological Association
For additional information, the following is
recommended: Current version of the Publication
Manual of the American Psychological Association.
GCU has made APA templates and other resources
available within the Student Success Center as
well as in the GCU Library. However, be aware that
a more complete APA Manual can be purchased at
your own expense. To order the APA manual, please
visit the American Psychological Association.
http://apa.org
Other
The Practice Immersion Experience
Review the “The Practice Immersion
Experience” resource to familiarize yourself
with the requirements for course assignments
and programmatic course components required to
successfully complete this course and the RN-toBSN program of study.
Electronic Resource
Guidelines for Undergraduate Field Experiences
Review the Guidelines for Undergraduate Field
Experiences resource in the Student Success
Center. This material contains important
information for your clinical experience,
including evaluation guidelines, the Clinical Site
Visit Application, and the Clinical Hour Tracking
Sheet for BSN Students Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment.
Electronic Resource
Nursing and Health Sciences Research Guides
View “Nursing and Health Sciences Research
Guides,” located on the Grand Canyon
University website. This is a discipline-specific
research guide to assist you with your research.
In particular, seek out the “Evidence-Based
Practice (EBP)” tab in the LibGuide for
highly specific information pertinent to the
capstone project.
http://libguides.gcu.edu/Nursing
Electronic Resource
Evaluating Websites
View “Evaluating Websites,” located on
the Grand Canyon University website. This tutorial
will explain how to evaluate websites for content
that you can trust.
http://tutorials.gcumedia.com/
evaluatingWebTutorial/interactiveIndex.html
Other
Practice Immersion Clinical Tools
The attached document contains all three
required Practice Immersion Clinical Tools. The
“Practice Immersion Clinical Evaluation
Tool – Student” will be completed by the
student’s Course Mentor and the faculty at the
course conclusion. The “Practice Immersion
Clinical Evaluation Tool – Mentor” will be
completed by the student and submitted to the
course faculty at the course conclusion. The
“Practice Immersion Clinical Evaluation Tool
– Agency” will be completed by students and
validated by faculty in regards to the clinical
site, and will also be submitted to course faculty
at the course conclusion.
Electronic Resource
Qualified Mentor/Preceptor Summary Form
Review the “Qualified Mentor/Preceptor
Summary Form” resource, located in the
Student Success Center. Use the “Qualified
Mentor/Preceptor Summary Form” as part of the
Topic 1 Course Mentor Identification and Approval
Process assignment requirements.
Other
Field Experience Site Information Form
Use the “Field Experience Site Information
Form” as part of the Topic 1 Course Mentor
Identification and Approval Process assignment
requirements.
Other
Practicum Hours Requirements for Washington
Registered Nurses
If you are a registered nurse in Washington, your
practicum experience must include a minimum of 50
hours in a community health setting.
Other
NRS-490 Course Objectives
During this course, the student will: Work
constructively with patients, communities,
organizational leadership, and other change
agents to improve practice within health care
settings. Apply Healthy People 2020 principles
in nursing practice. Synthesize nursing knowledge
and concepts into an evidence-based change
proposal for an issue or problem relevant to
nursing practice and population health outcomes.
Identify resources required to implement a
clinical change in nursing practice. Communicate
information and strategies to stakeholders in
order to implement and sustain an evidence-based
change proposal. Determine reliable methods to
measure the effectiveness of an evidence-based
change proposal project in achieving the intended
outcomes.
Topics
Topic 1: Change Proposal Subject
and Purpose Identification 1
Duration: 7 days
Description:
The first step in developing an evidence-based practice change
proposal is to identify an issue or problem to address. In this topic,
students will learn what resources are required and what skills they
will need to employ in order to create and deliver a robust capstone
practicum proposal.
Objectives:

  1. Identify problems, issues, and opportunities to improve patient
    care, patient outcomes, and organizational procedures within a
    clinical practice setting.
  2. Examine a health care clinical problem or an organization issue and
    its implications to nursing practice.
  3. Determine evidence-based solutions that address patient-care or
    clinical practice quality problems or issues.
  4. Analyze health care clinical problems and organizational issues
    utilizing the PICO(T) process
  5. Demonstrate values consistent with the role of a nursing
    professional through fundamental knowledge and advanced skills.
    Topic Material:
    Other
  6. Individual Success Plan
    Review this resource to familiarize yourself with the requirements for
    the Individual Success Plan (ISP) assignment in this topic.
    Website
  7. Optional: GCU Library Webinar Sign Up
    For additional information, the following is recommended: Review
    the webinar information offered by the GCU Library. From the
    “Webinars & Workshops: Webinar Calendar” page, select
    the “Category” tab and scroll down to the Nursing and Health
    Sciences selection. Webinar participation is optional.
    Electronic Resource
  8. Guidelines for Undergraduate Field Experiences
    Review the Guidelines for Undergraduate Field Experiences resource
    in the Student Success Center. This material contains important
    information for your clinical experience, including evaluation
    guidelines, the Clinical Site Visit Application, and the Clinical Hour
    Tracking Sheet for BSN Students.
    Electronic Resource
  9. Qualified Mentor/Preceptor Summary Form
    Review the “Qualified Mentor/Preceptor Summary Form”
    resource, located in the Student Success Center. Use the
    “Qualified Mentor/Preceptor Summary Form” as part of the
    Topic 1 Course Mentor Identification and Approval Process assignment
    requirements.
    Other
  10. Field Experience Site Information Form
    Use the “Field Experience Site Information Form” as part
    of the Topic 1 Professional Capstone and Practicum Documentation
    assignment requirements.
    Other
  11. Practicum Hours Requirements for Washington Registered Nurses
    If you are a registered nurse in Washington, your practicum experience
    must include a minimum of 50 hours in a community health setting.
    Other
  12. Scholarly Activity Summary
    You may use the “Scholarly Activity Summary” resource to
    help guide the preparation of the Scholarly Activities assignment, due
    in Topic 10.
    Electronic Resource
  13. Adopting Evidence-Based Practice in Clinical Decision making: Nurses’ Perceptions, Knowledge, and Barriers
    Read “Adopting Evidence-Based Practice in Clinical Decision making:
    Nurses’ Perceptions, Knowledge, and Barriers,” by Majid, Schubert,
    Luyt, Zhang, Theng, Chang, and Mokhtar, from the Journal of the Medial
    Library Association (2011).
    Electronic Resource
  14. Nurses, Information Use, and Clinical Decision Making – the Real World Potential for Evidence-Based Decisions in
    Nursing
    Read “Nurses, Information Use, and Clinical Decision Making – the Real
    World Potential for Evidence-Based Decisions in Nursing,” by Thompson,
    Cullum, McCaughan, Sheldon, and Raynor, from the BMJ website (2004).
    Electronic Resource
  15. Evidence-Based Practice or Practice-Based Evidence: What’s in a Name?
    Read “Evidence-Based Practice or Practice-Based Evidence: What’s
    in a Name?” by McKeon and McKeon, from International Journal of
    Athletic Therapy & Training (2015).
    Electronic Resource
  16. Nurses, Information Use, and Clinical Decision Making – the Real World Potential for Evidence-Based Decisions in
    Nursing
    Read “Nurses, Information Use, and Clinical Decision Making – the
    Real World Potential for Evidence-Based Decisions in Nursing,”
    by Thompson, Cullum, McCaughan, Sheldon, and Raynor, from the BMJ
    Journals website (2004).
    Gradable Items Details Points Possible
    Assignment Professional Capstone and Practicum
    Documentation
    The Professional Capstone and Practicum
    course requires students to
    select a course mentor. This mentor is
    not a preceptor, but an
    individual who will guide students as
    they work to complete the
    practice immersion hour requirements
    for this course. Students are not
    required to “shadow” their
    mentor.
    The course mentor should be someone who
    can provide professional
    development knowledge and guidance and
    who possesses a genuine
    interest in working with students to
    further their academic goals.
    Selection, approval, and retention of a
    course mentor must be
    completed as soon as possible at the
    start of this course, as this
    individual will be working with the
    student on each assignment that
    10.0
    Gradable Items Details Points Possible
    incorporates practice immersion hours.
    Working with a course mentor is
    mandatory.
    Once a course mentor has agreed to
    serve in the role, you must
    complete and submit the following
    required documentation so that
    practice experiences can begin in a
    timely manner:
    Field Experience Site Information Form
    Qualified
    Mentor/Preceptor Summary Form Mentor’s
    license,
    certification, and resume/curriculum
    vitae
    The student is responsible for
    obtaining all signatures for the
    paperwork submission. Course faculty
    will approve all sites and
    mentors according to student learning
    needs and specific course objectives.
    Do not initiate new work on practiceimmersion-hour-based course
    assignments until your course
    instructor has approved your course
    mentor.
    Once a course mentor is approved,
    students should contact the mentor
    within 1 week of receiving the approval
    notification. Students are
    encouraged to make an appointment to
    meet with their mentor in person
    and arrange to review the NRS-490
    course objectives and the Individual
    Success Plan (ISP).
    For more specific information on the
    course mentor process and roles
    and responsibilities, refer to Section
    Three of the Guidelines for
    Undergraduate Field Experiences
    resource.
    Assignment Individual Success Plan (ISP)
    Planning is the key to successful
    completion of this course and your
    overall program of study. The
    Individual Success Plan (ISP)
    assignment
    requires early collaboration with the
    course faculty and your course
    mentor. You will need to establish a
    plan for successful completion of
    25.0
    Gradable Items Details Points Possible
    (1) deliverables associated with weekly
    course objectives, (2),
    required practice immersion hours, and
    (3) deliverables associated
    with your capstone project.
    Access the “Individual Success
    Plan” resource in the Topic
    Materials. Read the information in the
    resource, including student
    expectations and instructions for
    completing the ISP document.
    Use the “Individual Success
    Plan” to develop a personal
    plan for completing your practice hours
    and how topic objectives will
    be met. Include the number of hours you
    plan to set aside to meet your goals.
    A combination of 100 supervised
    clinical hours in community health
    and leadership areas will be obtained
    through the application of the
    objectives listed in the Guidelines for
    Undergraduate Field
    Experiences manual.
    Practicum immersion experiences are
    required in a community health
    setting. Community-based settings
    should encourage community
    integration and involvement; expand
    accessibility of services and
    supports; promote personal preference,
    strengths, dignity; and empower
    people to participate in the economic
    mainstream.
    According to HealthyPeople.gov,
    educational and community-based
    programs and strategies are designed to
    reach people outside of
    traditional health care settings. These
    settings may include schools,
    worksites, health care facilities, and
    communities. Community health
    and leadership practice immersion can
    occur in the same site and in
    conjunction with the evidence-based
    project in the NRS-490 course.
    If you are a registered nurse in
    Washington, your practicum
    experience must include a minimum of 50
    hours in a community health setting.
    Gradable Items Details Points Possible
    Students should apply concepts from
    prior courses to critically
    examine and improve their current
    practice. Students should also
    integrate scholarly readings to develop
    case reports that demonstrate
    increasingly complex and proficient
    practice.
    Consider the challenges you expect to
    encounter as you continue the
    practice hour and competency
    requirements throughout this course.
    How
    might you overcome these challenges?
    You can renegotiate these deliverables
    with your faculty and mentor
    throughout this course and update your
    ISP accordingly.
    Once your ISP has been developed and
    accepted by your course
    faculty, you will have your course
    mentor sign it at the beginning of,
    and upon completion of, each assignment
    that incorporates practice
    immersion hours. You will track all
    course practice immersion hours in
    the ISP.
    APA format is not required, but solid
    academic writing is expected.
    You are not required to submit this
    assignment to Turnitin.
    Assignment Professional Capstone and Practicum
    Reflective Journal and Scholarly
    Activities
    Throughout the course, students will
    engage in weekly reflection and
    scholarly activities. These assignments
    are presented in Topic 1 to
    allow students to plan ahead, and
    incorporate the deliverables into
    the Individual Success Plan if they so
    choose.
    The weekly reflective journals and
    scholarly activities will not be
    submitted in LoudCloud each week; a
    final, culminating submission will
    be due in Topic 10. No submission is
    required until Topic 10.
    Professional Capstone and Practicum
    Reflective Journal
    0.0
    Gradable Items Details Points Possible
    Students are required to maintain
    weekly reflective narratives
    throughout the course to combine into a
    final, course-long reflective
    journal that integrates leadership and
    inquiry into current practice
    as it applies to the Professional
    Capstone and Practicum course. This
    course-long journal assignment will be
    due in Topic 10.
    In each week’s entry, you should
    reflect on the personal knowledge
    and skills gained throughout the
    Professional Capstone and Practicum
    course. Your entry should address a
    variable combination of the
    following, dependent on the specific
    practice immersion clinical
    experiences you encountered that week:
    New practice approaches
    Intraprofessional
    collaboration Health care delivery and
    clinical systems
    Ethical considerations in health care
    Population health
    concerns The role of technology in
    improving health care
    outcomes Health policy Leadership and
    economic
    models Health disparities
    In the Topic 10 submission, each of the
    areas should be addressed in
    one or more of the weekly entries.
    This reflection journal also allows
    students to outline what they
    have discovered about their
    professional practice, personal
    strengths
    and weaknesses that surfaced,
    additional resources and abilities that
    could be introduced to a given
    situation to influence optimal
    outcomes, and finally, how they met
    competencies and course objectives.
    Scholarly Activities
    Throughout the RN-to-BSN program,
    students are required to
    participate in scholarly activities
    outside of clinical practice or
    Gradable Items Details Points Possible
    professional practice. Examples of
    scholarly activities include
    attending conferences, seminars,
    journal club, grand rounds, morbidity
    and mortality meetings,
    interdisciplinary committees, quality
    improvement committees, and any other
    opportunities available at your
    site, within your community, or
    nationally.
    You are required to post one scholarly
    activity while you are in the
    BSN program, which should be documented
    by the end of this course. In
    addition to this submission, you are
    required to be involved and
    contribute to interdisciplinary
    initiatives on a regular basis.
    In Topic 10, you will submit a summary
    report of your scholarly
    activity. You may use the
    “Scholarly Activity Summary”
    resource to help guide this assignment.
    Discussion
    Question
    Topic 1 DQ 1
    Identify two GCU Library scholarly
    databases that will help you find
    the best research articles to support
    your EBP proposal. Discuss why
    these two databases are better than
    Google Scholar or a general
    Internet search.
    5.0
    Discussion
    Question
    Topic 1 DQ 2
    The Institute of Medicine has stated a
    goal that 90% of practice be
    evidence-based by 2020. According to
    HealthyPeople.gov, the United
    States is currently at approximately
    15%. Discuss two barriers that
    might hold nursing practice from
    achieving this goal, and suggest ways
    in which identified barriers may be
    addressed.
    5.0
    Participation 15.0
    Topic 2: Change Proposal Subject
    and Purpose Identification 2
    Duration: 7 days
    Description:
    The first step in developing an evidence-based practice change
    proposal is to identify an issue or problem to address. In this topic,
    students will learn what resources are required and what skills they
    will need to employ in order to create and deliver a robust Capstone
    practicum proposal.
    Objectives:
  17. Identify problems, issues, and opportunities to improve patient
    care, patient outcomes, and organizational procedures within a
    clinical practice setting.
  18. Examine a health care clinical problem or an organization issue and
    its implications to nursing practice.
  19. Determine evidence-based solutions that address patient-care or
    clinical practice quality problems or issues.
  20. Analyze health care clinical problems and organizational issues
    utilizing the PICO(T) process
  21. Demonstrate values consistent with the role of a nursing
    professional through fundamental knowledge and advanced skills.
    Topic Material:
    Other
  22. Capstone Project: Developing a Question
    Review “Capstone Project: Developing a Question” to assist
    you in developing a Capstone Project appropriate to the course and the
    RN-to-BSN overall program of study.
    Other
  23. Project Topic Checklist
    Access the “Project Topic Checklist” resource to complete an
    assignment in this topic.
    Website
  24. Optional: GCU Library Webinar Sign Up
    For additional information, the following is recommended: Review
    the webinar information offered by the GCU Library. From the
    “Webinars & Workshops: Webinar Calendar” page, select
    the “Category” tab and scroll down to the Nursing and Health
    Sciences selection. Webinar participation is optional.
    Electronic Resource
  25. Adopting Evidence-Based Practice in Clinical Decision making: Nurses’ Perceptions, Knowledge, and Barriers
    Read “Adopting Evidence-Based Practice in Clinical Decision making:
    Nurses’ Perceptions, Knowledge, and Barriers,” by Majid, Schubert,
    Luyt, Zhang, Theng, Chang, and Mokhtar, from the Journal of the Medial
    Library Association (2011).
    Electronic Resource
  26. Nurses, Information Use, and Clinical Decision Making – the Real World Potential for Evidence-Based Decisions in
    Nursing
    Read “Nurses, Information Use, and Clinical Decision Making – the Real
    World Potential for Evidence-Based Decisions in Nursing,” by Thompson,
    Cullum, McCaughan, Sheldon, and Raynor, from the BMJ website (2004).
    Gradable Items Details Points Possible
    Assignment Capstone Project Topic Selection and
    Approval
    In collaboration with your approved
    course mentor, you will identify
    a specific evidence-based practice
    proposal topic for the capstone
    project. Consider the clinical
    environment in which you are currently
    working or have recently worked. The
    capstone project topic can be a
    clinical practice problem, an
    organizational issue, a quality
    improvement suggestion, a leadership
    initiative, or an educational
    need appropriate to your area of
    interest as well as your practice
    immersion (practicum) setting. Examples
    of the integration of
    community health, leadership, and an
    EBP can be found on the
    “Educational and Community-Based
    Programs” page of the Healthy
    People 2020 website.
    Write a 500-750 word description of
    your proposed capstone project
    topic. Make sure to include the
    following:
    The problem, issue, suggestion,
    initiative, or educational
    need that will be the focus of the
    project The setting or
    context in which the problem, issue,
    suggestion, initiative, or
    educational need can be observed. A
    description providing a
    high level of detail regarding the
    problem, issue, suggestion,
    initiative, or educational need. Impact
    of the problem,
    issue, suggestion, initiative, or
    educational need on the work
    environment, the quality of care
    provided by staff, and patient
    outcomes. Significance of the problem,
    issue, suggestion,
    initiative, or educational need and its
    implications to
    nursing. A proposed solution to the
    identified project
    topic
    50.0
    Gradable Items Details Points Possible
    You are required to retrieve and assess
    a minimum of 8 peer-reviewed
    articles. Plan your time accordingly to
    complete this assignment.
    Prepare this assignment according to
    the guidelines found in the APA
    Style Guide, located in the Student
    Success Center. An abstract is not
    required.
    You are required to submit this
    assignment to Turnitin. Please refer
    to the directions in the Student
    Success Center.
    Assignment Topic 2 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    0.0
    Discussion
    Question
    Topic 2 DQ 1
    During your practicum, determine what
    clinical problem or issue the
    organization is facing. Discuss two
    implications for nursing.
    5.0
    Discussion
    Question
    Topic 2 DQ 2
    What is the main issue for your
    organization in addressing a solution
    to evidence-based nursing practice?
    Discuss what might be the first
    step in addressing and resolving this
    issue.
    5.0
    Participation 15.0
    Topic 3: Evidence-Based Practice
    Proposal Development Plan 1
    Duration: 7 days
    Description:
    The next step in developing an evidence-based practice proposal is to
    search the literature for support and evaluate the level of evidence.
    In this topic, students will learn what resources are required and
    what skills they will need to employ in order to create and deliver a
    Capstone Project proposal with a high level of evidence.
    Objectives:
  27. Evaluate evidence-based research and other appropriate resources to
    inform the development of a change plan.
  28. Identify strategies for logistical implementation of proposed
    solutions.
  29. Demonstrate the ability to evaluate levels of evidence into a
    concise format.
  30. Integrate evidence, clinical judgment, interprofessional
    perspectives, and patient preferences in planning, implementing,
    and evaluating outcomes of care.
    Topic Material:
    Electronic Resource
  31. Science of Improvement: Steps in the PDSA Cycle
    Read “Science of Improvement: Steps in the PDSA Cycle,” located on the
    Institute for Healthcare Improvement website.
    Website
  32. Change Theory
    Explore this website: Change Theory.
    Website
  33. Nursing Theory
    Explore this website: Nursing Theory. This website provides
    information on leading nursing theories.
    Website
  34. Nursing Theories
    Explore this website: Nursing Theories. This website provides
    information on leading nursing theories.
    Electronic Resource
  35. Asking Focused Questions
    Read “Asking Focused Questions” on the Centre for Evidence-Based
    Medicine website.
    Electronic Resource
  36. Formulating a Researchable Question: A Critical Step for Facilitating Good Clinical Research
    Read “Formulating a Researchable Question: A Critical Step for
    Facilitating Good Clinical Research,” by Aslam and Emmanuel, from the
    National Center for Biotechnology Information website (2010).
    Electronic Resource
  37. Research Questions, Hypotheses and Objectives
    Read “Research Questions, Hypotheses and Objectives, by Farrugia,
    Petrisor, Farrokhyar, and Bhandari, from the National Center for
    Biotechnology Information website (2010).
    Gradable Items Details Points Possible
    Assignment PICOT Statement Paper
    Review the Topic Materials and the work
    completed in NRS-433V to
    formulate a PICOT statement for your
    capstone project.
    A PICOT starts with a designated
    patient population in a particular
    clinical area and identifies clinical
    problems or issues that arise
    from clinical care. The intervention
    should be an independent,
    specified nursing change intervention.
    The intervention cannot require
    a provider prescription. Include a
    comparison to a patient population
    not currently receiving the
    intervention, and specify the timeframe
    needed to implement the change process.
    Formulate a PICOT statement using the
    PICOT format provided in the
    assigned readings. The PICOT statement
    will provide a framework for
    your capstone project.
    In a paper of 500-750 words, clearly
    identify the clinical problem
    and how it can result in a positive
    patient outcome.
    Make sure to address the following on
    the PICOT statement:
    Evidence-Based Solution Nursing
    Intervention
    Patient Care Health Care Agency Nursing
    Practice
    Prepare this assignment according to
    the guidelines found in the APA
    Style Guide, located in the Student
    Success Center. An abstract is not
    required.
    This assignment uses a rubric. Please
    review the rubric prior to
    beginning the assignment to become
    familiar with the expectations for
    successful completion.
    You are required to submit this
    assignment to Turnitin. Please refer
    to the directions in the Student
    Success Center.
    75.0
    Gradable Items Details Points Possible
    Assignment Topic 3 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    0.0
    Discussion
    Question
    Topic 3 DQ 2
    Name two different methods for
    evaluating evidence. Compare and
    contrast these two methods.
    5.0
    Discussion
    Question
    Topic 3 DQ 1
    Submit a summary of six of your
    articles on the discussion board.
    Discuss one strength and one weakness
    to each of these six articles on
    why the article may or may not provide
    sufficient evidence for your
    practice change.
    5.0
    Participation 15.0
    Topic 4: Evidence-Based Practice
    Proposal Development Plan 2
    Duration: 7 days
    Description:
    The next step in developing an evidence-based practice proposal is to
    search the literature for support and evaluate the level of evidence.
    In this topic, students will learn what resources are required and
    what skills they will need to employ in order to create and deliver a
    Capstone Project proposal with a high level of evidence.
    Objectives:
  38. Evaluate evidence-based research and other appropriate resources to
    inform the development of a change plan.
  39. Identify strategies for logistical implementation of proposed
    solutions.
  40. Demonstrate the ability to evaluate levels of evidence into a
    concise format.
  41. Integrate evidence, clinical judgment, interprofessional
    perspectives, and patient preferences in planning, implementing,
    and evaluating outcomes of care.
    Topic Material:
    Electronic Resource
  42. Science of Improvement: Steps in the PDSA Cycle
    Review “Science of Improvement: Steps in the PDSA Cycle,” located on
    the Institute for Healthcare Improvement website.
    Website
  43. Change Theory
    Explore this website: Change Theory.
    Website
  44. Nursing Theory
    Explore this website: Nursing Theory. This website provides
    information on leading nursing theories.
    Website
  45. Nursing Theories
    Explore this website: Nursing Theories. This website provides
    information on leading nursing theories.
    Electronic Resource
  46. Asking Focused Questions
    Review “Asking Focused Questions” on the Centre for Evidence-Based
    Medicine website.
    Other
  47. Literature Evaluation Table
    Review the “Literature Evaluation Table” resourced to assist
    you in completing the Literature Evaluation Table assignment.
    Electronic Resource
  48. Formulating a Researchable Question: A Critical Step for Facilitating Good Clinical Research
    Read “Formulating a Researchable Question: A Critical Step for
    Facilitating Good Clinical Research,” by Aslam and Emmanuel, from the
    National Center for Biotechnology Information website (2010).
    Electronic Resource
  49. Research Questions, Hypotheses and Objectives
    Read “Research Questions, Hypotheses and Objectives, by Farrugia,
    Petrisor, Farrokhyar, and Bhandari, from the National Center for
    Biotechnology Information website (2010).
    Gradable Items Details Points Possible
    Assignment Literature Evaluation Table
    In nursing practice, accurate
    identification and application of
    75.0
    Gradable Items Details Points Possible
    research is essential to achieving
    successful outcomes. Being able to
    articulate the information and
    successfully summarize relevant
    peer-reviewed articles in a scholarly
    fashion helps to support the
    student’s ability and confidence to
    further develop and synthesize the
    progressively more complex assignments
    that constitute the components
    of the course change proposal capstone
    project.
    For this assignment, the student will
    provide a synopsis of eight
    peer-reviewed articles from nursing
    journals using an evaluation table
    that determines the level and strength
    of evidence for each of the
    eight articles. The articles should be
    current within the last 5 years
    and closely relate to the PICOT
    statement developed earlier in this
    course. The articles may include
    quantitative research, descriptive
    analyses, longitudinal studies, or
    meta-analysis articles. A
    systematic review may be used to
    provide background information for
    the purpose or problem identified in
    the proposed capstone project.
    Use the “Literature Evaluation
    Table” resource to complete
    this assignment.
    While APA style is not required for the
    body of this assignment,
    solid academic writing is expected, and
    in-text citations and
    references should be presented using
    APA documentation guidelines,
    which can be found in the APA Style
    Guide, located in the Student
    Success Center.
    This assignment uses a rubric. Please
    review the rubric prior to
    beginning the assignment to become
    familiar with the expectations for
    successful completion.
    You are not required to submit this
    assignment to Turnitin.
    Assignment Topic 4 Practice Hours Completion
    Statement NRS-490
    0.0
    Gradable Items Details Points Possible
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    Discussion
    Question
    Topic 4 DQ 2
    Compare and contrast two change
    theories, and determine which theory
    makes the most sense for implementing
    your specific EBP project. Why?
    Has your mentor used either theory, and
    to what result?
    5.0
    Discussion
    Question
    Topic 4 DQ 1
    Why is understanding the health care
    system at the local level
    important to consider when planning an
    EBP implementation? Conduct
    research and solicit anecdotal evidence
    from your course mentor that
    you will take into consideration for
    your own change project.
    5.0
    Participation 15.0
    Topic 5: Evidence-Based Practice
    Proposal Project Development and
    Implementation Plan 1
    Duration: 7 days
    Description:
    Students need to be able to process and formulate an evidence-based
    and financially feasible solution to a clinical problem or issue.
    Working through the element of plan development requires them to
    assess and address the challenges, barriers, and other facets of
    change proposal implementation in the real world. The content in
    this topic will enable students to better understand the cultural
    environment(s) surrounding a change project and lead them through
    the steps of how to go about successful implementation of a strategic
    plan. A change or nursing theory must be used to support rational for
    proposed implementation plan.
    Objectives:
  50. Identify objectives, strategy, and measurable outcomes of the
    evidence-based practice proposal.
  51. List steps needed to implement each strategy in a change proposal.
  52. Outline the resources needed to develop and implement a change
    proposal.
  53. Describe methods for obtaining necessary support from key
    stakeholders.
  54. Develop a plan to evaluate the effectiveness of the change proposal
    project.
  55. Evaluate the role of information sources and technologies impacting
    the delivery of care within an adequate environment of care.
  56. Develop appropriate change plans that promote health and prevent
    disease.
    Topic Material:
    Gradable Items Details Points Possible
    Assignment Topic 5 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    0.0
    Discussion
    Question
    Topic 5 DQ 1
    Stakeholder support is necessary for a
    successful change proposal
    project implementation. Consider your
    internal stakeholders, such as
    the facility, unit or health care
    setting where the change process is
    situated, and your external
    stakeholders, like an individual or
    group
    5.0
    Gradable Items Details Points Possible
    outside the health care setting. Why is
    their support necessary to the
    success of your project, and how you
    will go about securing that support?
    Discussion
    Question
    Topic 5 DQ 2
    Technology is integral to successful
    implementation in many projects,
    through either support or integration
    or both. Name at least one
    technology that could improve the
    implementation process and the
    outcomes of your EBP project. Do you
    plan to use this technology? If
    not, what are the barriers that prevent
    its use?
    5.0
    Participation 15.0
    Topic 6: Evidence-Based Practice
    Proposal Project Development and
    Implementation Plan 2
    Duration: 7 days
    Description:
    Students need to be able to process and formulate an evidence-based
    and financially feasible solution to a clinical problem or issue.
    Working through the element of plan development requires them to
    assess and address the challenges, barriers, and other facets of
    change proposal implementation in the real world. The content in
    this topic will enable students to better understand the cultural
    environment(s) surrounding a change project and lead them through
    the steps of how to go about successful implementation of a strategic
    plan. A change or nursing theory must be used to support rational for
    proposed implementation plan.
    Objectives:
  57. Identify objectives, strategy, and measurable outcomes of the
    evidence-based practice proposal.
  58. List steps needed to implement each strategy in a change proposal.
  59. Outline the resources needed to develop and implement a change
    proposal.
  60. Describe methods for obtaining necessary support from key
    stakeholders.
  61. Develop a plan to evaluate the effectiveness of the change proposal
    project.
  62. Evaluate the role of information sources and technologies impacting
    the delivery of care within an adequate environment of care.
  63. Develop appropriate change plans that promote health and prevent
    disease.
    Topic Material:
    Gradable Items Details Points Possible
    Assignment Literature Review
    While the implementation plan prepares
    students to apply their
    research to the problem or issue they
    have identified for their
    capstone change proposal project, the
    literature review enables
    students to map out and move into the
    active planning and development
    stages of the project.
    A literature review analyzes how
    current research supports the
    PICOT, as well as identifies what is
    known and what is not known in
    the evidence. Students will use the
    information from the earlier PICOT
    Statement Paper and Literature
    Evaluation Table assignments to develop
    a 750-1,000 word review that includes
    the following sections:
    Title page Introduction section A
    comparison
    of research questions A comparison of
    sample
    populations A comparison of the
    limitations of the study
    A conclusion section, incorporating
    recommendations for further
    research
    Prepare this assignment according to
    the guidelines found in the APA
    Style Guide, located in the Student
    Success Center. An abstract is not
    required.
    This assignment uses a rubric. Please
    review the rubric prior to
    beginning the assignment to become
    familiar with the expectations for
    successful completion.
    You are required to submit this
    assignment to Turnitin. Please refer
    to the directions in the Student
    Success Center.
    100.0
    Assignment Topic 6 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    0.0
    Gradable Items Details Points Possible
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    Discussion
    Question
    Topic 6 DQ 1
    After discussion with your mentor, name
    one financial aspect, one
    quality aspect, and one clinical aspect
    that need to be taken into
    account for developing the evidencebased practice project. Explain
    how your proposal will directly and
    indirectly impact each of the aspects.
    5.0
    Discussion
    Question
    Topic 6 DQ 2
    Now that you have completed a series of
    assignments that have led you
    into the active project planning and
    development stage for your
    project, briefly describe your proposed
    solution to address the
    problem, issue, suggestion, initiative,
    or educational need and how it
    has changed since you first envisioned
    it. What led to your current
    perspective and direction?
    5.0
    Participation 15.0
    Topic 7: Change Proposal Project
    Evaluation and Dissemination Plan 1
    Duration: 7 days
    Description:
    Students need to learn how to evaluate the outcomes. Did they prove
    what they set out to prove and learn how to develop data to support
    it? Was there significance in the change as compared to the status
    prior to implementation? The content in this topic requires them
    to formulate information and to communicate it in an understandable
    and professional manner; adding synthesis of new knowledge to the
    profession
    Objectives:
  64. Identify methods to evaluate a proposed solution.
  65. Describe variables and outcomes to be assessed pre- and postproject implementation.
  66. Utilize appropriate tools such as basic statistics to evaluate
    project outcomes.
  67. Summarize plans for disseminating evidence.
  68. Use communication and collaboration skills to deliver high-quality,
    evidence-based, patient-centered care.
    Topic Material:
    Gradable Items Details Points Possible
    Assignment Topic 7 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    0.0
    Discussion
    Question
    Topic 7 DQ 1
    Describe one internal and one external
    method for the dissemination
    of your EBP project results. For
    example, an internal method may be
    the hospital board, and an external
    method may be a professional
    nursing organization. Discuss why it is
    important to report your
    results to both of these groups. How
    will your communication
    strategies change for each group?
    5.0
    Discussion
    Question
    Topic 7 DQ 2
    In order to evaluate an evidence-based
    practice project, it is
    important to be able to determine the
    effectiveness of your change.
    Discuss one way you will be able to
    evaluate whether your project made
    5.0
    Gradable Items Details Points Possible
    a difference in practice.
    Participation 15.0
    Topic 8: Change Proposal Project
    Evaluation and Dissemination Plan 2
    Duration: 7 days
    Description:
    Students need to learn how to evaluate the outcomes. Did they prove
    what they set out to prove and learn how to develop data to support
    it? Was there significance in the change as compared to the status
    prior to implementation? The content in this topic requires them
    to formulate information and to communicate it in an understandable
    and professional manner; adding synthesis of new knowledge to the
    profession
    Objectives:
  69. Identify methods to evaluate a proposed solution.
  70. Describe variables and outcomes to be assessed pre- and postproject implementation.
  71. Utilize appropriate tools such as basic statistics to evaluate
    project outcomes.
  72. Summarize plans for disseminating evidence.
  73. Use communication and collaboration skills to deliver high-quality,
    evidence-based, patient-centered care.
    Topic Material:
    Gradable Items Details Points Possible
    Assignment Topic 8 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    0.0
    Gradable Items Details Points Possible
    Discussion
    Question
    Topic 8 DQ 2
    Not all EBP projects result in
    statistically significant results.
    Define clinical significance, and
    explain the difference between
    clinical and statistical significance.
    How can you use clinical
    significance to support positive
    outcomes in your project?
    5.0
    Discussion
    Question
    Topic 8 DQ 1
    Based on how you will evaluate your EBP
    project, which independent
    and dependent variables do you need to
    collect? Why?
    5.0
    Participation 15.0
    Topic 9: Evidence-Based Practice
    Proposal Project 1
    Duration: 7 days
    Description:
    Content in this topic will enable students to pull together the
    assignment and discussion/reflective components they have been working
    on throughout the course and result in the production of the evidencebased practice proposal Capstone Project utilizing a professional
    format and product through a presentation.
    Objectives:
  74. Produce a comprehensive and professional change initiative
    presentation.
  75. Integrate acquired knowledge and skills into professional practice.
  76. Examine the implementation of evidence-based research in nursing
    practice.
  77. Analyze research findings for the enhancement of evidence-based
    practice in the clinical setting.
  78. Apply leadership concepts, skills, and decision making in
    the provision of high-quality nursing care in a collaborative
    interprofessional setting.
  79. Analyze the impact of organizational and environmental factors on
    health care delivery and practice.
  80. Demonstrate leadership and communication skills to effectively
    implement change initiatives for nursing practice.
    Topic Material:
    Website
  81. The Cochrane Collaboration Website
    Explore The Cochrane Collaboration website. In particular, familiarize
    yourself with information for “Practitioners, Providers and
    Policymakers,” which offers numerous resources on evidence-based care.
    Electronic Resource
  82. Presenters’ Corner
    View “Presenters’ Corner” on the Western Institute of
    Nursing website.
    Other
  83. Practice Immersion Clinical Tools
    The attached document contains all three required Practice Immersion
    Clinical Tools. The “Practice Immersion Clinical Evaluation Tool
    – Student” will be completed by the student’s Course Mentor and
    the faculty at the course conclusion. The “Practice Immersion
    Clinical Evaluation Tool – Mentor” will be completed by the student
    and submitted to the course faculty at the course conclusion. The
    “Practice Immersion Clinical Evaluation Tool – Agency” will be
    completed by both faculty and student in regards to the clinical site,
    and will also be submitted to course faculty at the course conclusion.
    Gradable Items Details Points Possible
    Assignment Benchmark – Capstone Project Change
    Proposal
    In this assignment, students will pull
    together the change proposal
    project components they have been
    working on throughout the course to
    create a proposal inclusive of sections
    for each content focus area in
    the course. At the conclusion of this
    project, the student will be
    able to apply evidence-based research
    steps and processes required as
    the foundation to address a clinically
    oriented problem or issue in
    future practice.
    Students will develop a 1,250-1,500
    word paper that includes the
    following information as it applies to
    the problem, issue, suggestion,
    initiative, or educational need
    profiled in the capstone change
    proposal:
    Background Problem statement Purpose of
    the
    change proposal PICOT Literature search
    strategy
    employed Evaluation of the literature
    Applicable
    change or nursing theory utilized
    Proposed implementation
    plan with outcome measures
    Identification of potential
    barriers to plan implementation, and a
    discussion of how these could
    be overcome Appendix section, if
    tables, graphs, surveys,
    300.0
    Gradable Items Details Points Possible
    educational materials, etc. are created
    Review the feedback from your
    instructor on the Topic 3 assignment,
    PICOT Statement Paper, and Topic 6
    assignment, Literature Review. Use
    the feedback to make appropriate
    revisions to the portfolio components
    before submitting.
    Prepare this assignment according to
    the guidelines found in the APA
    Style Guide, located in the Student
    Success Center. An abstract is not
    required.
    This assignment uses a rubric. Please
    review the rubric prior to
    beginning the assignment to become
    familiar with the expectations for
    successful completion.
    You are required to submit this
    assignment to Turnitin. Please refer
    to the directions in the Student
    Success Center.
    Assignment Topic 9 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    0.0
    Discussion
    Question
    Topic 9 DQ 2
    Sustaining change can be difficult, as
    there are many variables that
    can affect implementation. One critical
    component of EBP is to ensure
    that practice change is part of an
    organization’s culture so it will
    5.0
    Gradable Items Details Points Possible
    continue to impact outcomes over time.
    Name two potential barriers
    that may prevent your EBP change
    proposal from continuing to obtain
    the same desired results 6 months to a
    year from now, and your
    strategies for overcoming these
    barriers.
    Discussion
    Question
    Topic 9 DQ 1
    Discuss one personal strength and one
    weakness you have regarding
    professional presentations. Name one
    method for improvement for each
    of these, and discuss why it is
    important for you to work on these
    skills if you want to present your
    findings in a more formal setting.
    5.0
    Participation 15.0
    Topic 10: Evidence-Based Practice
    Proposal Project 2
    Duration: 7 days
    Description:
    Content in this topic will enable students to pull together the
    assignment and discussion/reflective components they have been working
    on throughout the course and result in the production of the evidencebased practice proposal Capstone Project utilizing a professional
    format and product through a presentation.
    Objectives:
  84. Produce a comprehensive and professional change initiative
    presentation.
  85. Integrate acquired knowledge and skills into professional practice.
  86. Examine the implementation of evidence-based research in nursing
    practice.
  87. Analyze research findings for the enhancement of evidence-based
    practice in the clinical setting.
  88. Apply leadership concepts, skills, and decision making in
    the provision of high-quality nursing care in a collaborative
    interprofessional setting.
  89. Analyze the impact of organizational and environmental factors on
    health care delivery and practice.
  90. Demonstrate leadership and communication skills to effectively
    implement change initiatives for nursing practice.
    Topic Material:
    Website
  91. The Cochrane Collaboration Website
    Explore The Cochrane Collaboration website. In particular, familiarize
    yourself with information for “Practitioners, Providers and
    Policymakers,” which offers numerous resources on evidence-based care.
    Electronic Resource
  92. Presenters’ Corner
    View “Presenters’ Corner” on the Western Institute of
    Nursing website.
    Other
  93. Practice Immersion Clinical Tools
    The attached document contains all three required Practice Immersion
    Clinical Tools. The “Practice Immersion Clinical Evaluation Tool
    – Student” will be completed by the student’s Course Mentor and
    the faculty at the course conclusion. The “Practice Immersion
    Clinical Evaluation Tool – Mentor” will be completed by the
    student and submitted to the course faculty at the course conclusion.
    The “Practice Immersion Clinical Evaluation Tool – Agency”
    will be completed by both faculty and student in regards to the
    clinical site, and will also be submitted to course faculty at the
    course conclusion.
    Other
  94. Scholarly Activity Summary
    You may use the “Scholarly Activity Summary” resource to
    help guide the preparation of the Scholarly Activities assignment.
    Gradable Items Details Points Possible
    Assignment Benchmark – Professional Capstone and
    Practicum Reflective Journal
    Students are required to maintain
    weekly reflective narratives
    throughout the course to combine into
    one course-long reflective
    journal that integrates leadership and
    inquiry into current practice
    as it applies to the Professional
    Capstone and Practicum course.
    In your journal, you will reflect on
    the personal knowledge and
    skills gained throughout this course.
    The journal should address a
    variable combination of the following,
    depending on your specific
    practice immersion clinical
    experiences:
    New practice approaches
    Intraprofessional
    collaboration Health care delivery and
    clinical systems
    Ethical considerations in health care
    Population health
    concerns The role of technology in
    improving health care
    outcomes Health policy Leadership and
    economic
    100.0
    Gradable Items Details Points Possible
    models Health disparities
    Students will outline what they have
    discovered about their
    professional practice, personal
    strengths and weaknesses that
    surfaced, additional resources and
    abilities that could be introduced
    to a given situation to influence
    optimal outcomes, and finally, how
    the student met the competencies
    aligned to this course.
    While APA style is not required for the
    body of this assignment,
    solid academic writing is expected, and
    in-text citations and
    references should be presented using
    APA documentation guidelines,
    which can be found in the APA Style
    Guide, located in the Student
    Success Center.
    This assignment uses a rubric. Please
    review the rubric prior to
    beginning the assignment to become
    familiar with the expectations for
    successful completion.
    You are required to submit this
    assignment to Turnitin. Please refer
    to the directions in the Student
    Success Center.
    Assignment Scholarly Activities
    Throughout the RN-to-BSN program,
    students are required to
    participate in scholarly activities
    outside of clinical practice or
    professional practice. Examples of
    scholarly activities include
    attending conferences, seminars,
    journal club, grand rounds, morbidity
    and mortality meetings,
    interdisciplinary committees, quality
    improvement committees, and any other
    opportunities available at your
    site, within your community, or
    nationally.
    You are required to post one scholarly
    activity while you are in the
    BSN program, which should be documented
    by the end of this course. In
    addition to this submission, you are
    required to be involved and
    10.0
    Gradable Items Details Points Possible
    contribute to interdisciplinary
    initiatives on a regular basis.
    Submit, as the assignment, a summary
    report of the scholarly
    activity, including who, what, where,
    when and any relevant take-home
    points. Include the appropriate program
    competencies associated with
    the scholarly activity as well as
    future professional goals related to
    this activity. You may use the
    “Scholarly Activity Summary”
    resource to help guide this assignment.
    While APA format is not required for
    the body of this assignment,
    solid academic writing is expected, and
    in-text citations and
    references should be presented using
    APA documentation guidelines,
    which can be found in the APA Style
    Guide, located in the Student
    Success Center.
    You are not required to submit this
    assignment to Turnitin.
    Assignment Practice Hours Documentation
    LoudCloud will be used to document and
    follow the status of your
    practice immersion hours throughout
    this course. Students must be able
    to document a minimum of 100 practice
    hours in association with this
    course to fulfill the total required
    practice hours in the RN-to-BSN
    program. Please review the Practice
    Hours Portfolio Required Elements
    below, then review the Guidelines for
    Undergraduate Field
    Experiences resource for details on
    what may or may not qualify
    as practice hours.
    Practice Hours Portfolio Required
    Elements
    The Practice Hours Portfolio will
    include all of the following elements:
    Individual Success Plan signed off by
    course mentor.
    Comprehensive clinical log of hours
    applied to program learning
    5.0
    Gradable Items Details Points Possible
    outcomes. Student evaluations (final).
    Course mentor
    evaluations (final). Faculty approvals
    of the Individual
    Success Plan and documented practice
    immersion hours. (Student is
    responsible for obtaining approvals.)
    Course mentor’s approval of the
    Individual Success Plan and
    documented practice immersion hours.
    (Student is responsible for
    obtaining approvals.)
    Assignment Practice Immersion Clinical Evaluation
    Tools Submission
    Submit the completed “Practice
    Immersion Clinical Evaluation
    Tool” to your course faculty by
    the end of the course, as it is
    required to successfully pass the
    course.
    0.0
    Assignment Topic 10 Practice Hours Completion
    Statement NRS-490
    Students will track their practice
    hours throughout the course via
    the Practice Hours Completion Statement
    provided in this assignment.
    Complete the following statement
    in a Word document and submit the
    attachment:
    Practice Hours Completion Statement
    NRS-490
    I, (INSERT NAME), verify that I have
    completed (NUMBER OF)
    practice hours in association with the
    goals and objectives for this
    course. I also verify that all required
    course approvals are in
    place from my faculty and practice
    mentor.
    0.0
    Discussion
    Question
    Topic 10 DQ 2
    Discuss why EBP is an essential
    component of the practice of a
    BSN-prepared RN. Identify two ways in
    which you will continue to
    integrate evidence into your practice
    and encourage it within your
    work environment. What obstacles could
    challenge this plan, and what
    5.0
    Gradable Items Details Points Possible
    steps will you take to minimize their
    impact?
    Discussion
    Question
    Topic 10 DQ 1
    Dissemination of EBP and research, such
    as presenting results at a
    conference or writing an article for a
    journal, is an important part
    of professional practice. Identify one
    professional journal and one
    nursing or health care conference where
    you might present your
    project. Discuss why each of your
    choices is the best option for you
    to disseminate your new knowledge.
    5.0
    Participation 15.0
    Grade Scale
    Letter
    Grade
    GPA Value Minimum Maximum Interpretation
    of Level of
    Performance
    A 4.0 95.0 100.0 Superior;
    outstanding
    scholarship
    A- 3.7 92.0 94.99 Superior;
    outstanding
    scholarship
    B+ 3.3 90.0 91.99 Superior;
    outstanding
    scholarship
    B 3.0 87.0 89.99 Above average; good
    work
    B- 2.7 84.0 86.99 Average standard
    performance
    C+ 2.3 80.0 83.99 Average standard
    performance
    C 2.0 76.0 79.99
    D 1.0 72.0 75.99 Below standard
    F 0.0 0.0 71.99 Failure
    I 0.0 0.0 Course work is
    incomplete
    W 0.0 0.0 Authorized
    withdrawal; no
    credit
    – 0.0 0.0
    – 0.0 0.0
    Policies

pdf (15)
For student policies, please refer to the University Policy Handbook Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment
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