NRS 490 Capstone Project Topic Selection and Approval GCU Examples
NRS 490 Capstone Project Topic Selection and Approval GCU Examples
In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. NRS 490 Capstone Project Topic Selection and Approval GCU Examples. Examples of the integration of community health, leadership, and an EBP can be found on the ”Educational and Community-Based Programs” page of the Healthy People 2020 website.
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Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:
The problem, issue, suggestion, initiative, or educational need that will be the focus of the project

The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.

A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.

Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.

Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.

A proposed solution to the identified project topic NRS 490 Capstone Project Topic Selection and Approval GCU Examples

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
You are required to submit this NRS 490 Capstone Project Topic Selection and Approval GCU Examples assignment to LopesWrite. Please refer to the directions in the Student Success Center.
 
NRS 490 Capstone Project Topic Selection and Approval GCU Examples – 1
Problem the Project Will Focus On.
Meeting with the mentor at my practicum site, we collaborated a problem that the facility was facing which is nurse turnover. My practicum site is a long-term or rehabilitation care that is majority occupied by geriatric patients, age 65 and older. Nurse turnover is one of the biggest problems many organizations faces due to work environment, staffing issues, or better salary at another facility. However, this facility has a tough time retaining nurse, because of the poor working environment, and inadequate staffing.
Setting
Like previously said, my practicum site is at a long-term care or rehabilitation center. This long-term care or rehabilitation center can house 99 residents, but currently has 92 resident that are 65 years of age and older. With that said, high turnover rates in a long-term care or rehabilitation center can result in the organization functioning ineffectively, and poor patient outcome (Black, 2015) NRS 490 Capstone Project Topic Selection and Approval GCU Examples.
Problem Description
Many nurses have intentions to seek new employment with an employer that can create a good working environment. Many nurses at this facility has said that they work under a lot of stress, because they are short of nurses, and have a larger workload (Foster,2015). These nurses reported that they get fatigued, and burnout because they must stay over to complete unfinished work or work extra to ensure patient care.
Moreover, the nurses reported that they lack the necessary equipment or resources to perform task, lack a specific role and autonomy, and have no support from management (Jones, 2014) NRS 490 Capstone Project Topic Selection and Approval GCU Examples.
Impact and Significant of Problem
When nurse cannot perform to the extent of their practice, patient care and outcome seems to be affected. Nurse satisfaction decrease along with their performance which adds to the poor working environment (Data, 2013). This problem is significant to the nursing practice because the nursing practice promotes quality patient care and improves patient outcome.
Proposal to Problem
The proposed solution to this problem is to recruit and retrain nurses. The facility has made the incentive to recruit nurses by attracting nurses with a sign-on bonus NRS 490 Capstone Project Topic Selection and Approval GCU Examples. However, sign-on bonus doesn’t necessarily cause a nurse to be committed to the facility or organization the sign to. Some other solution that can prevent nurse turnover, is managers engaging in management or leadership skills training to better support and lead staff (Maas, 20145), and adequate nurse to patient ratio to decrease nurse workload ( Sookyung, 2008).
References
Black, P. (2015). DEVELOPING AN ENHANCED PERSPECTIVE OF TURNOVER AND RETENTION OF NURSES AND HEALTH CARE AIDES IN LONG-TERM CARE HOMES. Perspectives: The Journal Of The Gerontological Nursing Association, 38(2), 25-30.
Sookyung, H., Bakken, S., Douglas, K., & Stone, P. W. (2008). Evidence-Based Staffing: Potential Roles for Informatics. Nursing Economic$, 26(3), 151-173.
Adams, Susan Louisa. 2016. “Influences of Turnover, Retention, and Job Embeddedness in Nursing Workforce Literature.” Online Journal Of Rural Nursing & Health Care 16, no. 2: 168-195. CINAHL Complete, EBSCOhost (accessed July 30, 2018).
Foster, S. (2015). Setting our sights on a Pathway to practice improvement. British Journal Of Nursing, 24(20), 1043. doi:10.12968/bjon.2015.24.20.1043 NRS 490 Capstone Project Topic Selection and Approval GCU Examples.
Nelson, I. E. (2017). Nurse Manager Perceptions of Work Overload and Strategies to Address It. Nurse Leader, 15406-408. doi:10.1016/j.mnl.2017.09.009
Maas, M. L., Specht, J. P., Buckwalter, K. C., Gittler, J., & Bechen, K. (2015). Nursing Home Staffing and Training Recommendations for Promoting Older Adults’ Quality of Care and Life Part 2. Increasing Nurse Staffing and Training. Research In Gerontological Nursing, 1(2), 134-152.
DATA BITS. Does Shift Length Affect Patient Outcomes and Nurse Satisfaction?. (2013). Kentucky Nurse, 61(4), 3.
Jones, T. L., Murry, N., & Hamilton, P. (2013). Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International Journal Of Nursing Studies, 52(6), 1121-1137 NRS 490 Capstone Project Topic Selection and Approval GCU Examples.
 
NRS 490 Capstone Project Topic Selection and Approval GCU Examples 2
Identified Problem
After meeting with the approved mentor and reviewing current problems within the clinical practicum site. It was decided that Central Line Associated Bloodstream Infections (CLABSI) would be the focus of the research project. It was identified that this site has struggled with reaching its zero CLABSI goal.
Setting
            The practicum site is a 640 bed multi-specialty, teaching level 1 trauma center. The hospital has an associated and attached clinical setting. There is also a level 4 neonatal intensive care unit (NICU) within the facility. The facility is stroke certified and is a primary heart attack center. The majority of the patients are adults. NRS 490 Capstone Project Topic Selection and Approval GCU Examples.
Problem Description
            CLABSI’s are usually preventable and avoidable (Haddadin & Hariharan, 2019). It is estimated that as many as 250,000 CLABSI’s occur each year and that the average cost of treatment is around $46,000 per occurrence (Haddadin & Hariharan, 2019).  More than 30,000 of those infections occurring in Intensive Care Units (ICU) alone, in the United States (US) (Centers for Disease Control and Prevention [CDC], 2019).
Impact of the Problem
CLABSI’s increase the cost of healthcare and cause unnecessary patient deaths each year (Haddadin & Hariharan, 2019). This is such a large and preventable problem that Joint Commission has listed CLABSI as one of the problems affecting patient’s health in the US (Joint Commission, 2012). CLABSI’s increase the morbidity and mortality of hospitalized patients each year (CDC, 2019). NRS 490 Capstone Project Topic Selection and Approval GCU Examples.
Significance of the Problem
CLABSI’s increase length of stay and patient morbidity and mortality rates (CDC, 2019). Increased length of stay increases the burden on nursing to continue to care for acutely ill patients. Nursing is the patients first line of defense against CLABSI’s. Nurses maintain and often place central lines. Centers for Medicare and Medicaid (CMS) will not reimburse for CLABSI’s incurred in inpatient settings (CMS, 2018).
Proposed Solution
An approach from multiple angles seems to be the best option for the facility to reach its zero CLABSI goal. The first change in practice would be to implement the use of alternative venous access devices when appropriate. The initiation of a central line placement protocol and checklist as well as the use of a central line care bundle. Reducing the number of patients who have central lines in place by removing them as soon as the patient no longer requires central access for the prescribed treatment or by screening patients for the need before a central line is placed can greatly reduce CLABSI rates. NRS 490 Capstone Project Topic Selection and Approval GCU Examples. Central line placement protocols for nurse led vascular access teams requiring two nurses to be present during the placement of central lines along with a real time checklist can reduce the risk of CLABSI related to placement. The use of central line care bundles can help reduce CLABSI rates by notifying staff as soon as a central line is no longer needed, the use of a sterile central line dressing change kit and requirement of two nurses being present during all dressing changes can also greatly reduce CLABSI rates.
 
References
Centers for Disease Control and Prevention (2019). Blood infection event (Central-line associated bloodstream infection and non-central line associated bloodstream infection). Retrieved from https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf
Haddadin, Y., & Hariharan, R. (2019). Central line associated blood stream infections. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430891/ NRS 490 Capstone Project Topic Selection and Approval GCU Examples
Joint Commission (2012). New monograph aims to decrease central line associated bloodstream infections. Retrieved from https://www.pwrnewmedia.com/2012/joint_commission/clabsi/
Centers for Medicare and Medicaid (2018). Hospital acquired condition reduction program. Retrieved from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html NRS 490 Capstone Project Topic Selection and Approval GCU Examples