NRS 493 Topic 1 Capstone Change Project PaperWork with your preceptor to perform a needs assessment

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. Reg

Solution: