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Capella NURS-FPX4900 Assessments

NURS-FPX4900 Assessment 1: Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

• In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective.
• Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Introduction

Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.

Too often, change agents jump to a conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate, based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:

• Develop a problem statement for a patient, family, or population that’s relevant to your practice.
• Begin building a body of evidence that will inform your approach to your practicum.
• Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.

Preparation

In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective. During this time, you may also choose to consult with subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).

To prepare for the assessment, complete the following:

• Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.
• Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.

In addition, you may wish to complete the following:

• Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.
• Review thePracticum Focus Sheet: Assessment 1 [PDF], which provides guidance for conducting this portion of your practicum.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Supportpage.

Instructions

Complete this assessment in two parts.

Part 1

Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective and establish your evidence and research base to plan, implement, and share findings related to your project.

Part 2

Connect with the patient, family, or group you’ll work with during your practicum. During this portion of your practicum, plan to spend at least 2 hours meeting with the patient, family, or group and, if desired, consulting with subject matter and industry experts of your choice. The hours you spend meeting with them should take place outside of regular work hours. Use the Practicum Focus Sheet [PDF] provided for this assessment to guide your work and interpersonal interactions. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Capella Academic Portal

Complete the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal. Include a description of your relationship to the patient, family, or group in the Volunteer Experience comments field.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

• Define a patient, family, or population health problem that’s relevant to your practice.
  • Summarize the problem you’ll explore.
  • Identify the patient, family, or group you intend to work with during your practicum.
  • Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
  • Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
• Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
  • Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
  • Explain how you would know if the data are unreliable.
  • Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
  • Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
  • Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
  • Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.
• Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.
  • Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.
  • Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
  • Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.
• Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.
  • Discuss research on the effectiveness of leadership strategies.
  • Define the role that you anticipate leadership must play in addressing the problem.
  • Describe collaboration and communication strategies that you anticipate will be needed to address the problem.
  • Describe the change management strategies that you anticipate will be required to address the problem.
  • Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
• Organize content so ideas flow logically with smooth transitions.
• Apply APA style and formatting to scholarly writing.

Additional Requirements

• Format: Format your paper using APA style.APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
  • A title page and reference page. An abstract is not required.
  • Appropriate section headings.
• Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
• Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
• Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
  • Define a patient, family, or population health problem that’s relevant to personal and professional practice.
• Competency 2: Make clinical and operational decisions based upon the best available evidence.
  • Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.
• Competency 5: Analyze the impact of health policy on quality and cost of care.
  • Explain how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem.
• Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
  • Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
• Competency 8: Integrate professional standards and values into practice.
  • Organize content so ideas flow logically with smooth transitions.
  • Apply APA style and formatting to scholarly writing.

Assessing the Problem, Leadership, Collaboration, Communication, Change Management, and Policy Considerations Example Approach

Nurses, who make up the majority of the healthcare workforce, are vital to patient care. Nurses in all professional roles strive to improve organizational processes and achieve positive patient outcomes. In particular, nurses identify problems, plan interventions/strategies, and implement the strategies-skills, all of which directly impact patient outcomes and organizational effectiveness (Wakefield et al., 2021).

Patient care is constantly evolving, and this evolution is due to the initial identification of a problem and the pursuit of solutions. However, before embarking on a specific change management strategy, the best approach is to assess and review credible evidence to determine appropriate interventions. As a result, nurses must be actively involved in the entire change process, beginning with the prodromal phase of justifying the appropriateness of interventions to be implemented (Wakefield et al., 2021).

Using hypertension as an example, the goal of the following discussion is to elaborate on the problem extensively, drawing on evidence from relevant databases, and to discuss the effectiveness of nursing standards/or policies in improving the patient problem, as well as the leadership strategies relevant to the problem identified.

Identification of the Patient/Family/Population Health Problem Relevant to My Practice

Summary of the Health Problem

Chronic illness management places a significant burden on patients and the healthcare system as a whole. A significant proportion of the global population is affected by hypertension, chronic disease, and the leading preventable risk factor for cardiovascular disease (CVD). Hypertension is defined as high blood pressure, with a systolic blood pressure of ≥140 mm Hg and a diastolic blood pressure of ≥90 mm Hg (AHA, 2022).

Also, Mills et al. (2020) define hypertension as the current use of antihypertensive medications for research purposes. In 2010, the condition affected 1.38 billion people, or 31.1% of the global population, with men having a slightly higher prevalence of 31.9% than females, who had a prevalence of 30.1% (Mills et al., 2020). Modifiable risk factors for hypertension include obesity, alcohol, smoking, diet, and physical inactivity.

In contrast, the non-modifiable risk factors include a family history of hypertension, age over 65, and comorbidities such as chronic kidney disease [CKD] (WHO, 2021). Since hypertension is mostly asymptomatic, most people are unaware they have it, earning it the moniker “silent killer.”

If symptoms exist, they are often nonspecific and may include headaches, fatigue, nosebleeds, irregular heartbeats, vision changes, and ear buzzing (WHO, 2022). Because of the serious damage that hypertension causes to essential body organs such as the kidney, heart, eyes, brain, and so on, it is recommended that the problem be identified and treated as soon as possible to avoid rapid progression to unwanted sequela.

Patient/Family/Group that I intend to work with

I plan to work with adult hypertensive patients during my practicum. Patients with a systolic blood pressure of 140 mm Hg and a diastolic blood pressure of 90 mm Hg, or those who are currently taking hypertensive medications, fall into this category. According to WHO (2021), an estimated 1.28 billion adults aged 30-79 worldwide have hypertension, with two-thirds of them living in low-to-middle-income countries.

Approximately 46% of adults with hypertension are unaware of their condition, and approximately 42% are diagnosed and treated (WHO, 2021). Furthermore, it is estimated that only one in every five adults (21%) has hypertension under control. As a result, while efforts to control hypertension have long existed, more efforts are still required to meet the global target of a 33% reduction in hypertension prevalence between 2010 and 2030 (WHO, 2021). Adult hypertensive patients would be a potentially valuable population for my practicum.

Significance and Relevance of the Problem

Hypertension contributes significantly to the global burden of CVD and premature death. In 2015, there were approximately 10.7 million all-cause deaths associated with a systolic blood pressure of ≥110-115 mm Hg (19.2% of all deaths) and 7.8 million (14% of all deaths) all-cause deaths associated with a systolic blood pressure of ≥140 mm Hg (Mills et al., 2020). Various CVDs were responsible for these deaths, including ischemic heart disease (IHD), ischemic stroke, and hemorrhagic stroke.

In addition to CVD events, several studies have shown that hypertension is a significant independent risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). In one study, 332544 men aged 35-57 years who were screened for entry into the MRFIT trial and did not have ESRD at baseline were followed for 16 years, and when compared to normotensive men with a systolic blood pressure of <120 mm Hg and diastolic blood pressure of <80 mm Hg, the findings revealed that the relative risk of ESRD for men with hypertension who had a systolic BP >210 mmHg or diastolic BP >120 mmHg was 22.1 [P < 0.001] (Mills et al., 2020).

Additionally, individuals with hypertension in the United States (US) are estimated to have nearly $ 2,000 higher annual healthcare expenditures than their non-hypertensive peers, and hypertension is associated with approximately $131 billion in healthcare costs (Kirkland et al., 2018). With the obvious burden of hypertension, it is only necessary to work on strategies to lessen the disease’s impact.

Why is the Problem Relevant to My Practice as a Baccalaureate-Prepared Nurse

Nurses are frequently the first point of contact for patients. As a Baccalaureate-prepared nurse, I am trained to provide quality patient care, including initial review at the emergency unit, blood pressure measurements, diagnosis, treatment advice, or referral to a physician or other specialists. The interventions we provide to this group of patients must be aimed at lowering blood pressure and preventing the progression to unfavorable sequelae.

According to Rahimi et al. (2021), every 10 mm Hg reduction in systolic BP significantly reduces the risk of major CVD events by 20% (relative risk 0.80, 95% CI 0.77–0.83), IHD by 17% (relative risk 0.83, 0.78–0.88), stroke by 27% (relative risk 0.73, 0.68–0.77), heart failure by 28% (relative risk 0.72, 0.67–0.78) and all-cause mortality by 13% (0.87, 0.84–0.91). This indicates that even nurses’ efforts to assist hypertensive patients in managing their blood pressure count, and thus, the relevance of my practice to the population group chosen.

Evidence from Peer-Reviewed Literature

Barriers to the Implementation of Evidence-Based Practice in addressing the Problem

As the adult population with hypertension grows, it becomes more difficult for healthcare professionals to assist their patients with blood pressure control. According to the American Medical Association (AMA), there are five barriers to implementing evidence-based practice in hypertensive patients’ care. First, inaccurate and inconsistent blood pressure measurement techniques may impede hypertension diagnosis and management (AMA, 2018).

It is recommended that at least two blood pressure measurements be taken, with the cuff bladder encircling at least 80% of the arm (CDC, 2022), failure of which may result in incorrect readings and the inability to diagnose hypertension. Second, masked hypertension, which causes patients to appear to have normal blood pressures in the office while having elevated blood pressures outside the office, may contribute to hypertension underdiagnosis.

Third, clinical inertia, blamed on the care team, who may be hesitant to initiate and intensify hypertension treatment, may delay treatment and hasten disease progression (AMA, 2018). Fourth, the care team may lack appropriate evidence-based treatment protocols. Finally, poor patient participation in self-management behaviors may jeopardize blood pressure control.

Effectiveness of Nursing Standards/or Policies in Improving the Population Outcomes for the Problem

Nurses play an integral role in the care of hypertensive patients in various ways. Nurses identify, refer, and follow up on hypertensive patients. They use the best blood pressure measurement methods and also lead blood pressure screening and verification initiatives in community settings. Furthermore, they determine whether the readings are normal or in the hypertensive range according to the site protocol and then refer for urgent care (Georgiopoulos et al., 2018).

Nurses also assist in the diagnosis and management of hypertensive patients’ medications. According to Georgiopoulos et al. (2018), nurse-led hypertension management results in higher rates of blood pressure control than standard care. In addition, nurses provide patient education, counseling, and skill development, allowing patients to develop better self-management strategies that aid in blood pressure control.

Furthermore, nurses ensure care coordination—they are skilled at establishing and maintaining both formal and informal collaborative links between providers, resources, and services within and outside their practice settings (Georgiopoulos et al., 2018). Moreover, performance measurement and quality improvement indicators, a task of nurses, allow for the determination of whether or not the interventions provided to patients are effective. Leveraging the tasks nurses perform, effective blood pressure control is achieved, with a reduction in complications and mortality rates.

Role of Nurses in Policy Making to Improve Outcomes, prevent Illnesses and Reduce Hospital Readmissions.

Nurses spend significant time working directly with patients, so they are familiar with the specific needs of the people they serve. As a result, nurses can advocate for public policy changes that benefit the patients they care for. They develop policies where none exist, reform harmful or ineffective policies, and ensure those good policies are implemented and enforced (Turale & Kunaviktikul, 2019).

One of the most critical areas where nurses can influence policy is smoking cessation, where policies such as imposing heavy taxes on cigarettes or prohibiting smoking within specific areas may aid in smoking cessation. Because smoking is a risk factor for hypertension, smoking reduction or cessation is an evidence-based lifestyle modification to lower blood pressure (improve outcomes), prevent hypertension, or reduce readmission of already hypertensive patients.

Nursing Theory or Conceptual Framework that frames and guides Actions during my Practicum

Nursing theories provide the foundations for the knowledge and skills used in practice. Comfort is a valuable outcome of care during delivery; I would thus refer to Katharine Kolcaba’s theory of comfort. Kolcaba distinguished three types of comfort: relief, which involves relieving patients of, say, pain, ease, which addresses comfort in a state of contentment, and transcendence, which is a state of comfort in which patients can rise above their challenges. (Oliveira et al., 2020).

Understanding that comfort can take the form of physical, psychospiritual, environmental, or sociocultural contexts; I will ensure that all strategies and care interventions delivered aim to provide comfort to the population group identified.

How State Board Nursing Practice Standards and/or Organizational or Governmental Policies affect the Population Problem Defined

Each state has its own set of nursing standards that resident nurses must follow. The standards frequently dictate independent practice and prescriptive authority. In Alabama, for example, a certified registered nurse (RN) is responsible for providing continuous and comprehensive care for a wide range of conditions for which the certified RN is educationally prepared, taking patients’ health histories and performing physical examinations, formulating working diagnoses, prescribing (albeit with limited prescriptive authority), administering and providing therapeutic measures, tests, and drugs, counseling patients, consulting and referring to other professionals (Alabama Board of Nursing, 2022).

The scope of practice established by the State Board of Nursing allows nurses to be fully responsible for the patients they care for, in this case, adult hypertensive patients. Specific organizational rules also govern how nurses care for patients. For example, certain organizations, such as the one with which I work, limit nurses’ prescriptive authority and only allow them to do so under the supervision of a physician. This can have negative consequences because one must wait for a physician to prescribe medications, which can cause the patient’s treatment to be delayed.

Leadership Strategies to Improve Outcomes, Patient-Centered Care, and Patient Experience related to the Population Problem Identified

Leadership is a critical tool in healthcare. It serves as the organization’s engine, providing fuel and direction as it journeys toward its objectives. Leaders are thus essential to the operation of an organization, and the strategies employed to determine whether or not the organization’s objectives are met.

Transformational leadership would be used in the care of adult hypertensive patients. Collins et al. (2020) define transformational leadership as an approach that causes a change in individuals and social systems. The practicum’s goal is to develop interventions or change strategies to improve the management of the defined population health problem, so transformational leadership is the best strategy.

In terms of collaboration, strategies that would ensure the team works effectively include (1) being aware of and respecting each other’s duties, (2) effective communication, (3) viewing patients as partners, and (4) recognizing the efforts of others. Preparing the organization for change, crafting a vision and plan for change, implementing the changes, embedding the changes within the organizational culture and practices, and finally, reviewing progress and analyzing the results (Barrow et al., 2021) are the change management strategies that I anticipate will be required.

The first step, which involves preparing people and organizations for change, is critical because it determines whether the subsequent phases are smooth or bumpy. With this in mind, pre-change management preparations in terms of finances, human personnel, skills, and organizational attitude are critical.

Conclusion

Change is a constant in healthcare, and it has greatly aided in the improvement of healthcare services. Before change can occur, an initial phase of identifying the problem and establishing the resources required for the change is pertinent. In the case of adult hypertensive patients, baccalaureate-prepared nurses play a significant role in identifying patient care needs and implementing evidence-based interventions and strategies to meet those needs.

However, using evidence-based strategies in the care of hypertensive patients can be hampered by various factors, including a lack of appropriate evidence-based treatment protocols and clinical inertia. These challenges can be forestalled with the right leadership and collaborative strategies, enabling patients to receive high-quality, safe, and cost-effective care.

References

Alabama Board of Nursing. (2022). Alabama State Board Nursing Practice Standards. Alabama.gov. https://www.abn.alabama.gov/

American Heart Association. (2022). High blood pressure. Www.heart.org. https://www.heart.org/en/health-topics/high-blood-pressure

American Medical Association. (2018, November 20). 5 barriers to hypertension control: What they are and how to address them. American Medical Association. https://www.ama-assn.org/delivering-care/hypertension/5-barriers-hypertension-control-what-they-are-and-how-address-them

Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2021). Change Management. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459380/

CDC. (2022, September 8). Measure your blood pressure. Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/measure.htm

Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nursing Standard (Royal College of Nursing (Great Britain): 1987), 35(5), 59–66. https://doi.org/10.7748/ns.2019.e11408

Georgiopoulos, G., Kollia, Z., Katsi, V., Oikonomou, D., Tsioufis, C., & Tousoulis, D. (2018). Nurse’s contribution to alleviate non-adherence to hypertension treatment. Current Hypertension Reports, 20(8), 65. https://doi.org/10.1007/s11906-018-0862-2

Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N., Mauldin, P. D., & Moran, W. P. (2018). Trends in healthcare expenditures among US adults with hypertension: National estimates, 2003-2014. Journal of the American Heart Association, 7(11). https://doi.org/10.1161/JAHA.118.008731

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews. Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2

Oliveira, S. M. de, Costa, K. N. de F. M., Santos, K. F. O. D., Oliveira, J. D. S., Pereira, M. A., & Fernandes, M. das G. M. (2020). Comfort needs as perceived by hospitalized elders: an analysis under the light of Kolcaba’s theory. Revista Brasileira de Enfermagem, 73(suppl 3), e20190501. https://doi.org/10.1590/0034-7167-2019-0501

Rahimi, K., Bidel, Z., Nazarzadeh, M., Copland, E., Canoy, D., Ramakrishnan, R., Pinho-Gomes, A.-C., Woodward, M., Adler, A., Agodoa, L., Algra, A., Asselbergs, F. W., Beckett, N. S., Berge, E., Black, H., Brouwers, F. P. J., Brown, M., Bulpitt, C. J., Byington, R. P., … Davis, B. R. (2021). Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet, 397(10285), 1625–1636. https://doi.org/10.1016/s0140-6736(21)00590-0

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship: Nurses’ contribution to health policy and advocacy. International Nursing Review, 66(3), 302–304. https://doi.org/10.1111/inr.12550

Wakefield, M., Williams, D. R., Le Menestrel, S., & Flauber, J. L. (2021). The role of nurses in improving health equity. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK573898/

World Health Organization. (2021). Hypertension. Who.int. https://www.who.int/news-room/fact-sheets/detail/hypertension

NURS-FPX4900 Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations

• In a 5-7 page written assessment, assess the effect of the patient, family, or population problem you’ve previously defined on the quality of care, patient safety, and costs to the system and individual.
• Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during your first two practicum hours.

Introduction

Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.

Preparation

In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

• • Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
  • Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
  • Review the Practicum Focus Sheet: Assessment 2 [PDF], which provides guidance for conducting this portion of your practicum.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Supportpage.

Instructions

Complete this assessment in two parts.

Part 1

Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 2 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2

Report on your experiences during your first 2 practicum hours, including how you presented your ideas about the health problem to the patient, family, or group.

• • Whom did you meet with?
    • What did you learn from them?
  • Comment on the evidence-based practice (EBP) documents or websites you reviewed.
    • What did you learn from that review?
  • Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
    • What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
      • Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?
      • What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
    • What changes, if any, did you make to your definition of the problem, based on your discussions?
    • What might you have done differently?

Capella Academic Portal

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

• • Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
    • Cite evidence that supports the stated impact.
    • Note whether the supporting evidence is consistent with what you see in your nursing practice.
  • Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
    • Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
    • Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
    • Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
  • Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
    • Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
    • Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
    • Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  • Use paraphrasing and summarization to represent ideas from external sources.
  • Apply APA style and formatting to scholarly writing.

Additional Requirements

• • Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
    • A title page and reference page. An abstract is not required.
    • Appropriate section headings.
  • Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
  • Supporting evidence: Cite at least 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
  • Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• • Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
    • Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
    • Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  • Competency 5: Analyze the impact of health policy on quality and cost of care.
    • Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
  • Competency 8: Integrate professional standards and values into practice.
    • Use paraphrasing and summarization to represent ideas from external sources.
    • Apply APA style and formatting to scholarly writing.

NURS-FPX4900 Assessment 3 Instructions: Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations

• In a 5-7 page written assessment, determine how health care technology, coordination of care, and community resources can be applied to address the patient, family, or population problem you’ve defined. In addition, plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during the second 2 hours of your practicum.

Introduction

As a baccalaureate-prepared nurse, you’ll be positioned to maximize the use of technology to achieve positive patient outcomes and improve organizational effectiveness. Providing holistic coordination of patient care across the entire health care continuum and leveraging community resource services can lead both to positive patient outcomes and to organizational improvements.

Preparation

In this assessment, you’ll determine how health care technology, coordination of care, and community resources can be applied to address the health problem you’ve defined. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

• • Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
  • Conduct sufficient research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
  • Review the Practicum Focus Sheet: Assessment 3 [PDF], which provides guidance for conducting this portion of your practicum.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Supportpage.

Instructions

Complete this assessment in two parts.

Part 1

Determine how health care technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 3 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2

Report on your experiences during the second 2 hours of your practicum.

• • Whom did you meet with?
    • What did you learn from them?
  • Comment on the evidence-based practice (EBP) documents or websites you reviewed.
    • What did you learn from that review?
  • Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual.
    • Did your plan to address the problem change, based upon your experiences?
    • What surprised you, or was of particular interest to you, and why?

Capella Academic Portal

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

• • Analyze the impact of health care technology on the patient, family, or population problem.
    • Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.
    • Determine whether the evidence is consistent with technology use you see in your nursing practice.
    • Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem.
  • Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.
    • Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.
    • Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.
    • Identify barriers to the use of care coordination and community resources in the context of this problem.
  • Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
    • Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.
    • Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources.
    • Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.
    • Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  • Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
  • Apply APA style and formatting to scholarly writing.

Additional Requirements

• • Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
    • A title page and reference page. An abstract is not required.
    • Appropriate section headings.
  • Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
  • Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
  • Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• • Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
    • Analyze the impact of health care technology on a patient, family, or population problem.
  • Competency 5: Analyze the impact of health policy on quality and cost of care.
    • Analyze state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  • Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
    • Explain how care coordination and the utilization of community resources can be used to address a patient, family, or population problem.
  • Competency 8: Integrate professional standards and values into practice.
    • Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
    • Apply APA style and formatting to scholarly writing.

NURS-FPX4900 Assessment 4 Instructions: Patient, Family, or Population Health Problem Solution

• Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. In a separate written deliverable, write a 5-7 page analysis of your intervention.

Please submit both your solution/intervention and the 5-7 page analysis to complete Assessment 4.

Introduction

In your first three assessments, you applied new knowledge and insight gleaned from the literature, from organizational data, and from direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your assessment of the problem. You’ve examined the problem from the perspectives of leadership, collaboration, communication, change management, policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources. Now it’s time to turn your attention to proposing an intervention (your capstone project), as a solution to the problem.

Preparation

In this assessment, you’ll develop an intervention as a solution to the health problem you’ve defined. To prepare for the assessment, think about an appropriate intervention, based on your work in the preceding assessments, that will produce tangible, measurable results for the patient, family, or group. In addition, you might consider using a root cause analysis to explore the underlying reasons for a problem and as the basis for developing and implementing an action plan to address the problem. Some appropriate interventions include the following:

• • Creating an educational brochure.
  • Producing an educational voice-over PowerPoint presentation or video focusing on your topic.
  • Creating a teaching plan for your patient, family, or group.
  • Recommending work process or workflow changes addressing your topic.

Plan to spend at least 3 direct practicum hours working with the same patient, family, or group.

In addition, you may wish to complete the following:

• • Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
  • Conduct sufficient research of the scholarly and professional literature to inform your work and meet scholarly expectations for supporting evidence.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Supportpage.

Instructions

Complete this assessment in two parts: (a) develop an intervention as a solution to the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.

Part 1

Develop an intervention, as a solution to the problem, based on your assessment and supported by data and scholarly, evidence-based sources.

Incorporate relevant aspects of the following considerations that shaped your understanding of the problem:

• • Leadership.
  • Collaboration.
  • Communication.
  • Change management.
  • Policy.
  • Quality of care.
  • Patient safety.
  • Costs to the system and individual.
  • Technology.
  • Care coordination.
  • Community resources.

Part 2

Submit your proposed intervention to your faculty for review and approval.

In a separate written deliverable, write a 5–7 page analysis of your intervention.

• • Summarize the patient, family, or population problem.
  • Explain why you selected this problem as the focus of your project.
  • Explain why the problem is relevant to your professional practice and to the patient, family, or group.

In addition, address the requirements outlined below. These requirements correspond to the scoring guide criteria for this assessment, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

• • Define the role of leadership and change management in addressing the problem.
    • Explain how leadership and change management strategies influenced the development of your proposed intervention.
    • Explain how nursing ethics informed the development of your proposed intervention.
    • Include a copy of the intervention/solution/professional product.
  • Propose strategies for communicating and collaborating with the patient, family, or group to improve outcomes associated with the problem.
    • Identify the patient, family, or group.
    • Discuss the benefits of gathering their input to improve care associated with the problem.
    • Identify best-practice strategies from the literature for effective communication and collaboration to improve outcomes.
  • Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of your proposed intervention.
    • Cite the standards and/or policies that guided your work.
    • Describe research that has tested the effectiveness of these standards and/or policies in improving outcomes for this problem.
  • Explain how your proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
    • Cite evidence from the literature that supports your conclusions.
    • Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
  • Explain how technology, care coordination, and the utilization of community resources can be applied in addressing the problem.
    • Cite evidence from the literature that supports your conclusions.
  • Write concisely and directly, using active voice.
  • Apply APA formatting to in-text citations and references.

Additional Requirements

• • Format: Format the written analysis of your intervention using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
    • A title page and reference page. An abstract is not required.
    • Appropriate section headings.
  • Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
  • Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
  • Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.

Portfolio Prompt: Save your intervention to your ePortfolio. After you complete your program, you may want to consider leveraging your portfolio as part of a job search or other demonstration of your academic and professional competencies.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• • Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
    • Define the role of leadership and change management in addressing a patient, family, or population health problem.
  • Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
    • Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
  • Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
    • Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem.
  • Competency 5: Analyze the impact of health policy on quality and cost of care.
    • Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention.
  • Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
    • Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem.
  • Competency 8: Integrate professional standards and values into practice.
    • Write concisely and directly, using active voice.
    • Apply APA formatting to in-text citations and references.

Assessment 5 Instructions: Intervention Presentation and Capstone Video Reflection

• Present your approved intervention to the patient, family, or group and record a 10-15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Introduction

Baccalaureate-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

For this assessment, you’ll present your approved intervention to the patient, family, or group and reflect on various aspects of your capstone practicum experience. Such reflection will give you a chance to discuss elements of the project of which you are most proud and aspects of the experience that will help you grow in your personal practice and nursing career.

Reference

Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. Sciedu International Journal of Higher Education, 7(4).

Instructions

Complete this assessment in two parts: (a) present your approved intervention to the patient, family, or group and (b) record a video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program.

Part 1

Present your approved intervention to the patient, family, or group. Plan to spend at least 3 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Be sure you’ve logged all of your practicum hours in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Use the Intervention Feedback Form: Assessment 5 [PDF] as a guide to capturing patient, family, or group feedback about your intervention. You’ll include the feedback as part of your capstone reflection video.

Part 2

Record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. A transcript of your video is not required.

You’re welcome to use any tools and software with which you are comfortable, but make sure you’re able to submit the deliverable to your faculty. Capella offers Kaltura, a program that records audio and video. Refer to Using Kaltura for more information about this courseroom tool.

Note: If you require the use of assistive technology or alternative communication methods to participate in these activities, please contact DisabilityServices@Capella.edu to request accommodations. If you’re unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for supporting evidence.

• • Assess the contribution of your intervention to patient or family satisfaction and quality of life.
    • Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.
    • Explain how your intervention enhances the patient, family, or group experience.
  • Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.
    • Explain how the principles of evidence-based practice informed this aspect of your project.
  • Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.
    • Identify opportunities to improve health care technology use in future practice.
  • Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.
    • Note specific observations related to the baccalaureate-prepared nurse’s role in policy implementation and development.
  • Explain whether capstone project outcomes matched your initial predictions.
    • Discuss the aspects of the project that met, exceeded, or fell short of your expectations.
    • Discuss whether your intervention can, or will be, adopted as a best practice.
    • Describe the generalizability of your intervention outside this particular setting.
    • Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  • Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.
    • Address your provision of ethical care and demonstration of professional standards.
    • Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.
  • Communicate professionally in a clear, audible, and well-organized video.

Additional Requirements

Cite at least three scholarly or authoritative sources to support your assertions. In addition to your reflection video, submit a separate APA-formatted reference list of your sources.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• • Competency 2: Make clinical and operational decisions based upon the best available evidence.
    • Describe one’s use of evidence and peer-reviewed literature to plan and implement a capstone project.
  • Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
    • Explain whether capstone project outcomes matched one’s initial predictions and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  • Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
    • Assess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group.
  • Competency 5: Analyze the impact of health policy on quality and cost of care.
    • Explain how health policy influenced the planning and implementation of one’s capstone project, as well as any contributions the project made to policy development.
  • Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
    • Assess the contribution of an intervention (capstone project) to patient, family, or group satisfaction and quality of life.
  • Competency 8: Integrate professional standards and values into practice.
    • Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.
    • Communicate professionally in a clear and well-organized video.