Capstone Project: Milestone #2: Design Proposal

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Based on the assignment Milestone #1 (attached and was completed by different tutor, all assignments are based on the material from same PICOT question you completed), please complete Milestone project #2. Attached you will find: 1) Milestone #1 Project, 2) Milestone #2 Guidelines, 3) Milestone #2 Template. Please let me know if you have any issues, I have to turn in the assignment on 03/26/17... sorry I didn't post it with more time in advanced but I had to wait on the previous tutor since this assignment is based on the previous one.

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Chamberlain College of Nursing NR451: RN Capstone Course Capstone Project Milestone 2: Design for Change Proposal Guidelines 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. (PO #1) 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. (PO #2) DUE DATE Milestone 2 consists of the proposal for your Design for Change Capstone Project. Submit this assignment to the Dropbox by the end of Week 4. POINTS Milestone 2 is worth 225 points. DIRECTIONS 1. Create a proposal for your Design for Change Capstone Project. Open the NR451_Milestone2_Design_Proposal_ template in Course Resources to create 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. 2. The format for this proposal will be a paper following the Publication manual of APA 6th edition. 3. The paper is to be four- to six-pages excluding the Title page and Reference page. 4. As you organize your information and evidence, include the following topics. a. 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. b. Change Model Overview: Overview of ACE Star model; define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members. NR451 W4 Milestone 2 Guidelines 2/16/17 GH 1 Chamberlain College of Nursing NR451: RN Capstone Course c. Evidence: Conduct internal and external searches of evidence; integrate and d. e. 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. 5. Citations and References must 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. 6. Tables and Figures may be added as 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. GRADING CRITERIA: DESIGN FOR CHANGE CAPSTONE PROJECT Category Points % Description Introduction 25 11% Introduction to the plan is nursing focused, with evidence-based problem identification and potential solutions clearly identified. Change Model Overview 50 22% Practice issue is identified and is nursing focused. An overview of the ACE Star model is given. The need for change is evident. Stakeholders are identified. Practice area, team members and their role are identified and discussed. Scope of the problem is identified. State how nurses should use this model as a guide to facilitate change. Evidence 50 22% Evidence is provided thru statistical information that indicates a change is needed. For example, there have been 6 urinary tract infections over the last two months and there were none present the last two years at the same time period. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use? Translation 50 22% Activities to achieve the final steps of change are fully described. What is needed to achieve. How do you translate what information you have gathered into practice? How do you inform staff? What is your plan of action to pilot the plan? What is the timeline? Conclusion 25 11% Clear, solid summary summarizing the key points and steps of the change plan is included; ways to sustain the change plan are described. APA Format 25 11% Minimal errors. 225 points 100% Total GRADING RUBRIC: CAPSTONE PROJECT MILESTONE #2 NR451 W4 Milestone 2 Guidelines 2/16/17 GH 2 Chamberlain College of Nursing Assignment Criteria Introduction 25 points Change Model Overview 50 points NR451: RN Capstone Course A (100%) Exceptional B (88%) Exceeds C (80%) Meets Outstanding or highest level of performance Introduction to the plan is nursing focused, and evidencebased. Potential interventions clearly identified. 25 points ☐ Very good or high level of performance Introduction to the plan is nursing focused, and evidencebased solutions identified but not clear. 22 points ☐ Competent or satisfactory level of performance Introduction to the plan is provided; however, the plan is not nursing focused and evidencebased solutions are not convincing. 20 points ☐ Practice issue is nursing focused. Overview of the ACE Star model is given. Rationale for change is present. Stakeholders are identified. Practice area, team members and role are discussed. Scope of problem is identified. 50 points ☐ Practice issue is nursing focused. Overview of the ACE Star model is given. Rationale for change is not present. Stakeholders are identified. Practice area, team members and role are discussed. Scope of problem is identified. 44 points ☐ Practice issue is nursing focused. Overview of the ACE Star model is given. Rationale for change is not present. Stakeholders are not identified. Practice area, team members and role are discussed but without detail. Scope of problem is identified. 40 points ☐ NR451 W4 Milestone 2 Guidelines 2/16/17 GH NI (38%) Needs Improvement Poor or failing level of performance Introduction lacks evidence to support need for change and/or potential solution is not evidencedbased. 10 points ☐ Practice issue is nursing focused. Overview of the ACE Star model is given. Rationale for change is not present. Stakeholders are not identified. Practice area, team members and role are not discussed. Scope of problem is identified. 19 points ☐ F (0%) Developing Unsatisfactory level of performance Introduction is missing. 0 points ☐ Change Model Overview is missing 0 points ☐ 3 Chamberlain College of Nursing Evidence 50 points Translation 50 points Conclusion 25 points APA formatting, scholarly writing 25 points Evidence is thoroughly provided thru statistical information of the current problem in the work setting indicating a change is needed. Interventions discovered in Evidence Summary are used in planning for change. 50 points ☐ Activities to achieve final steps of change are fully described. Ways to translate evidence into practice is discussed. Methods to inform staff, activities planned for plan of action and timeline are discussed. 50 points ☐ Detailed summary of main points. Ways to sustain plan are thoroughly described. 25 points ☐ APA format sixth edition. Grammar, sentence structure, punctuation, and spelling correct. NR451 W4 Milestone 2 Guidelines NR451: RN Capstone Course Evidence is briefly provided thru statistical information of the current problem in the work setting indicating a change is needed. Some of the interventions discovered in Evidence Summary are used in planning for change. 44 points ☐ Activities to achieve final steps of change are fully described. How to translate evidence into practice is discussed but is not clear. Methods to inform staff, activities planned for plan of action and timeline are discussed. 44 points ☐ Summary of main points is brief. Ways to sustain plan are briefly described. 22 points ☐ Evidence is vaguely provided thru statistical information of the current problem in the work setting indicating a change is needed. Some of the interventions discovered in Evidence Summary are used in planning for change. 40 points ☐ Activities to achieve final steps of change are fully described. How to translate evidence into practice is not discussed. Methods to inform staff, activities planned for plan of action but timeline is not mentioned. 40 points ☐ Evidence is provided thru statistical information of the current problem but is not convincing. Interventions discovered in Evidence Summary are not used in planning for change. 19 points ☐ Evidence is not provided thru statistical information of the current problem; there is no indication of change; there no interventions listed from the Evidence Summary. 0 points ☐ Activities to achieve final steps of change are described but not in detail. How to translate evidence into practice is not discussed. Methods to inform staff, activities planned for plan of action but timeline is not mentioned. 19 points ☐ Activities for final change plan is missing. Translation of evidence into practice is missing. 0 points ☐ Summary of main points is vague. Ways to sustain plan are vaguely described. 20 points ☐ Summary of main points is vague. Ways to sustain change are not described. 10 points ☐ Summary is missing. There is no plan to sustain change. 0 points ☐ Two to three errors. 22 points ☐ Four to five errors. 20 points ☐ Six to seven errors. 10 points ☐ More than seven errors. 0 points ☐ 2/16/17 GH 4 Chamberlain College of Nursing NR451: RN Capstone Course References, citations correct. Paper formatted in APA format. No errors to one error. 25 points ☐ Total Points NR451 W4 Milestone 2 Guidelines 2/16/17 GH 5 Running head: TYPE SHORT TITLE IN ALL CAPS Title Your Name Chamberlain College of Nursing NR451 RN Capstone Course Term and Year 1 TYPE SHORT TITLE IN ALL CAPS 2 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 TYPE SHORT TITLE IN ALL CAPS 3 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. 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 TYPE SHORT TITLE IN ALL CAPS 4 How will you implement the plan on a larger scale? Will this be applicable to other units or the facility as a whole? What will you do to ensure that the implementation becomes permanent? Disseminate Findings How will you communicate your findings internally (within your organization) and externally (to others outside of your organization)? Conclusion Provide a clear and concise summary. Review the key aspects of the problem as well as the change model. Be sure to include important aspects of the five points of the ACE Star change model EBP process and ways to maintain the change plan. TYPE SHORT TITLE IN ALL CAPS 5 References Chamberlain College of Nursing NR451 RN Capstone Course Capstone Project Milestone 1: Practice Issue and Evidence Summary Worksheets Student Name: Indira Castilla Date: 03/13/17 Practice Issue Worksheet What is the Practice Issue? There are several patients who possess little education on the appropriate measures such as how to follow appropriate diet, safe exercise routines, how to properly take nitroglycerin and smoking cessation. Define the scope of the Practice Issue: The study was restricted to 44 patients who have post-acute myocardial infarction and from the in-patient department, Police General Hospital. There was the random assigning into both control group and experimental group. Those assigned in the control group were given conventional care while those assigned in the experimental group were exposed to an aa fourweek self-efficacy enhancement program that comprised of motivation, skill practice and monitoring skills. There was the analysis of data using descriptive statistics, t-test and Pearson’s correlation. NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 1 Chamberlain College of Nursing NR451 RN Capstone Course What is the practice area? __X_ Clinical ___ Administration ___ Education ___ Other (list)_________________________________ How was the practice issue identified? (check all that apply) ___ Difference between hospital and community _X__ Safety/risk management concerns practice _X__ Unsatisfactory patient outcomes ___ Clinical practice issue is a concern X___ Wide variations in practice ___ Procedure or process is a time waster ___ Significant financial concerns __X_ Clinical practice issue has no scientific base __ Other: Describe the rationale for your checked selections: The practice issue was identified through safety/ risk management concerns, poor patient outcomes, clinical practice issue and wide variations in practice are a concern. Hospital or the facility management was concerned about the identified risks in the hospital and realized there was a practice problem. They also assessed the information on patient’s assessment of overall NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 2 Chamberlain College of Nursing NR451 RN Capstone Course care and nursing care in the hospitals. The clinical practice issue is a matter of concern since it is the core duty of the nurses to deliver and take care of their patients. What evidence must be gathered? (check all that apply) __X_ Literature search ___ Clinical Expertise ___ Guidelines ___ Financial Analysis ___ Expert Opinion ___ Standards (Regulatory, professional, community) ___ Patient Preferences ___ Other Describe the rationale for your checked selections: Literature research is essential. It helps in gathering information with regard to the impact of self-efficacy enhancement program on the adherence of medication when it comes to patients with post-acute myocardial infarction patients. 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 NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 3 Chamberlain College of Nursing NR451 RN Capstone Course population, setting and magnitude of the problem in measurable terms: Patients do not have sufficient information with regard to the appropriate measures that are needed in the treatment of MI. This is what has resulted in increased rates of readmission. Therefore, the research will help the patients to have information on what is required in the administration of MI. Find a source of evidence that is a systematic review article on a nursing topic that is relevant to your practice problem. Write the complete APA reference for the systematic review article you selected: Polsook, R., Aungsuroch, Y., & Thongvichean, T. (2016). The effect of self-efficacy enhancement program on medication adherence among post-acute myocardial infarction. Applied Nursing Research, 32, 67-72. Define the search terms for your systematic review: Home care of post-acute myocardial infarction Identify the objectives of the article. The objective of the article is to research on the impacts of a self-efficacy enhancement program on the adherence to medication for individuals being treated of MI. Provide a statement of the questions being addressed in the work and how they relate to your practice issue: NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 4 Chamberlain College of Nursing NR451 RN Capstone Course ➢ Can post management of an MI reduce readmissions for further complications and reoccurrences? The question relate to the practice issue in that it helps in ascertaining the impact of postmanagement of MI readmission. This further checks into what can be done so as to avoid readmissions. Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes. The interventions suggested by the authors include the proper adherence to good diets, having safe exercise routines, stopping smoking behaviors and the taking of the recommended nitroglycerin. 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. The main findings of the research are that the efficiency of the self-efficacy enhancement program was effective for the enhancement of medication adherence in the patients admitted with post-acute myocardial infarction. The mean score on the medication adherence in the experimental group who were administered with the enhancement program was substantially greater than the control group. Therefore, there was a greater relationship between self- NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 5 Chamberlain College of Nursing NR451 RN Capstone Course efficacy and the adherence of medications for patients with post-acute MI. Outline evidence-based solutions that you will consider for your project. ➢ Improvement of the quality of cardiovascular care ➢ Improvement of the accessibility to invasive cardiology procedures and the management of MI for remote communities ➢ Training of nurses to ensure the application of best practices for the treatment of postacute MI such as helping patients with the adherence to proper diet, proper exercise and the stopping of smoking. Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project. There are a few limitations of the research. These include; errors and lack of information with regard to the resources to be devoted to the purpose of the development and the implementation of remedies for the patients with poor outcomes on the administration of selfefficacy enhancement program. There was also a possible limitation for selection bias on the number of patients who respond well to the self-efficacy enhancement program. Therefore, there is the need for nurses in the clinical practice to ensure the right outcomes for the patients with post-acute MI. NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 6
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Running head: DESIGN FOR CHANGE PROPOSAL

Design for Change Proposal
Name of student
Name of institution

1

DESIGN FOR CHANGE PROPOSAL

2

Design for Change Proposal
The problem under examination, in this case, is that patients lack the knowledge on the
appropriate measures on how to follow safe exercise routines, appropriate diet, and proper taking
of nitroglycerin. Several mitigation measures have been designed to correct the situation based
on the available evidence. The proposal will define the change model applicable for solving the
prevailing nursing issue. Therefore, the essay will outline the expected change plan including a
discussion on the applicable change model and the evidence.
ACE Star Model
ACE Star Model refers to a framework of for systematic inclusion of evidence into
practice the model comprises of five stages that include the discovery of knowledge, a summary
of the evidence, translating into recommendations, integrating into practice and evaluation. Ace
star model is a framework that is commonly applied in evidence-based nursing. Dr Kathleen
Stevens developed the model at the academic center for evidence-based practice, at the
University of Texas Health Science Center (Keele, 2011). The model has been instrumental in
interventions to raise the evidence-based practice competencies. It is also applicable in
measuring the readiness of evidence-based practice.
The evidence-based practice is patient’s limited education on the appropriate measures
that accompany medication. Knowledge of the measures is essential since they boost the
functioning of the medication that the patient takes. Lack of such information is a big pro...


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