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GCU RN-BSN Professional Capstone and Practicum (NRS-493) Week 1- 10 explained

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• Author Writezilas

Most RN-BSN student at the Grand Canyon University find this course very tough and confusing. Being the climax of their program, many lose the opportunity to finish with a 4.0 GPA just because they messed up with this course. The course is 10 weeks long. Before you begin this course ensure you have found a;

Practicum Site – you will be expect to complete 100 hours practicum at your site. Divided in to 50 hours of leadership and equal hours for community.

Preceptor/Mentor - Throughout the program, you will work in collaboration with your preceptor. It must be someone with at least a BSN and work in a hospital, public health clinic, community health, and/or a Nursing Home. He must be able to offer leadership and must be person you can contact anytime.

You will also need at least three topics which you will submit to your instructor for Approval. Conduct a deep research about the population select to ensure you will have adequate information for the study throughout the practicum. You focus will be the approved topic for the rest of the weeks.

I will provide weekly insight of task and what is expected of you. I will also provide samples and tips to complete each task.

Discussions

Topic 1 DQ1

Identify two GCU Library scholarly databases that will help you find the best research articles to support your capstone project change proposal. Discuss why these two databases are better than Google Scholar or a general Internet search.

Example of Databases from GCU library include CINHAL and PubMed.

Preview Sample Below

Topic 1 dq2.

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.

Barrier of Evidence based practice are divided in to two: Individual and organizational barriers. Example of individual barriers are Nurse personal attitude and experience while organizational barriers include lack of support and supervision. Discuss each barrier comprehensively

Individual Success Plan

Do not get confused by this form. You just need to fill the contact information, and fill in week 1. You do not need to have the whole document filled in the first week. Next scroll down to where the student is supposed to sign. Input your signature and date. Forward the same to the preceptor to sign in the option "Upon initiation of the course” and you are good to go.

NB: You need to print and manually sign, then scan. Digital signature will be rejected

Professional Capstone and Practicum Reflective Journal

Here, you are given a list of 10 topics to write about. You will need to write them in any order but it is advisable to follow the order in which they are listed to minimize chances of mixing things up. You will compile this journals at the end of course. Therefore, save them somewhere you will easily retrieve them.

The content of each topic is in relation to your chosen topic for the course.

Lopes activity hours

Proceed to the dashboard of your account and scroll down to section written ‘lopes activity’. Open it and you will need to record you weekly activity here. Remember its 100hrs. 50 hours for leadership and 50 hours for collaboration.

The rest of the tasks for week 1 are for you to get the forms signed by you and the preceptor.

During your practicum, determine what clinical problem or issue the organization is facing. Discuss two implications for nursing.

Topic 2 DQ2

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.

Capstone Project Topic Selection and Approval

The purpose of this task is to identify an evidence-based topic for the capstone project proposal. The topic can be a clinical problem, leadership issue, organizational issue, quality improvement issue or any other issue related to patient population/community

Length 500-750 words.

Review the sample attached below.

Capstone Topic Summary

This is a summary of the interventions and category for your proposed topic. For reference, see attached sample.

Not more than 250 words in length.

Professional Capstone and Practicum Reflective Journal week 2

Topic 3 dq1.

Submit a summary of six of your articles on the discussion board. Discuss one strength and one weakness for each of these six articles on why the article may or may not provide sufficient evidence for your practice change.

Sample Attached below

Topic 3 DQ2

Name two different methods for evaluating evidence. Compare and contrast these two methods.

PICOT Statement Paper

You are to formulate a PICOT paper base on your research issue or problem. PICOT stands for Population(P), Intervention(I), Comparison(C), Outcomes(O), and Time(T). Ensure you state your PICOT question clearly on the first paragragh.

Use this Template to formulate a PICOT question.

In ____________________(P), how does ____________________ (I) compared to ____________________(C) affect _____________________(O) within ___________(T)?

See An Example of PICOT Statement Paper

Topic 4 DQ1

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 preceptor that you will take into consideration for your own change project.

Topic 4 DQ2

Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention. Why? Has your preceptor used either theory, and to what result?

Topic 5 DQ1

Stakeholder support is necessary for a successful project implementation. Consider your internal stakeholders, such as the facility, unit, or health care setting where the change proposal is being considered, and your external stakeholders, like an individual or group outside the health care setting. Why is their support necessary to the success of your change proposal, and how you will go about securing that support?

Topic 5 DQ2

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 capstone project change proposal. Do you plan to use this technology? If not, what are the barriers that prevent its use?

Strategic Plan Summary

Assess the culture of the organization for potential challenges in incorporating the nursing practice intervention. Use this assessment when creating the strategic plan. Write a 150-250 word strategic plan defining how the nursing practice intervention will be implemented in the capstone project change proposal. APA style is not required, but solid academic writing is expected. You are not required to submit this assignment to LopesWrite.

Professional Capstone and Practicum Reflective Journal week 5

Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice. This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s). In each week's entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below. In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

Topic 5 on the list

Topic 6 DQ1

After discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.

Topic 6 DQ2

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?

Literature Review

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, 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 Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

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.

Capstone Change Project Resources

Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented. Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal. The assignment will be used to develop a written implementation plan. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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 LopesWrite.

Professional Capstone and Practicum Reflective Journal week 6

Topic 6 on the list

Topic 7 DQ1

Describe one internal and one external method for the dissemination of your evidence-based change proposal. 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 change proposal to both of these groups. How will your communication strategies change for each group?

Topic 7 DQ2

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 a difference in practice.

Topic 8 DQ1

Based on how you will evaluate your EBP project, which independent and dependent variables do you need to collect? Why?

Topic 8 DQ2

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?

Benchmark - Capstone Project Change Proposal

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Clinical problem statement.

Purpose of the change proposal in relation to providing patient care in the changing health care system.

PICOT question.

Literature search strategy employed.

Evaluation of the literature.

Applicable change or nursing theory utilized.

Proposed implementation plan with outcome measures.

Discussion of how evidence-based practice was used in creating the intervention plan.

Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.

Plan for evaluating the proposed nursing intervention.

Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Benchmark Information This benchmark assignment assesses the following programmatic competencies: RN to BSN 1.1: Exemplify professionalism in diverse health care settings. 2.2: Comprehend nursing concepts and health theories. 3.2: Implement patient care decisions based on evidence-based practice.

Professional Capstone and Practicum Reflective Journal week 8

Topic 8 on the list

Topic 9 DQ1

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.

Topic 9 DQ2

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 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.

Capstone Project Change Proposal Presentation for Faculty Review and Feedback

Create a professional presentation of your evidence-based intervention and change proposal to be disseminated to an interprofessional audience of leaders and stakeholders. Include the intervention, evidence-based literature, objectives, resources needed, anticipated measurable outcomes, and how the intervention would be evaluated. Submit the presentation in LoudCloud for feedback from the instructor. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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 LopesWrite.

Professional Capstone and Practicum Reflective Journal week 9

Topic 9 & 10 on the list

Topic 10 DQ1

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.

Topic 10 DQ2

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 steps will you take to minimize their impact?

Capstone Project Change Proposal Presentation

Review the feedback on the change proposal professional presentation and make required adjustments to the presentation. Present your evidence-based intervention and change proposal to an interprofessional audience of leaders and stakeholders. Be prepared to answer questions and accept feedback. After presenting your capstone project change proposal, write a 250-350 word summary of the presentation. Include a description of the changes that were suggested by your preceptor before your presentation and how you incorporated that feedback. Describe how this interprofessional collaboration improved the effectiveness of your presentation. Include a description of the feedback and questions from your audience after your presentation, and how this experience will affect your professional practice in the future. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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 LopesWrite

Scholarly Activities

This document describes the scholarly activity elements that should be included in a five paragraph summary. You may use this resource to help guide the preparation of the Scholarly Activities assignment, due in Topic 10. Overview This section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you. Problem This section consists of either a short narrative or a list of bullet points that concisely identifies the problems the scholarly activity is designed to solve. Educate: What is the current state of the activity topic? Explain why this is a problem, and for whom is it a problem? Inspire: What could a nurse achieve by participating in the scholarly activity? Use declarative sentences with simple words to communicate each point. Less is more. Solution This section consists of either a short paragraph or a list of bullet points that concisely describes the solution to a proposed practice problem that the scholarly activity addressed and how it addresses the problem outlined in the previous section. Opportunity This section consists of short paragraphs that define the opportunity that the scholarly activity is designed to capture. It is important to cover the objectives and goals that were met. How will attending/participating in this scholarly activity help you grow as a nurse? Program Competencies Addressed This section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP.

See Sample below

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Expert Answer to Benchmark Capstone Project Change Proposal NRS 493 Best Solution

• June 8, 2022
• blog , Nursing Paper Solutions

The post has the instructions and complete paper for Benchmark Capstone Project Change Proposal NRS 493. This is a benchmark capstone project change proposal, gcu capstone project example and professional capstone and practicum reflective.

What You'll Learn show 1 Benchmark Capstone Project Change Proposal 1.1 Benchmark Information 1.2 Expert Solution to Benchmark Capstone Project Change Proposal 1.2.1 Introduction to benchmark capstone project change proposal 1.2.2 Background 1.2.3 Clinical Problem Statement 1.2.4 Purpose of Change Proposal 1.2.5 PICOT Question 1.2.6 Literature Search 1.2.7 Evaluation of Literature 1.2.8 Change or Nursing Theory 1.2.9 Implementation Plan and Outcome Measures 1.2.10 Use of Evidence-Based Practice in Intervention Plan 1.2.11 Plan for Evaluating Proposed Nursing Intervention 1.2.12 Potential Barriers and Plan to Overcome Barriers 1.2.13 Conclusion 1.2.14 References 1.3 Appendix B 1.4 Appendix C 1.4.1 Frequently Asked Questions on benchmark capstone project change proposal 1.4.1.1 What is a capstone project change proposal? 1.4.1.2 What are the parts of a capstone project? 1.4.1.3 What are the deliverables in a capstone project? 1.4.1.4 4. How many pages is a capstone project proposal? 2 Working On an Assignment With Similar Concepts Or Instructions? ​ Benchmark Capstone Project Change Proposal In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice . Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the benchmark capstone project change proposal : 1.     Background 2.     Clinical problem statement. 3.     Purpose of the change proposal in relation to providing patient care in the changing health care system. 4.     PICOT question. 5.     Literature search strategy employed. 6.     Evaluation of the literature. 7.     Applicable change or nursing theory utilized. 8.     Proposed implementation plan with outcome measures. 9.     Discussion of how evidence-based practice was used in creating the intervention plan . 10.   Plan for evaluating the proposed nursing intervention . 11.   Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. 12.   Appendix section, if tables, graphs, surveys , educational materials, etc. are created. Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review and benchmark capstone project change proposal. Use this feedback to make appropriate revisions to these 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. benchmark capstone project change proposal fall prevention You are required to submit this assignment to LopesWrite. Refer to the  LopesWrite Technical Support articles  for assistance. Benchmark Information This benchmark assignment assesses the following programmatic competencies: RN to BSN 1.1:     Exemplify professionalism in diverse health care settings. 2.2:     Comprehend nursing concepts and health theories. 3.2:     Implement patient care decisions based on evidence-based practice.

Expert Solution to Benchmark Capstone Project Change Proposal

Introduction to benchmark capstone project change proposal.

All papers require an introduction and thesis statement. There is a difference between the introduction and background.

Banner Heart Hospital has a problem with nonfunctional Peripheral IVs (PIVs) coming to the Cardiac Cath Lab (CCL) for procedures. Some PIVs are on the wrong arm for the procedure, and some are compromised or occluded. Compromised PIVs are a cause of potential harm to patients and negatively impact the flow of the CCL. Changing this weak area of the institution can result in more positive patient outcomes and reduce costs for the hospital. Patient satisfaction improves when PIVs are not a source of pain, infection, or harm. Patient safety is improved when PIVs are properly working and maintained (Garrett et al., 2017).

Clinical Problem Statement

Nonworking IVs delay cases in the CCL, which causes staff to stay late to finish cases, increasing hospital costs. Compromised PIVs can cause patient harm through infiltration, phlebitis, and extravasation. This is painful for the patient, it can cause serious harm. Extravasation causes tissue damage when vesicant medications infiltrate tissue from the PIV catheter displaced from the vein. Infiltration is when IV fluids running through a displaced IV spread into the nearby tissue. These issues cause patients to stay longer in the hospital and increase costs (Keogh et al., 2016).

Purpose of Change Proposal

The change project aims to reduce the number of patients entering the CCL with nonworking PIVs. The proposed solution is to establish a pre-operative checklist for the perioperative nurses . The checklist will include criteria that need to be addressed by the pre-op nurse before allowing the patient to leave the floor. The checklist also needs to be communicated in the report between the CCL nurse and pre-op nurse. This solution requires education to be disseminated to all nurses involved regarding the standards of practice for PIV maintenance, the significance of maintaining a working PIV, and how to implement and communicate the checklist (Yagnik et al., 2017).

PICOT Question

PICOT question: Does developing a standardized pre-procedure checklist for PIV standard of practice improve patient outcomes? The development of a pre-procedure checklist would ensure the decreased risk of extravasation, improve procedure times and decrease infection rates. gcu capstone project examples

Literature Search

The GCU library to find all eight research articles. To gather the necessary evidence to support the change proposal, various search engines were used within the database. For instance, databases such as CINAHL , PubMed, and academic search completed helped. Within those databases, filters were used to obtain only the necessary articles that would help the project. Inputting extravasation prevention protocols, and PIV maintenance were the words searched predominantly. The search engines provided valuable supporting evidence.

Evaluation of Literature

Two of my articles were studies performed to decrease the dwell-time of pre-hospital PIVs. Garrett et al. (2017) research studied trauma patients and evaluated the reduction in pre-hospital PIV complications post-intervention. The Ruegg et al. (2018) study followed all patients admitted to a medical centre and evaluated the number of pre-hospital PIVs that remained in place over 24 hours. The interventions used in both studies involved education for staff and a small practice change, placing an identifying sticker on each field stick site. Both studies had positive clinical outcomes, which helped support my PICOT question of implementing education and a small practice change, in my case a checklist, to improve patient PIV outcomes.

The Yagnik et al. (2017) study found that using inexpensive, simple interventions resulted in nurse practice improvement and increased adherence to PIV guidelines (Capps, 2020d). Another article explored the positive impact of dressing integrity on reducing PIV complications (Corley et al., 2019). Part of the low-cost education piece for my intervention will include EBP on dressings and securement practices; dressing assessments will be an item on the pre-procedure checklist as well. Keogh et al. (2016) explored the effects of different flushing methods on PIV failure. No conclusive findings were discovered that proved any one method better than another. Flushing PIVs per policy will be included in the PIV maintenance education and on the checklist. Two of my articles, Salgueiro et al. (2019) and Brady et al. (2016) showed that nurses often do not follow policy on PIV maintenance and that quality improvement projects and education can increase nursing compliance. This supports both my issue and my intervention. My final article, by Willassen et al. 2018, supports the idea that a checklist improves patient safety when adhered to by all team members. All of my articles lend support to my PICOT question.

Change or Nursing Theory

Lewin’s three-part Theory of Planned Change supports my research proposal. In the first phase of my project, data will be gathered on the number of nonworking PIVs arriving at CCL. This gives evidence and understanding that change is needed, which is Lewin’s first phase. During the second phase, education will be implemented utilizing the pre-procedure checklist. The final phase is to establish a new normal. During this phase, continued assessment of PIVs working or nonworking will be evaluated entering the CCL (Barrow et al., 2020).

Implementation Plan and Outcome Measures

My plan is to re-educate nursing staff who send patients to the CCL regarding EBP for PIV maintenance and to introduce a pre-procedure checklist to be communicated in report between the pre-op and CCL nurses. Education will be given verbally in pre-shift over a 4-week period before use of the checklist begins. A read-and-sign document with the written education and example of the checklist will be in the breakroom of each unit involved. Handouts of the education and checklist will be there for staff to take. Emails will be sent to all staff with the same information. A poster will be hung in each breakroom as a visual reminder (Yagnik et al., 2017). All staff must participate in the read-and-sign by the appointed date, at which time the checklist will be live for all nurses sending patients for a CCL procedure.

My project has three anticipated outcomes. First, a reduction in the number of compromised PIVs sent to the CCL. Secondly, the implementation of a pre-procedure checklist that is discussed in the report prior to procedures. This practice change must occur in order to achieve the first outcome. Finally, the nursing staff will incorporate practice changes and maintain PIVs according to EBP and hospital policy. When nurses are maintaining PIVs according to EBP and hospital policy, complications will be fewer and caught sooner (Salgueiro et al., 2019). This overall better PIV health for the hospital will roll over into better PIVs entering the CCL.

Use of Evidence-Based Practice in Intervention Plan

Many studies have shown that nursing practice varies when it comes to PIV maintenance. The education portion of my intervention will use EBP for proper PIV care and maintenance. This will include the type of dressing and securement, dating it, and when to change it. Dressings need to be changed every 5-7 days or when wet, soiled, or loose. EBP will also include flushing PIVs according to hospital policy. Also, reminders for documentation of the PIV insertion date and any complications will be included. Placement of PIVs will be addressed, as EBP has shown that insertion of PIVs at the antecubital fossa has a high rate of occlusion and accidental removal (Brady et al., 2016).

Plan for Evaluating Proposed Nursing Intervention

Evaluation will compare the number of nonfunctional PIVs entering the CCL before the intervention with the number of nonfunctional PIVs after the intervention. Data will be collected on the past 6 weeks of nonworking PIVs to use for a comparison. Each procedure room will be given a checklist to document, “Compromised IV / Incorrect Side.” I’ll number the list vertically and across the top will be the headings, “Date,” “Sending Department (i.e., ER, CVICU, 4 th Floor, etc.),” and “Description of Problem (i.e., clotted, leaking, phlebitis, pain with flushing, wrong arm, etc.).” The CCL team will be presented with the plan prior to the 6-week assessment period and will be reminded each morning in huddle. Each time a problem PIV presents for procedure, the nurse can simply write the date, sending unit, and issue on the list. Lists will be collected at the end of 6 weeks. Following this, the 4-week intervention roll-out will take place, and the same evaluation will be performed again for 6 weeks (Garrett et al., 2017). At the end of the post-evaluation period, lists will be collected, and the numbers will be counted and compared.

Potential Barriers and Plan to Overcome Barriers

Possible barriers for implementation of this project include lack of administrative support and staff resistance to change. A couple of years ago, the hospital did away with clinical managers for the inpatient units . This puts a big strain on the directors and senior clinical managers. Adding in another project that requires staff follow-up and consistent education may be impossible for them. Staff resistance may occur, and I would like to recruit peer support from specific floor nurses to speak positively of the project and to encourage others to make the change and better patient outcomes (Ginex, 2018).

Creating a patient experience free of unnecessary complications contributes to patient safety and increases patient satisfaction. Anticipation of CCL procedures can cause patients anxiety without the compounding effect of a nonworking PIV. Maintaining healthy PIVs and heeding the PIV checklist requirements contribute to positive patient outcomes.

Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Change Management. StatPearls . https://www.ncbi.nlm.nih.gov/books/NBK459380/#article-89.s1

Brady, T., Bruno, F., Marchionni, C., & Paquet, F. (2016). Prevalence and maintenance practices of peripheral intravenous catheters. Vascular Access , 11–19. https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=80&sid=f8b8457c-a699-4b83-b17c-2f62928f4320%40pdc-v-sessmgr05

Corley, A., Ullman, A. J., Mihala, G., Ray-Barruel, G., Alexandrou, E., & Rickard, C. M. (2019). Peripheral intravenous catheter dressing and securement practice is associated with site complications and suboptimal dressing integrity: a secondary analysis of 40,637 catheters. International Journal of Nursing Studies , 100 . https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0020748919302160?via%3Dihub

Garrett, A., Drake, S. A., & Holcomb, J. B. (2017). Process to decrease complications in trauma patients with prehospital peripheral intravenous access. Journal of Trauma Nursing , 24 (4), 236–241. https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=16&sid=f65e61f5-8501-4bc4-9664-1a72f71b0af5%40sdc-v-sessmgr01

Ginex, P. K. (2018, May 30). Overcome barriers to applying an evidence-based process for practice change . ONS Voice. https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change

Grand Canyon University. (n.d.). Find Journal Articles . https://libguides.gcu.edu/az.php

Keogh, S., Flynn, J., Marsh, N., Mihala, G., Davies, K., & Rickard, C. (2016). Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomized controlled trial in adult medical-surgical hospital patients. Trials , 1 , 1–10. https://doi.org/10.1186/s13063-016-1470-6

Ruegg, L., Faucett, M., & Choong, K. (2018). Emergency inserted peripheral intravenous catheters: A quality improvement project . British Journal of Nursing , 27 (14), S28–S30. https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=25&sid=f65e61f5-8501-4bc4-9664-1a72f71b0af5%40sdc-v-sessmgr01

Salgueiro, A. D., Costa, P. J., Graveto, J. M., Costa, F. J., Osorio, N. I., Cosme, A. S., & Parreira, P. M. (2019). Nurses’ peripheral intravenous catheter-related practices: A descriptive study. Revista de Enfermagem Referência , 4 (21), 111–120. https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=21&sid=f65e61f5-8501-4bc4-9664-1a72f71b0af5%40sdc-v-sessmgr01

Vascular Access Policy Group. (2019). Peripheral intravenous therapy, adults (Number 687, Version 16). Banner Health Policy. benchmark capstone project change proposal

Willassen, E., Jacobsen, I., & Tveiten, S. (2018). Safe surgery checklist, patient safety, teamwork, and responsibility—coequal demands? A focus group study. Global Qualitative Nursing Research , 5 , 233339361876407. https://doi.org/10.1177/2333393618764070

Yagnik, L., Graves, A., & Thong, K. (2017). Plastic in patient study: prospective audit of adherence to peripheral intravenous cannula monitoring and documentation guidelines, with the aim of reducing future rates of intravenous cannula-related complications. American Journal of Infection Control , 45 (1), 34–38. https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0196655316308628?via%3Dihub

                                                                            Appendix B

Pre-Procedure Checklist for Cath Lab

• Is the procedure a pacemaker or ICD? IV must be on the same arm as the side the device being placed.
• Does IV flush easily?
• Does IV have blood return?
• How many days has IV been in place?
• Is the dressing clean, dry, and intact?
• Is IV secured?
• Are there any signs of redness, leaking, or infiltration? Does the patient have pain with flushing? If yes to any of these, discontinue IV and start a new IV. benchmark capstone project change proposal

PIV Eduation

• Background: Complications from IVs cause harm to patients, extend hospital stays, and increase costs.
• PIVs for Cath/EP Lab: Nonworking PIVs cause delays in cath lab cases and increase patient anxiety due to lying on a cold, hard table getting poked for a new PIV. Patients receive vesicant medications in the cath lab that require a patent, well-placed PIV.
• Pacemakers/Defibrillators: Patients going for a pacemaker or defibrillator implant must have a PIV on the SAME arm as the side of the chest the device will be placed. This is typically the left side, but not always; check your orders or call the doctor if they did not specify. A CENTRAL LINE IS NOT ACCEPTABLE FOR DEVICE PROCEDURES. This is because IV contrast is pushed under fluoroscopy through the PIV so the cardiologist can visualize the vascular anatomy of the patient when they stick for access. Pushing through a central line does not highlight the needed area. benchmark capstone project change proposal gcu
• Flushing: Hospital policy requires peripheral IVs (PIVs) to be flushed with a minimum of 3 ml every 12 hours to maintain catheter patency. PIVs should be flushed before and after medication administration
• Dressings: Must be adherent at insertion site. Edges can be reinforced if insertion site is intact. Dressing must be changed every 5-7 days or if soiled, wet, or nonadherent.
• Dwell time : Change PIV sites when clinically indicated—pain, phlebitis, infiltration, leaking, extravasation, or occluded. Exception – remove field sticks within 24 hours.

• Hand-off Communication: Discuss the Pre-Procedure Checklist in report with the cath lab RN before the procedure. Inform them of any issues related to the PIV. Resolving issues before taking the patient down constitutes a better and safer experience for the patient. benchmark capstone project change proposal portfolio

benchmark capstone project change proposal

Frequently Asked Questions on benchmark capstone project change proposal

What is a capstone project change proposal.

A capstone project change proposal provides evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice

What are the parts of a capstone project?

Most capstones are made up of six sections that include the abstract, introduction, methods, discussion, conclusion, and references. The example above provides a clear step by step framework you can follow.

What are the deliverables in a capstone project?

A capstone project includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

• Clinical problem statement.
• Purpose of the change proposal in relation to providing patient care in the changing health care system.
• PICOT question.
• Literature search strategy employed.
• Evaluation of the literature.
• Applicable change or nursing theory utilized.
• Proposed implementation plan with outcome measures.
• Discussion of how evidence-based practice was used in creating the intervention plan.
• Plan for evaluating the proposed nursing intervention.
• Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
• Appendix section, if tables, graphs, surveys, educational materials, etc. are created

4. How many pages is a capstone project proposal?

The Paper Requirements for a capstone project proposal are 5 to 7 pages. Generally, a capstone project is about 20-25 pages long, but no longer than 45 pages. Proposal cover only 30-40% of the full capstone project.

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(Answered) NRS 493 week 8: Benchmark – Capstone Project Change Proposal

Description: In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Clinical problem statement. Purpose of the change proposal in relation to providing patient care in the changing health care system. PICOT question. Literature search strategy employed. Evaluation of the literature. Applicable change or nursing theory utilized. Proposed implementation plan with outcome measures. Discussion of how evidence-based practice was used in creating the intervention plan. Plan for evaluating the proposed nursing intervention. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. Appendix section, if tables, graphs, surveys, educational materials, etc. are created. Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Benchmark Information This benchmark assignment assesses the following programmatic competencies: RN to BSN 1.1: Exemplify professionalism in diverse health care settings. 2.2: Comprehend nursing concepts and health theories. 3.2: Implement patient care decisions based on evidence-based practice.

Benchmark Capstone Project Change Proposal

In order to sustain change and to make sure there is sufficient supply of nursing staff, effective solutions must be developed in all areas including nursing education, policy and regulations, and healthcare delivery systems (Gerardi, Farmer, & Hoffman, 2018). This capstone project proposal focuses on the educational sector by proposing a change, particularly in terms of the time that taken by nursing students in college to address the nursing shortage. The sections of the paper include a background, problem statement, purpose of the change proposal, PICOT question, search strategies for literature, literature evaluation, applicable change / nursing theory, proposed implementation plan, use of evidence-based practice (EBP) in intervention plan’s creation, plan for evaluation of the intervention, and potential barriers to implementation with strategies for addressing them.

The shortage of Registered Nurses (RN) has continued to be a chronic problem affecting the nursing field and generally, the health care sector at all levels from local, state, national, and international. Bureau of Labor Statistics (n.d) predicted the growth of the RN profession from 2.9 million to 3.4 million (15 percent growth rate) from 2016 to 2026. This growth demands for extra 203,700 new RNs on an annual basis for replacement of the retiring one. The number of RN retirements is estimated to be one million by the year 2030 and this will lead to significant loss in the number of RNs with sufficient knowledge, qualifications, competence, and experience in nursing (Gerardi et al., 2018). Aside from the high RN retirement rates, other contributing factors to the increasing shortage of RN include a slow rate of growth in nursing school enrollment, inadequate number of nursing faculties in educational institutions which also restrain the number of nursing programs’ enrollments.C lick link below to purchase full tutorial at $10

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Assignment: NRS 493 Benchmark – Capstone Project Change Proposal

Sample Answer for Assignment: NRS 493 Benchmark – Capstone Project Change Proposal Included After Question

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Clinical problem statement.

Purpose of the change proposal in relation to providing patient care in the changing health care system.

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PICOT question.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalLiterature search strategy employed.

Evaluation of the literature.

Discussion of how evidence-based practice was used in creating the intervention plan.

Plan for evaluating the proposed nursing intervention.

Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.

Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalPrepare 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

1.1: Exemplify professionalism in diverse health care settings.

2.2: Comprehend nursing concepts and health theories.

3.2: Implement patient care decisions based on evidence-based practice.

A Sample Answer For the Assignment:  Assignment: NRS 493 Benchmark – Capstone Project Change Proposal

Title: assignment: nrs 493 benchmark – capstone project change proposal.

Nurses have a role to ensure patient safety and quality outcomes in their practice settings and environment. Hospital acquired pressure injuries or ulcer (HAPIs) among patients in critical care settings like the intensive care unit are a critical patient safety concern due to their rising prevalence and negative effects. Evidence shows that over 2.5 million patients are affected by HAPIs with about 60,000 dying each year due to related complications and comorbidities related to them (AHRQ, 2022). Again, the healthcare system spends close to $11 billion each year on HAPIs and their related effects like increased hospital stay and comorbidities (Amirah et al., 2020). Nurses in critical care settings encounter the increased vulnerability of patients who suffer from these injuries and require interventions that are evidence-based to reduce their prevalence and susceptibility in critical care settings (Saunders et al., 2019). Patients suffering from HAPIs require these interventions to improve their quality of life and attain better outcomes from the facilities.

Ensuring that nurses can implement care bundle approach to HAPIs can enhance the quality of life for the patients, reduce their prevalence and lower the associated cost of treatment and prolonged stay in hospitals (Lam et al., 2020). The purpose of this paper is to present a capstone project change proposal aimed at reducing and preventing the occurrence of HAPIs among patients in critical care settings. The paper combines different aspects and sections of the proposed project for effective implementation and evaluation of expected outcome. Implementing a care bundle approach will ensure that nurses have different intervention based on the status of individual patient to reduce their susceptibility to HAPIs. The care bundle model will ensure that nurses have sufficient knowledge about these interventions and use an evidence-based practice approach to integrate them in their practice settings for quality care provision and better patient outcomes.

As observed through existing evidence from literature, hospital acquired pressure injuries (HAPIs) are a critical patient safety concern, particularly in critical and progressive care units. These HAPIs impact the quality of patient care while also increasing nurses’ workload and costs for the healthcare system, families and patients. Pressure injuries or ulcers arise mainly due to the nature of patients in the critical care settings or units, particularly because of reduce mobility, severity of their conditions and delicate nature of their care (Zhang et al., 2020). These patients are at an elevated risk of HAPIs when there is interruption of blood supply to the brain or connected tissues. Risks also increase because of poor nutrition, poor hydration and poor sensory reception and perception.

Developing and implementing an evidence-based intervention or solution would confer benefits to patients and their families, healthcare providers, and the entire health system. Strategies like pressure distribution and repositioning of patients implore nurses to change the patents at least each one to two hours. Again, pressure distribution utilizing special devices like air mattresses are EBP strategies that can improve care and overall outcomes (Amirah et al., 2020). However, the implementation of a care bundle approach entails an organized set of interventions that lead to better compliance based on guidelines and integration of measures that are tailored to meet patient needs and situation. The care bundle approach will consist of best practices tested and proved in different settings and tailored at meeting the unique patient needs and improving the overall competencies among nurses to handle diverse situations. As stated, HAPIs are a safety issue and lead to increased cost of care patients, their families and healthcare system. Therefore, the problem requires interventions that are both nurse-driven and patient-centered to attain quality care outcomes and improve the patient conditions while in critical care settings.

Clinical Problem Statement

Hospital acquired pressure injuries (HAPIs) pose a critical threat to patient safety and quality care provision in critical care settings. The issue also results in increases cost of care and other complications like comorbidities and fatalities, in severe situations. Evidence shows that over 60,000 deaths occurs each year associated with HAPIs (Lavallée et al., 2019). HAPIs lead to increased stay in healthcare facilities which also exposes patients to other infections due to their vulnerability and susceptibility. The implication is that health care facilities and nurses need to implement interventions that will improve clinical outcomes by reducing the adverse effects of HAPIs and ensuring that patients have better conditions as they continue to stay based on their disease prognosis.

Existing studies show that a majority of HAPIs occur in critical care setting that include the intensive care unit, especially the surgical ICUs. Pitman et al. (2019) observe that despite preventive approaches, HAPIs continue to occur, particularly in critical care, raising concerns about if some of these injuries cannot be avoided. Cox et al. (2022) assert that older patients with a mean age of 63.5 years and mostly male have increased risk for getting these injuries. The study notes that the prevalence of HAPIs among critically ill patients is higher compared to other patients with those having diabetes mellitus, mechanical ventilation and vasopressor agents at the highest risk for the condition. Pitman et al. (2019) note that while unavoidable HAPIs can happen. However, in cases where preventive interventions are not identified, documented, and deployed effectively, hospitals and healthcare providers can experience HAPIs. The implication is that as a clinical problem, nurses must deploy the right interventions through care bundle to deal with the issue. HAPIs care bundle offers nurse the relevant knowledge and approaches to help patients mitigate the negative effects of the condition. Nurses require sufficient knowledge on HAPIs to develop right interventions through informed decisions and collaboration with other providers.

Purpose of the Change Proposal in Offering Patient Care & Health care System

Hospital acquired pressure injuries are a critical patient safety problem and affect patient care and the entire health care system through different ways that include increased cost of care, poor outcomes, and longer hospital stays and even fatalities. As such, the purpose of this proposed change is to implement a care bundle intervention tailored on patient’s health status to reduce and prevent the occurrence of HAPIs. The change proposal aims at increasing awareness among critical care nurses about hospital acquired pressure injuries (HAPIs) based on the rationale that effective understanding of these injuries will enhance nurses’ approach to the issue by offering them sufficient information to implement better interventions in their practice settings.

The second objective of this proposed change project is prevent and reduce the prevalence of HAPIs in critical care units. Reducing the prevalence of these injuries will lower the overall cost burden to individuals, health population and the entire health care system (Coyer et al., 2022). The third focus of this project is to improve patients’ and providers’ safety through quality care delivery. This aim is essential because it aligns with professional and regulatory requirements concerning standards of care and best practices expected of nurses by professional entities like the American Nurses Association (ANA) and the American Association of Critical Care Nurses (AACN). Patients in critical care are delicate and require safety measures to enhance their conditions and health statuses (Gaspar et al., 2019). Therefore, it is critical for these patients through nurse-led and driven interventions focused on patients, deliver better practices to improve their chances of attaining quality care.

The proposed change project also aims at implementing evidence-based practice (EBP) interventions to manage HAPIs among the most susceptible patients. The change project will entail effective implementation of the proposed intervention to reduce and prevent the occurrence of HAPIs by 50% through an EBP care bundle comprising different tailored components to meet patient needs. Through this implementation, the proposed project will lead to better care delivery, reduce the overall burden of these injuries on the health care system, and ensure that all providers have sufficient knowledge and information on prevention and management of HAPIs for critical care patients.

PICOT Statement & Question

The PICOT model is a critical part of EBP process and helps nurses and research to implement interventions after interrogating and gathering sufficient evidence. The PICOT model focuses on identification of the population, intervention, comparison, outcomes and the time required to implement proposed measures to reduce and prevent HAPIs in critical care settings. In this case, the PICOT statement for the proposed EBP Capstone change project proposal entails the following:

Population: Hospitalized patients in critical care units with hospital acquired pressure injuries

Intervention: Care bundle on HAPIs management for patients

Comparison: Normal interventions

Outcome: Reduce HAPIs by 40%

Time: 3 months

PICOT Question

Among hospitalized patients in critical care unit with hospital acquired pressure injuries (HAPIs) ( P ), does the implementation of care bundle ( I ) compared to normal measures ( C ), reduce HAPIs by 40% ( O ) within three months ( T )?

The identified population consist of patients who suffer the brunt of HAPIs due to the delicate nature of their health. Critical care patients have limited mobility and are at an increased risk for HAPIs due to the interruption of blood or death of brain tissue. The population may also experience other factors like poor nutrition, poor hydration and poor sensory perception. The intervention, care bundle is an evidence-based approach that implores nurses in the critical care to implement strategies that align with patient state of health and needs. This implies that not all strategies are a one-size-fits-all aspects because of the patient diversity in needs (Melnyk et al., 2022). The care bundle will have guidelines and best practices as well as devices that leverage technological advancements to improve the quality of care and reduce exposure to HAPIs for patients in these settings. Based on the suggested approach, nurses will get sufficient knowledge and information that will lead to reduced HAPIs while also avoiding those that can be avoided. They will improve their attitude and help alter their approaches and perspectives on HAPIs prevention to improve overall patient safety and care.

Evidence from literature suggests that compared to normal interventions like pressure distribution and use of air mattresses, care bundle will entail other guidelines and practices that improve the disposition of nurses and the targeted patients (Amirah et al., 2020; Lam et al., 2020). The care bundle approach will implore nurses to develop tailored interventions based on patient condition, level of delicacy, and integrate their opinions through the use of limited resources in an engaging manner for all stakeholders. The expected outcomes will enhance care delivery and reduce costs while also improving teamwork among all stakeholders, especially nurses Furthermore, the timeline for the implementation is appropriate as it include monitoring and evaluating the effectiveness of the care bundle to reduce prevalence and prevent occurrence (Floyd et al., 2021). As delicate patient safety issue, effective and timely interventions that do not require longer timelines would be appropriate for leaders to determine the impact of the initiative through a cost-benefit analysis approach.

Literature Search Strategy Used

Searching for supportive and evidence-based literature is critical when implementing changes through capstone projects. The EBP process implores one to get and critique existing literature to ascertain the evidence for their proposed intervention. Using current evidence gives nurses and other healthcare providers who want to implement best practices through EBP to collect relevant evidence to support and justify their proposed initiatives to enhance patient safety and care (Melnyk et al., 2022). The proposed capstone project deployed effective literature search strategies to get evidence and information on the implementation and effectiveness of HAPIs care bundle for patients in critical care settings.

The primary search strategy was the use of search engines to get peer reviewed journal articles from health-allied databases. These included journals that contained relevant information and articles. The databases included PubMed, Cochrane, CINAHL, and Google Scholar. The second strategy was to employ terminologies associated with the topic. These comprised terms like “hospital acquired pressure injuries,” “prevalence of HAPIs in critical care,” “care bundle approach for HAPIs,” “critical care nurses and HAPI prevention” “patient safety and HAPIs in critical care,” and “importance of care bundle for HAPIs.” Through these strategies, the paper generated several peer-reviewed journal articles. The paper also employed the CRAAP framework to attain evidence of current and relevant article to support the proposed initiative (Lam et al., 2020). The use of CRAAP implied that the collected evidence from literature was current or within the last five years, relevant to the issue under inquiry, accurate to imply that it is not only credible but also authoritative and written by subject matter experts (Melnyk et al., 2022). This implies that the strategies led to the identification of 15 peer-reviewed articles meeting the selection criteria and used in justifying the proposed intervention. The identified articles consisted of different levels of evidence; from systematic reviews and meta-analyses to randomized control trials and non-randomized articles. These sources also comprised of primary qualitative and quantitative studies within the required timelines based on the CRAAP framework. The sources also include authoritative organizational websites and industry reports from professional organizations like ANA, Centers for Disease Control and Prevention (CDC), AACN, and even Centers for Medicare and Medicaid Services as well as the Agency for Healthcare Research and Quality (AHRQ).

Literature Evaluation

The evaluated literature focused on the effective implementation of care bundle by nurses in critical care settings to improve patient safety and reduce the overall cost implications. Through the evaluated literature, nurses and stakeholders in critical care units can compare the interventions, the research approaches by various authors based on their sample populations, research questions, methodologies deployed, and even limitations that may hinder effective use of such sources (Melnyk et al., 2022). In a majority of the evaluated studies and literature, the authors utilized sufficient and targeted population samples to determine the overall effectiveness of having care bundle in critical care settings. For instance, most of the sources deployed in this project proposal focused on determining the type of care bundle interventions that nurses can deploy based on the acuity levels of patients suffering from pressure injuries because of their stay in critical care units.

The majority of the reviewed literature based on the evaluation table shows that the authors asked critical research questions similar to the ones that this initiative advances. For instance, the article by Amira et al. (2019) explores the prevalence and risk factors related to critically ill patients making them vulnerable to HAPIs. Similarly, Qaddumi et al. (2019) raise similar questions. Studies by Edsberg et al. (2022), Yilmazer et al. (2022) and Coyer et al. (2022) focus on the effectiveness of having a care bundle approach to prevent the occurrence of pressure injuries in critical care settings in various hospitals.

The reviewed articles show that most of the researchers deployed sufficient and targeted samples in determining the effectiveness of care bundles to reduce HAPIs among patients. As such, a majority of the sources used in this project focused on sample population to illustrate the positive impact of using different interventions based on patient condition to reduce and prevent HAPIs. For example, Edsberg et al. (2022) used a sample population of over 290,000 patients in over 1800 acute care setting yet Lindhardt et al. (2019) and Coyer et al. (2021) used the intensive care units but do not disclose the sample size. Yilmazer et al. (2022) and Amirah et al. (2019) as well as Pitman et al. (2019) deployed diverse samples ranging from 200 to 460 and in various critical care settings. What is evident is that having diverse sample populations and settings is essential to improving the credibility and reliability of the suggested interventions as it means that they can work with different patients and parts of the critical care areas.

The evaluated literature shows that having samples and questions that align with the PICOT question and statement is critical to attaining better results during the implementation of any capstone change project. Comparing the limitations of the sources is also critical to understanding and appreciating findings and their application to the issue of HAPIs in critical care units (Lam et al., 2020). The core limitation of most of the evaluated study is the used methodology based on sample sizes and analytical methods used by the authors and even reviewers. For instance, small sample sized studies can have limitations associated with the overall implementation to larger populations while certain research designs can fail to consider the critical components of the investigations, and authors’ settings. The rise in incidences and prevalence of HAPIs in various settings also implies that researchers should integrate these areas to reduce their effects on patient safety. These limitations can reduce the overall significant effects of the findings and implementation of related projects to improve patient safety. It would be critical to expand the scope of HAPI as a patient safety issues not just for patients in critical care but even those who take longer times in general wards, particularly those with chronic and terminal conditions.

The sources used in this capstone change project demonstrate consistent outcomes and findings based on their effectiveness despite having limitations and issues related to the sample sizes. These studies are evident that HAPIs are a patient safety issue among patients in critical care settings. The studies all agree that facilities and their leadership should implement EBP strategies like the care bundle approach to reduce and prevent their occurrence and associated adverse effects that include, in serious cases, fatalities (Lam et al., 2020). Having the care bundle approach will prepare nurses and patients to implement patient-centered yet nurse-driven strategies to reduce and prevent HAPIs and their negative effects on patient care.

Applicable Change and Nursing Theory Used

Change is always unpredictable with increased chances of resistance from any people due to the alterations that it brings in any situation or setting. As such, to counter such situations that may jeopardize effective implementation and realization of set goals, the proposed change initiative will use a change model and an appropriate nursing theory to help stakeholders navigate any issues that may crop up. Change theories allow those involved to prepare staff appropriately to implement suggested measures and strategies aimed at quality improvement in any healthcare setting. As such, the project team will deploy Kurt Lewin’s change model that contains three critical areas or stages. These include unfreezing, change, and refreezing (Melnyk et al., 2022). The freezing stage implores organizational leaders and nurses to evaluate and assess the urgency and need for change using a needs analysis approach by collecting data on the number of HAPIs, their effects and ways to manage them to justify the suggested intervention or approach. The stage will be critical so that all providers and patients accept the idea and express the willingness to implement it.

The second stage would entail implementation of the proposed intervention, having a care bundle approach to reduce and prevent HAPIs in critical care settings. The implementation will ensure that the concept and its related aspects are integrated into care management based on patient’s condition and delicate nature. The third stage would be refreezing where the critical care units will embed the most appropriate measures based on effective assessment of patients and their needs (Park et al., 2021). The stage would mean that critical care units in different healthcare facilities make care bundle a part of their policy best practices and safety culture. Through the adoption of the strategy nurses and stakeholders will leverage nursing theories to attain overall care outcomes and patient satisfaction.

The relevant nursing theory is Imogene King’s goal attainment. The theory advances that nurses are part of patient’s environment and the nurse-patient interaction is aimed at meeting goals towards better health outcomes. The theory emphasizes the role of nurses and patients in attaining set goals like improving outcomes and reducing aspects like injuries. Nurses influence patients and their perspectives on disease condition and even recovery (Park, 2021). As such, goal attainment theory is applicable to the capstone change initiative as it emphasizes the importance of nurses interacting with patients to develop patient-centered interventions in critical care settings to eliminate issues like HAPIs.

Proposed Implementation and Outcome Measures

The implementation of the initiative will entail deploying a host of strategies and interventions based on the acuity level of patients in critical care settings. These strategies will include guidelines and best practices aimed at reducing and preventing HAPIs (Rivera et al., 2021). The facility will implement the intervention by establishing an inter-professional collaboration team and using the Lewin’s change model to communicate the need for changes and expected outcomes. Using this approach, the team will create an urgency for change by compiling available data of patients and their rates of HAPIs over the last six months. The team will them train nurses through educational sessions on the care bundle to understand the interventions that can work in the unit as well as those not appropriate (Melnyk et al., 2022) After the training sessions, nurses in collaboration with quality improvement and safety department will develop a plan for deployment of the interventions based on the level of acuity of patients. For example, nurses who change patients and allocate different devices and equipment will offer data about their conditions and identify the appropriate strategy for individual patient. Therefore, all patients will have diverse interventions based on their needs and concerns in the facility.

The project will have different yet fundamental outcomes, especially in the management of HAPIs. The primary outcome will be the reduction of HAPIs by 40% within the shortest time possible or three months as advanced. The second outcome will be a rise in nurses’ knowledge about HAPIs and how appropriate intervention can reduce their prevalence. The project will also aim at improving patient safety to better levels for the facility and its stakeholders.

Integration of EBP Process

Hospitals and healthcare providers can attain quality care through integration of EBP to create intervention like care bundle to reduce HAPIs. The proposed project leveraged different aspects of EBP to develop the intervention. The EBP process entails evaluation of the need for change, assessing and critiquing current literature for evidence and justification, and identification of appropriate change and nursing theory to execute the changes (Saunders et al., 2019). The model also implores implementation team to involve all stakeholders. As such, the development of suggested solution in this initiative through literature evidence demonstrates the integration of EBP process. The EBP process implores researchers to have sufficient evidence to implement certain initiatives for effective evaluation and eventual integration into care provision as part of the overall safety culture.

Evaluation Plan for the Proposed Nursing Intervention

The evaluation plan based on the strategic plan of the project will illustrate its effectiveness in mitigating hospital acquired pressure injuries (HAPIs). The evaluation will comprise collection of data on the prevalence of HAPIs before and after the implementation of the care bundle. The evaluation will collect information and satisfaction levels through surveys and questionnaires for patients and nurses in critical care settings. Through the summative assessment of HAPIs, the team will determine the associated reduction within the implementation timelines. Feedback from patients will also be critical to improving their overall safety to attain better outcomes (Mohamed-Mayhob et al., 2022). The effectiveness of the project will entail a significant reduction of HAPIs and attainment of set goals and outcome measures.

Potential Barriers to Planned Implementation & Overcoming Them

Planned change implementation may face barriers like resistance to change, insufficient organizational resources and support, limited time, and ineffective communication that can hamper the participation of all stakeholders. Furthermore, individual bias and attitude by nurses may also be barriers in the implementation of this capstone project (Melnyk et al., 2022). Barriers like organizational support and scarcity of resources can have significant effects on planned change. Having a supportive organizational leadership and culture is key to the success of any change initiative, particularly in quality care improvement focused on patient safety and delivery of quality measures. Consequently, it is important to overcome these barriers to execute this project in the most effective manner.

Navigating these barriers entail having a change team with change agents and champions and involving the leadership by justifying the need for change. Additionally, having effective communication, and engaging all stakeholders, especially nurses in the facility, will ensure that they embrace change and are willing to implement the interventions (Mohamed-Mayhob et al., 2022). Furthermore, it would be critical for the team to use appropriate change models like Lewin’s three step change approach to communicate change and involve all stakeholders.

Hospital acquired pressure injuries (HAPIs) in critical care settings are a patient safety and quality issue that affect patients and lead to adverse effects or outcomes as outlined in this capstone change project paper. Evaluated literature and evidence show that HAPIs can lead to increased cost of care and poor care as well as fatalities. The implementation of care bundles to reduce and prevent the occurrence of HAPIs is evidence-based practice best practice in many critical care settings and entails ensuring that nurses have sufficient knowledge on diverse strategies to tackle the problem. The proposed capstone project focuses on implementing care bundle to improve the management of HAPIs from occurrence to prevention and execution of patient-centered yet nurse-led approaches to benefit both patients and the healthcare system.

Amirah, M., Rasheed, A., Parameaswari, P., Awajeh, A., Issa, M., & Abdallah, M. (2019).

Pressure injury prevalence and risk factors among adult critically ill patients at a large intensive care unit. Journal of Intensive and Critical Care, 5(2), 9. DOI: 10.21767/2471-8505.100128

Cox, J., Edsberg, L. E., Koloms, K., & VanGilder, C. A. (2022). Pressure injuries in critical care

patients in US hospitals: results of the International Pressure Ulcer Prevalence Survey. Journal of Wound, Ostomy, and Continence Nursing, 49(1), 21. DOI: 10.1097/WON.0000000000000834

Coyer, F., Cook, J. L., Doubrovsky, A., Campbell, J., Vann, A., McNamara, G., … & Fulbrook,

• (2022). Implementation and evaluation of multilayered pressure injury prevention strategies in an Australian intensive care unit setting. Australian Critical Care, 35(2), 143-152. https://doi.org/10.1016/j.aucc.2021.03.005

Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on

hospital‐acquired pressure ulcers prevention: a systematic review. International wound journal, 16(5), 1087-1102. https://doi.org/10.1111/iwj.13147

Edsberg, L. E., Cox, J., Koloms, K., & VanGilder-Freese, C. A. (2022). Implementation of

pressure injury prevention strategies in acute care: results from the 2018-2019 International Pressure Injury Prevalence survey. Journal of Wound, Ostomy, and Continence Nursing, 49(3), 211. DOI: 10.1097/WON.0000000000000878

Grešš Halász, B., Bérešová, A., Tkáčová, Ľ., Magurová, D., & Lizáková, Ľ. (2021). Nurses’

knowledge and attitudes towards the prevention of pressure ulcers. International journal of environmental research and public health, 18(4), 1705. https://doi.org/10.3390/ijerph18041705

Lindhardt, C. L., Beck, S. H., & Ryg, J. (2020). Nursing care for older patients with pressure

ulcers: A qualitative study. Nursing open, 7(4), 1020-1025. DOI: 10.1002/nop2.474

Pittman, J., Beeson, T., Dillon, J., Yang, Z., & Cuddigan, J. (2019). Hospital-acquired pressure

injuries in critical and progressive care: avoidable versus unavoidable. American journal of critical care, 28(5), 338-350. DOI: 10.4037/ajcc2019264.

Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing &

            healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Rivera, J., Donohoe, E., Deady-Rooney, M., Douglas, M., & Samaniego, N. (2020).

Implementing a Pressure Injury Prevention Bundle to Decrease Hospital-Acquired Pressure Injuries in an Adult Critical Care Unit: An Evidence-Based, Pilot Initiative. Wound Management & Prevention, 66(10), 20-28. DOI: 10.25270/wmp.2020.10.2229

Floyd, N. A., Dominguez-Cancino, K. A., Butler, L. G., Rivera-Lozada, O., Leyva-Moral, J. M.,

& Palmieri, P. A. (2021). The effectiveness of care bundles including the Braden scale for preventing hospital acquired pressure ulcers in older adults hospitalized in ICUs: A Systematic review. The Open Nursing Journal, 15(1): 74-84. DOI: 10.2174/1874434602115010074

Lam, C. K., Schubert, C. F., & Herron, E. K. (2020). Evidence‐based practice competence in

nursing students preparing to transition to practice. Worldviews on Evidence‐Based Nursing, 17(6), 418-426. DOI: 10.1111/wvn.12479.

Lavallée, J. F., Gray, T. A., Dumville, J. C., & Cullum, N. (2019). Preventing pressure injury in

nursing homes: developing a care bundle using the Behavior Change Wheel. BMJ open, 9(6), e026639. http://dx.doi.org/10.1136/bmjopen-2018-026639

Mohamed-Mayhob, M., & Abdelsalam Amin, M. (2021). Effect of Implementing Care Bundle

on Preventing Pressure Ulcers Development among Immobilized Orthopedic Patients. Egyptian Journal of Health Care, 12(4), 1675-1680. DOI: 10.21608/ejhc.2021.227151

Park, B. M. (2021, June). Development and effect of a fall prevention program based on King’s

theory of goal attainment in long-term care hospitals: An experimental study. Healthcare, 9(6): 715. DOI: 10.3390/healthcare9060715

Qaddumi, J. A., & Almahmoud, O. (2019). Pressure ulcers prevalence and potential risk factors

among intensive care unit patients in governmental hospitals in Palestine: A cross-sectional study. The Open Public Health Journal , 12(1). https://creativecommons.org/licenses/by/4.0/legalcode.

Yilmazer, T., & Tuzer, H. (2019). Pressure ulcer prevention care bundle: A Cross-sectional,

Content Validation Study. Wound Management & Prevention, 65(5):33-39. DOI:10.25270/wmp.2019.5.3339

Zhang, X., Wu, Z., Zhao, B., Zhang, Q., & Li, Z. (2021). Implementing a pressure injury care

bundle in Chinese intensive care units. Risk Management and Healthcare Policy , 14: 2435-2442. DOI: https://doi.org/10.2147/RMHP.S292579

Appendix: Lewin’s change model

NRS493 Professional Capstone And Practicum

Week 8 Assignment

Benchmark – Capstone Project Change Proposal

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalClinical problem statement.

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Applicable change or nursing theory utilized.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalProposed implementation plan with outcome measures.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalPlan for evaluating the proposed nursing intervention.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalAppendix section, if tables, graphs, surveys, educational materials, etc. are created.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalBenchmark Information

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Assignment: NRS 493 Benchmark – Capstone Project Change Proposal

NRS493 Professional Capstone And Practicum

Week 8 Assignment

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Purpose of the change proposal in relation to providing patient care in the changing health care system.

PICOT question .

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalLiterature search strategy employed.

Evaluation of the literature.

Assignment: NRS 493  Capstone Project Change Proposal

Applicable change or nursing theory utilized.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalProposed implementation plan with outcome measures.

Discussion of how evidence-based practice was used in creating the intervention plan.

Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalAppendix section, if tables, graphs, surveys, educational materials, etc. are created.

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Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper , and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Assignment: NRS 493 Benchmark – Capstone Project Change ProposalPrepare 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

This benchmark assignment assesses the following programmatic competencies:

1.1: Exemplify professionalism in diverse health care settings.

2.2: Comprehend nursing concepts and health theories.

3.2: Implement patient care decisions based on evidence-based practice.

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NRS-493: Individual Success Plan – Professional Capstone and Practicum Reflective Journal – Homework Solution

Individual success plan.

Directions:

Planning is the key to successful completion of this course and program-related objectives. The Individual Success Plan (ISP) assignment requires early collaboration with the course faculty and your course preceptor. Students must establish a plan for successful completion of

• The required 50 community direct clinical practice experience hours, 50 leadership direct clinical practice hours, and 25 indirect clinical experience hours.
• Completion of work associated with program competencies.
• Work associated with completion of the student’s capstone project change proposal.

Students will use the “Individual Success Plan” to develop an individual plan for completing practice hours and course objectives. As a part of this process, students will identify the number of hours set aside to meet course goals.

Student expectations and instructions for completing the ISP document are provided in the “NRS-493 Individual Success Plan” resource, located in the Study Materials and in the assignment instructions.

Students should apply concepts from prior courses to critically examine and improve their current practice. Students are expected to integrate scholarly readings to develop case reports that demonstrate increasingly complex and proficient practice.

After the ISP has been developed by the student and approved by the course faculty, students will initiate a preconference with the faculty and preceptor to review the ISP.

Work with your preceptor to perform a needs assessment of the organization and community for your practicum. Review the needs assessment to identify possible project topics. In preparation for the capstone change project proposal, compile a list of three to five possible topics for your project and submit to the assignment instructor in LoudCloud.

Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

• New practice approaches
• Interprofessional collaboration
• Health care delivery and clinical systems
• Ethical considerations in health care
• Practices of culturally sensitive care
• Ensuring the integrity of human dignity in the care of all patients
• Population health concerns
• The role of technology in improving health care outcomes
• Health policy
• Leadership and economic models
• Health disparities

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.

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