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NRS 493 capstone change project outcomes

Capstone Change Project Outcomes

After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale.

  The capstone project intervention of multimodal strategies to reduce burnout in nurses has four measurable outcomes and they are as follows:

Outcome 1: reduced turnover ratio in health care

As more nurses will collaborate together and work towards reducing stress in the work environment, turnover ratio decreases as a smaller number of nurses will leave the job (Yao et al., 2018).

Outcome 2: increased nurse to patient ratio in health care

As more nurses are recruited to handle the burden and burnout in nurses, nurse to patient ratio will increase and thus, it will further increase quality care (Lahana et al., 2017).

Outcome 3: reduced health care errors 

As number of patients per nurses will be less, then the nurses will have time to manage everything without stress and fatigue, health care errors will be less (Magtibay et al., 2017). 

Outcome 4: reduced burnout in nurses

The stress management, self-efficacy, and support will reduce burnout in nurses as burden sharing, quality interprofessional collaboration, and high nurse to patient ratio will be beneficial (Rees et al., 2019).

References 

Ang, S., Dhaliwal, S., Ayre, T., Uthaman, T., Fong, K., & Tien, C. et al. (2016). Demographics and personality factors associated with burnout among nurses in a singapore tertiary hospital.  Biomed Research International ,  2016 , 1-12. https://doi.org/10.1155/2016/6960184

Jang, H., Park, J., Choi, Y., Park, S., & Lim, H. (2016). Effect of general hospital nurses’ perception of patient safety culture and burnout on safety management activities.  Journal Of Korean Academy Of Nursing Administration ,  22 (3), 239. https://doi.org/10.11111/jkana.2016.22.3.239

Lahana, E., Papadopoulou, K., Roumeliotou, O., Tsounis, A., Sarafis, P., & Niakas, D. (2017). Burnout among nurses working in social welfare centers for the disabled.  BMC Nursing ,  16 (1). https://doi.org/10.1186/s12912-017-0209-3

Magtibay, D., Chesak, S., Coughlin, K., & Sood, A. (2017). Decreasing stress and burnout in nurses.  JONA: The Journal Of Nursing Administration ,  47 (7/8), 391-395. https://doi.org/10.1097/nna.0000000000000501

Nowrouzi, B., Lightfoot, N., Larivière, M., Carter, L., Rukholm, E., Schinke, R., & Belanger-Gardner, D. (2015). Occupational stress management and burnout interventions in nursing and their implications for healthy work environments.  Workplace Health & Safety ,  63 (7), 308-315. https://doi.org/10.1177/2165079915576931

Rees, C., Eley, R., Osseiran-Moisson, R., Francis, K., Cusack, L., Heritage, B., & Hegney, D. (2019). Individual and environmental determinants of burnout among nurses.  Journal Of Health Services Research & Policy ,  24 (3), 191-200. https://doi.org/10.1177/1355819619840373

Yao, Y., Zhao, S., Gao, X., An, Z., Wang, S., & Li, H. et al. (2018). General self-efficacy modifies the effect of stress on burnout in nurses with different personality types.  BMC Health Services Research ,  18 (1). https://doi.org/10.1186/s12913-018-3478-y

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3. Constructing a Guiding Question

Learning Objectives

By the end of this chapter, you will be able to:

• Describe the process and importance of guiding-question development for research-based capstone projects.
• Incorporate the FINER approach into guiding question development.
• Explain the role of the Fundamental Four in guiding question development.
• Describe and Apply the PICOT approach to developing a specific question for your capstone projects.

This chapter introduces you to strategies and frameworks that can be used to construct a sound question to guide your capstone experience.  The FINER approach to general question development is presented followed by the Fundamental Four approach.  Finally, the Problem, Intervention, Comparison, Outcome, and Time (PICOT) approach to specific capstone question development is illustrated.  The tactics for question development introduced in this chapter will provide you with an initial basis for mutual understanding, communication, and direction for a meaningful and purposeful capstone project.

Introduction

Good literature reviews begin with a clear, answerable question that addresses an important problem, identified need, or phenomenon of interest (Considine, Shaban, Fry & Curtis, 2017).  The challenge in developing an appropriate question is in determining which professional practice uncertainties could or should be studied and rationalizing the need for their investigation.

Planning and Preparing for the Development of a Guiding Question(s) for Capstone Projects

Once a capstone topic has been selected, it is critical for you to develop a question that will support an efficient literature review (Stage 2).  A preliminary scope of literature (Stage 1, Chapter Two) regarding a selected topic will help you construct a question that will inform the rest of the literature review for your capstone project. For a question to be effective and complement the design of a capstone project, its needs to be succinct.  Additionally, guiding questions will vary in relation to the purpose it serves.  For example, the purpose of one capstone project may be to describe the experiences of participants, another may explore their experiences, while yet another may aim to compare participants’ experiences.  While all of them pertain to the participants’ experience, what is being studied in regard to the experiences differs (Burke & Dempsey, 2022).  Clarity about a capstone project’s purpose can also help you develop a good guiding question (Refer to Figure 3-1:  Words That Can Be Used for Creating a Capstone Purpose).

Figure 3.1:     Words that Can Be Used for Creating a Capstone Purposes

Developing a General Question:  The FINER Criteria

Once you have an approved topic for your capstone project, it is important to take the time to develop a high-quality guiding question. The FINER criteria highlight useful points that should be considered in general question development (Farrugia, Petrisor, Farrokhyar & Bhandari, 2010). (Refer to Table 3.1:  The FINER Criteria).

Table 3.1:  The FINER Criteria

Sources: Farrugia, P., Petrisor, B. A., Farrokhyar, F., & Bhandari, M. (2010). Research questions,hypotheses and objectives.  Canadian journal of surgery ,  53 (4), 278; Patino, C. M., & Ferreira, J. C. (2016). Developing research questions that make a difference.  Jornal Brasileiro de Pneumologia ,  42 ,403-403.

Developing a Question:  The Fundamental Four

During the early stages of the capstone process, your guiding question may be broad in scope and subsequently difficult to answer.  Therefore, considerable care and time should be spent refining problem, need, or phenomenon of interest so the question facilitates a rigorous and robust search of the literature, using key terms and phrases.  Planning and preparing for the development of a guiding question for quality outcomes should address four fundamental questions (Considine, et al., 2017).  (Refer to Table 3.2:  The Fundamental Four for Informing Quality Research).

Table 3.2:  The Fundamental Four for Informing Quality Research

In the quest of designing a capstone project, it is crucial to invest time, energy, and resources into the construction of a guiding question before proceeding to the study design (Lopes, Hurtado-Puerto, Moreno, Fregni, Falcão & Amorim, 2016)

Transforming a General Question into a Specific Question:  The PICOT Approach

Evidence-based practice proposes that clinical problems that emerge from care practice, teaching, or research can be broken down and organized using the PICOT strategy.  PICOT represents an acronym for Population, Intervention, Comparison, Outcome, and Time.  These components are essential elements of guiding question development in evidence-based practice and in the construction of a solid question (Santos, Pimenta & Nombre, 2007).  (Refer to Table 3.3:  Description of the PICOT Strategy).   T

The PICOT approach will help you generate a specific question that aids in constructing the framework of your capstone project.  The PICOT approach also aids in program protocol development by addressing the inclusion and exclusion criteria for the population involved in your study.  Furthermore, identifying a specific population of interest, an intervention, and outcomes of interest can also help you identify and/or develop an appropriate outcome measurement tool (Farrugia, et al., 2010).  It should be noted that not all PICOT questions will require a comparison.  The decision to compare two interventions will be based on the needs of your facility and the nature of your capstone project.  Additionally, not all questions will require a time period; however, it is important to keep this aspect of your capstone project in mind while performing an extensive literature review and developing your program or intervention.

Table 3.3:  Description of the PICOT Strategy

By following the PICOT format an idea can be developed into a useful clinical question, which is the foundation for developing a comprehensive capstone project.

You do not have to be an epidemiologist or clinical research methodologist to develop a good guiding question.  Most research questions for clinical practitioners start with an idea or observation that arises from daily practice, observation, or reading of published literature.  The concept of evidence-based practice incorporates the routine of developing good clinical questions as part of day-to-day clinical or service management.  Recognizing an area that requires additional study is the first step while developing the skills to clearly articulate a question that should be asked is the next step.  Although it can be challenging and time-intensive to develop a guiding question, the strategies and approaches for constructing a guiding question included in this chapter will help you to develop and refine this skill.  Once the skill of constructing clinical questions is acquired, evidence-based practice will become commonplace and the foundation on which to design a methodologically sound capstone project is established (Heddle, 2007).

Case Study:  Constructing a Guiding Questions

• Glynn completed Stage 1 of her literature review. During this literature review, Glynn became aware of a Health Literacy Universal Precautions Toolkit, which is an open-access resource provided to all health care professionals by the United States Department of Health and Human Services.
• Glynn’s initial literature review also enlightened them to the fact that there is a gap in the literature regarding health literacy universal precautions and occupational therapy clinical practice. Glynn has again met with their mentor and capstone instructors, who initially approved the topic of health literacy, to discuss health literacy universal precautions and occupational therapy clinical practice as a topic for their capstone project.  Glynn’s mentor and instructors have approved this.  Glynn will initiate their research-based capstone  project by developing a guiding question.
• After reviewing the FINER and Fundamental Form Approaches to general guiding question development, Glynn was ready to apply the PICOT framework to create a specific guiding question.
•  Does a ( I) health literacy universal precautions workshop for (P) occupational therapy practitioners (O) improve their working knowledge about health literacy, and increase their self-perceived ability to identify, assess and implement client-centered interventions that optimize outcomes for low-health literate patients?
• The PIO question above will be the focus of Glynn’s research-based capstone project. Glynn is ready to begin their comprehensive and thorough literature review to locate the most current research and information supporting their project.

Optimizing Your Capstone Experience: A Guidebook for Allied Health Professionals Copyright © 2023 by Virginia E. Koenig is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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Capstone Change Project Outcomes

ANSWER This capstone change project aims to improve patient outcomes by providing nurses with evidence-based tools and resources. The specific aim of this project is to reduce the incidence of pressure ulcers in hospitalized patients. Various interventions will be implemented to achieve this goal, including using an interdisciplinary team approach, evidence-based guidelines for the prevention and management of pressure ulcers, and educational resources for nurses. It is anticipated that these interventions will lead to a decrease in the incidence of pressure ulcers, as well as improved patient outcomes. This capstone change project is expected to positively impact patient care and safety, as well as the overall quality of care provided by nurses. In addition, it is hoped that this project will catalyze further change and improvement within the nursing profession. Pressure ulcer incidence, patient outcomes, interdisciplinary team, evidence-based guidelines, nurse education, and quality of care. It is anticipated that implementing this capstone change project will lead to improved patient outcomes by reducing pressure ulcers.

After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale.Capstone Change Project Outcomes

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

APA style is not required, but solid academic writing is expectedCapstone Change Project Outcomes

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Designing effective capstone experiences and projects for entry-level doctoral students in occupational therapy: One program’s approaches and lessons learned

Entry-level doctoral occupational therapy programs require students to complete a capstone experience and project that supports advanced skills through an in-depth learning experience with a student-selected mentor. Strong curriculum design and mentorship are vital aspects of successful capstone experiences and projects. Through the application of these key components, students are supported, in collaboration with mentors, to achieve mutually beneficial projects allowing advancement of the profession through dissemination of capstone work.

The first entry-level occupational therapy doctoral (OTD) program in the US was accredited in 1998 ( American Occupational Therapy Association [AOTA], 2014 ), and the initial entry-level OTD education accreditation standards were set forth by the American Council for Occupational Therapy Education (ACOTE) in 2006. The doctoral section of the ACOTE standards were subsequently updated in 2011 and 2018 ( ACOTE, 2018 ; AOTA, 2011 ). In 2015, there were six accredited entry-level OTD programs in the US; currently, approximately 170 entry-level OTD programs are either fully accredited, in the application process for accreditation, or in the development phase of accreditation ( AOTA, 2019 ). A steady increase of new OTD programs emerging has resulted in major changes to the accreditation standards that outline the uniqueness of the doctoral degree compared with the master’s degree.

One pivotal and consistent component of the doctoral standards is the requirement for students to complete an advanced competency experience at the end of the curriculum. The most recent ACOTE standards, to be implemented in the summer of 2020, changed the name from the previously entitled “doctoral experiential component” to the “capstone experience and project” ( ACOTE, 2018 , p. 38). Capstone components in entry-level OTD curricula support previous literature, both inside and outside of the profession, that asserts that graduates from these programs must engage in experiences and projects that demonstrate synthesis and application of knowledge gained through the curriculum ( ACOTE, 2018 ; Campbell, 2011 ). In addition, the literature reflects the view that doctoral students should participate in professional scholarly endeavors ( ACOTE, 2018 ; Jirikowic et al., 2015 ). The OTD capstone is an essential component of entry-level OTD programs that prepare graduates to accept responsibility and professional autonomy in assuming leadership roles in the health care delivery system ( AOTA, 2013 ). According to ACOTE standards, the capstone should not be designed as a third fieldwork; rather, it should provide students with an in-depth experience in one or more of eight identified focus areas: clinical practice skills, research skills, administration, leadership, program and policy development, advocacy, education, and theory development ( ACOTE, 2018 ). Further, compared with the previous ACOTE standards, the newest standards provide more detail on the requirements for students, educational programs, and capstone mentors.

The entry-level OTD capstone is divided into a 14-week capstone experience and project (herein called capstone), which ACOTE requires to be aligned with each program’s vision, mission, and curricular design ( ACOTE, 2018 ). During the capstone, students are mentored by an individual with expertise in the student’s area of interest, and students complete an individual capstone project that demonstrates synthesis of advanced knowledge as well as application of gained knowledge ( ACOTE, 2018 ). Through capstone experiences and projects, occupational therapy (OT) students are afforded significant opportunities to enhance knowledge, skills, and motivation by engaging in emerging practice areas, primary care, interprofessional teams, and specialty practice areas ( Olsen et al., 2010 ). Capstone experiences and projects are widely used as a component of teaching in graduate health profession programs and are often associated with higher levels of student learning because of the deeper approach that allows students to gain experience integrating ideas into real-world practice ( Campbell, 2011 ). Clinical doctoral programs, many of which include capstone projects, have become the new educational standard among most health professions ( Brownell & Swaner, 2009 ; Campbell, 2011 ). An entry-level schema for clinical doctorates is a precedent that has been established by a variety of health-related professions, including OT.

Both the increasing number of entry-level OTD programs in the US and demands to recruit and support new capstone opportunities have created a need to describe the capstone curricula and educational methods of existing programs as potential models for other programs. Having gained experience and addressed key challenges in designing and implementing OTD capstone curricula, the authors are motivated to share the program’s model and lessons learned with peers in academic and nonacademic OT settings. This paper will describe the curriculum design of this institution’s capstone program as well as the processes of academic preparation, the roles and responsibilities of capstone partners, the mentor selection processes, approaches to capstone evaluation and outcomes, and lessons learned. The intent of this article is to support academic colleagues in informing the development and implementation of effective new capstone programs for OTD students

Key ACOTE Standards Related to Capstone

ACOTE is an associated advisory council of the executive board of AOTA and is the recognized accrediting agency for OT education. Academic resources outlined in the A.2.0 ACOTE (2018) standards address the roles, qualifications, general responsibilities, and release-time expectations of the capstone coordinator (CC). Capstone definitions and requirements are addressed in the eight D standards ( ACOTE, 2018 ). These capstone-specific standards address the design of the doctoral capstone and its reflection of the curriculum design, preparation for capstone, contractual agreements, duration of the capstone experience, mentor requirements, mechanism of evaluation, and doctoral project stipulations ( ACOTE, 2018 ). In the following sections, key ACOTE standards are summarized for capstone experiences and projects, demonstrating approaches to achieving these standards most effectively.

Doctoral Program Overview

This university’s OT program is 33 months in length and comprises 2 years of didactic coursework. It includes three Level I fieldwork rotations, 6 months of Level II fieldwork, and a 14-week capstone that occurs in the final semester. When the inaugural cohort of students were enrolled, six other accredited entry-level OTD programs existed nationwide, with numerous others in varying stages of accreditation. With limited numbers of similar programs as guiding models, the faculty created a capstone curriculum through alignment with the program’s vision, mission, and targeted educational outcomes for students. Curriculum development was guided by the ACOTE standards, with the faculty actively seeking advice through extensive faculty discussions and networking with other OTD programs. To date, this program has four cohorts of capstone students totaling 131 students and capstone projects. This OTD program follows the practice-scholar model as a prominent thread in the curriculum. The design of this model is to support students in developing professional skills and abilities to be lifelong learners and effective consumers of evidence, students who are evidence-informed and evidence-based practitioners and who have a drive for research design and innovation ( Crist et al., 2005 ). Regarding the curriculum and the OTD capstone, significant time and effort is spent building and following the practice-scholar model tenants in an already densely packed curriculum. This approach presents unique challenges because priority is placed on service learning where the allotment of resources is in areas outside of minimum curricular requirements, including numerous experiences in community engagement and project-based learning; thus, there is a risk of not emphasizing foundational knowledge and skills. To address these and other challenges in the capstone process, the program incorporates several distinguishing features in the following areas: capstone curriculum; role delineation for the faculty, CC, mentor, and student; dissemination; and the themes and characteristics of the mentors’ and students’ projects.

Capstone Curriculum

The OT students take three designated courses related to capstone: (a) Doctoral Capstone Planning, (b) Doctoral Capstone, and (c) Practice-Scholar Culmination. Jirikowic et al. (2015) and DeIuliis and Bednarski (2019) outline a similar structure for capstone development centered around four stages: idea development, planning, implementation, and dissemination. Although the first capstonerelated course (idea development and planning) begins in the fifth semester, or spring of the students’ second year, students are encouraged to develop and document ideas of interest from the start of the program. A successful strategy that students have employed for collecting ideas is creating a shared online document to store topics and capstone project ideas gleaned from interactions with guest lecturers, community partners, and faculty. This early and student-directed collection of capstone ideas from the start of the program allows students to generate ideas to cultivate by the time the capstone planning class occurs. The second and third capstone-related courses (implementation and dissemination) occur during the sixth and final semester of the program ( DeIuliis & Bednarski, 2019 ). The following section includes examples of assignments and activities that have been successful in the planning, preparation, implementation, and dissemination phases for our OTD students.

Doctoral Capstone Planning

During the initial capstone class, students engage in a 15-week capstone planning course that consists of traditional lecture, in-class and online discussions, self-study, and guest panel presentations. This course supports students in designing individualized capstone level plans, with faculty direction to guide the development and implementation of the 14-week doctoral capstone. The student’s plan will reflect the desired outcomes from the doctoral capstone, which are to acquire practice-scholar competencies reflecting the degree program’s sequence and scope of content in the curriculum design. The goals of the capstone planning course include identifying interest areas, topics, and mentors, as well as finalizing a draft of the capstone plan. Because the initial capstone plans are created a year in advance, much can change for a mentor and mentor site. Thus, capstone plans need to be fluid, working documents that allow for changes to meet the evolving needs of the students, mentors, and sites. The high value coursework included in the capstone planning class, above and beyond the ACOTE requirement of needs assessment and literature review, is described as follows:

• Students explore capstone ideas and supporting evidence in an online discussion board. The final capstone idea is derived from this initial discussion board work.
• Students create individualized marketing materials to send to potential mentors. Materials include a flyer that defines capstone, details student ideas, and clearly identifies mentor roles.
• Students are encouraged to be creative in capstone flyer design while also adhering to health care literacy standards and accessibility standards.
• Using the content from the flyer, students work in small groups to hone a capstone elevator speech for mentors.
• Students engage in peer-to-peer teaching via feedback assignments through online discussion boards. Students upload marketing materials and provide one another with constructive feedback.
• Current capstone experience students in the community return to campus to present capstone projects to the planning class. Students are required to include information regarding the journey of planning, mentor selection, collaboration process with mentors, and the challenges and successes experienced. Students who complete capstones farther from campus are asked to submit video summaries to the online learning system detailing capstones work.
• Examples of exemplar capstone projects are shared with the students to support developing capstone ideas and selecting of mentors.

An ACOTE requirement is that students must complete a literature review and needs assessment before the capstone experience. One of the fundamental challenges is that students have not yet completed longer clinical rotations and do not have the context for application to practice for a robust needs assessment. Another challenge is that students may not identify a mentor during the planning class and need to complete these two requirements while on fieldwork where the focus is on developing entrylevel practice skills. While students become proficient in literature reviews during the program, most do not have enough relevant experience to envision focus areas and application in practice. To meet these challenges, content in the capstone planning class was designed to support students in fulfilling these requirements so that they are not doing this activity while on fieldwork. Students must identify a topic of interest; a search strategy inclusive of search engines, search terms, and article yields; and a summary of topic-focused articles that can be shared with potential mentors. Students complete a needs assessment via a strengths, weaknesses, opportunities, and threats (SWOT) analysis based on the literature or in collaboration with a mentor (if identified early in the planning class) ( Rizzo & Kim, 2005 ).

Another component in the class is the development of a student’s capstone plan. This consists of eight parts: (a) mentor information, (b) capstone overview relating the plan to AOTA’s Vision 2025 and to the program’s overall mission and goals, (c) focus areas identified (d) mentor name and qualification information, (e) learning objectives (based on focus area), (f) proposed learning activities, (g) proposed evidence or deliverables of the project (what is being provided to the mentor/site), and (h) the project timeline ( AOTA, 2017 ). In this capstone plan are weekly activity tracking forms, program created midterm evaluation forms (narrative), and the program created final capstone evaluation form, all of which are requirements in the D standards of ACOTE (2018) .

Doctoral Capstone

The students complete the capstone during the final semester of the program in one or more of the eight identified focus areas per ACOTE. Several programs elect to embed the capstone project throughout their curriculum; often, faculty serve as the mentors for the project, and students identify a mentor to implement projects during the experience portion. In contrast to students in other entry-level OTD capstone programs, the students in this program complete projects and experiences in the same semester with identified mentors in the community ( DeIuliis & Bednarski, 2019 ). This approach supports the collaboration between community-based mentors and students to ensure that sustainable and site or practice-related projects are created. During the implementation phase, students remain engaged with the faculty and peers through online discussion posts during Weeks 2, 7, and 12. These serve as check-ins on progress and completed work. Also, the program has designed its own internal evaluation form embedded in a student’s capstone plan. Key components of evaluations include progress toward learning activities, projects, remaining work, sustainability of projects, mentor-perceived value of projects, and narrative summaries from both students and mentors. Evaluations of capstone are completed at midterm (Week 7) with the CC and the final (Week 14) with the student and mentor.

Students and mentors complete a midterm evaluation at Week 7. Students provide a summary of progress toward individualized objectives and projects and summarize completed activities and plans for the remaining seven weeks. Further, mentors can provide feedback and complete an evaluation to date at this time. The capstone plan has the embedded evaluative measure that allows mentors to indicate whether projects are achieved, in progress, or discontinued; in addition, the evaluation includes the mentors’ comments on the overall practicality and sustainability of projects. This midterm evaluation is uploaded to the online learning platform for the CC to review. The students and mentors also complete a midterm phone call and/or site visit.

During Week 14, students and mentors complete the final evaluation of the capstone. Specifically, students describe progress toward proposed learning activities and evidence and project deliverables. Mentors provide feedback regarding individual learning objectives and activities and evaluate whether the objectives were achieved, if evidence of a deliverable was provided, if the project or deliverable is sustainable, if the project is valuable to the setting, and if students have identified future projects and overall mentor feedback.

Practice-Scholar Culmination

Dissemination is achieved through the third capstone-related class and is driven by the practice-scholar model to allow for a demonstration of synthesis of skills learned throughout the program, wrapping up three exemplary components: capstone presentations and artifacts, practice-scholar apprentice presentations, and professional development presentations. Final evaluation of the capstone is completed by the CC during this dissemination phase and feedback is given through the designed rubrics.

Through this feature of the class, the practice-scholar model epitomizes the goal of cultivating highly respected OT practitioners who are also scholars with the ability and interest to establish knowledge translation and practice-based evidence projects, support research initiatives, and who can translate observed changes from interventions into outcome studies. A practice-scholar is not only a consumer of evidence but creates evidence in context. This class, occurring in the final semester, is a blend of online and on-campus assignments and activities. The online assignments include:

• resume writing and marketing self as a future occupational therapy practitioner, and
• professional development presentation preparation, in which students work in small groups to create a conference-style presentation with active learning components to be provided on campus to peers and community practitioners.

The final week of the semester the students are on campus to complete the following activities:

• provide an evaluation and reflection to the program related to the didactic portion of the curriculum, fieldwork rotations, and capstone experience;
• engage in several opportunities to practice and collaborate with peers, faculty, and mentors to finalize culminating presentations for a half day symposium;
• prepare for future employment: Students attend several training sessions that focus on the application process for the national certification examination and state licensure, in addition to understanding employment options and interviewing techniques;
• present during the final day to a symposium capstone presentations, professional development presentations, and practice-scholar projects to peers, faculty, university leadership, and community practitioners;
• present in a “Floor us in 4 Minutes” model, which allows the student to clearly and succulently summarize capstone work. This innovative approach to dissemination is designed to improve students’ communication skills as well as the capacity to present research, scholarship, and/or creative works effectively;
• present a 50-min small group professional development presentation composed of students with like interests. The team creates a conference-style presentation that focuses on a topic that was learned in the program and/or fieldwork. Each team is required to create a presentation that includes learning objectives, the evidence to support the material presented, and an active learning strategy for the attendees; and
• present an outcome of the research that was accomplished in the practice-scholar team. Outcomes may include a manuscript, poster presentation, or program developed.

Roles of Faculty, Capstone Coordinators, Students, and Mentors

Faculty members, other than the CC, may support the capstone experience in several ways. A student may select a faculty member to be the capstone mentor if doing so aligns with the student’s learning outcomes; however, our faculty serve as designated capstone mentors only in limited instances. One reason is that this role poses challenges to faculty if workload is not allocated to support the mentoring work. To address this issue, faculty who choose to serve as designated capstone mentors fold the mentoring time and work into scholarship or research allocated time. To date, there have been three faculty members who have served as capstone mentors and, when serving as a mentor, are required to complete all of the mentor roles and responsibilities as outlined in the program’s MOU. More frequently, when a faculty member’s area of expertise aligns with a student’s interest area, the faculty member will provide guidance on capstone ideas, identify potential mentors, assist in making mentor selection, and help the student develop the capstone plan.

Academic Fieldwork Coordinator (AFWC)

The AFWC works closely with the CC on similar tasks, but these are two distinct roles in the department ( DeIuliis & Bednarski, 2019 ). Effective collaboration between the AFWC and the CC is crucial in identifying potential capstone sites and mentors, managing contracts, and ensuring that sitespecific requirements are known to both the AFWC and the CC.

Capstone Coordinator (CC)

The CC in the program is a full-time, 12-month, core faculty member who oversees and supports the capstone portion of the program to ensure compliance with ACOTE D standards ( ACOTE, 2018 ). Broadly, the minimum responsibilities of the coordinator are to provide a framework for students to develop, plan, implement, and disseminate capstone work ( DeIuliis & Bednarski, 2019 ; Jirikowic et al., 2015 ). A major challenge facing programs is how to structure the CC position to meet the needs of mentors and students, as well as faculty expectations. To that end, the CC has other responsibilities in the department, college, and university, including teaching non-capstone courses, providing service, and engaging in research. In contrast to other OTD program models, in which faculty serve as mentors or there are capstone committees, the program’s CC is solely responsible for oversight of each aspect of the capstone ( DeIuliis & Bednarski, 2019 ). The coordinator and students select and work collaboratively with mentors from the community to implement the capstone. The results of this intentional approach are a clear communication path for capstone contact for students, a primary point of contact for mentors, and a single point of contact to manage contracts, the memorandum of understanding (MOU), and capstone plans.

Capstone is a student-driven process in which the onus falls on the student to create an idea, search the literature, complete a needs assessment, and identify a mentor. Students struggle at times to convey capstone interests beyond general themes, such as an interest in stroke rehabilitation, and to understand how project-based work unfolds in a real-world setting. When students lack clarity, it is difficult for mentors to understand how to best support a capstone student. Assignments in the planning class, such as refining a student’s capstone idea in a capstone elevator speech, address this issue directly. At a minimum, students are required to complete the following activities:

• develop a personal definition and explanation of capstone for potential mentors;
• complete a capstone plan, which includes a plan for supervision and culminating project identification;
• develop an objective evaluative measure of achievement for capstone; and
• develop a timetable for capstone with week-by-week objectives.

At a minimum, students are responsible for the achieving the following objectives and milestones:

• success of the culminating project,
• meeting with the mentor on a routine basis to assess progress toward the capstone plan and culminating project,
• contacting the CC about concerns regarding progress that the mentor is not able to address,
• meeting with the CC and mentor to complete a midterm visit and program developed evaluation, and
• meeting with the mentor to complete final program developed evaluation of the capstone and culminating project.

Capstone Mentor

A mentor is defined by ACOTE (2018) as an individual with expertise consistent with the student’s area of focus. Mentoring is further defined as “the relationship between two people in which one person (the mentor) is dedicated to the personal and professional growth of the other (the mentee). A mentor has more experience and knowledge than the mentee” ( ACOTE, 2018 , p. 51). The mentor does not have to be an occupational therapist. The mentor identification and selection process begins in the fifth semester of the program during the capstone planning class. As illustrated in Figure 1 , there are nine identifiable steps in the program’s mentor selection process, several of which are imbedded as planning class assignments. Mentors appear to best serve students when there is a clear understanding of the differences between a Level II fieldwork rotation and the capstone experience. In addition, capstone mentors are most effective when the differences between mentoring and supervision are well understood. Most capstones are a blend of supervision and mentoring, and collaborations are successful when mentors and students clearly define expectations. Capstone mentors are responsible for the following activities, deliverables, and milestones:

• providing the CC with a resume, curriculum vitae, or bio sketch that provides evidence of the mentor’s expertise consistent with the student’s area of interest;
• reviewing and signing the MOU before the capstone begins;
• providing feedback on and final approval of the capstone plan;
• providing the student with the mentorship and resources required to fulfill the capstone responsibilities and achieve the highest educational goals;
• reaching out to the CC with any concerns or questions that cannot be resolved with the capstone student; and
• coming to an agreement with the student and the program as to proprietorship and/or authorship for capstone projects.

Flow Chart of Mentor Selection Process

The Capstone Component

To date, in four cohorts, 131 students in the OTD program have successfully completed capstones with 127 mentors, with two mentors having taken multiple students. Core to the program is the mission to serve the state population and support its workforce for OT. While students are required to complete Level I and Level II fieldwork rotations in the state, with a few exceptions, capstone can be completed outside the state or internationally. In keeping with the mission, many students are selecting capstone sites and mentors in the state (see Figure 3 ). In the inaugural cohort, 13 of the 23 (56%) mentor sites were cultivated from existing fieldwork contracts and relationships. In subsequent cohorts, 38 (29%) mentors have returned to mentor another student on new projects (see Figure 2 ). To date, 93 out of 127 (73%) were first-time mentors for the program’s capstone students (see Figure 3 ).

4-year Mentor Demographics

4-year Capstone Locations Summary

Nearly all of this program’s students (96%) select two or more focus areas for capstone projects, and 20% of students select at least four focus areas (see Figure 4 ). The most selected focus areas are clinical practice skills and program development. There appears to be emerging focus trends in capstone, with the most apparent surrounding clinical skill development and program development. Students are frequently drawn to clinicians who practice in specialty areas or are recognized for advanced level of practice, so it makes sense that clinical skill development would be a focus for students. Students most frequently collaborate with mentors on program development projects, with none choosing theory development to date (see Figure 4 ). This theme indicates that students and mentors are, in fact, collaborating on projects that meet a site need or clinical practice initiative.

Selected Capstone Focus Area Outcomes

Students typically take one of three paths toward mentor selection (see Figure 5 ). First, the mentor-focused path involves selecting the mentor based on shared interest or expertise. This approach can be student-driven but also offers the chance that mentors already have projects for students to join, so students do not necessarily generate the ideas. Second, the idea/project-focused path involves an outof-the-box or emerging practice area, perhaps something that students may or may not have a chance to do in the future. This is the most student-driven approach, as students approach potential mentors with ideas already in formation. Third, the location-focused path involves selecting the location site where students plan to live and work and then finding a mentor. This path narrows the students’ scope in terms of finding both a mentor and site open to taking a capstone student. This is emerging as the least studentdriven pathway, tending to be more mentor-directed in terms of project availability and clinical practice exposures.

Capstone Selection Pathways

Lessons Learned

Communication.

The capstone was initially entitled residency when the program first started to distinguish it from fieldwork and set it apart from other student experiences. However, this term has different meanings in medical models and health care settings, and in some cases, the term residency was prohibited because it is designated for medical students. After faculty discussion and feedback from community stakeholders and students, the department changed the name to doctoral experiential component (DEC) to align with the 2011 ACOTE standard terminology. In accordance with the most recent 2018 ACOTE standards, the term capstone is now used to ensure the experience and project are consistently represented in the profession. This term more closely aligns with the project nature of the clinical doctorate outcomes. The multiple name changes have been a barrier for the CC to overcome, as clarification is needed to update mentors and students on the overarching goals of capstone.

Close communication with the AFWC is essential to build mentors and sites for capstone. The AFWC is key in providing sites and potential mentors with site-specific examples of capstone opportunities. This is accomplished during all Level II fieldwork rotations, during which the AFWC completes 90% of midterm evaluations in person. Based on experiences over the past 4 years, it seems non-occupational therapy mentors and occupational therapists in nontraditional roles readily engage in mentoring capstone students more so than traditional occupational therapists. Examples of nonoccupational therapy mentors to date are child life specialist, director of pediatric hospice program, primary school teacher, recreation therapists, life coach, yoga instructor, volunteer program coordinator of non-profit organization, and director for youth foster congregate care homes. At times, it has been easier to recruit non-occupational therapists because these mentors do not necessarily have the constraints of productivity and clinical practice responsibilities, and there is not a need to differentiate between a capstone and fieldwork student.

The department chair, faculty, CC, and AFWC all work to communicate a single message and theme of capstone when collaborating or communicating with the program’s numerous stakeholders. Capstone mentors and project ideas can and do come from these relationships. For example, during an OT state association lunch, an occupational therapist identified a need to collect and analyze data on the evaluation process and discharge recommendation practice habits of the staff. The CC helped define the project question and research questions and connected a capstone student for the project. This resulted in policy and program changes in the mentor’s practice setting and created elevation of practice in discharge planning. Collaborating with existing mentors to get the word out on capstone has been well received at AOTA and state conferences. As a bonus, not only does this provide mentors to engage in scholarship through presentations, potential mentors hear from mentors who have been through the process and can relate best how capstone translates in clinical practice.

Social media platforms are an effective way to share capstone stories and projects. Students, mentors, and projects are routinely showcased on the program’s numerous social media platforms. Students create the narrative to be shared, which benefits the university, OT program, and mentors.

Each year, there is a period of developing and evolving expectations with each new cohort of OTD students and mentors ( Hansen et al., 2007 ). New mentors and students require time to explore capstone projects and collaborations to determine if capstone is a good fit for the mentor and student. Most capstones are a blend of supervision and mentoring, and collaborations are successful when mentors and students clearly define expectations, allocate time for clinical skills and projects, and discuss communication styles.

There currently are few resources available for academic programs and mentors to guide capstone curricular development or clinical site capstone programs. Mentors seeking this information have access to fieldwork resources and rely on adapting them to meet the needs of capstone students in the practice setting. Feedback from mentors and students indicates that the structure of a consistent capstone plan is preferred rather than every capstone plan being in a different format. Uniformity has helped with familiarizing mentors to the program and supports branding and expectations of student projects.

Mentor Preparation

A challenge facing students and programs is that people who excel in professional fields are not always master educators or mentors, and mentoring involves a complex and dynamic exchange between mentors and mentees ( Smith, 2007 ). However, capstone mentors, when knowledgeable about the expectations and components of capstone, can further personal professional development and achieve a higher level of mastery ( Stoffel et al., 2014 ). Mentor sites, when familiar with the expectations and potential for program development, may bolster recruitment and retention of staff and highlight new programs by engaging in capstone mentoring partnerships with students and academic programs. Occupational therapists are familiar with fieldwork because all occupational therapists go through the process. There is a plethora of fieldwork literature, frameworks, and supports for fieldwork educators to follow. There currently are few frameworks and resources for OT capstone mentors outside of academia. CCs need to provide capstone mentors with resources and education regarding the capstone for mentors to feel more confident in their responsibilities and understanding of the differences between fieldwork and capstone requirements.

The capstone experience is an important and vital element of entry-level OTD programs. It is an individualized component of entry-level OTD education to produce a culminating project ( Case-Smith et al., 2014 ). In this student-informed process, the onus is on students and mentors to develop programs and envision how projects are springboards for future practice, such as research, quality improvement projects, and staff development ( Fortune et al., 2012 ). AOTA’s Vision 2025 charges occupational therapists to increase capacity and collaboration ( AOTA, 2017 ). OT mentors can meet Vision 2025 by engaging in mentor partnerships with capstone students. Through curriculum design, academia can promote capstone partnerships with occupational therapists and non-occupational therapist mentors that offer the opportunity not only to engage in scholarship, but also to advance programs that are of importance to the student, mentor, community, and or facility. The future holds exciting opportunities among established and developing OTD programs to share structural elements of capstone curriculum and program outcomes, to clarify language used for descriptions, and to better engage mentors in capstone collaborations.

Acknowledgements:

Technical editing was provided by Laurence Green and supported, in part, by NIH/NIMHD RCMI U54MD012388 (Baldwin/Stearns-MPI). Special thanks to our Founding Chair Patricia Crist, PhD, OTR, PC, FAOTA, for her direction and support in the development of the program.

Conflicts of Interest: None

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Nursing Bay

Nrs 493 topic 4 capstone change project outcomes paper.

After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale.

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.

NRS493 Capstone Change Project Outcomes Sample

Every healthcare quality improvement project requires well-formulated expected outcomes to inform the specific activities. These expected outcomes are the basis for project control, monitoring, and evaluation. This essay explores the expected outcomes for the capstone project and their rationales. Expected outcomes for the diabetes education program are:

Increased medication adherence and self-care

Educating the patients will sensitize them on the importance of self-care and medication adherence. Increased knowledge leads to ethical responsibility to care. Patients efficiently carry out activities such as self-injection, exercises, and dieting after education (Lee et al., 2019)

Improved diabetes follow-up visits

Diabetes follow-up visits help determine the patients’ prognosis, make clinical decisions such as therapy changes, and manage complications as they arise (Lee et al., 2019). The follow-up visits also help in modality changes. The education program will increase the patient’s desire for a healthy life and will thus evoke initiative and responsibility.

Improved the number of patients achieving therapeutic targets in the HbA1c tests and glucose levels

Diabetes management is determined by the blood glucose levels tests, blood sugar variations, and diabetic examinations results. Education decreases patients’ negligence. They take their medications on time (the blood glucose levels remain relatively stable), eat balanced diets (avoids hypoglycemia and hyperglycemia), and adhere to their follow-up visits (thus, effective treatment changes and complications are diagnosed and treated early) (Zheng et al., 2019). Therefore, the therapeutic targets are thus relatively achieved by these individuals compared to individuals who do not receive the education.

Decreased episodes of hypoglycemia or hyperglycemia and other complications

Hypoglycemia and hyperglycemia are both consequences of poor medications adherence and self-care negligence. Poor eating habits principally cause hypoglycemia with or without medication adherence. Hyperglycemia majorly results from non-adherence to medications. These two complications are the most common yet most preventable complications in pregnancy. These expected outcomes will inform the controlling, monitoring, and evaluation processes.

Lee, S. K., Shin, D. H., Kim, Y. H., & Lee, K. S. (2019). Effect of diabetes education through pattern management on self-care and self-efficacy in patients with type 2 diabetes. International Journal Of Environmental Research And Public Health, 16(18), 3323. https://doi.org/10.3390/ijerph16183323

Zheng, F., Liu, S., Liu, Y., & Deng, L. (2019). Effects of an outpatient diabetes self-management education on patients with type 2 diabetes in China: a randomized controlled trial. Journal of Diabetes Research, 2019. https://doi.org/10.1155/2019/1073131

NRS 493 Topic 4 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 5 Practice Experience Conference (Mid-Conference)

Students are required to initiate a mid-conference that will occur during Topic 5, using the  “Practice Experience Conference Form (Mid-Conference)” resource. This conference is intended for the student, preceptor, and faculty to discuss progress toward meeting the learning goals and course objectives contained in the Individual Success Plan (ISP). NRS 493 Topic 4 Capstone Change Project Outcomes Paper progress toward completing the written capstone project will also be discussed, including faculty recommendations for project development. Student progress will be documented on the Clinical Evaluation Tool (CET), which is submitted in LoudCloud prior to the conference. The CET will be discussed during the mid-conference and graded in LoudCloud by the faculty after the mid-conference. If the student receives an “Unacceptable” or “Below Expectations” in any category, the student will remediate for that category of the CET.

NRS 493 Topic 5 Midterm Evaluation of Student

The preceptor will perform a midterm evaluation with the faculty. The faculty will input the evaluation content into the Lopes Activity Tracker. The student will upload the evaluation into LoudCloud after meeting with the preceptor to discuss the midterm evaluation.

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 4 Capstone Change Project Outcomes Paper.

NRS 493 Professional Capstone Practicum Essays GCU – Topic 5 Clinical Practice Experience Remediation

Students who are not making appropriate progress on their capstone project and receive an “Unacceptable” or “Below Expectations” on the CET will be required to complete remediation activities. Required remediation activities are listed on the “NRS-493: Clinical Experience Remediation” document.  The required activities must be submitted in LoudCloud upon their completion by the end of Topic 7.  All required remediation activities will be reviewed and approved by the faculty.

NRS 493 Topic 5 Professional Capstone and Practicum Reflective Journal

Nrs 493 topic 5 strategic plan summary.

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.

Strategic Plan Summary  Example

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.

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Nrs493 strategic plan summary example 2.

Strategic planning in healthcare is vital. The planned intervention for the capstone project is diabetes healthcare education using a diabetes education checklist. Once the education is delivered, the checklist will be filled in the healthcare information system. Educating older Hispanic women will require time considerations due to their decreased ability to understand. Education is best delivered before all interventions when the client is still concentrating. Educating the patients on all aspects of care also enhances their collaboration in the activities later performed.

Healthcare education accommodates ethnic, racial, intellectual, and other reasonable and community diversities. In this capstone project, the interest population is elderly Hispanic women. As mentioned earlier, this population is financially and intellectually disadvantaged. Their intellectual capacity limits communication because most of them have poor understanding and poorly communicate in English. There is a need for mutual understanding to ensure the education delivered is effective (Squires, 2018). The language barrier is a significant potential problem for the capstone project implementation hence the need for a Hispanic interpreter to ensure effective delivery of information to and from the patient. The interpreter or interpretation system will serve the essential purpose of ensuring effective education and cultural sensitivity (Schouten et al., 2020). In addition, getting an interpreter will enhance patient morale and boost their sense of importance when they see that their needs are considered in care delivery.

Schouten, B. C., Cox, A., Duran, G., Kerremans, K., Banning, L. K., Lahdidioui, A., … & Krystallidou, D. (2020). Mitigating language and cultural barriers in healthcare communication: Toward a holistic approach. Patient Education and Counseling, 103(12), 2604-2608. https://doi.org/10.1016/j.pec.2020.05.001

Squires, A. (2018). Strategies for overcoming language barriers in healthcare. Nursing Management, 49(4), 20. https://dx.doi.org/10.1097/01.NUMA.0000531166.24481.15

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:

• 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.

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

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.

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.

NRS 493 Topic 6 Professional Capstone and Practicum Reflective Journal

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.

NRS 493 Topic 7 Professional Capstone and Practicum Reflective Journal

NRS 493 Topic 4 Capstone Change Project Outcomes Paper uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

NRS 493 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:

• 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.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

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

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.

NRS 493 Topic 9 Professional Capstone and Practicum Reflective Journal

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.

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.

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.

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:

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.

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 4 Capstone Change Project Outcomes Paper course.

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

Measurable Outcomes for Capstone Project Intervention

After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a two – three sentence rationale. In regards to low nurse staff, high burnout, and high turnover as it relates to patient care/outcome

Outcome 1: Reduction in Nurse Burnout Rates

Rationale:High levels of nurse burnout have been linked to decreased job satisfaction, lower quality of care, and increased turnover rates. By implementing interventions to reduce burnout, such as stress management programs and workload redistribution, we aim to improve nurse well-being, leading to enhanced patient care outcomes.

Outcome 2: Increase in Nurse Retention Rates

Rationale: High turnover rates among nursing staff can negatively impact patient care continuity and staff morale. By addressing the underlying causes of turnover, such as inadequate support systems and heavy workloads, we expect to see an increase in nurse retention rates, resulting in a more experienced and committed nursing team capable of providing consistent, high-quality patient care.

Outcome 3: Improvement in Patient Satisfaction Scores

Rationale: Nurse burnout and turnover can influence patient satisfaction by affecting the overall care experience. When nurses are overwhelmed and stressed, patients may perceive a lack of attentiveness and compassion. By addressing these issues through our intervention, we anticipate an improvement in patient satisfaction scores as nurses are better equipped to provide holistic and patient-centered care.

Outcome 4: Decrease in Medication Errors and Adverse Events

Rationale: Burnout and high turnover among nursing staff can contribute to errors and adverse events due to reduced attention and focus. Our intervention aims to enhance nurse engagement and job satisfaction, leading to improved vigilance and adherence to best practices, ultimately resulting in a decrease in medication errors and adverse events , positively impacting patient safety and outcomes.

Outcome 5: Increase in Team Collaboration and Communication

Rationale: Burnout and high turnover can strain communication and collaboration within healthcare teams. By implementing interventions that promote open communication, teamwork, and mutual support, we expect to foster a healthier work environment that encourages nurses to collaborate effectively, leading to coordinated care delivery and improved patient outcomes .

The proposed measurable outcomes for the capstone project intervention focus on addressing low nurse staffing, high burnout, and high turnover rates, with the ultimate goal of improving patient care and outcomes. By reducing burnout, increasing nurse retention, enhancing patient satisfaction, decreasing errors, and fostering team collaboration, the intervention aims to create a more positive and supportive work environment for nurses, resulting in better patient-centered care and positive healthcare outcomes.

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Capstone Change Project Outcomes

by ella | Apr 10, 2024 | Nursing

After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two-sentence rationale. 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. Subject: Nursing/Staffing shortage in long term acute care

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After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention.

After working with your preceptor to assess organizational policies , create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale.

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.

Answer preview After working with your preceptor to assess organizational policies , create a list of measurable outcomes for your capstone project intervention.

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