REQUIRED PRACTICE HOURS: 100 Direct Clinical Experience (50 hours community/50 hours leadership) – 25 Indirect Clinical Experience Hours.
Application-based Learning Course AssignmentsList of Current Course ObjectivesNumber of Clock Hours Associated with Each AssignmentAssignment Date DueSelf-Assessment: GCU RN-to-BSN University Mission Critic Competencies and Programmatic Domains Competencies(see Appendix A)WEEK 1Agreement between Grand Canyon University and HillCrest Hospital Develop ISP and share ideas with mentor. Submit documentation for Course Mentor identification process Plan for a capstone research project105/16/2021MCI-MC5 Domains 1.1: 2.3:Course mentor11:59:594.1: 5.1Identification andDiscussionapproval processtopic duePre-conference Individual Successdates#1 5/12/21Plan11:59:59Capstone change#2 5/14/21project topics11:59:59Lopes Activity TrackerReflective JournalDiscussion topic 1&2WEEK 2Identify a topic problem, and opportunities to improve patient care, and outcomes, within a clinical practice setting. Determine evidence? based solutions Identify strategies for logistical Implementation of a105/23/202111:59:59 Discussion topic due dates#1 5/19/2111:59:59MCI-M5 Domains 1.1: 1.2: 1Capstone Topic Summary,1.4 :2.1:2.2: 2.3 3.1:3.2: 3.3 34.1: 4.3: 5.1: 5.2Selection, andApprovalLopes ActivityTrackerReflective JournalDiscussion topic 1&2solution. Use the PICOT process in analyzing a clinical problem or organization issue.#2 5/21/2111:59:59WEEK 31. Evaluate evidence-105/30/2021MC1-MC5: Domai.3ns 1.1:1.2:1.3: 1.4: 2.1: 2.2:2.3: 3.1:4.14.2: 4.3: 5.1:5MC1-MC5 Domains 1.1: 1.21.4: 1.5: 2.1: 2.2;2.3: 3.1: 4.14.2: 4.3: 5.1: 5.2
MC1-MC5 Domains 1.1: 1.2
1.5: 2.1: 2.2: 2.3: 3.1: 3.2: 3.
PICOT Statement Paper (Discussion with mentor)Lopes Activity Trackerbased research and other appropriate resources to inform the development of a change plan.2. Identify strategies for logistical11:59:59Discussion topic due dates#1 5/26/21Discussion topic 1&2Reflective journalimplementation of proposed solutions.3. Demonstrate the11:59:59#2 5/28/21Benchmark Capstone Change Project Objectivesability to evaluate levels of evidence into a concise format.4. Integrate evidence,11:59:59clinical judgment, inter-professionalperspectives, and patientpreferences in planning,implementing, andevaluating outcomes ofcare.WEEK 41. Evaluate evidence-106/06/2021Evidence-Based Practice Proposal Development Plan 2Literature Evaluation Tablebased research and other appropriate resources for the development of a change plan.2. Identify strategies for logistical11:59:59Discussion topic due dates#1 6/2/21Lopes Activity tracker Reflective journalimplementation of proposed solutions.3. Demonstrate the11:59:59#2 6/4/21Discussion topic 1&2Capstone Change Project Outcomesability to evaluate levels of evidence into a concise format.4. Integrate evidence, clinical judgment, inter-11:59:59professionalperspectives, andpatients’ preferences inplanning, implementing,and evaluatingoutcomes of care.WEEK 5Evidence-BasedIdentify the objectives, strategies, and best outcomes of the106/13/2111:59:59Practice Proposalevidence-based practice proposal. Mapped out steps to implement the strategies for change proposalFind resources to organize and implement the proposal.Establish an evaluation plan for change proposal effectiveness in ensuring adequate health promotion and disease prevention
Discussion4.2; 4.3: 5.1:5.2: 5.3:5.4:MC1-MC5 Domains 1.1: 1.21.4; 1.5: 2.1; 2.2: 2.3: 3.1: 3.3.3: 3.4: 4.1: 4.2: 4.3: 5.1:5.25.3: 5.4:
MC1-MC5 Domains-1.1, 1.2
1.4: 2.1: 2.2: 2.3, 2.4: 3.1: 3.
3.3: 3.4: 4.1: 4.2, 4.3: 4.4; 4.
5.1: 5.2: 5.3: 5.4: 5.5
Projecttopic dueDevelopment anddatesImplementation Plan 1 (Practice#1 6/9/21Hours Completion11:59:59Statement lopes activity tracker#2 6/11/2111:59:59Reflective journalDiscussion topic1&2Midterm Evaluationof studentMid-ConferenceWEEK 6Identify the objectives, strategies, and best outcomes of the evidence-based practice proposal. Find resources to organize and implement the proposal. Analyzing how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence.106/20/202111:59:59discussion topic due dates#1 6/16/2111:59:59#2 6/18/21
11:59:59
Evidence-BasedPractice ProposalProjectDevelopment andImplementationPlan 2 (LiteratureReview withMentorCapstone ChangeProject resourcesReflective journalLopes activitytrackerDiscussion topic1&2WEEK 7Ability to identify ways106/27/2021Change Proposal Project Evaluation and Dissemination Planof evaluating a proposed solution. Assess variables and outcomes before and after project implementation using11:59:59Discussion topic due datesLopes activity trackerbasic statistics. Address plans of making#1 6/23/21Reflective journal Discussion topic 1&2evidence for change proposal known. Employ excellent communication and11:59:59#2 6/25/2111:59:59teamwork withinterdisciplinarymembers to deliver the best evidence-based patient care.WEEK 8 Change Proposal Project Evaluation and Dissemination Plan 2Practice Hours Completion Statement Reflective journal Lopes activity tracker Discussion topic 1&2Apply evidence-based research steps and processes required as the foundation to address clinically oriented problem or issue in future practice. Address plans of making evidence for change proposal known. Employ excellent communication and teamwork with interdisciplinary members to deliver the best evidence-based patient care.107/04/202111:59:59 Discussion topic due dates#1 6/30/2111:59:59#2 7/2/21
11:59:59
MC1-MC5 Domains -1.1, 1.21.3, 1.4, 2.1, 2.2, 2.3, 2.4, 3.13.2, 3.3, 3.4, 4.1, 4.2, 4.3, 4.44.5, 5.1, 5.2, 5.3, 5.4, 5.5WEEK 9Evidence-Based Practice Proposal Project 1(Capstone Project Change Proposal)Lopes activity tracker Reflective journalDiscussion topic 1&2Present a professional comprehensive change initiative. Apply new knowledge and skill to nursing practice watching the process of evidence- based research utilization by nursing staff. Analyze research studies for use as evidence-based practice in healthcare settings. Be an active interprofessional collaborator in leadership, skills and decision-making to provide in providing high-quality patient careKnow the organization and other barriers that can derail change proposals to affect10711/202111:59:59 Discussion topic due dates#1 7/7/2111:59:59#2 7/9/21
11:59:59
health care delivery and practice. Effectively communicate and exemplify good leadership traits in ensuring a successful implementation of the change initiative.WEEK 10Evidence-Based Practice Proposal Project 2Benchmark & Professional Capstone and Practicum Reflective Journal Individual Success PlanLopes activity trackerPost Conference
Present a professional comprehensive change initiative. Apply new knowledge and skill to nursing practice watching the process of evidence-based research utilization by nursing staff. Analyze research studies for use as evidence-based practice in healthcare settings. Be an active interprofessional collaborator in leadership, skills and decision-making to provide in providing high-quality patient careKnow the organization and other barriers that can derail change proposals to affect health care delivery and practice.Effectively communicate and exemplify good leadership traits in ensuring a successful implementation of the change initiative.
107/18/202111:59:59 Discussion topic due dates#1 7/14/2111:59:59#2 7/16/21
11:59:59
MC1-MC5 Domains -1.1, 1.21.3, 1.4, 2.1, 2.2, 2.3, 2.4, 3.13.2, 3.3, 3.4, 4.1, 4.2, 4.3, 4.44.5, 5.1, 5.2, 5.3, 5.4, 5.5Personal evaluation with mentor7/18/2111:59:59Scholarly Activity7/18/2111:59:59Comprehensive Log100.7/11MC2; MC5of Practice Immersion Hours1:59:59Domain 1.1; 1.2; 1.3; 1.4; 1.5By typing in his/her signature below, the student agrees to have read, understood, and be accountable for the instructions, assignments, and hours shown above and that all questions have been satisfactorily answered by the faculty.
Preceptors will sign upon initial receipt and at the end of the course to confirm that assignments have been complete with your guidance.
Student SignatureName:TLDate:5/14/2021Mentor Signature [Upon Initiation of Course]Name:CTDate:5/14/21Mentor Signature [Upon Completion of Course]Name:Week 10 mentor signs when date assignment completed is filled in.Date:APPENDIX A:
MC1: Effective Communication: Therapeutic communication is central to baccalaureate nursing practice. Students gain an understanding of their ethical responsibility and how verbal and written communication affects others intellectually and emotionally. Students begin to use nursing terminology and taxonomies within the practice of professional and therapeutic communication.
Courses require students to write scholarly papers, prepare presentations, develop persuasive arguments, and engage in discussion that is clear, assertive, and respectful.
MC2: Critical Thinking: Courses require students to use critical thinking skills by analyzing, synthesizing, and evaluating scientific evidence needed to improve patient outcomes and professional practice.
MC3: Christian Worldview: Students will apply a Christian worldview within a global society and examine ethical issues from the framework of a clearly articulated system of professional values. Students will engage in discussion of values-based decisions made from a Christian perspective.
MC4: Global Awareness, Perspectives, and Ethics: The concept of global citizenship is introduced to baccalaureate students in the foundational curriculum. Some courses will focus on the human experience across the world health continuum. The World Health Organization (WHO) definitions of health, health disparities, and determinants of health are foundational to nursing practice.
MC5: Leadership: Students will apply a Christian worldview within a global society and examine ethical issues from the framework of a clearly articulated system of professional values. Students will engage in discussion of values-based decisions made from a Christian perspective.
Graduates of Grand Canyon University’s RN-BSN program will be able to incorporate professional values to advance the nursing profession through leadership skills, political involvement, and life-long learning.
Competencies:
Graduates of Grand Canyon University’s RN-BSN program will have acquired a body of nursing knowledge built on a theoretical foundation of liberal arts, science, and nursing concepts that will guide professional practice.
Graduates of Grand Canyon University’s RN-BSN program will be able to utilize the nursing process to provide safe quality care based on nursing best practices.
Graduates of Grand Canyon University’s RN-BSN program will be able to manage information and technology to provide safe quality care in a variety of settings. In addition, graduates will be able to communicate therapeutically and professionally to produce positive working relationships with patients and health care team members.
Graduates of Grand Canyon University’s RN-BSN program will be able to provide holistic individualized care that is sensitive to cultural and spiritual aspects of the human experience.
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
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.
You are not required to submit this assignment to LopesWrite.
Students are required to initiate a preconference that will occur during the first week of class and must include the faculty member and the preceptor. Conferences may be conducted face-to-face or via synchronous technology such as Skype, Zoom, or GoToMeeting.
The student, preceptor, and faculty must be present at the conference. The student and preceptor will complete the “Practice Experience Conference Form (Preconference)” and the student will submit it to the instructor in LoudCloud after the conference has taken place.
You are not required to submit this assignment to LopesWrite.
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.
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.
During your practicum, determine what clinical problem or issue the organization is facing. Discuss two implications for nursing.
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.
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.
Kristler et al., (2018)
Strengths: The journal was informative on the demographic characteristics, methods used were survey and sampling, included data that I need for the focus of factors related to falls, with a time period. The data analysis is useful, and the limiters are identified.
Weakness: The target was more geared to CKD and the elderly results.
Ø CDC, (2021)
Strengths: The facts on falls and the statistical data are credited related to the CDC is the source. Falls in the U.S. is a comparison that is needed in the study. The education/ teaching tools are available to pull from for the project.
Weakness: There are many variables to search through to retrieve data, information, and are not complex to a specific age group for this journal.
Ø United Health Foundation, (2022)
Strengths: This website is detailed oriented toward the focus. The content is supportive of the data to Texas and falls age 65 and older. The references give this site credibility and therefore will be useful.
Weakness: The journal has information as a secondary source, and there are no comparisons as a peer-reviewed journal has methods and comparisons, limiters to search for that are user friendly.
Ø Ximenes et al., (2021)
Strengths: This journal is a systematic review, that includes interventions that are educational, peer-reviewed, and had methodological aspects of falls to offer assessments of the studies in hospitals, nursing homes, and specifically noted follow-up at home that utilized home visits. The focus of the research is home visits after hospitalization, and observance data comparisons. This provides the researcher with evidence-based information.
Weakness: The journal article showed the weaknesses, however, the focus only consisted of four risk factors. There were outliers of influence identified with all ages and therefore not specific to the target age.
Ø Bjerk, M., Brovold, T., Davis, J., & Bergland, A. (2019)
Strengths: The research literature review is clearly stated. The variables (dependent and independent) are identified clearly; as well as the statistical data for the analysis and descriptive results were identified. The research design is clearly stated. There is validity.
Weakness: Interviews were used and sometimes can be biased without a control group via observation. This is a secondary analysis of data and a randomized control trial identified as “elsewhere”. There were more women than men, and more education interventions are needed.
Ø Ozen, B., & Demir, G. (2020).
Strengths: The article is original, contains key elements such as statistics, methodology, and results. The risk factors were identified. The study was for sleepiness, however, there is data to support the researchers’ PICOT. The results were compared to previous studies.
Weakness: The research was geared to sleepiness in 65 and older adults. Educational interventions were not descriptive. There are no variables (this is a descriptive-relational study). There could be more studies that can continue the study searching more focus to specifics.
References
Bjerk, M., Brovold, T., Davis, J., & Bergland, A. (2019). Evaluating a falls prevention intervention in older home care recipients: a comparison of SF?6D and EQ?5D. Quality of life research. 28:3187–3195. https://doi.org/10.1007/s11136-019-02258-x
CDC. (2021). Facts about falls. Centers for Disease Control and Prevention. Retrieved February 22, 2022, from https://www.cdc.gov/falls/facts.html
Kistler, B., Khubchandani, J., Jakubowicz, G., Wilund, K., & Sosnoff, J. (2018). Falls and Fall-Related Injuries Among US Adults Aged 65 or Older With Chronic Kidney Disease. Preventing chronic disease, 15, E82. https://doi.org/10.5888/pcd15.170518
Ozen, B., & Demir, G. (2020). A determinant for falls and risk factors in the elderly: Daytime sleepiness. Volume 13 | Issue 1| Page 732. http://www.internationaljournalofcaringsciences.org/docs/81_ozen_original_13_1.pdf
United Health Foundation. (2022). Explore falls – ages 65+ in Texas: 2021 senior report. America’s Health Rankings. Retrieved February 22, 2022, from https://www.americashealthrankings.org/explore/senior/measure/falls_sr/state/TX
Ximenes, M., Brandao, M., de Araujo, T., Neto, N., Barros, L., Caetano, J. (2021). Effectiveness of educational interventions for fall prevention: a systematic review. Texto & Contexto – Enfermagem [internet]. 2021, v. 30:e20200558. Available from: <https://doi.org/10.1590/1980-265X-TCE-2020-0558>. Epub 30 Aug 2021. ISSN 1980-265X. https://doi.org/10.1590/1980-265X-TCE-2020-0558
Garcia et al (2019) found that burnout among nurses have a direct negative impact on the quality-of-care patients receive, particularly in terms of compromising their safety. The nurses get prone to medical errors because the focus, concentration and critical thinking skills gets impaired due to the psychological and physical exhaustion. The paper is strong on developing and defending the causal link on the variables under discussion. It is a review of published materials and not statistical research in itself.
Kelly et a l (2021) explains how when burnout inducing condition prevail in a hospital, clinic or nurses’ working environment not just the patients’ care but also the entire organization is affected. The paper does a great job in highlight the broader impact of nurse burnout and not just restricting it to the effects on patients. This is important because it drags the attention of management of medical establishments to take the issue of nurse burnout seriously because the operation of the organization can be crippled. The weakness is that the study surveyed nurses from three facilities only, opening up the study to question about whether it was representative enough.
Mua (2019) explains in details how investing in improving the work condition for nurses so that their burnout is dealt with has a direct impact on improving the experience of patients under their care. It finds that nurses who are motivated to work, has time to refresh and replenish and who have workload evenly distributed tend to give better quality service. The paper is effective in vouching for dealing with nurse burnout in a progressive and effective manner. It however does not highlight how patient behaviors also tend to frustrate nurses into burnout even if some of the conditions for the nurses are addressed.
Sasangohar et al. (2020) examines how the physical and psychological impacts of COVID-19 translated into stressing and overstretching ICU nurses, causing them to experience burnout. The article’s strength is that it lays bare how nurses experience burnout when they get overstretched by huge influx of patients into hospitals needing intensive care. This perspective is accurate. The weakness is that the paper uses pandemic times which has been an emergency to suggest conclusions which it purports to be generalized.
Shah et al (2021) discusses the how widespread the problem of nurse burnout is among nurses in the United States and what factors contribute to it. It found that the up to 31.5% nurses who report to have left their job cite burnout as the principal reason. Hospitals and clinics with 20 hour a week working schedule setting were associated with greater odds of burnout. The strength of this article is that it clearly links the factors to the outcome which forms the basis for its conclusion. The weakness is that it only sampled 50,000 nurses to represent 3.9 million people, a sample I think is too small to be representative.
Kelly et al. (2021) use evidence-based studies to build a case of how nurses can deal with burnout and shield themselves from it. The detailed suggestion highlight how nurses can reduce their pre-exposure to physical and emotional exhaustion that drains the work drive. The weakness is that articles reviewed to generate the suggestions seem so limited to give credible conclusions that can be relied upon.
References
Garcia, C. D. L., Abreu, L. C. D., Ramos, J. L. S., Castro, C. F. D. D., Smiderle, F. R. N., Santos, J. A. D., & Bezerra, I. M. P. (2019). Influence of burnout on patient safety: systematic review and meta-analysis. Medicina, 55(9), 553.
Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing outlook, 69(1), 96-102.
Kelly, L. A., Weston, M. J., & Gee, P. M. (2021). A Nurse Leader’s Guide to Reducing Burnout: Strategies to Improve Well-Being. Nurse Leader, 19(5), 467-473.
Mua, A. (2019). Compounding Effects of Reducing Nurse Burnout and How It Can Produce an Increase in Patient Safety and Satisfaction.
Sasangohar, F., Jones, S. L., Masud, F. N., Vahidy, F. S., & Kash, B. A. (2020). Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit. Anesthesia and analgesia.
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA network open, 4(2), e2036469-e2036469.
Name two different methods for evaluating evidence. Compare and contrast these two methods.
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.
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?
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?
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?
After discussion with your
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