Capstone Project Essay

Capstone Project Essay

Background

Nursing communication is a key factor in healthcare and ensuring continuity of care. Shift reporting requires different stakeholders such as the nurses and the patient to be involved. The patients deserve to know their progress, their caregiver, and the interventions since they are important stakeholders in healthcare progress. Therefore, bedside shift reporting is considered compared to traditional nursing reporting. Shift reporting provides the opportunity for off-going nurses to communicate with the oncoming nurse about the patient’s progress. In so doing, on coming nurse get on board with the patient care. This process can be done at the bedside instead of the nursing station to confirm the patient’s condition according to the report being given by the nurse.

In the psychiatry facility, there lacks a clear shift reporting protocol. Implementation of one will facilitate change in the facility and improve performance and patients’ health outcomes. Improving communication can enhance patient safety by minimizing medication and medical errors. When transitioning care through coordination and collaboration, adequate and proper communication with the relevant stakeholders is expected to improve patient care holding other factors constant. Involving patient care in shift reporting enables them to understand that someone is responsible for their care, which initiates their involvement. Alongside offering physical medical care, the patients also desire to be aware of the tests and interventions being done on them. This improves the ethical principle of respect of autonomy here the patient input and through are considered when offering nursing care (Dorvil, 2018).

Clinical problem statement

Nursing communication is a key factor for the coordination of collaboration in healthcare. The role of nurses in care coordination depends on their collaborative and communication skills. The outcome of shift reporting reflects the quality of this care coordination. Nursing communication at the bedside and the station accommodates different care stakeholders. Nursing coordination involves collaboration and communication with various partners in the patient’s care to improve this care, as aforementioned (Dorvil, 2018).

Nursing interventions can be done to the patient at any stage of the care. Still, those specific to shift reporting include nursing documentation, progress review and notes updating progress notes, physical examination, answering patients’ concerns, and providing meaningful feedback (Dorvil, 2018). The nurse’s role is to involve patients, educate the patient about their care, and provide necessary feedback to improve patient-centeredness in the care, thus improving the quality of nursing and health care.

Purpose of the change proposal

This project aims to determine the effectiveness of implementing bedside nursing shift reporting compared to using traditional nursing shift reporting. The project aims to encourage healthcare facilities to use bedside nursing shift reporting due to its benefits in improving patient care and healthcare outcomes.

PICOT question

In nursing communication in mental health nursing (P), how does bedside shift reporting (I) compared to traditional nursing shift reporting (C) affect healthcare quality (O) within six months (T)?

Literature search strategy employed

The articles used were published during the last five years. Wiley Online Library, National Institutes of Health Library (NIH), and National Center for Biotechnology Information Library databases (NCBI) were used in the search. The articles were also found via Google scholar. Bedside nursing shift reporting, traditional nurse shift reporting, and nurse shift reporting are some of the terms used to search in the strategy. Following the article search, the resources discovered were reviewed.

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Evaluation of the literature

Eight articles were used in the study to answer the PICOT question. Baldwin & Spears (2019) compared the outcomes of patients’ anxiety levels and patients during traditional and bedside nursing reporting. The bedside nursing report increased patient engagement and communication, which facilitated increased care coordination. The article by Forde et al. (2020) aimed at analyzing the activities and contents that constitute bedside handover in critical care during a nursing shift change. The article concludes that bedside nursing handover is preferred as it increases the critical patient information. Similarly, the study by Gosh et al., 2018 aimed to determine how bedside shift change reporting can be improved to improve the overall rating of the process. The study concludes that bedside nursing reporting is important in nursing communication.

The study by Jimmerson et al., 2021 focused on the nurses’ opinions on bedside reporting methods according to their experiences. The study concludes that bedside nursing reports are useful in hospitals, including mental facilities, as they improve patients’ satisfaction, safety, and their families and nurses. L. Foster et al., 2019 study records the views of emergency care nurses on bedside shift reporting. The study shows that bedside shift reporting is the appropriate method, but the nurses’ experience is different since the actual practices are different from what is recommended.

McAllen et al., 2018, focused on shifting nursing shift reporting to the bedside. The study concludes that bedside reporting impacts patient and nurses’ satisfaction positively. The study by McClay et al., 2021 identified the changes on the care shift report sheet and the solutions during bedside shift reporting. The conclusion was that improving the shift reporting tool’s frequency, consistency, and completion time can increase nurse satisfaction with bedside shift reporting. In the study by Walsh et al., 2018, the focus was on the standardizing bedside reporting to promote nurses’ work effectiveness. The study concluded that this type of reporting could positively impact nurse communication, effectiveness, and satisfaction since traditional shift reporting also considers accountability.

All the discussed articles agree that bedside nursing shift reporting is better than traditional nursing shift reporting due to benefits such as the involvement of patients in the care process.

Applicable change or nursing theory utilized

The most sensible theory in implementing an evidence-based practice change in the psychiatric ward is the Lewin’s theory. Lewin’s change theory is pragmatic and rational. It also leads to quick adoption to change by strengthening the driving forces and reducing restraining forces. Lewin’s change theory has three steps: unfreezing, change/movement, and refreezing. Unfreezing involves disrupting the status quo by making people understand the need for change by increasing the driving forces and decreasing restraining forces. The second step is the movement where the employees develop new behaviors that encourage change and is done through persuasion that the current status quo is not beneficial. The final step is refreezing, which entails adopting the new norm and the change is reinforced (Udod & Wagner, 2018).

Proposed implementation plan with outcome measures

The proposed implementation plan will involve eight steps that facilitate successful change implementation. The first step is to create urgency among the involved stakeholders. It involves making them learn the usefulness of the change and how it helps organizational development. The next step is forming a powerful change team composed of influential people who comprise different levels. Next, create a clear change vision. After creating the vision, communicate it to the involved stakeholders. Communicate it frequently to remind people and help them respond swiftly (Galli, 2018).

The fifth step is removing barriers to the change implementation like ineffective communication and change-resistant organizational culture. The next step is the creation of short-term achievements and wins. The next step is building on the change intervention by improving what went wrong and setting goals for continuous improvement. The last step is making the change part of the organizational culture (Galli, 2018). In evaluating the project, the project outcomes should be measured. If patients’ health outcomes, coordination, and effective communication skills in shift reporting and utilization of bedside shift reporting as the facility’s norm are improved after the project’s implementation, the project’s set objectives would be achieved and promote positive patient outcomes.

Use of evidence-based practice in creating the implementation plan

Evidence-based practice is critical in this project. The participants will rely on the project’s findings to make important decisions. For example, the evidence-based practice will be utilized to create a project proposal to present to the hospital administration and other stakeholders when persuading them to see that the healthcare issue is a threat to the facility’s performance in providing healthcare services. Therefore, the evidence-based practice should have priority in implementation plan creation. Evidence-based practice will be used to create the project’s background. For example, the study by McAllen et al., 2018, focused on shifting nursing shift reporting to the bedside. The study concludes that bedside shift reporting positively impacts and nurses’ satisfaction positively. In addition, the reliability of the change project will be based on evidence-based practice.

 

Plan for evaluating the proposed nursing intervention

The best way to evaluate the success of my project would be the summative evaluation technique, also known as end-term evaluation. Summative evaluation occurs at the end of the project implementation (Boothroyd, 2018). The summative evaluation assesses the project’s output, impact, or outcome at the end of the implementation process to identify the objectives met and correct mistakes. The aim is to determine how well the change project was implemented, the cost-effectiveness of the interventions, whether the interventions solved the problem they were intended to, and determine the sustainability of the evidence-based project (Bhat & Bhat, 2019).

Before the actual implementation, I would create a conceptual model to determine the key points to evaluate. Secondly, I would formulate the necessary questions to guide the evaluation process to keep it on track and evaluate the important parts of the program. In addition, I would select the necessary tools for evaluation to use in data collection during the evaluation process. Next is the collection of data to determine if the objectives were achieved. Next is data analysis, presenting the report, and disseminating the results.

Potential barriers and how they can be mitigated

Every project faces some challenges during the implementation. Many barriers will be available in implementing the change project, but they will be mitigated. One of the barriers is communication problems because the stakeholders may not agree with the methods and channels of communication used. The barrier will be mitigated by having a common communication channel set specifically for the project. Secondly, the team members might have conflicts in agreement which may delay the implementation process. Conflicts will be handled using the appropriate conflict resolution method, which will effectively solve the internal conflicts. Additionally, lack of funds will be a barrier since financial resources may not be available for the project implementation. The mitigation plan is to apply for grants to support the program and the involvement of external stakeholders to fund the project (Dandage et al., 2018).

Conclusion

The purpose of the capstone project was to determine the benefits of bedside nursing shift reporting compared to traditional nursing shift reporting. The eight articles were analyzed to answer the PICOT question. Nursing interventions can be performed on the patient at any time during their care. Nursing paperwork, progress review and notes updating progress notes, physical examination, resolving patients’ concerns, and offering relevant feedback are all examples of shift reporting responsibilities. The nurse’s role is to involve patients, educate them about their care, and provide the required feedback to increase patient-centeredness in care, hence increasing nursing and health care quality.

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References

Baldwin, K. M., & Spears, M. J. (2019). Improving the patient experience and decreasing patient anxiety with nursing bedside reports. Clinical Nurse Specialist CNS, 33(2), 82–89. https://doi.org/10.1097/NUR.0000000000000428

Bhat, B. A., & Bhat, G. J. (2019). Formative and summative evaluation techniques for improvement of learning process. European Journal of Business & Social Sciences, 7(5), 776-785. Retrieved from https://www.researchgate.net/profile/Bilal-Bhat-6/publication/

Boothroyd, R. A. (2018). Process and outcome evaluation approaches. Louis de la Parte Florida Mental Health Institute, University of South Florida. Retrieved from https://www.usf.edu/cbcs/mhlp/tac/documents/

Dandage, R. V., Mantha, S. S., Rane, S. B., & Bhoola, V. (2018). Analysis of interactions among barriers in project risk management. Journal of Industrial Engineering International, 14(1), 153-169. https://doi.org/10.1007/s40092-017-0215-9

Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability. Nursing Management, 49(6), 20–25. https://doi.org/10.1097/01.numa.0000533770.12758.44

Forde, M. F., Coffey, A., & Hegarty, J. (2020). Bedside handover at the change of nursing shift: A mixed-methods study. Journal of Clinical Nursing, 29(19–20), 3731–3742. https://doi.org/10.1111/jocn.15403

Galli, B. J. (2018). Change management models: A comparative analysis and concerns. IEEE Engineering Management Review, 46(3), 124-132. DOI: 10.1109/EMR.2018.2866860

Ghosh, K., Curl, E., Goodwin, M., Morrell, P., & Guidroz, P. (2018). An exploratory study on how to improve bedside change-of-shift process: Evidence from one hospital using technology to support verbal reporting. Proceedings of the 51st Hawaii International Conference on System Sciences. https://doi.org/10.24251/hicss.2018.401

Jimmerson, J., Wright, P., Cowan, P. A., King-Jones, T., Beverly, C. J., & Curran, G. (2021). Bedside shift report: Nurses’ opinions based on their experiences. Nursing Open, 8(3), 1393–1405. https://doi.org/10.1002/nop2.755

55. Foster, C., P. Abraham, S., & R. Gillum, D. (2019). Emergency room nurses’ views on bedside shift reporting. International Journal of Studies in Nursing, 4(4), 55. https://doi.org/10.20849/ijsn.v4i4.677

McAllen, E., Stephens, K., Swanson-Biearman, B., Kerr, K., & Whiteman, K. (2018). Moving shift report to the bedside: An evidence-based quality improvement project. Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02ppt22

McClay, R., Natividad, J., & Mileski, M. (2021). Changes to a shift reporting sheet on critical care unit-nurse perceptions and lessons learned. Journal of Multidisciplinary Healthcare, 14, 381–387. https://doi.org/10.2147/JMDH.S289384

Udod, S., & Wagner, J. (2018). Common change theories and application to different nursing situations. Leadership and influencing change in nursing. Retrieved from https://opentextbooks.uregina.ca/

Walsh, J., Messmer, P. R., Hetzler, K., O’Brien, D. J., & Winningham, B. A. (2018). Standardizing the bedside report to promote nurse accountability and work effectiveness. Journal of Continuing Education in Nursing, 49(10), 460–466. https://doi.org/10.3928/00220124-20180918-06

Williams, C. L. (2018). A comparison of the risks and benefits of nursing bedside shift report vs. Traditional shift report: A systematic review of the literature. International Journal of Studies in Nursing, 3(2), 40. https://doi.org/10.20849/ijsn.v3i2.382

 

Assessment Description
In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

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

Background
Clinical problem statement.
Purpose of the change proposal in relation to providing patient care in the changing health care system.
PICOT question.
Literature search strategy employed.
Evaluation of the literature.
Applicable change or nursing theory utilized.
Proposed implementation plan with outcome measures.
Discussion of how evidence-based practice was used in creating the intervention plan.
Plan for evaluating the proposed nursing intervention.
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
Appendix section, if tables, graphs, surveys, educational materials, etc. are created.
Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

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

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

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1: Exemplify professionalism in diverse health care settings.

2.2: Comprehend nursing concepts and health theories.

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

pls i think most of these documents you guys have already my project is on violence prevent in pschiatrist hospitals using Broset score and if you need other information pls email me

Rubric

Collapse All RubricCollapse All

collapse New Practice Approaches assessment

New Practice Approaches

0 points

Criteria Description

New Practice Approaches

5. 5: Excellent

0 points

New practice approaches are present, complete, and incorporate additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

New practice approaches are present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

New practice approaches are present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

New practice approaches are present, but they are incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

New practice approaches are not present.

collapse Interprofessional Collaboration (C4.3) assessment

Interprofessional Collaboration (C4.3)

0 points

Criteria Description

Interprofessional Collaboration (C4.3)

5. 5: Excellent

0 points

Interprofessional collaboration information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Interprofessional collaboration information is present and complete. The submission provides the basic information required.

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3. 3: Satisfactory

0 points

Interprofessional collaboration information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Interprofessional collaboration information is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Interprofessional collaboration information is not present.

collapse Health Care Delivery and Clinical Systems assessment

Health Care Delivery and Clinical Systems

0 points

Criteria Description

Health Care Delivery and Clinical Systems

5. 5: Excellent

0 points

Health care delivery and clinical systems information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Health care delivery and clinical systems information is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Health care delivery and clinical systems information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Health care delivery and clinical systems information is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Health care delivery and clinical systems information is not present.

collapse Ethical Considerations In Health Care (C2.3) assessment

Ethical Considerations In Health Care (C2.3)

0 points

Criteria Description

Ethical Considerations In Health Care (C2.3)

5. 5: Excellent

0 points

Information regarding ethical considerations in health care is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Information regarding ethical considerations in health care is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Information regarding ethical considerations in health care is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Information regarding ethical considerations in health care is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Information regarding ethical considerations in health care is not present.

collapse Practice of Culturally Sensitive Care (C5.3) assessment

Practice of Culturally Sensitive Care (C5.3)

0 points

Criteria Description

Practice of Culturally Sensitive Care (C5.3)

5. 5: Excellent

0 points

Information regarding the practice of culturally sensitive care is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Information regarding the practice of culturally sensitive care is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Information regarding the practice of culturally sensitive care is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Information regarding the practice of culturally sensitive care is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Information regarding the practice of culturally sensitive care is not present.

collapse Preservation of Integrity of Human Dignity in the Care of All Patients (C5.4) assessment

Preservation of Integrity of Human Dignity in the Care of All Patients (C5.4)

0 points

Criteria Description

Preservation of Integrity of Human Dignity in the Care of All Patients (C5.4)

5. 5: Excellent

0 points

Information regarding the preservation of integrity and human dignity in the care of all patients is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Information regarding the preservation of integrity and human dignity in the care of all patients is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Information regarding the preservation of integrity and human dignity in the care of all patients is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Information regarding the preservation of integrity and human dignity in the care of all patients is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Information regarding the preservation of integrity and human dignity in the care of all patients is not present.

collapse Population Health Concerns assessment

Population Health Concerns

0 points

Criteria Description

Population Health Concerns

5. 5: Excellent

0 points

Information regarding population health concerns is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Information regarding population health concerns is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Information regarding population health concerns is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Information regarding population health concerns is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Information regarding population health concerns is not present.

collapse Role of Technology in Improving Health Care Outcomes (C4.1) assessment

Role of Technology in Improving Health Care Outcomes (C4.1)

0 points

Criteria Description

Role of Technology in Improving Health Care Outcomes (C4.1)

5. 5: Excellent

0 points

Information on the role of technology in improving health care outcomes is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Information on the role of technology in improving health care outcomes is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Information on the role of technology in improving health care outcomes is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Information on the role of technology in improving health care outcomes is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Information on the role of technology in improving health care outcomes is not present.

collapse Health Policy assessment

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Health Policy

0 points

Criteria Description

Health Policy

5. 5: Excellent

0 points

Health policy information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Health policy information is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Health policy information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Health policy information is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Health policy information is not present.

collapse Leadership and Economic Models assessment

Leadership and Economic Models

0 points

Criteria Description

Leadership and Economic Models

5. 5: Excellent

0 points

Information on leadership and economic models is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Information on leadership and economic models is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Information on leadership and economic models is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Information on leadership and economic models is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Information on leadership and economic models is not present.

collapse Health Disparities assessment

Health Disparities

0 points

Criteria Description

Health Disparities

5. 5: Excellent

0 points

Information on health disparities is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Information on health disparities is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Information on health disparities is present Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Information on health disparities is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Information on health disparities is not present.

collapse Outline of Overall Personal Discovery assessment

Outline of Overall Personal Discovery

0 points

Criteria Description

Outline of Overall Personal Discovery

5. 5: Excellent

0 points

Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

4. 4: Good

0 points

Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present and complete. The submission provides the basic information required.

3. 3: Satisfactory

0 points

Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present. Some minor details or elements are missing, but the omissions do not impede understanding.

2. 2: Less Than Satisfactory

0 points

Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present, but it is incomplete or otherwise lacking in required detail.

1. 1: Unsatisfactory

0 points

Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is not present

collapse Mechanics of Writing (includes spelling, punctuation, grammar, language use) assessment

Mechanics of Writing (includes spelling, punctuation, grammar, language use)