New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Capstone Project: Developing a Question
Recall the components of PICOT from your research course:
(P) Population of Focus
(I) Intervention
(C) Comparison
(O) Outcome
(T) Time
Identify each of the components in relation to your approved Capstone Project topic.
P:
I:
C:
O:
T:
Then, develop a PICOT question/statement.
Examples of PICOT questions/statements:
· In adult cardiac surgery patients experiencing post-operative pain (P) immediately following surgery (P), is morphine (I) or fentanyl (C), administered intravenously, more effective in reducing postoperative (T) pain (O)?
· For immune-compromised patients, 50 years and older (P), does the use of pneumonia vaccine (I) reduce the future risk (T) of pneumonia (O) compared with patients who have not received the vaccine (C)?
© 2015. Grand Canyon University. All Rights Reserved.
33SPECIAL FOCUS ON NURSING LEADERSHIP IN HOME AND COMMUNITY CARE
Integrated Comprehensive Care – A
Case Study in Nursing Leadership
and System Transformation
Laura Wheatley, MHSc
Hamilton Niagara Haldimand Brant (HNHB) Integrated Comprehensive Care Lead
St. Joseph’s Healthcare Hamilton
Hamilton, ON
Winnie Doyle, RN, BScN, MN
Executive Vice President Clinical Programs and Chief Nursing Officer
St. Joseph’s Healthcare Hamilton
Hamilton, ON
Cheryl Evans, RN, MScN
Acting Director of Nursing
St. Joseph’s Healthcare Hamilton
Hamilton, ON
Carolyn Gosse, RPH, ACPR, PharmD
Vice President of Integrated Care, St. Joseph’s Health System
President, St. Joseph’s Home Care
Hamilton, ON
Kevin Smith, DPhil
CEO
St. Joseph’s Health System
Hamilton, ON
Abstract
Calls for transformational change of our healthcare system are increasingly clear,
persuasive and insistent. They resonate at all levels, with those who fund, deliver,
provide and receive care, and they are rooted in a deep understanding that the
system, as currently rigidly structured, most often lacks the necessary flexibility to
comprehensively meet the needs of patients across the continuum of care. The St.
Joseph’s Health System (SJHS) Integrated Comprehensive Care (ICC) Program, which
bundles care and funding across the hospital to home continuum, has reduced
fragmentation of care, and it has delivered improved outcomes for patients, provid-
ers and the system. This case study explores the essential contribution of nursing
leadership to this successful transformation of healthcare service delivery.
34 Nursing Leadership Volume 30 Number 1 • 2017
Introduction
Healthcare providers and organizations are challenged to consistently deliver
high-quality care within the current system, especially for those with complex and
chronic conditions. From the perspectives of patients and providers alike, episodes
of care are too often fragmented and lack integration between sectors and provid-
ers. If we are to improve the patient experience and health outcomes and ensure
optimal value for the system, the design of care delivery must change. Patient-
centred care and coordination of care are by no means new concepts; however,
building healthcare services that enable these concepts to live every day for every
patient has not come easily. Historically, patient movement between acute care
and community home care services has often been typified by:
• Continuity of care disruptions at each transition point, leading to poor
integration of care, higher risk of readmissions and unwarranted costs.
• Communication gaps and patient dissatisfaction created during the process of
transfer, often described in terms of contradictory instructions, lack of clarity
on self-care expectations, uncertainty about whom to contact when problems
arose and strain on the patient and family with requests to repeat their story
multiple times to multiple care providers.
• The absence of
Welcome to Topic 2: Identification of Issue Significant to Nursing Practice II
Welcome to Topic 2: Identification of Issue Significant to Nursing Practice II. Thanks for the introductions to your preceptors and the discussion of the proposed topics in your preconference.
Please be aware of the weekly feedback and the Rubric for each assignment, it is expected that you utilize the comments from the feedback in the upcoming assignments. In this week’s topic, students will continue to explore the context of their chosen clinical issue, problem or organizational issue and its implications to nursing practice.
It must be within the scope of nursing practice.
1. Capstone Topic Summary.
The earlier you start working on your PICOT statement the better it will be in your final paper, which must be written out in the following format;
P- Population/ focus,
I – intervention what do you plan to do to correct what is being done, or isn’t being done
for the issue and needs attention.
C – current practice or practice that is not being followed
O- outcome decrease/increase by 10% minimum and
T- once intervention has been completed, it will take time to integrated the new policy/ process or practice strategy into practice and then the data can be collected for 6 months to verify the effectiveness of the project) by writing a 150-250 +-word summary explaining which category your topic and intervention.
This will serve as the introduction for your final paper. You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment and these references will be utilized throughout your future assignments. 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.
2. Capstone Project Topic Selection and Approval
. If we have settled on a topic during the preconference, then you don’t need to list the other topics, Just the focus topic and the objectives you have settled on and hope to accomplish.
Please review and coordinate with preceptor the PIOCT statement for your selected topic and introduce the issue or problem with a minimum of
8 peer reviewed articles
to support your approach to the issue/s or problem which will be utilized throughout your next assignments and the final paper in Week 8.
3. Professional Capstone and Practicum Reflective Journal
. This a paragraph of the continuation of your journal on the actions taken to solve the selected project.
Capstone Project Topic Selection and Approval – Rubric
Collapse All Capstone Project Topic Selection And Approval – RubricCollapse All
Project Topic for Focus of Change Proposal
2.5 points
Criteria Description
Project Topic for Focus of Change Proposal
5. Excellent
2.5 points
The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is clearly and logically presented. Support and rationale are evident.
4. Good
2.23 points
The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is presented. Minor aspects are unclear or require support.
3. Satisfactory
1.98 points
The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is summarized. There are some omissions or inaccuracies. Some support is needed.
2. Less Than Satisfactory
1.88 points
The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is presented but is largely incomplete.
1. Unsatisfactory
0 points
The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is omitted.
Setting or Context Where Project Topic Is Observed
5 points
Criteria Description
Setting or Context Where Project Topic Is Observed
5. Excellent
5 points
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is logically presented. Support and rationale are evident.
4. Good
4.45 points
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is presented. Minor aspects are unclear or require support.
3. Satisfactory
3.95 points
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is summarized. There are some omissions or inaccuracies. Some support is needed.
2. Less Than Satisfactory
3.75 points
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is presented but is largely incomplete.
1. Unsatisfactory
0 points
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is omitted.
Detailed Description of Project Topic
7.5 points
Criteria Description
Detailed Description of Project
Submission Ide: 8873e36e-1f80-4560-bc16-ba7b58c58da5
42% SIMILARITY SCORE 6 CITATION ITEMS 10 GRAMMAR ISSUES 0 FEEDBACK COMMENT
Internet Source 0%
Institution 42%
Makoya Suomie
Capstone Project Topic Selection and Approval
Summary
879 Words
1
2
Community Education
Problem Description
Diabetes is a serious health condition affecting many people in the United States.
Community Education
Student’s Name
Grand Canyon university
NRS-493-0505
DR. Vernon Thacker
02/21/22
Diabetes involves a metabolic disorder that happens because of elevated levels of bloodstream
glucose. Type 2 is the most common diabetes type and happens when the human body becomes
resistant to insulin or when the body does not generate adequate insulin (Rooney et al., 2021).
Without interventions for lifestyle changes, including the community teaching on the topic to
reverse the condition, patients are at risk of developing more chronic health complications.
Community teaching programs to improve the population’s understanding of the need for healthy
diets, regular body exercise, and maintaining a healthy weight can assist in bringing to normal
the levels of blood sugar (Echouffo-Tcheugui & Selvin, 2021). When poorly controlled, diabetes
mellitus results in severe consequences, leading to a broad rage body tissue and organs damaged,
including kidney, heart, nerves, and eyes. According to Moonesinghe et al. (2018), diabetes risk
factors include overweight, large waist size, unhealthy diets, 45 years and above, inactivity,
ethnicity and gestational diabetes, smoking, and obstructive sleep apnea.
Context
Diabetes is very prevalent in the United States, with 37.3 million Americans suffering
from the condition. However, 8.5 million people in the country are unaware that they have
diabetes (Zhu et al., 2019). This demonstrates that 14.7% of the US population is diabetic. The
prevalence of diabetes increases with age: 29.2% of people aged 65 years and above are diabetic.
18.9% of American aged between 45 and 64 years have diabetes, while 4.8% of those aged
between 18 and 44 suffer from the condition too. About 15.4% of male adults have prediabetes,
3
while 14.1% are women. According to Zhu et al. (2019), diabetes shows disparity along ethnic
and racial lines, with the disease being more prevalent among the Black non-Hispanic group with
a prevalence of 17.4%, followed by Asian non-Hispanic, Hispanic with 15.5%, and then the
Whites non-Hispanic ethnic group with 13.6% prevalence.
Impact of Diabetes
Diabetes has both health and psychological effects on the patient. The patients are at
higher risk of stroke, heart disorder, and cancer. The condition can lead to psychological distress,
including signs and symptoms of depression, apathy, anxiety, and insomnia. Diabetes patients
experience hyperglycemia, which can impa
DQ1
Sierra Cossano
A clinical problem my organization is facing is fragmentation communication on several levels. These lapse in communication are leading to negative patient outcomes and some examples are missed organ donor referrals, hospital acquired infections and skin injuries, and increased risk of patient harm. In fact, it is not one single clinical problem that exists in excess, but a small number of multiple different problems. My preceptor and I kept coming to the same conclusion at the end of different debriefings that communication is key to closing these gaps. 70% of medical errors can be drawn back to communication (Itamaro et al., 2016). Although communication can be complex, multifaceted, and is perceived differently person to person there is a lot of research to support communication techniques in healthcare. This also means that there has to be different approaches to communicating the desired message so that it is passed accurately. For example, a clinical problem occurring in this organization is that there are a high number of central line infections. When conducting a root cause analysis, it was determined that the lack of plan for removal of the line played a role in the continuation of the line. This facility often has temporary doctors covering random shifts in the ICU. Therefore, the nurses operating as staff RN’s (about ½ the unit is travelers and ½ full time nurses) are the one consistency. Where lack of consistency exists, strong communication must be present. There is recognition and support from administration to hold some accountability on the physician part. However, nurses must feel accountable for their own care also. Raising awareness of these situations and keeping the mindset of reducing patient harm and improving outcomes can drive nurses to advocate for those complication-preventing interventions; like having a plan to remove a no longer needed central line.
Two implications for nursing are the adoption and implementation of bedside reports in some capacity. Due to the various methods of RN-RN handoff done at this facility, introducing a standardized handoff is something the administration wants. The current culture is to sit outside a patient room to do a report and a beside assessment is only required for specific patients. Creating a guide to hand-off ensures that staff are talking about all the important aspects of care amidst the chaos of working in the ICU. Itamaro et al. (2016) researched experienced NICU nurses (average 10.5 yrs), from various shifts who implemented a bedside report found that nurses developed attitudes of improved patient safety, while increasing patient satisfaction, and creating a more complete view of the patient at handoff. There also is acknowledgement that a partially written report with a visual component is common. I would like to use my project to promote this safety culture within the ICU. It is important that the nurses maintain their autonomy to conduct report how t
DQ2
Patrick Queisne
One of the greatest barriers that the organization I am at for my practicum has with implementation of evidence-based practice (EBP) is education. Historically, the use of would tactics such as mentorship, online learning modules, in person skills days, and lectures. However, the COVID-19 pandemic forced facilities shift in person educational avenues with an attempt to adapt by using technology. Live streaming videos rapidly became the go to replacement for the in-person class. This was the same approach that was taken by nursing programs across the country to replace clinical time for nursing students. Now there are new graduate nurses entering facilities with little, if any, in person clinical time.
Staff has now realized the opportunity to have flexibility for training as there is no commute time associated with attending virtual sessions. However, as the facility seeks to return to the new normal, in person classes are not well received. The intent of continuing education is to help keep nurses informed of the latest EBP (Fletcher, 2016). Now faced with a lack of staff engagement related to long working and staffing shortages leaves the empty classrooms for in-person education. From an educational standpoint, the first part of developing a plan to determine how individuals in the organization want the information delivered. This involves having open lines of communication between educators for the facility and the staff receiving the education.
References
Fletcher, S. (2016). Nurse education specialist utilizing career coaching to encourage lifelong learning. Journal of Nursing Education and Practice, 6(6), 71-74. doi: 10.5430/jnep.v6n6p71
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