NRS 493 Topic 5 Strategic Plan Summary Paper

Assess the culture of the organization for potential challenges in incorporating the nursing practice intervention. Use this assessment when creating the strategic plan.

Write a 150-250 word strategic plan defining how the nursing practice intervention will be implemented in the capstone project change proposal.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

Strategic Plan Summary Sample Solution

Various barriers may impair implementation when implementing a new change in an organization. These barriers can either be organizational or individual. Among the common barriers is resistance to change. Team members may opt to stick to their previous practice while resisting adapting to the new change. This may be attributed to a lack of knowledge about the proposed change, personal differences, poor communication strategy, or individuals perceiving change to have minimal effects. Besides, a lack of resources and organizational support for change can impair implementation. For instance, my project, which advocates for the daily use of chlorohexidine to reduce ventilator-associated pneumonia, requires a continuous supply of chlorhexidine and wipes to achieve positive outcomes. Failure to access these resources may impinge implementation, resulting in ineffectiveness. However, an exemplary implementation plan would help overcome some of the challenges.

Likewise, I came up with an implementation plan for my project. Because nurses are the intervention group in this project, I will start by surveying them to evaluate their knowledge and attitude toward the proposed evidence-based (EBP) plan. This will help in identifying gaps as well as be used for comparison after implementation of the project. Then, I will conduct sessions to educate nurses about the importance of the EBP. Demonstration of the EBP will occur concurrently with education. This aims at improving knowledge and skills about the EBP. Besides, I will encourage feedback that help in improving the proposed change. Launching and monitoring the progress of the change project would follow. Monitoring will help make any modifications that will improve the efficiency of the project. Finally, a resistance handling plan will be put in place to address any resistance that may arise during the implementation of the change project.

NRS 493 Topic 6 Literature Review

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

Title page
Introduction section
A comparison of research questions
A comparison of sample populations
A comparison of the limitations of the study
A conclusion section, incorporating recommendations for further research

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Ventilator-acquired Pneumonia Literature Review Example Paper

Ventilator-acquired pneumonia (VAP) is among the most common nosocomial infections in patients admitted to the Intensive care unit (ICU). While intubation is a necessity in supporting respiration, it acts as a conduit through which micro-organisms access the lower respiratory tract causing VAP. In addition, other risk factors such as advanced age, reduced immunity, immobility, and supine position increase the risk of VAP. Consequently, VAP negatively affects patient outcomes while increasing the rate of morbidity, mortality, and hospitalization. The cost of care is also increased. In some cases, the bacteria develop resistance to bacteria, causing a challenge in the management. Therefore, there is a need to adopt a nurse-led initiative that will help in preventing VAP. Various methods have been used. However, there is strong evidence supporting the use of Chlorohexidine (CHG) in reducing microbial load, preventing VAP, and improving patient outcomes. Such findings have been supported by the literature review I conducted on my PICOT question. Therefore, I recommend the adoption of using CHG to prevent VAP in my institution. This paper will discuss the comparison of the research questions, sample populations, limitations, and the usefulness of the evidence in my project.

PICOT: In adult patients intubated in ICU (P), how does daily use of Chlorohexidine (I) compared to not using (C) reduce the risk of Ventilator Acquired Pneumonia (VAP) (O) over three months? (T)

Comparison of Research Questions

Various studies have focused on different aspects regarding ventilator-acquired pneumonia. For instance, Deschepper et al. (2018) sought to find out the role of CHG in reducing mortality. The question stated, ‘Does the use of chlorohexidine oral care in critical and non-critical patients reduce mortality? D’Journo et al. (2018) stated ‘does the use of CHG prevent respiratory complications post-surgery for patients with lung cancer? In a meta-analysis by Jackson and Owens (2019), the authors analyzed various randomized control trials (RCT) to assess the effectiveness of CHG in reducing VAP among intubated patients. In another study by Pallotto et al. (2019), the research question stated, ‘can the use of a soap-like solution of 4% CHG followed by water rinsing reduce the incidence of hospital-acquired infections (HAIs) in ICU patients? Compared to a study by Reagan et al. (2019), which used mathematical analysis to determine the effectiveness of using CHG to reduce the incidences of HAIs and the cost of care, the study by Triamvisit et al. (2021) posed the question of whether the use of modified VAP-care bundle reduces the risk of VAP in neurosurgical patients. Finally, (Urbancic et al. (2018) stated; `does the use of CHG compared to triclosan reduce the rates of HAIs in ICU patients?

Comparison of Sample

The studies presented in the literature were done in different settings for patients with various needs and characteristics. However, it was common for most studies that the sample population comprised of patients admitted to the ICU while nurses intervened for most of the care. Sampling methods and numbers differed in various studies. A retrospective observational study by Deschepper et al. (2018) sampled 82,274 patients while 11,113 patients received CHG. Despite being done in different settings, studies by D’Journo et al. (2018) and Pallotto et al. (2019) sampled 450 patients each and used simple randomization to divide patients into either control or intervention groups. On the other hand, Reagan et al. (2019) simulated 850 patients from a single center using a mathematical model to analyze the cost of care. Triamvisit et al. (2021) recruited 291 patients from two neurosurgical ICU units. Simple randomization was used to classify 146 participants as control, while 145 formed the cohort group. Finally, a study by Urbancic et al. (2018) followed a total sample of 4262 ICU admissions and compared outcomes.

Comparison of Study Limitations

Despite the literature yielding relevant information, several limitations were highlighted. First, adherence to evidence-based practice (EBP) was a challenge to some nurses leading to incomprehensive results. Some nurses were resistant to change while opting to continue with their prior practices. Furthermore, it wasn’t clear how frequently should CHG be applied to enhance its effectiveness. In addition, the acquisition of resources proved futile in some centers, thus limiting the implementation process. Finally, studies had smaller sample sizes that could not represent the whole population.

Conclusion and Recommendations

Despite VAP being among the common nosocomial infection that impairs patient outcomes, the use of CHG has proved effective in reducing mortality and morbidity associated with it. The ability of CHG to inhibit cell wall integrity makes it effective against both gram-negative and gram-positive bacteria, the major cause of VAP. Therefore, there is a need to equip all nurses with the necessary knowledge on how to apply CHG and adhere to the protocols to prevent VAP. However, future research should focus on studying issues around the frequency of bathing with CHG, the effectiveness of the various concentrations in reducing VAP, and the adverse effects associated with CHG use. Finally, more randomized control studies should be done while including larger sample sizes that represent the entire population. Essentially, having credible evidence will enhance the adoption of the EBP in various ICU settings and improve healthcare outcomes.

References

Deschepper, M., Waegeman, W., Eeckloo, K., Vogelaers, D., & Blot, S. (2018). Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study. Intensive Care Medicine, 44(7), 1017–1026. https://doi.org/10.1007/s00134-018-5171-3

D’Journo, X. B., Falcoz, P.-E., Alifano, M., Le Rochais, J.-P., D’Annoville, T., Massard, G., Regnard, J. F., Icard, P., Marty-Ane, C., Trousse, D., Doddoli, C., Orsini, B., Edouard, S., Million, M., Lesavre, N., Loundou, A., Baumstarck, K., Peyron, F., Honoré, S., … Thomas, P. A. (2018). Oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate in lung cancer surgery: a randomized clinical trial. Intensive Care Medicine, 44(5), 578–587. https://doi.org/10.1007/s00134-018-5156-2

Jackson, L., & Owens, M. (2019). Does oral care with chlorhexidine reduce ventilator-associated pneumonia in mechanically ventilated adults? British Journal of Nursing (Mark Allen Publishing), 28(11), 682–689. https://doi.org/10.12968/bjon.2019.28.11.682

Pallotto, C., Fiorio, M., De Angelis, V., Ripoli, A., Franciosini, E., Quondam Girolamo, L., Volpi, F., Iorio, P., Francisci, D., Tascini, C., & Baldelli, F. (2019). Daily bathing with 4% chlorhexidine gluconate in intensive care settings: a randomized controlled trial. Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 25(6), 705–710. https://doi.org/10.1016/j.cmi.2018.09.012

Reagan, K. A., Chan, D. M., Vanhoozer, G., Stevens, M. P., Doll, M., Godbout, E. J., Cooper, K., Pryor, R. J., Hemphill, R. R., & Bearman, G. (2019). You get back what you give: Decreased hospital infections with improvement in CHG bathing, mathematical modeling, and cost analysis. American Journal of Infection Control, 47(12), 1471–1473. https://doi.org/10.1016/j.ajic.2019.07.003

Triamvisit, S., Wongprasert, W., Puttima, C., Chiangmai, M. N., Thienjindakul, N., Rodkul, L., & Jetjumnong, C. (2021). Effect of a modified care bundle for prevention of ventilator-associated pneumonia in critically-ill neurosurgical patients. Acute and Critical Care, 36(4), 294–299. https://doi.org/10.4266/acc.2021.00983

Urbancic, K. F., Mårtensson, J., Glassford, N., Eyeington, C., Robbins, R., Ward, P. B., Williams, D., Johnson, P. D., & Bellomo, R. (2018). Impact of unit-wide chlorhexidine bathing in intensive care on bloodstream infection and drug-resistant organism acquisition. Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine, 20(2), 109–116. https://pubmed.ncbi.nlm.nih.gov/29852849/

NRS 493 Professional Capstone Practicum Essays GCU – Topic 6 Capstone Change Project Resources

Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented.

Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal.

The assignment will be used to develop a written implementation plan.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 6 Professional Capstone and Practicum Reflective Journal

Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes.

Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.

In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
Ensuring the integrity of human dignity in the care of all patients
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 7 Capstone Change Project Evaluation Plan

Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources. Develop a process to evaluate the intervention if it were implemented. Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention.

The assignment will be used to develop a written implementation plan.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 7 Professional Capstone and Practicum Reflective Journal

Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.

In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
Ensuring the integrity of human dignity in the care of all patients
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

NRS 493 Professional Capstone Practicum Essays GCU – Topic 8 Benchmark Capstone Project Change Proposal

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course.

For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Background
Clinical problem statement.
Purpose of the change proposal in relation to providing patient care in the changing health care system.
PICOT question.
Literature search strategy employed.
Evaluation of the literature.
Applicable change or nursing theory utilized.
Proposed implementation plan with outcome measures.
Discussion of how evidence-based practice was used in creating the intervention plan.
Plan for evaluating the proposed nursing intervention.
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

NRS 493 Topic 5 Strategic Plan Summary Paper uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Also Read:

NRS 493 Topic 1 Individual Success Plan Essay Paper

NRS 493 Grand Canyon University Scholarly Virtual Tools Activities Discussion

NRS 4930507 Grand Canyon University Wk 10 Care Delivery and Clinical Systems Essay

NRS 493 Topic 7 Capstone Change Project Evaluation Plan Paper

NRS 493 Topic 6 Capstone Change Project Resources Essay

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1: Exemplify professionalism in diverse health care settings.

2.2: Comprehend nursing concepts and health theories.

3.2: Implement patient care decisions based on evidence-based practice.

NRS 493 Topic 8 Professional Capstone and Practicum Reflective Journal

Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below. In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
Ensuring the integrity of human dignity in the care of all patients
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities

NRS 493 Topic 5 Strategic Plan Summary Paper uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 9 Capstone Project Change Proposal Presentation for Faculty Review and Feedback

Create a professional presentation of your evidence-based intervention and change proposal to be disseminated to an interprofessional audience of leaders and stakeholders. Include the intervention, evidence-based literature, objectives, resources needed, anticipated measurable outcomes, and how the intervention would be evaluated. Submit the presentation in LoudCloud for feedback from the instructor.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 9 Professional Capstone and Practicum Reflective Journal

Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course.

Journal entries should address one or more of the areas stated below. In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
Ensuring the integrity of human dignity in the care of all patients
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 10 Capstone Project Change Proposal Presentation

Review the feedback on the change proposal professional presentation and make required adjustments to the presentation. Present your evidence-based intervention and change proposal to an interprofessional audience of leaders and stakeholders. Be prepared to answer questions and accept feedback.

After presenting your capstone project change proposal, write a 250-350 word summary of the presentation. Include a description of the changes that were suggested by your preceptor before your presentation and how you incorporated that feedback.

Describe how this interprofessional collaboration improved the effectiveness of your presentation. Include a description of the feedback and questions from your audience after your presentation, and how this experience will affect your professional practice in the future.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 10 Individual Success Plan (ISP)

The completed Individual Success Plan (ISP) signed off by the preceptor must be submitted to LoudCloud for faculty approval. Student expectations and instructions for completing the ISP document are provided on the “NRS-493 Individual Success Plan” document.

Faculty must approve of the completed ISP. Obtaining preceptor feedback and signature is the responsibility of the student.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 10 Benchmark Professional Capstone and Practicum Reflective Journal

Students maintained and submitted weekly reflective narratives throughout the course to explore the personal knowledge and skills gained throughout this course.

This assignment combines those entries into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

NRS 493 Topic 5 Strategic Plan Summary Paper

This final submission should also outline what students have discovered about their professional practice, personal strengths and weaknesses that surfaced during the process, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and, finally, how the student met the competencies aligned to this course.

The final journal should address a variable combination of the following, while incorporating your specific clinical practice experiences:

New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
Ensuring the integrity of human dignity in the care of all patients
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

NRS 493 Topic 5 Strategic Plan Summary Paper Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

2.3: Understand and value the processes of critical thinking, ethical reasoning, and decision making.

4.1: Utilize patient care technology and information management systems.

4.3: Promote interprofessional collaborative communication with health care teams to provide safe and effective care.

5.3: Provide culturally sensitive care.

5.4: Preserve the integrity and human dignity in the care of all patients.

NRS 493 Topic 10 Scholarly Activities

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice.

Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post at least one documented scholarly activity by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

Submit, by way of this assignment, a summary report of the scholarly activity, including who, what, where, when, and any relevant take-home points.

Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

NRS 493 Topic 10 Practice Experience Conference (Post-Conference)

Students are required to initiate a Post- Conference that will occur during Topic 10. This meeting is intended for the student, preceptor, and faculty to discuss the completion of the clinical practice experience, the learning goals contained in the Individual Success Plan (ISP), and course learning objectives.

Completion of the written capstone project change proposal will also be discussed, including preceptor recommendations. Completion of the clinical practice experience will be documented on the “Clinical Evaluation Tool” (CET), which is submitted in LoudCloud prior to the Post- Conference.

The CET will be reviewed during the Post-Conference including recommendations from the preceptor. Faculty will grade the submitted CET after the conference.

NRS 493 Topic 10 Indirect Clinical Practice Experience

Submit the completed “NRS-493 Indirect Clinical Practice Experience Hours” form to LoudCloud by the end of Topic 10.

NRS 493 Professional Capstone Practicum Essays GCU – Topic 10 Student Evaluation of Preceptor and Site

Access the Lopes Activity Tracker to complete the “Student Evaluation of Preceptor and Site.” Upload and submit the evaluation through the dropbox in LoudCloud.

NRS 493 Topic 10 Final Evaluation of Student by Preceptor

The preceptor will complete your final evaluation in the Lopes Activity Tracker.

Both the student and preceptor must sign the form. The final evaluation is completed and submitted by the student to the Dropbox in LoudCloud.

Students must meet all clinical expectations of the course, earn a passing grade on all benchmark assignments, and successfully complete remediation (if necessary) in order to receive a passing grade in the NRS 493 Topic 5 Strategic Plan Summary Paper.

If there are any competencies on the final evaluation that are “Below Expectations,” this may result in failure of the course.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.