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
Purchase answer to see full
attachment