Capstone Change Project Evaluation Plan

Apr 25-May 1, 2022

Students must develop skills related to systematic evaluation for intervention effectiveness. The content covered this week prepares students to evaluate the effectiveness of interventions and develop communication plans for the dissemination of information related to project outcomes. Synthesis of information from the process of evaluating outcomes (whether outcomes were met or not) generates new knowledge and adds to the body of knowledge for nursing practice. Capstone Change Project Evaluation Plan

Objectives:

1. Determine how the capstone project change proposal could be disseminated to leadership.
2. Create a plan to evaluate outcomes of the proposed nursing practice intervention used in the change proposal.
3. Integrate reflective practice into the practicum reflective journal.
4. Demonstrate interprofessional collaboration during the creation of the capstone project change proposal.

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DQ1

Describe one internal and one external method for the dissemination of your evidence-based change proposal. For example, an internal method may be the hospital board, and an external method may be a professional nursing organization. Discuss why it is important to report your change proposal to both of these groups. How will your communication strategies change for each group?

DQ2

In order to evaluate an evidence-based practice project, it is important to be able to determine the effectiveness of your change. Discuss one way you will be able to evaluate whether your project made a difference in practice.

Capstone Change Project Evaluation Plan

SUBMIT ASSIGNMENT

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. Capstone Change Project Evaluation Plan

DQ1
Kayla Machingo

One internal method for the dissemination of the early mobility change proposal is the house wide shared governance council. This council incorporates ethics, quality, and leadership into each department. It does so by each unit having representatives for a specific topic that research new evidence-based practices and aid in implementation. It is very important to have this large group of nurses involved as they are the foundation of Mission Hospital. More specifically, they can help advocate for the change proposal by requesting funds, creating newsletters, and sharing the new knowledge with other units. Being that I am apart of this council, my communication strategy would be more friendly and engaging, as I know many of the individuals. This would be more of a group bonding experience and could really lead to something great!

One external method for dissemination of the proposal would be the American Nurses Association (ANA). This organization has an entire webpage directed to mobility programs and aids nurses in mobilizing patients safely. More specifically, they advocate for the use of lift devices to prevent injury for the nurses (American Nurses Association, 2022). This would be an important foundation to have by my side, as this project involves a lot of activity from the nurses including the use of the lift device. Therefore, the ANA can be a great resource for providing mobility education and support for the nurses working at the bedside. This form of communication would be extremely formal and would provide detail about the project and its goals. Capstone Change Project Evaluation Plan

Reference

American Nurses Association. (2022). Health and safety. https://www.nursingworld.org/practice-policy/work-environment/health-safety/handle-with-care/

DQ1
Virginia Gallardo

One important aspect is ensuring the dissemination of our evidence-based proposal, which can be achieved via internal and external methods. The goal of dissemination is to gather the created evidence and communicate it to the population of interest (Zhu et al., 2017). Disseminating such information can be challenging because we deal with multiple barriers affecting our healthcare system, like underfunding and understaffing. Internal methods include sharing our change proposal with the hospital board via email, individual, or group discussions. A poster or podium presentation can be an efficient means of sharing one’s scholarly work (Astroth & Hain, 2019). I have chosen to disseminate information through nurse leaders via unit huddles. Nurse leaders add information to this huddle that they want to discuss with staff. During huddles, nurses and other healthcare providers discuss any problems the organization has. This strategy allows me and those supporting my project to receive instant feedback as we see how nurses feel regarding the issue and the planned interventions to address the problem. It also will enable nurses to ask questions and have them answered promptly.  Capstone Change Project Evaluation Plan

An external method for disseminating my evidence-based proposal may be through a professional organization. There are various organizations, and many health professionals turn to these organizations to gain new knowledge on evidence-based practice. These organizations hold various conferences allowing us to meet multiple nurses of different backgrounds and share information like our change proposal. Sharing information via an external method like a professional nursing organization will provide more access to nurses outside of my organization.

Reference

Astroth, K. S., & Hain, D. (2019, September 1). Disseminating Scholarly Work through Nursing Presentations. Nephrology Nursing Journal, 46(5), 545.

Zheng Zhu, Weijie Xing, Yan Hu, Yingfeng Zhou, & Ying Gu. (2018). Improving Evidence Dissemination and Accessibility through a Mobile-based Resource Platform. Journal of Medical Systems, 42(7), 118. https://doi-org.lopes.idm.oclc.org/10.1007/s10916-018-0969-7 Capstone Change Project Evaluation Plan

Neoma Rice

For my change project, it is going to be proposed for a small privately own neurology clinic. So, the internal method for dissemination would be with the doctor and his nurse practitioners, who are all open about potentially implementing this practice of proper nutritional assessment and education for multiple sclerosis patients by nursing. I’m slightly troubled trying to think of what would be my external method of dissemination, but as I thought more I thought I could reach out to my National Multiple Sclerosis Society representative, Emily. She has a world of knowledge as someone who lives with MS, but she also works for the organization that has plentiful resources. I feel it would be important to share with Emily as she could provide me the latest and greatest nutritional recommendations that are being studied to aid me in helping these patients. Emily and i mostly communicate through email. She sent me an email today with new webinars of different MS related topics.

It has been founded that technology and training can play an important role with dissemination and implementation of an evidence-based practice (Novins et al, 2013).

Novins, D. K., Green, A. E., Legha, R. K., & Aarons, G. A. (2013). Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review. Journal of the American Academy of Child and Adolescent Psychiatry, 52(10), 1009–1025.e18. Capstone Change Project Evaluation Plan https://doi.org/10.1016/j.jaac.2013.07.012

DQ2

Kayla Machingo

Evaluation will be important in the early mobility capstone. The main idea I have been considering for evaluation is having patients complete a mini- evaluation on day of discharge and then again 6 months from day of surgery. I was considering using the Microsoft team’s application which has a poll application that can be sent out to individuals via email. This e-mail is secured and would represent Providence hospital. This form of evaluation seems the easiest for both me and the patients. The poll can be no more than ten questions, can have a time restriction and can be sent to all the patients (Microsoft, 2022). Once the results are back, a PDF can be created which will be useful in identifying if the early mobility project was effective (Microsoft, 2022). After a six-month period, I can compare these results with audits from 2021 to determine if the length of stay was decreased by ten percent or greater. If the evidence shows improved/shortened length of stay, then I will know that the project made a difference in practice.

Reference

Microsoft. (2022). Create a poll in teams. https://support.microsoft.com/en-us/topic/92bc2481-b5e4-4650-8a87-d90103ee95a1 Capstone Change Project Evaluation Plan

Evidence Based Capstone

assessment Description

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. Evidence Based Capstone

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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. Evidence Based Capstone

Nurs-6512 Discussion Wk8

Discussion: Assessing Musculoskeletal Pain

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

To prepare:

• Your Discussion post should be      in the Episodic/Focused SOAP Note format rather than the traditional      narrative style Discussion posting format. Refer to Chapter 2 of the      Sullivan text and the Episodic/Focused SOAP Template in the Week 5      Learning Resources for guidance. Remember that all Episodic/Focused SOAP      notes have specific data included in every patient case. Nurs-6512 Discussion Wk8
• Review the following case      studies:

Case Study:

A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical assessment will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?

With regard to the case study, you were assigned:

• Review this      week’s Learning Resources and consider the insights they provide about the      case study.
• Consider      what history would be necessary to collect from the patient in the case      study you were assigned.
• Consider      what physical assesments and diagnostic tests would be appropriate to      gather more information about the patient’s condition. How would the      results be used to make a diagnosis?
• Identify at least five possible      conditions that may be considered in a differential diagnosis for the      patient. Nurs-6512 Discussion Wk8
  

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Assignment

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

Episodic/Focused SOAP Note Template

Patient Information:

Initials, Age, Sex, Race

S.

CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patient’s own words – for instance “headache”, NOT “bad headache for 3 days”.

HPI: This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example:

Location: head

Onset: 3 days ago

Character: pounding, pressure around the eyes and temples

Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia

Timing: after being on the computer all day at work

Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better. Nurs-6512 Discussion Wk8

Severity: 7/10 pain scale

Current Medications: include dosage, frequency, length of time used and reason for use; also include OTC or homeopathic products.

Allergies: include medication, food, and environmental allergies separately (a description of what the allergy is ie angioedema, anaphylaxis, etc. This will help determine a true reaction vs intolerance).

PMHx: include immunization status (note date of last tetanus for all adults), past major illnesses and surgeries. Depending on the CC, more info is sometimes needed

Soc Hx: include occupation and major hobbies, family status, tobacco & alcohol use (previous and current use), any other pertinent data. Always add some health promo question here – such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system.

Fam Hx: illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent.

ROS: cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.

Example of Complete ROS:

GENERAL:  No weight loss, fever, chills, weakness or fatigue.

HEENT:  Eyes:  No visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat:  No hearing loss, sneezing, congestion, runny nose or sore throat. Nurs-6512 Discussion Wk8

SKIN:  No rash or itching.

CARDIOVASCULAR:  No chest pain, chest pressure or chest discomfort. No palpitations or edema.

RESPIRATORY:  No shortness of breath, cough or sputum.

GASTROINTESTINAL:  No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

GENITOURINARY:  Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY.

NEUROLOGICAL:  No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL:  No muscle, back pain, joint pain or stiffness.

HEMATOLOGIC:  No anemia, bleeding or bruising.

LYMPHATICS:  No enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  No history of depression or anxiety.

ENDOCRINOLOGIC:  No reports of sweating, cold or heat intolerance. No polyuria or polydipsia.

ALLERGIES:  No history of asthma, hives, eczema or rhinitis.

O.

Physical exam: From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head to toe format i.e. General: Head: EENT: etc.

Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines)

A.

Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence based guidelines.

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 6^th edition formatting. Nurs-6512 Discussion Wk8

Impact of Nursing Shortage on Healthcare

Wk 6 Quest:

Part I

• 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. Impact of Nursing Shortage on Healthcare

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.

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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

Part II

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

• Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?