Prompt
Your capstone assessment will consist of two components. The first component is a change proposal that comprehensively addresses a professional practice issue
of local, state, or national importance. Your instructor should approve your change proposal topic early in the course. Subject to instructor approval, you may use
the same topic, and portions of your literature review from NUR 440. Because change does not happen in isolation and often has far-reaching impacts, your proposal will need to incorporate multiple aspects of health practice, including strategies to improve quality of care or health outcomes.
The following concepts will need to be addressed within the change proposal:
Patient and nurse safety
Appropriate use of technology
Health literacy
Policy, regulatory, and financial constraints
Strategies for building support for proposed changes
In addition to the change proposal, you will also create a brief statement that expresses your philosophy of nursing practice. To do this, you will reflect on what
you have learned, relevant theories of nursing practice, and the importance of professional integrity, ethics, and self-reflection in caring for patients. Your goal is to
articulate how your philosophy of nursing has evolved as a result of the experiences and knowledge you gained in the RN-BSN program.
Change Proposal
In the first portion of your capstone, you will create a comprehensive change proposal designed to address a professional practice issue. This artifact will showcase
your abilities as a nursing professional capable of leading change in a complex healthcare environment.
As a practicing RN-BSN, you will be expected to bring clinical expertise to your work and take on a leadership role in continually improving patient care. Your change proposal should be geared toward convincing an audience of administrative decision-makers that change is needed and that your plan is desirable and viable. It should clearly and concisely lay out the problem you are seeking to address and suggest specific evidence-based changes, including a plan for implementing and evaluating those changes. You should also specify and approximate a timeframe for carrying out your plan and the resources you will need. (Note: You do not need to actually implement the change and evaluate it, just create a plan for how you would do so.)
Remember that in order for your proposal to gain support, it will need to be succinct, clear, and well-supported throughout by credible research and evidence.
Your proposal should contain the following sections:
I. Introduction
A. Identify a professional practice issue of local, state, or national importance for which you can act as a change agent.
B. Discuss the background and significance of the problem to nursing. Be sure to substantiate your claims with specific examples from research.
II. Justification of Practice Change Recommendation
A. Provide a scholarly summary of the research reviewed.
B. Identify the expected outcome from the practice change recommendation.
III. Pre-Implementation Plan
A. Identify a specific change theory that will assist you with planning stages of your change proposal
B. Identify activities needed prior to implementing your change, making theory-to-practice connections with each key element and impact of change to the element.
C. Discuss a plan for activities needed to leverage this element to promote change and identify the stakeholders that may be involved in these activities.
The activities you propose must cover multiple aspects of health practice surrounding the problem, including but not limited to:
a. Patient and Nurse Safety
b. Information Management Systems
c. Health Literacy
d. Administrative Policies
e. Ethical Considerations (i.e., equity of access and treatment, etc.)
IV. Implementation Plan
A. Assess the factors that are likely to affect the implementation of your recommended activities
B. Identify evidence-based rationales to propose how you will address them, incorporating your identified change theory.
Your plan should encompass the following with evidence to support your rationale:
a. Technological challenges
b. Institutional structures
c. Strategies for building buy-in among different stakeholders, including nurses
d. Financial trends and anticipation of the availability of human resource and project funding
e. Hospital or governmental policy constraints
f. Regulatory requirements
g. Patient diversity
V. Evaluation plan:
A. Propose steps for evaluating your suggested changes based on your change theory and evidence on existing best practices. Include the indicators that you will use to measure success, both in implementing the change itself and in ensuring quality outcomes for diverse patients.
B. Identify appropriate benchmarks from which to measure the effectiveness of the change.
C. Discuss the processes you will use for gathering feedback from relevant stakeholders including nurses, patients, and their families on what is and is not working in order to support continuous improvement.
VI. Time and resource allocation:
A. Give an approximate timeframe for the different stages and activities in your proposal
B. Estimate the human and other resources that will be needed to carry out your proposal. You do not need to include specific dollar amounts, but you should anticipate what each activity requires in terms of resources in general terms. For example, you might need a certain number of full- or part-time staff or the services of a contracted firm, specific software, hospital supplies, laptops, publicity materials, and so forth. You may find it useful to use an Excel spreadsheet or other table for presenting this information.
VII. Conclusion
A. Summarize the proposed change, its significance, and expected outcomes as a result of implementing the proposed change.
