NRS 493 Topic 1 Capstone Change Project Paper

NRS 493 Topic 1 Capstone Change Project Paper

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.

You are not required to submit this NRS 493 Topic 1 Capstone Change Project Paper assignment to LopesWrite.

NRS 493 Topic 1 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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 NRS 493 Topic 1 Capstone Change Project Paper 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 NRS 493 Topic 1 Capstone Change Project Paper assignment to LopesWrite.

NRS 493 Topic 2 Capstone Topic Summary

In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Write a 150-250 word summary explaining which category your topic and intervention are under (community or leadership).

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 2 Capstone Project Topic Selection and Approval

In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

Write a 500-750 word description of your proposed capstone project topic. Include the following:

1. The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.
2. The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
3. A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
4. Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
5. Significance of the topic and its implications for nursing practice.
6. A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.

You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Capstone Project Topic Selection and Approval Example Solution

Workplace Incivility in Nursing

Advancing a civil workplace culture has been a topic of interest in the current healthcare practice. Daily in nursing practice and training, nurses have to deal with some level of workplace incivility in many settings (Crawford et al., 2019). The impact of workplace incivility in nursing has been felt in more stressful environments such as emergency care units and operation units. This paper aims to describe this health issue, its impact on collaboration in nursing, its significance in nursing practice, and propose a solution to this issue.

Description of the Issue

Workplace incivility in nursing encompasses activities and behaviors that include but are not limited to bullying, eye-rolling, silent treatment, horizontal violence, and bullying, among other behaviors in the nursing workplace. In nursing education, incivility manifests as a lack of professionalism, disrespect to learners, and making these learners feel unwanted or ignored (Zhu et al., 2019). In worst-case scenarios, incivility in nursing education can present as illegal activities such as abuse, either sexual or physical, according to Zhu et al. (2019). Nursing incivility behaviors can be overt or covert. These behaviors can be perpetrated verbally or nonverbally. Disrespectful behaviors from staff toward learners can have consequences on civility in the long term because future nurses who will try to emulate these behaviors they learn from seniors.

Perpetrators of nursing incivility can be multiple in a single workplace. In most cases, the senior nurse practitioners or students are the key perpetrators of incivility (Stalter et al., 2020). Junior nurses experience uncivil nursing behaviors from instructors, healthcare assistants, subordinate workers, and sometimes physicians (Green, 2019). In other cases, these activities are horizontal. Behaviors are directed from fellow nurses and perpetrators are nurses of the same cadre in practice. Nursing incivility, especially bullying, aims at removing the victim’s power through aggression (Howard, 2019). Some cases of incivility can be deemed trivial in practice, but their impacts go beyond aggression and ego and power struggles.

Impacts of Nursing Incivility

Nursing workplace incivility impacts not only the individual victims but also the healthcare organization, the healthcare system, and the nursing profession. These impacts are organizational, academic, work unit-related, or personal (Crawford et al., 2019). Nursing, as a profession, is a system that relies on collaboration internally and with other professions to promote their interventions and achieve goals in care. These behaviors can seem insignificant but may have far-reaching negative consequences on nursing practice. The victims of nursing incivility can intentionally quit the profession or intentionally reduce their work effort.

The prevailing workforce shortage and availability or demand of nurses in the market are used to mask the impacts of incivility (Green, 2019). When these victims decide to stay in the profession, their intentions to leave the work or profession are always higher due to incivility. They spend a substantial amount of time worrying about their work and practice (Bar-David, 2018). In worse cases, the victims may take their frustrations on the clients.

Therefore, patient safety is jeopardized just because of workplace incivility. The risk of medication and medical errors rises due to frustration. Viciously, this culture can be passed down to learners who later practice uncivil behaviors in the workplace (Andersen et al., 2019). Poor mental health has been reported among nurses who experience workplace incivility (Howard, 2019). This impacts their productivity and the quality of the care they offer.

Significance of the Issue

Nursing workplace incivility is a universal issue that silently undermines the quality of care. By jeopardizing patient safety, patient satisfaction reduces. Work efficiency and effectiveness are also likely to reduce due to a lack of motivation and high intention to quit work or profession. This issue thus can be addressed in the early steps, that is, nursing education and the workplace, to mitigate its negative impact on the healthcare system and profession. The nursing profession was built on Caritas and tenderness and upholding these virtues to our clients, it is only logical that the nurses show them to their colleagues first. Addressing civility in the workplace improves nurses’ and nurse administrators’ leadership and administrative skills.

Proposed Solution

Addressing nursing workplace incivility can be achieved by evidence-based practice (EBP). Evidence-based teaching strategies promote systems thinking that would prevent patient harm by improving patient outcomes (Stalter et al., 2020). Evidence-based nursing education and teaching that encourages nurses and empowers them to create a civil environment for learning and working have improved nursing civility by addressing behavior change (Crawford et al., 2019). The American Nurses Association stands for zero tolerance against workplace incivility and to abide by their professional conduct codes, nurses must begin change at the personal levels. However, nursing incivility is multifactorial, and addressing the behavioral aspects only would not solve the issue completely.

Conclusion

The nursing profession has turned into a profession that ‘eats its own’ through workplace incivility. This has been seen in nursing education and practice. Some senior nurses and fellow nurses have practiced varying degrees of incivility that have consequences on the personal, academic, professional, system, and organizational outcomes. Evidence-based nursing teaching and education have been documented in literature evidence to help mitigate nursing workplace incivility

NRS 493 Topic 1 Capstone Change Project Paper References

Andersen, P., McAllister, M., Kardong-Edgren, S., Miller, C. W., & Churchouse, C. (2019). Incivility behaviors exhibited by nursing students: clinical educators’ perspectives of challenging teaching and assessment events in clinical practice. Contemporary Nurse, 55(4–5), 303–316. https://doi.org/10.1080/10376178.2019.1634480

Bar-David, S. (2018). What’s in an eye roll? It is time we explore the role of workplace incivility in healthcare. Israel Journal of Health Policy Research, 7(1), 15. https://doi.org/10.1186/s13584-018-0209-0

Crawford, C. L., Chu, F., Judson, L. H., Cuenca, E., Jadalla, A. A., Tze-Polo, L., Kawar, L. N., Runnels, C., & Garvida, R., Jr. (2019). An integrative review of nurse-to-nurse incivility, hostility, and workplace violence: A GPS for nurse leaders: A GPS for nurse leaders. Nursing Administration Quarterly, 43(2), 138–156. https://doi.org/10.1097/NAQ.0000000000000338

Green, C. (2019). Incivility among nursing professionals in clinical and academic environments: Emerging research and opportunities: Emerging research and opportunities (Vol. 181). Medical Information Science Reference. https://doi.org/10.4018/978-1-5225-7341-8

Handzel, S., BSN, & RN. (2020, October 19). Incivility in nursing: An approach for change. Wolterskluwer.com. https://www.wolterskluwer.com/en/expert-insights/incivility-in-nursing

Howard, M. S. (2019). Bullying in nursing: Implementing solutions for practice. Creating Healthy Work Environments 2019. https://stti.confex.com/stti/chwe19/webprogram/Paper94227.html

Stalter, A. M., Phillips, J. M., Goldschmidt, K. A., Brodhead, J., Ruggiero, J. S., Scardaville, D. L., McKay, M., Bonnett, P. L., & Merriam, D. (2020). Promoting civility in nursing practice using systems thinking: Evidence-based teaching strategies for nurse educators. Nursing Forum, 55(4), 754–762. https://doi.org/10.1111/nuf.12493

Zhu, Z., Xing, W., Lizarondo, L., Guo, M., & Hu, Y. (2019). Nursing students’ experiences with faculty incivility in the clinical education context: a qualitative systematic review and meta-synthesis. BMJ Open, 9(2), e024383. https://doi.org/10.1136/bmjopen-2018-024383

NRS 493 Topic 2 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

You are not required to submit this assignment to LopesWrite.

Professional Capstone and Practicum Reflective Journal- Topic 2 Example Solution

Topic Focus: Interprofessional Collaboration

Interprofessional collaboration involves interaction between two or more professionals with common goals and problem-solving needs. This topic has introduced me to various aspects of problem-solving and made me realize some strengths and weaknesses in my training so far. At the end of the course and training, I aim at acquiring the best quality and safety education in nursing (QSEN) competencies to offer the best care to my patients in the future.

In this topic, I aimed at dealing with teamwork and collaboration as a part of the progress to achieve the best competencies. My evaluation of problems and issues relevant to my practice and this competency element was civility in the workplace. I believe that a civil working and learning environment encourages reciprocal interaction that will enhance academic and professional growth. Therefore, based on my experience worth the topic I dug deep into the issue and presented my issue using evidence-based practice.

One of the strengths that I realized from this topic is evidence-based practice and interprofessional collaboration. The knowledge behind these strengths was enhanced by the passion to look up and interpret relevant literature evidence. In the future, I intend to work in an environment will many professionals thus the need to sharpen further my interprofessional skills. Hopefully, the skills that I will gain throughout the course will develop this strength and make me a competent nurse. Additional resources such as interactive multimedia learning and simulated scenarios will impact greatly my leadership and collaboration skills. This will expose my learning to various real-life scenarios and ensure stimulative learning. It is my wish that my individual commitment to work with my fellows will ensure future success.

NRS 493 Topic 3 PICOT Question Paper

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care.

The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

PICOT Question Example

The human body comprises complex systems that perform various functions that promote life. The immune system is among the essential systems that prevent the body from infections. Immunity is not limited to the lymphoid system, intact skin, initial inflammatory response, and oral mucosa (Bankanie et al., 2021). Unlike healthy individuals who have improved immunity, patients in the intensive unit (ICU) are at increased risk of several infections due to reduced immunity and invasive life-saving procedures such as endotracheal intubation, central lines, and mechanical ventilation (Chen et al., 2022).

As a result, they are susceptible to most infections, including bacteremia, periodontal disease, central line infections, infective endocarditis, and ventilator-acquired pneumonia (VAP). Reducing such infections requires nurse-led interventions to reduce incidences while improving patient outcomes. Among the common interventions aimed at improving oral hygiene, preventing aspiration of micro-biota, and reducing colonization by micro-organisms. To get more insight, I came up with a PICOT question that will aid in improving my knowledge of this subject.

PICOT: In adult patients intubated in ICU (P), how does daily use of Chlorohexidine (I) compared to not using (C) reduce the risk of ventilator-acquired pneumonia (VAP) (O) over three months? (T)

Clinical Problem

VAP is a lung infection that develops more than 48 hours after intubation for mechanical ventilation. It is the most common nosocomial infection among intubated ICU patients, accounting for 9-27% of infections in the ICU (Bankanie et al., 2021). Endotracheal intubation is performed to save the lives of critically ill patients who are unable to breathe, unconscious, or sedated by medications. It helps by maintaining the patency of the airway and supplying oxygen for metabolic demands. Despite being useful, they act as a breach through which microorganisms access the respiratory tract, causing VAP.

VAP is caused by various micro-organisms that invade the respiratory tract. Among the most common isolated bacteria include Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae (Chen et al., 2022). These pathogens inoculate either in the oropharynx, gastrointestinal, subglottic, or oral mucosa, where they spread to the lower respiratory system, causing the infection.

In addition to endotracheal intubation, other risk factors increase the risk of VAP, including advanced age, immobilization, supine body positioning, certain medications, and ventilatory support (Dale et al., 2019). The development of VAP negatively impairs patient outcomes. It increases the risk of mortality, hospital stay, and morbidity, consequently increasing the cost of care. Reducing the negative outcomes requires the installation of preventive methods that improve outcomes.

Nursing Intervention

Despite the adverse effects caused by VAP, nurses have a vital role in devising preventive measures to reduce incidences. Among the various preventive measures, the use of chlorhexidine gluconate (CHG) is an evidence-based practice that has been used in various settings (Kocaçal et al., 2019). CHG is an antiseptic agent that has a bactericidal effect against harmful bacteria. It is effective against both gram-positive and gram-negative bacteria. It acts by binding to the cell wall of bacteria, thus inhibiting cell wall integrity and causing bacterial death (Niedzwiecka et al., 2019). Therefore, it leads to a reduction in microbial load while reducing incidences of nosocomial infections, including VAP. This leads to improved patient outcomes while reducing morbidity and mortality.

Summary

VAP is a common clinical problem yet preventable. Integration of using CHG in clinical practice has proved to be effective in reducing the incidences. Therefore, it is paramount that all nurses adhere to preventive methods while managing patients. This will help in reducing the cost of care, reduce hospital stays, improve patient satisfaction, reduce mortality and morbidity, and improve patient outcomes. Finally, prevention of VAP will reduce the rate of drug-resistant organisms that are difficult to treat.

References

Bankanie, V., Outwater, A. H., Wan, L., & Yinglan, L. (2021). Assessment of knowledge and compliance to evidence-based guidelines for VAP prevention among ICU nurses in Tanzania. BMC Nursing, 20(1), 209. https://doi.org/10.1186/s12912-021-00735-8

Chen, S., Hua, L., Jin, Q., & Wang, H. (2022). Correlation of ICU nurses’ cognitive level with their attitude and behavior toward the prevention of ventilator-associated pneumonia. Journal of Healthcare Engineering, 2022, 8229812. https://doi.org/10.1155/2022/8229812

Dale, C. M., Rose, L., Carbone, S., Smith, O. M., Burry, L., Fan, E., Amaral, A. C. K.-B., McCredie, V. A., Pinto, R., Quiñonez, C. R., Sutherland, S., Scales, D. C., & Cuthbertson, B. H. (2019). Protocol for a multi-centered stepped wedge, cluster randomized controlled trial of the de-adoption of oral chlorhexidine prophylaxis and implementation of an oral care bundle for mechanically ventilated critically ill patients: the CHORAL study. Trials, 20(1), 603. https://doi.org/10.1186/s13063-019-3673-0

Kocaçal Güler, E., & Türk, G. (2019). Oral chlorhexidine against ventilator-associated pneumonia and microbial colonization in intensive care patients. Western Journal of Nursing Research, 41(6), 901–919. https://doi.org/10.1177/0193945918781531

Niedzwiecka, T., Patton, D., Walsh, S., Moore, Z., O’Connor, T., & Nugent, L. (2019). What are the effects of care bundles on the incidence of ventilator-associated pneumonia in paediatric and neonatal intensive care units? A systematic review. Journal for Specialists in Pediatric Nursing: JSPN, 24(4), e12264. https://doi.org/10.1111/jspn.12264

 

NRS 493 Topic 3 Benchmark Capstone Change Project Objectives

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations.

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 LopesWrite.

Benchmark Information 

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.5:  Advocate for autonomy and social justice for individuals and diverse populations.

NRS 493 Topic 3 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

You are not required to submit this assignment to LopesWrite.

Professional Capstone and Practicum Reflective Journal Topic 3 Example

Health Care Delivery and Clinical Systems

As a nursing student, I have realized that clinical systems and healthcare delivery are crucial components in a work environment. A good collaboration between the two guarantees that the organization and patient interests are observed efficiently. I have also learned the importance of teamwork. I am confident that working together with other players in the healthcare industry can ensure success for both the institution, patients, and care providers. This paper will reflect on the critical aspects that make healthcare delivery and clinical systems crucial and their significance in the institution.

In the healthcare system, healthcare delivery is a critical segment, and it determines the perception of the system to the outside world. That is all the patients and the public see when they look at healthcare institutions. Regarding how a hospital is equipped or the type of services they provide, the most critical aspect is ensuring that the healthcare delivery is convenient for the people (Cerise et al., 2021). This topic further elaborated on the healthcare system and its diverse aspects. Therefore, it helps me understand the concept of the healthcare system in a greater way and provides me with different perceptions.

As a nursing student, I have realized that the most crucial point is that when there is good healthcare delivery, it is possible to experience improved diagnosis, treatment of ailments, and enhance health promotion. There is a guarantee of covering public health, primary and specialized care, pharmaceutical care, and mental healthcare with better healthcare delivery. Through my interactions in the healthcare industry, I have also learned some important healthcare aspects, such as the importance of patient-centeredness and integration in care delivery.

Through innovation and proactive practices, I feel these areas can help improve healthcare delivery and profit the patients and the public more. It also guarantees effective and smooth operations for the healthcare workers and enhances the organization’s satisfaction by meeting the expectations of their respective clients.

On the other hand, for healthcare delivery to be effective, it is essential to operate hand-to-hand with the clinical systems. In my capacity, I have come to realize that for healthcare delivery to be effective. The present clinical systems have to be efficient. According to Rhatigan (2020), the systems make it possible to provide patient-centered and evidence-based care under all care preferences. It ensures that the hospital experiences minimal medical errors, reduces unnecessary healthcare costs increase legibility, and boosts the quality of care.

With better clinical systems, it is easy for the hospital to capture, store, and process critical information and ensure timely transfer to relevant bodies to guarantee rapid and correct decision-making. Therefore, it ensures that the patients visiting the facility receive personalized care and build a network of trust with caregivers for future healthcare benefits. In my opinion, by enhancing the clinical systems, the deficit of trust between team players will be eliminated, allowing all institution organs to operate together for the interests of the patients.

Additionally, through mobilizing better clinical systems, the organization has better and increased opportunities to expand and improve critical hospital equipment (Rhatigan, 2020). Therefore, service delivery will be efficient and directly address the issues of concern to the specific clients that the hospital receives. Synchronizing clinical systems and healthcare delivery also enhances hospital decongestion by ensuring that the facility reduces the number of patient admissions. This way, the organization’s economic model will be functional, and patient’s satisfaction will increase.

References

Cerise, F. P., Moran, B., Huang, P. P., & Bhavan, K. P. (2021). The imperative for integrating public health and health care delivery systems. NEJM Catalyst Innovations in Care Delivery, 2(4). DOI:https://doi.org/10.1056/CAT.20.0580

Rhatigan Jr, J. J. (2020). Health systems and health care delivery. In Hunter’s Tropical Medicine and Emerging Infectious Diseases (pp. 214-218). Elsevier. https://doi.org/10.1016/B978-0-323-55512-8.00028-4

NRS 493 Professional Capstone Practicum Essays GCU – Topic 4 Literature Evaluation Table

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.

The assignment will be used to develop a written implementation plan.

For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question 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.

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 LopesWrite.

NRS 493 Topic 4 Capstone Change Project Outcomes

After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale.

The assignment will be used to develop a written implementation plan.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 4 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 5 Practice Experience Conference (Mid-Conference)

Students are required to initiate a mid-conference that will occur during Topic 5, using the  “Practice Experience Conference Form (Mid-Conference)” resource. This conference is intended for the student, preceptor, and faculty to discuss progress toward meeting the learning goals and course objectives contained in the Individual Success Plan (ISP). Progress toward completing the written capstone project will also be discussed, including faculty recommendations for project development.

Student progress will be documented on the Clinical Evaluation Tool (CET), which is submitted in LoudCloud prior to the conference. The CET will be discussed during the mid-conference and graded in LoudCloud by the faculty after the mid-conference. If the student receives an “Unacceptable” or “Below Expectations” in any category, the student will remediate for that category of the CET.

NRS 493 Topic 5 Midterm Evaluation of Student

The preceptor will perform a midterm evaluation with the faculty. The faculty will input the evaluation content into the Lopes Activity Tracker. The student will upload the evaluation into LoudCloud after meeting with the preceptor to discuss the midterm evaluation.

Students must meet all clinical expectations of the course, earn a passing grade on all benchmark assignments, and successfully complete remediation (if necessary) in order to receive a passing grade in the NRS-493 course.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

NRS 493 Professional Capstone Practicum Essays GCU – Topic 5 Clinical Practice Experience Remediation

Students who are not making appropriate progress on their capstone project and receive an “Unacceptable” or “Below Expectations” on the CET will be required to complete remediation activities. Required remediation activities are listed on the “NRS-493: Clinical Experience Remediation” document.  The required activities must be submitted in LoudCloud upon their completion by the end of Topic 7.  All required remediation activities will be reviewed and approved by the faculty.

NRS 493 Topic 5 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 5 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.

NRS 493 Topic 6 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:

1. Title page
2. Introduction section
3. A comparison of research questions
4. A comparison of sample populations
5. A comparison of the limitations of the study
6. 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

NRS 493 Topic 6 Literature Review – Ventilator-acquired Pneumonia Literature Review Example Solution

Ventilator-acquired pneumonia (VAP) is among the most common nosocomial infections in patients admitted to the Intensive care unit (ICU). While intubation is a necessity in supporting respiration, it acts as a conduit through which micro-organisms access the lower respiratory tract causing VAP. In addition, other risk factors such as advanced age, reduced immunity, immobility, and supine position increase the risk of VAP. Consequently, VAP negatively affects patient outcomes while increasing the rate of morbidity, mortality, and hospitalization.

The cost of care is also increased. In some cases, the bacteria develop resistance to bacteria, causing a challenge in the management. Therefore, there is a need to adopt a nurse-led initiative that will help in preventing VAP. Various methods have been used. However, there is strong evidence supporting the use of Chlorohexidine (CHG) in reducing microbial load, preventing VAP, and improving patient outcomes. Such findings have been supported by the literature review I conducted on my PICOT question. Therefore, I recommend the adoption of using CHG to prevent VAP in my institution. This paper will discuss the comparison of the research questions, sample populations, limitations, and the usefulness of the evidence in my project.

PICOT: In adult patients intubated in ICU (P), how does daily use of Chlorohexidine (I) compared to not using (C) reduce the risk of Ventilator Acquired Pneumonia (VAP) (O) over three months? (T)

Comparison of Research Questions

Various studies have focused on different aspects regarding ventilator-acquired pneumonia. For instance, Deschepper et al. (2018) sought to find out the role of CHG in reducing mortality. The question stated, ‘Does the use of chlorohexidine oral care in critical and non-critical patients reduce mortality? D’Journo et al. (2018) stated ‘does the use of CHG prevent respiratory complications post-surgery for patients with lung cancer? In a meta-analysis by Jackson and Owens (2019), the authors analyzed various randomized control trials (RCT) to assess the effectiveness of CHG in reducing VAP among intubated patients.

In another study by Pallotto et al. (2019), the research question stated, ‘can the use of a soap-like solution of 4% CHG followed by water rinsing reduce the incidence of hospital-acquired infections (HAIs) in ICU patients? Compared to a study by Reagan et al. (2019), which used mathematical analysis to determine the effectiveness of using CHG to reduce the incidences of HAIs and the cost of care, the study by Triamvisit et al. (2021) posed the question of whether the use of modified VAP-care bundle reduces the risk of VAP in neurosurgical patients. Finally, (Urbancic et al. (2018) stated; `does the use of CHG compared to triclosan reduce the rates of HAIs in ICU patients?

Comparison of Sample

The studies presented in the literature were done in different settings for patients with various needs and characteristics. However, it was common for most studies that the sample population comprised of patients admitted to the ICU while nurses intervened for most of the care. Sampling methods and numbers differed in various studies. A retrospective observational study by Deschepper et al. (2018) sampled 82,274 patients while 11,113 patients received CHG.

Despite being done in different settings, studies by D’Journo et al. (2018) and Pallotto et al. (2019) sampled 450 patients each and used simple randomization to divide patients into either control or intervention groups. On the other hand, Reagan et al. (2019) simulated 850 patients from a single center using a mathematical model to analyze the cost of care. Triamvisit et al. (2021) recruited 291 patients from two neurosurgical ICU units. Simple randomization was used to classify 146 participants as control, while 145 formed the cohort group. Finally, a study by Urbancic et al. (2018) followed a total sample of 4262 ICU admissions and compared outcomes.

Comparison of Study Limitations

Despite the literature yielding relevant information, several limitations were highlighted. First, adherence to evidence-based practice (EBP) was a challenge to some nurses leading to incomprehensive results. Some nurses were resistant to change while opting to continue with their prior practices. Furthermore, it wasn’t clear how frequently should CHG be applied to enhance its effectiveness. In addition, the acquisition of resources proved futile in some centers, thus limiting the implementation process. Finally, studies had smaller sample sizes that could not represent the whole population.

Conclusion and Recommendations

Despite VAP being among the common nosocomial infection that impairs patient outcomes, the use of CHG has proved effective in reducing mortality and morbidity associated with it. The ability of CHG to inhibit cell wall integrity makes it effective against both gram-negative and gram-positive bacteria, the major cause of VAP. Therefore, there is a need to equip all nurses with the necessary knowledge on how to apply CHG and adhere to the protocols to prevent VAP. However, future research should focus on studying issues around the frequency of bathing with CHG, the effectiveness of the various concentrations in reducing VAP, and the adverse effects associated with CHG use. Finally, more randomized control studies should be done while including larger sample sizes that represent the entire population. Essentially, having credible evidence will enhance the adoption of the EBP in various ICU settings and improve healthcare outcomes.

References

Deschepper, M., Waegeman, W., Eeckloo, K., Vogelaers, D., & Blot, S. (2018). Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study. Intensive Care Medicine, 44(7), 1017–1026. https://doi.org/10.1007/s00134-018-5171-3

D’Journo, X. B., Falcoz, P.-E., Alifano, M., Le Rochais, J.-P., D’Annoville, T., Massard, G., Regnard, J. F., Icard, P., Marty-Ane, C., Trousse, D., Doddoli, C., Orsini, B., Edouard, S., Million, M., Lesavre, N., Loundou, A., Baumstarck, K., Peyron, F., Honoré, S., … Thomas, P. A. (2018). Oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate in lung cancer surgery: a randomized clinical trial. Intensive Care Medicine, 44(5), 578–587. https://doi.org/10.1007/s00134-018-5156-2

Jackson, L., & Owens, M. (2019). Does oral care with chlorhexidine reduce ventilator-associated pneumonia in mechanically ventilated adults? British Journal of Nursing (Mark Allen Publishing), 28(11), 682–689. https://doi.org/10.12968/bjon.2019.28.11.682

Pallotto, C., Fiorio, M., De Angelis, V., Ripoli, A., Franciosini, E., Quondam Girolamo, L., Volpi, F., Iorio, P., Francisci, D., Tascini, C., & Baldelli, F. (2019). Daily bathing with 4% chlorhexidine gluconate in intensive care settings: a randomized controlled trial. Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 25(6), 705–710. https://doi.org/10.1016/j.cmi.2018.09.012

Reagan, K. A., Chan, D. M., Vanhoozer, G., Stevens, M. P., Doll, M., Godbout, E. J., Cooper, K., Pryor, R. J., Hemphill, R. R., & Bearman, G. (2019). You get back what you give: Decreased hospital infections with improvement in CHG bathing, mathematical modeling, and cost analysis. American Journal of Infection Control, 47(12), 1471–1473. https://doi.org/10.1016/j.ajic.2019.07.003

Triamvisit, S., Wongprasert, W., Puttima, C., Chiangmai, M. N., Thienjindakul, N., Rodkul, L., & Jetjumnong, C. (2021). Effect of a modified care bundle for prevention of ventilator-associated pneumonia in critically-ill neurosurgical patients. Acute and Critical Care, 36(4), 294–299. https://doi.org/10.4266/acc.2021.00983

Urbancic, K. F., Mårtensson, J., Glassford, N., Eyeington, C., Robbins, R., Ward, P. B., Williams, D., Johnson, P. D., & Bellomo, R. (2018). Impact of unit-wide chlorhexidine bathing in intensive care on bloodstream infection and drug-resistant organism acquisition. Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine, 20(2), 109–116. https://pubmed.ncbi.nlm.nih.gov/29852849/

NRS 493 Professional Capstone Practicum Essays GCU – Topic 6 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.

NRS 493 Topic 6 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

You are not required to submit this assignment to LopesWrite.

Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week\'s entry, students should reflect on the personal knowledge and skills gained.

Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.

Topic Focus: Population health concerns

While APA style is not required for the body of this assignment, solid academic writing is expected.

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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. 

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance

Professional Capstone and Practicum Reflective Journal

Population Health Concerns

This week, I engaged my preceptor in discussing population health concerns. I realized that issues with population health are a larger and more critical topic that requires the attention of all stakeholders in healthcare. Population health requires the collaboration of multidiscipline organizations and healthcare systems working in hand with community members. This helps identify various health concerns affecting people and the determinants of health.

Notably, individual health is a combination of various factors, including environment, relationships, and personal factors (Spruce, 2019). The environment, for instance, includes neighborhood, food security, sanitation, income, social status, education, and social support that influence health. Besides, access to care and the quality of care further influence health choices and health-seeking behaviors, which in turn influence personal health. While addressing the community’s health concerns, hypertension and diabetes were the identifiable issues.

Despite hypertension and diabetes being the most studied subjects in health research, they continue to affect many people in the community and are associated with morbidity and mortality. The rise in these conditions could be attributed to laxity in healthcare to promote primary health practices. Educating the community on issues such as lifestyle modifications, regular physical exercise, weight reduction, and adopting appropriate stress management techniques.

Failure to promote health, early diagnosis, and offering management can lead to complications such as stroke and heart failure that require intensive care to stabilize patients. In addition, mechanical ventilation could be used, which predisposes to the risk of ventilator-acquired pneumonia. Chlorohexidine would be used in intubated patients to reduce nosocomial infections. Finally, I evaluated the level of organizational preparedness while addressing the potential barriers to implementing the project change. I devised a strategic plan to guide the implementation process while overcoming challenges.

References

Spruce, L. (2019). Back to basics: Social determinants of health. AORN Journal, 110(1), 60–69. https://doi.org/10.1002/aorn.12722

NRS 493 Topic 7 Capstone Change Project Evaluation Plan

Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources. Develop a process to evaluate the intervention if it were implemented. Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention.

The assignment will be used to develop a written implementation plan.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 7 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

You are not required to submit this assignment to LopesWrite.

Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week\'s entry, students should reflect on the personal knowledge and skills gained.

Write a  reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.

Topic Focus: The Role of Technology in Improving Health Care Outcomes

While APA style is not required for the body of this assignment, solid academic writing is expected.

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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. 

Professional Capstone and Practicum Reflective Journal Example Solution

This week, I spent some time with my preceptor to discuss the role of technology in improving healthcare outcomes. I realized that technological development positively impacts patient care and health outcomes through revolutionization. This is because technology can be used in every step of patient care, including triaging, diagnosis, management, and follow-up of patients. Besides, technology offers an opportunity for transforming and improving healthcare by reducing errors, improving care coordination, tracking records, and improving practice efficiency (Tummers et al., 2020). For instance, telemedicine is an example of technology currently being used to manage patients with chronic conditions such as diabetes mellitus.

Using telemedicine, the healthcare provider and the patient are connected and easily communicate to enhance care. Patients can self-monitor blood sugars in remote areas while the caregiver is made aware of the readings. In case of any abnormal findings, an intervention is provided quicker. Furthermore, telemedicine improves check-ups and scheduling, and reduces the need for paperwork. As a result, patient sugars are well controlled, resulting in improved health outcomes and a reduction in mortality, morbidity, and other complications associated with diabetes.

Another aspect of technology is the use of information management systems, which have improved efficiency and speed in the services provided. Furthermore, it improves communication between different departments, ensuring care is coordinated through enhanced information sharing (Tummers et al., 2020). Doctors and other healthcare providers can also share information worldwide through improved communication to enhance care. Finally, technology allows nurses to search for information in evidence-based practice that helps guide care during decision-making. Therefore, it is prudent that all healthcare settings acquire various technologies to improve health outcomes.

Reference

Tummers, M., Kværner, K., Sampietro-Colom, L., Siebert, M., Krahn, M., Melien, Ø., Hamerlijnck, D., Abrishami, P., & Grutters, J. (2020). On the integration of early health technology assessment in the innovation process: reflections from five stakeholders. International Journal of Technology Assessment in Health Care, 36(5), 481–485. https://doi.org/10.1017/S0266462320000756

NRS 493 Topic 8 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:

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. 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.

NRS 493 Topic 8 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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 presen ted 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 LopesWrite.

Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week\'s entry, students should reflect on the personal knowledge and skills gained.

Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.

Topic Focus: Health Policy

While APA style is not required for the body of this assignment, solid academic writing is expected.

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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. 

Topic 8 Practicum Reflection

Like the previous weeks, this week, I discussed with my preceptor about health policy. World Health Organization (WHO) defines health policy as plans, decisions, and actions that guide the access and delivery of care in a health setting (Annesley, 2019). Both patients and healthcare providers are guided by the various policies that protect patient rights and protect health workers.

Such policies range from financing public health, pharmaceuticals, mental health, financing, insurance, healthcare services, and global health. Besides, policies help to clarify priorities, including expectations and roles of various groups, including doctors, nurses, and patients, while enhancing consensus between communities and health systems. Like other facilities, I am sure that my facility operates under the guidelines set by the health policy that ensures the best care is provided to ensure improved patient outcomes.

Because health policies are a vital part of health, nurses have an important to play a role in promoting policies. Nurses can participate in the implementation of health policies as well as influence organizations and health systems to ensure better health outcomes (Turale & Kunaviktikul, 2019). Additionally, nurses can analyze existing policies, propose new ones based on the encountered needs, and meet with policymakers to lobby for changes.

Nurses also spend a lot of time interacting with patients, thus making them understand patient needs that can be included in the policies. Therefore, every nurse must understand their roles in health policies and enhance safety and access to care. As a nurse, I have utilized my opportunity to come up with a health policy to enhance patient safety and outcomes by using chlorohexidine to reduce ventilator-associated pneumonia. This week, I completed the implementation plan and the evaluation plan for my project change.

References

Annesley, S. H. (2019). The implications of health policy for nursing. British Journal of Nursing (Mark Allen Publishing), 28(8), 496–502. https://doi.org/10.12968/bjon.2019.28.8.496

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship: Nurses’ contribution to health policy and advocacy. International Nursing Review, 66(3), 302–304. https://doi.org/10.1111/inr.12550

NRS 493 Topic 9 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.

NRS 493 Topic 9 Professional Capstone and Practicum Reflective Journal

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.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

You are not required to submit this assignment to LopesWrite.

Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week\'s entry, students should reflect on the personal knowledge and skills gained.

Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.

Topic Focus: Leadership and Economic Models

While APA style is not required for the body of this assignment, solid academic writing is expected.

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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. 

Professional Capstone and Practicum Reflective Journal Example Solution

This week, I discussed leadership and economic models with my preceptor. My preceptor emphasized that every nurse should understand the subject matter. Leadership is an integral part of nursing to help solve the various challenges experienced in healthcare. Besides, leadership skills are required to provide quality care, train others, and guide other nurses about nursing practices and conduct (Bleich, 2019).

As a result, effective leadership skills, including integrity, hard work, communication, time management, and collaboration with other disciplines, are required. Such skills are necessary to enhance teamwork, personal relationships, planning, and quality of care, leading to better patient outcomes. Additionally, good leaders can identify gaps in healthcare and encourage evidence-based practice (EBP) to coordinate care while improving nursing practice (Bleich, 2019). The use of EBP also improves the ability of nurses to make decisions that are essential in clinical practice. Fortunately, I have the leadership skills and knowledge of what nurse leaders should do to ensure quality care.

In addition to leadership, understanding the economic model is another essential component of healthcare delivery. An economic model is a simplified mathematical model that embodies the economic procedures based on hypothetical conduct (Major, 2019) Because overseeing the activities of healthcare requires the use of resources, knowledge about the economic model is useful in various procedures.

Such include planning and resource allocation, prediction of economic activities, prescription of new economic models, justification of economic policies, and lastly, help in trading and investment speculations (Major, 2019). Finally, having good leadership and an understanding of the economic models ensures the provision of high-quality care at a reduced cost while improving patient satisfaction and health outcomes. I have used my leadership skills to come up with an EBP that will improve the quality of care and reduce the cost of care.

References

Bleich, M. R. (2019). Health care leadership in the new economy. Journal of Continuing Education in Nursing, 50(5), 196–198. https://doi.org/10.3928/00220124-20190416-03

Major, D. (2019). Developing effective nurse leadership skills. Nursing Standard (Royal College of Nursing (Great Britain): 1987), 34(6), 61–66. https://doi.org/10.7748/ns.2019.e11247

NRS 493 Topic 10 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.

NRS 493 Topic 10 Individual Success Plan (ISP)

The completed Individual Success Plan (ISP) signed off by the preceptor must be submitted to LoudCloud for faculty approval. Student expectations and instructions for completing the ISP document are provided on the “NRS-493 Individual Success Plan” document. Faculty must approve of the completed ISP.  Obtaining preceptor feedback and signature is the responsibility of the student.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 10 Benchmark Professional Capstone and Practicum Reflective Journal

Students maintained and submitted weekly reflective narratives throughout the course to explore the personal knowledge and skills gained throughout this course. This assignment combines those entries into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

This final submission should also outline what students have discovered about their professional practice, personal strengths and weaknesses that surfaced during the process, 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.

The final journal should address a variable combination of the following, while incorporating your specific clinical practice experiences:

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. 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.

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

2.3:     Understand and value the processes of critical thinking, ethical reasoning, and decision making.

4.1:     Utilize patient care technology and information management systems.

4.3:     Promote interprofessional collaborative communication with health care teams to provide safe and effective care.

5.3:     Provide culturally sensitive care.

5.4:     Preserve the integrity and human dignity in the care of all patients.

NRS 493 Topic 10 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 at least one documented scholarly activity 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.

Submit, by way of this 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 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.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 10 Practice Experience Conference (Post-Conference)

Students are required to initiate a Post- Conference that will occur during Topic 10.  This meeting is intended for the student, preceptor, and faculty to discuss the completion of the clinical practice experience, the learning goals contained in the Individual Success Plan (ISP), and course learning objectives.

Completion of the written capstone project change proposal will also be discussed, including preceptor recommendations. Completion of the clinical practice experience will be documented on the “Clinical Evaluation Tool” (CET), which is submitted in LoudCloud prior to the Post- Conference.  The CET will be reviewed during the Post-Conference including recommendations from the preceptor.  Faculty will grade the submitted CET after the conference.

NRS 493 Topic 10 Indirect Clinical Practice Experience

Submit the completed “NRS-493 Indirect Clinical Practice Experience Hours” form to LoudCloud by the end of Topic 10.

NRS 493 Professional Capstone Practicum Essays GCU – Topic 10 Student Evaluation of Preceptor and Site

Access the Lopes Activity Tracker to complete the “Student Evaluation of Preceptor and Site.” Upload and submit the evaluation through the dropbox in LoudCloud.

NRS 493 Topic 10 Final Evaluation of Student by Preceptor

The preceptor will complete your final evaluation in the Lopes Activity Tracker.

Both the student and preceptor must sign the form. The final evaluation is completed and submitted by the student to the Dropbox in LoudCloud.

Students must meet all clinical expectations of the course, earn a passing grade on all benchmark assignments, and successfully complete remediation (if necessary) in order to receive a passing grade in the NRS-493 course. If there are any competencies on the final evaluation that are “Below Expectations,” this may result in failure of the course.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.