Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal
Practice Issue Worksheet Directions
A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.
Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..
ORDER A CUSTOM-WRITTEN,  PLAGIARISM-FREE PAPER NOW
Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.
Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.
Your practice issue will be the same for all three Milestone assignments in this course.
Please type your answers directly into the worksheet. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.
Evidence Summary Worksheet Directions

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Develop an evidence summary by following the grading criteria below.
Document this on the evidence summary portion of the worksheet.
You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
Please type your answers directly into the worksheet.
Guidelines
Purpose
Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star Model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project.
Course Outcomes
This assignment enables the student to meet the following course outcomes:

CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO4)
CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO8)

Due Dates
Milestone 1 consists of the completion of ONE form with two worksheets. Complete both worksheets and submit the form (Attached)
You are required to use the linked article (under order 201804) and Worksheets or you will earn a “0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required Worksheet or article will be evaluated for evidence of an academic integrity violation.
Practice Issue Worksheet Directions

Choose the ONEsystematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List( submitted under order 201804)
Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.
Download the required worksheets (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions. – Attached
Your practice issue will be the same for all three Milestone assignments in this course.
Please type your answers directly into the worksheet Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.
Document this on the evidence summary portion of the worksheet.
You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
Please type your answers directly into the worksheet.

Rubric
NR451_Milestone_1_2

NR451_Milestone_1_2

Criteria
Ratings
Pts

This criterion is linked to a Learning OutcomePractice Issue Statement, Scope of Practice, Practice Area
Identifies a practice issue statement that is an independent nursing decision, and is relevant to the systematic review topic chosen from among the approved list provided in the course. Describes the scope of practice issues. Example: The number of falls in your facility has been increasing, especially during shift change. What do you believe may be causing this? Are there any new interventions that could be put into place that would lessen or eliminate the falls? This is where you begin your initial search into the problem or practice issue identified. Identifies the practice area.

20.0 pts
Practice issue is identified based on the approved systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is fully described. Practice area identified.
18.0 pts
Practice issue is identified but is not clear, however it is based on the approved systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is described in simple terms. Practice area identified.
16.0 pts
Practice issue is identified but is not clearly related to a nursing practice issue, however it is based on the approved systematic review topic chosen. Practice issue is not an independent nursing decision. Scope of practice issue is described but is not clear. Practice area identified.
8.0 pts
Practice issue is unclear. Practice issue is not based on the approved systematic review topic. Practice Issue is not an independent nursing decision. Scope of practice issue is not described. Practice area identified.
0.0 pts
Practice issue is not identified; practice issue is not an independent nursing decision; scope of practice issue is not described; practice area is not identified.
Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

20.0 pts

This criterion is linked to a Learning OutcomePractice Issue-Rationale for Selections
Identifies how rationale behind how the practice issue was selected as a practice issue/problem. Documents the practice issue in a logical manner.

35.0 pts
Identifies and documents what types of evidence is needed for review. Thoroughly describes rationale for all checked types of evidence selected.
31.0 pts
Identifies and documents what types of evidence is needed for review. Briefly describes rationale for all checked types of evidence selected.
28.0 pts
Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence.
13.0 pts
Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence.
0.0 pts
Does not document types of evidence or rationale.

35.0 pts

This criterion is linked to a Learning OutcomeTypes of Evidence Gathered-Rationale for Selections
Identifies and documents types of evidence that must be gathered for review of the Practice Issue. Describes rationale for each type of evidence that is selected.
Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

20.0 pts
Identifies and documents what types of evidence is needed for review. Thoroughly describes rationale for all checked types of evidence selected
18.0 pts
Identifies and documents what types of evidence is needed for review. Briefly describes rationale for all checked types of evidence selected.
16.0 pts
Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence.
8.0 pts
Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence.
0.0 pts
Does not document types of evidence or rationale.

20.0 pts

This criterion is linked to a Learning OutcomePractice Problem Description
States practice problem in own words, with reference to the population, setting, and magnitude and in measurable terms. Describes practice setting in measureable terms. Example: Consider the example given in the evidence summary above. The setting is the long term care facility where falls have been increasing and a trend has been identified that it seems to occur mainly during shift change. What do you believe may be causing this? What can be done to lessen or eliminate the falls? How does this number of falls relate to other months that have been tracked?

10.0 pts
-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is identified -Magnitude of problem is discussed. -The practice issue is stated in measurable terms.
9.0 pts
-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is discussed. -The practice issue is stated in measurable terms.
8.0 pts
-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is not discussed. -The practice issue is stated in measurable terms.
4.0 pts
-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is not discussed. -The practice issue is stated but not measurable.
0.0 pts
-Practice problem is not in own words -There are no references to the population of interest. -Setting and magnitude of problem is not discussed -The practice issue is not stated in measurable terms.

10.0 pts

This criterion is linked to a Learning OutcomeSource(s) of Evidence
Identifies a source of evidence that is a nursing topic and is the subject of a systematic review article. Provides a complete reference for the systematic review article that was chosen from the list, as well as any optional scholarly source in support of the project topic.

20.0 pts
Full Marks
-Source is a Systematic Review article chosen from the approved list (plus optional scholarly article of support). Complete APA formatted reference(s) is given for with no errors. The source (s) must be relevant to the practice issue identified.
18.0 pts
-Source is a Systematic Review article chosen from the approved list (plus optional scholarly article of support). -A reference is given, but it has APA formatting errors. -The source must be relevant to the practice issue identified.
16.0 pts
-Source is a Systematic Review article chosen from the approved list. (plus optional scholarly article of support). -No reference is provided. -The source must be relevant to the practice issue identified.
8.0 pts
-Source of evidence is a research article or systematic review not on the approved list. -A reference for the article or systematic review is given. -The source is not relevant to the practice issue identified.
0.0 pts
-Source of evidence is not provided, or is not a research article or systematic review. -Reference is missing.

20.0 pts

This criterion is linked to a Learning OutcomeArticle Objectives/Statement of Questions
Identifies the objectives of the article. Identifies questions being addressed by author/s. Explains relationship to the chosen practice issue

20.0 pts
-Objectives of article are identified. -Questions addressed by author/s are thorough. -Relationship to your practice issue is explained.
18.0 pts
-Objectives of article are identified. -Questions addressed by author/s are explained but not thorough. -Relationship to your practice issue is explained.
16.0 pts
-Objectives of article are identified. -Questions addressed by author/s are not thorough. -Relationship to your practice issue is vague.
8.0 pts
-Objectives of article are identified. -Questions addressed by author/s is missing. -Relationship to your practice issue is not explained.
0.0 pts
-Objectives of article are not identified. -Questions addressed in article and relationship to own practice is not identified.

20.0 pts

This criterion is linked to a Learning OutcomeInterventions/Main Findings Summary
Summarizes, in own words, suggested interventions by the author/s to improve patient outcomes. Summarizes main findings of the author/s including strength of evidence for each main outcome. Describes the relevance to the Milestone 2 paper.
Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

30.0 pts
-Thoroughly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Thoroughly summarized main findings of the author/s. -Included strength of evidence for each main outcome.
26.0 pts
-Briefly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Briefly summarized main findings of the author/s. -Included strength of evidence for each main outcome.
24.0 pts
-Vaguely summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Vaguely summarized main findings of the author/s. -Included strength of evidence for most of main outcomes.
11.0 pts
-Summary of interventions is not in own words. -Summarized main findings of the author/s is not apparent. -Did not include strength of evidence for any of the main outcomes.
0.0 pts
-Summary of the interventions the author(s) suggest to improve patient outcomes is missing. -Summary of the main findings of the author is missing. -The strength of the evidence for outcomes are missing.

30.0 pts

This criterion is linked to a Learning OutcomeEvidence-based Solutions and Limitations
Outlines evidence-based solutions to consider for the capstone project. Discusses any limitations to the studies included in the systematic review that he/she believes may impact use of the evidence provided in their project

20.0 pts
-Outline of evidence-based solutions considered for project is documented and clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project.
18.0 pts
-Outline of evidence-based solutions being considered for project is documented but not clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project.
16.0 pts
-Outline of evidence-based solutions considered for project is documented but not clear. Discussed most limitations to the studies performed. Documents limitations believed may impact use in project.
8.0 pts
-Outline of evidence-based solutions being considered for project is not documented. -Discussed most limitations to the studies performed. Documents limitations believed may impact use in project.
0.0 pts
-Outline of evidence-based solutions, limitations of studies and potential impact to project is missing.

20.0 pts

Total Points: 175.0

NR451_W3_Milestone1_Worksheets
Capstone Project Milestone 1:
Practice Issue and Evidence Summary Worksheets
Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal
 
Student Name:                                                          Date:
Directions

Refer to the guidelines for specific details on how to complete this assignment.
Type your answers directly into the worksheets below.
Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.
Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response.

 
Practice Issue Worksheet
 

List the topic and include the citation for the systematic review you have selected from our approved list (optional: an additional scholarly source of support):
Health-Associated Infection
Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults. Cochrane Database of Systematic Reviews, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

What is the nursing practice issue you have identified related to the topic you have chosen?
The nursing practice issue to be addressed is whether or not incorporating antibiotic prophylaxis when using long-term indwelling urinary catheters reduces the incidence of symptomatic bacteruria for adults’ patients with lower urinary tract problems. As a result, it intends to answer the question: In adults with lower urinary tract problems, does the use of long-term indwelling urinary catheters in combination with antibiotic prophylaxis, versus indwelling urinary catheters used in isolation, affect the incidence of symptomatic bacteruria over a period of three months?

Fully describe the scope of the practice issue:
Nurses are typically advised to use antibiotics with caution, particularly when facing the possibility of resistance development. Still, for adult patients suffering from lower urinary tract problems and using long-term indwelling urinary catheters, the catheters present an additional risk of infection. That is because they act as avenues for infection, especially from repeated handling. Despite the warning linked with antibiotics use, analysis shows that reducing the risk of infection is the best outcome for the patient. Antibiotic prophylaxis improves the capacity for preventing infection, thus presenting a good possibility for application by nursing personnel Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

What is the practice area?
_X_ Clinical
___ Education
___ Administration
___ Other (List):

How was the practice issue identified? (check all that apply)
___ Safety/risk management concerns
_X_ Unsatisfactory patient outcomes
___ Wide variations in practice
___ Significant financial concerns
 
 
___ Difference between hospital and community practice
_X_ Clinical practice issue is a concern
___ Procedure or process is a time waster
___ Clinical practice issue has no scientific base
__ Other:

Describe the rationale for your checked selections:
Using catheters increases the risk of the patients’ acquiring opportunistic infections. As such, the research intends to show that using antibiotic prophylaxis can reduce the risk of acquiring opportunistic infection.

What evidence must be gathered? (check all that apply)

_X_ Literature search
___ Guidelines
_X_ Expert Opinion
___ Patient Preferences
_X_ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
___ Other
 

Describe the rationale for your checked selections:
A literature search will be conducted to understand how past publications view the current topic.
Expert opinion and clinical expertise will be collected to understand how nursing personnel understand the problem. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 
Evidence Summary Worksheet
Directions: Please type your answers directly into the worksheet.
 

Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms:
Even when used in clear environments, catheters still present a route for opportunistic infection. This occurs through regular handling by the nursing personnel. The risk for infection is higher among adult patients suffering from lower urinary tract problems since their immune system appears compromised and they can easily be infected. As such, it is prudent to adopt a proactive approach by using antibiotic prophylaxis that effectively prevents the possibility of opportunistic infection.

Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Include the APA reference for any additional optional supplemental scholarly source related to the review you wish to use.
Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults. Cochrane Database of Systematic Reviews, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

Identify the objectives of the article:
The article intended to determine the effectiveness different policies for replacing long-term indwelling urinary catheters in adults.
Provide a statement of the questions being addressed in the work and how these relate to your practice issue:
The article answer the question of whether there are any differences in the outcomes from the different policies applied in replacing long-term indwelling urinary catheters in adults. This is an acknowledgement that each policy presents a risk of infection although at different levels. This shows that even with the best policy, there is still some risk of infection Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. By including antibiotic prophylaxis, the risk of infection is greatly reduced.

Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.
The article concludes that the best policy for replacing urinary catheters must take into account certain factors that include the patients’ satisfaction, quality of life, type of trauma on the urinary tract, economics, replacement method used, environment-specific performance difference at home and hospital, catheter replacement strategy, and lubrication used.
Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper. (If an optional supplemental source is also used, include a statement of relevance to it as well.)
The article makes it clear that additional evidence is required before a conclusion can be reached. More information must be collected on the different policies for a complete evaluation.
 

Outline evidence-based solutions that you will consider for your project.
The project considers the position that antibiotic prophylaxis can play in reducing the possibility of infection so that the differences in policies for handling catheters become of less significance.
Discuss any limitations to the studies that you believe impacts your ability to utilize the research in your project.
The major study limitation will be how to decide from among the many types of antibiotics that are available in the market. In essence, there are many pathogens that can cause infection. Using the many types of antibiotics on a single patient is unrealistic, while using one type means that the prophylaxis does not offer protection against the other types of antibiotics Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 
Capstone Project Milestone 2: Design for Change Proposal
Purpose
You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet from your Capstone Project Milestone 1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program.
Course Outcomes
This assignment enables the student to meet the following course outcomes.

CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO1)
CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO2)

Rubric
Click to view and download the NR451 Milestone 2: Design for Change Proposal Rubric (Links to an external site.)Links to an external site..
Points
Milestone 2 is worth 225 points.
You are required to use one of the required articles from the Week 3 Milestone 1 assignment or you will earn a “0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required article will be evaluated for evidence of an academic integrity violation.
After the due date, there will be no opportunity for revision or resubmission of assignments that have been uploaded to the submission area. It is your responsibility to submit the correct assignment to the correct submission area.
Directions

A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=b0c912eaf53b4aabb1347a026466c60e(Links to an external site.)Links to an external site.
Review the feedback you received from your instructor for Milestone 1, and use it to develop this milestone.
Create a proposal for your Design for Change Capstone Project. Open the recommended assignment specific Milestone 2 Design Proposal Template(Links to an external site.)Links to an external site.. Use this to write your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice.
The format for this proposal will be a paper following the Publication manual of APA6 th
The paper is to be four- to six-pages excluding the Title page and Reference page.
As you organize your information and evidence, include the following topics.

Introduction:Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.
Change Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.
Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.
Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.
Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.

Citations and Referencesmust be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.
Tables and Figures may be addedas appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Title
Your Name
Chamberlain College of Nursing
NR451 RN Capstone Course
Term and Year
 
Your title here
This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so you cannot use first person. Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper.
Change Model Overview
In this first paragraph, provide an overview of the ACE Star model Evidence-Based Practice Process. Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the ACE Star model EBP Process.
Define the Scope of the EBP
Restate your practice issue. Why is this a problem? Give statistics and information to back the scope of the problem at your facility/work area. How does this problem impact healthcare on a broader scale?
Stakeholders
You will be the leader of the team since this is your project. Who will you also include in your team? Make sure you choose relevant stakeholders. You should have no more than eight members. Do not list your team members by name but instead by position (pharmacists, charge nurse, etc.).
Determine Responsibility of Team Members
Why are the members chosen important to your project? What are their roles?
Evidence
Conduct internal/ external search for evidence. What type of evidence did you find in addition to you Evidence Summary? EBP guidelines? Quality improvement data? Position statements? Clinical Practice Guidelines?  Briefly discuss the strength of this research. This is not where you describe the results of your studies. This is done in the following steps.
Summarize the Evidence
In this section, you need to synthesize the information from the systematic review article. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use? Be sure and cite all of your references, in proper APA format, from any and all articles into this one paragraph.
Develop Recommendations for Change Based on Evidence
What is your recommendation based on the research? Ideally, you will have found enough support in your evidence to proceed with implementing your pilot program. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.
Translation
Action Plan
You have not implemented your project yet, therefore, this section will be hypothetical. Develop your plan for implementation. What are the specific steps you will take to implement your pilot study?  What is the timeline for your plan? Make sure you include a plan for evaluation of outcomes and method to report the results.
Process, Outcomes Evaluation and Reporting
What are the desired outcomes? How will they be measured? How will you report the results to the key stakeholders?
Identify Next Steps
How will you implement the plan on a