NR451 RN –Design for Change Proposal Paper

NR451 RN –Design for Change Proposal Paper

PICOT -

In school age children and adolescents, what is the effect of patient education and monthly follow-up help with reducing the incidence of asthma exacerbation and number of absent school days compared with no intervention, within a 2 year period.NR451 RN –Design for Change Proposal Paper

Chosen System review:-

Childhood/School Health

Kuethe MC, Vaessen-Verberne AAPH, Elbers RG, Van Aalderen WMC. Nurse versus physician-led care for the management of asthma. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD009296. DOI: 10.1002/14651858.CD009296.pub2.NR451 RN –Design for Change Proposal Paper

Capstone Project Milestone 2: Design for Change Proposal Guidelines

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Updated 2/5/2018

Purpose

You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet from your Capstone Project Milestone 1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program.NR451 RN –Design for Change Proposal Paper

Course Outcomes

This assignment enables the student to meet the following course outcomes.

  • CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO1)
  • CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO2)NR451 RN –Design for Change Proposal Paper

Rubric

Directions

  1. A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=b0c912eaf53b4aabb1347a026466c60e (Links to an external site.)Links to an external site.
  2. Review the feedback you received from your instructor for Milestone 1, and use it to develop this milestone.
  3. Create a proposal for your Design for Change Capstone Project. Open the recommended assignment specific Milestone 2 Design Proposal Template (Links to an external site.)Links to an external site.. Use this to write your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice.NR451 RN –Design for Change Proposal Paper
  4. The format for this proposal will be a paper following the Publication manual of APAth
  5. The paper is to be four- to six-pages excluding the Title page and Reference page.
  6. As you organize your information and evidence, include the following topics.
    1. Introduction:Write an introduction but do not use "Introduction" as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.
    2. Change Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.NR451 RN –Design for Change Proposal Paper
    3. Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.
    4. Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.
    5. Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.
  7. Citations and Referencesmust be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, "How do I know this?" and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.NR451 RN –Design for Change Proposal Paper
  8. Tables and Figures may be addedas appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.
  9. Submit your paper by 11:59 p.m. MT by Sunday of the end of Week 4.

**Academic Integrity Reminder**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.NR451 RN –Design for Change Proposal Paper

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

NOTE: Please use your browser's File setting to save or print this page.NR451 RN –Design for Change Proposal Paper

NR451 Milestone2 Rubric

 

Criteria Ratings Pts
This criterion is linked to a Learning Outcome Introduction

Introduction to the plan is nursing focused, with evidence-based problem identification and potential solutions clearly identified.)

25.0 pts

Introduction to the plan is nursing focused, and evidence-based. Potential interventions clearly identified.

22.0 pts

Introduction to the plan is missing one of the elements listed in the first column.NR451 RN –Design for Change Proposal Paper

20.0 pts

Introduction to the plan is missing two elements listed in the first column.

10.0 pts

Introduction lacks evidence to support need for change and/or potential solution is not evidenced-based.

0.0 pts

Introduction is missing.

25 pts
This criterion is linked to a Learning Outcome Change Model Overview

An overview of the ACE Star model as a guide for change is given. Scope of the problem is identified. Stakeholders are identified. Team members and their roles and practice area are identified and discussed. State how nurses should use this model as a guide to facilitate change.

50.0 pts

Overview of the ACE Star model is given. Scope of problem is identified. Rationale for change is present. Stakeholders are identified. Practice area, team members and role are discussed.

44.0 pts

All elements in the first column are included but discussion of one or more items lacks details.

40.0 pts

Overview is missing one of the elements from the first column.

19.0 pts

Overview of the ACE Star model is given. Scope of problem is not identified. Rationale for change is not present. Stakeholders are not identified. Practice area, team members and role are not discussed.NR451 RN –Design for Change Proposal Paper

0.0 pts

Change Model Overview is missing all elements of the first column.

50 pts
This criterion is linked to a Learning Outcome Evidence

Evidence is provided thru basic information that indicates a change is needed. For example, there have been 6 urinary tract infections over the last two months and there were none present the last two years at the same time period. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use?

50.0 pts

Evidence summary is thoroughly provided with information of the current problem in the work setting indicating a change is needed. Interventions discovered in Evidence Summary are used in planning for change.NR451 RN –Design for Change Proposal Paper

44.0 pts

Evidence summary contains all elements in the first column, however, one or more items lacks detail.

40.0 pts

Evidence is vaguely provided through information of the current problem in the work setting indicating a change is needed. Some of the interventions discovered in Evidence Summary are used in planning for change.

19.0 pts

Evidence is provided through information of the current problem but is not convincing. Interventions discovered in Evidence Summary are not used in planning for change.

0.0 pts

Evidence summary is not provided.

50 pts
This criterion is linked to a Learning Outcome Translation

Activities to achieve the final steps of change are fully described. What is needed to achieve? How do you translate what information you have gathered into practice? Include measurable outcomes. How do you inform staff? What is your plan of action to pilot the plan? What is the timeline?

50.0 pts

Activities to achieve final steps of change are fully described. Ways to translate evidence into practice are discussed (outcomes). Methods to inform staff, activities planned for plan of action and timeline are discussed.

44.0 pts

Activities to achieve final steps of change are adequately described.

40.0 pts

Activities to achieve final steps of change are briefly described.

19.0 pts

Minimal description of the activities to achieve final steps of change.NR451 RN –Design for Change Proposal Paper

0.0 pts

Activities for final change plan are missing. Translation of evidence into practice is missing.

50 pts
This criterion is linked to a Learning Outcome Conclusion

Clear, solid summary of the key points, ACE Star model and steps of the change plan are included; ways to sustain the change plan are described.

25.0 pts

Detailed summary of main points using ACE Star model. Ways to sustain plan are thoroughly described.NR451 RN –Design for Change Proposal Paper

22.0 pts

Summary of main points/model is brief. Ways to sustain plan are briefly described.

20.0 pts

Summary of main points/model is vague. Ways to sustain plan are vaguely described.

10.0 pts

Summary of main points/model OR ways to sustain plan are not described.

0.0 pts

Summary is missing. There is no plan to sustain change.

25 pts
This criterion is linked to a Learning Outcome Mechanics

APA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors

25.0 pts

APA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors

22.0 pts

Two to three errors in elements from the first column.NR451 RN –Design for Change Proposal Paper

20.0 pts

Four to five errors in elements from the first column.

10.0 pts

Six to seven errors in elements from the first column.

0.0 pts

More than seven errors.

25 pts
Total Points: 225NR451 RN –Design for Change Proposal Paper

Capstone Project Milestone 1:

Practice Issue and Evidence Summary Worksheets

For Use March 2018

 

Student Name: JO                                                    Date:  Mar 15 2018

Directions

  1. Refer to the guidelines for specific details on how to complete this assignment.
  2. Type your answers directly into the worksheets below.
  3. Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.
  4. Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response.NR451 RN –Design for Change Proposal Paper

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Practice Issue Worksheet

 

List the topic and include the citation for the systematic review you have selected from our approved list (optional: an additional scholarly source of support):NR451 RN –Design for Change Proposal Paper

Childhood/School Health

Kuethe MC, Vaessen-Verberne AAPH, Elbers RG, Van Aalderen WMC. Nurse versus physician-led care for the management of asthma. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD009296. DOI: 10.1002/14651858.CD009296.pub2.

 

What is the nursing practice issue you have identified related to the topic you have chosen?

The nursing practice issue identified is to have specialized nurses (such as nurse practitioners or asthma nurse) to manage the care of asthmatic pediatric patients to reduce ER visits. The focus of the specialized nurses would be to improve the education levels of the target population to allow them make better health choices to reduce the incidence of asthma emergencies and the need to visit the ER. NR451 RN –Design for Change Proposal Paper

PICOT: In school age children and adolescents, what is the effect of patient education and monthly follow-up help with reducing the incidence of asthma exacerbation and number of absent school days compared with no intervention, within a 2 year period.

 NR451 RN –Design for Change Proposal Paper

Fully describe the scope of the practice issue:

The specialized registered nurse scope of practice is to include:

·         Firstly, providing comprehensive and continuous care for the children diagnosed with asthma all though the disease management.

·         Secondly, health promotion that enables the target population to have greater control over their health and even improve outcomes.

·         Thirdly, offering health education to the target population by focusing on improving their knowledge levels.NR451 RN –Design for Change Proposal Paper

·         Finally, offering preventive health services that targets those who have not been diagnosed with asthma. This occurs by ensuring that the school environment does not encourage asthma incidence. Instead, the school environment should active seek to relieve the condition of persons already diagnosed with asthma and prevent those without such a diagnosis from contracting the ailment.

What is the practice area?

_X__ Clinical

_X__ Education

___ Administration

___ Other (List):

How was the practice issue identified? (check all that apply)

_X__ Safety/risk management concerns

___ Unsatisfactory patient outcomes

___ Wide variations in practice

___ Significant financial concerns

 

 

___ Difference between hospital and community practice

_X__ Clinical practice issue is a concern

___ Procedure or process is a time waster

___ Clinical practice issue has no scientific base

__ Other:NR451 RN –Design for Change Proposal Paper

Describe the rationale for your checked selections:

The practice issue addresses safety and risk management concerns by seeking to create an environment ER visits owing to asthma-related complications for the target population.

It addresses a clinical practice issue since the ER visits is a source of concern. It places a strain on the patients along with medical resources that include equipment and personnel. Pursuing the project is anticipated to reduce ER visits, thereby easing the strain on resources.NR451 RN –Design for Change Proposal Paper

What evidence must be gathered? (check all that apply)
_X__ Literature search

_X__ Guidelines

_X__ Expert Opinion

___ Patient Preferences

_X__ Clinical Expertise

___ Financial Analysis

___ Standards (Regulatory, professional, community)

___ Other

 

Describe the rationale for your checked selections:

A literature search will identify the level of verifiable evidence available on the topic. In fact, it illuminates the issue by identifying viable solutions that are then explored in the project.NR451 RN –Design for Change Proposal Paper

Guidelines will offer information on the project limitations, particularly conditions that must be met for nurses to be incorporated into the project as well as any existing issues that may conflict or complement the project.

Expert opinion will present act as a source of new ideas on how to look at the issue. It will present knowledge- and experienced-based information that expresses the reality of what would constitute a viable idea.

Clinical expertise will present the reality of the responsibilities that nurses can take on in the project based on their experiences and knowledge.NR451 RN –Design for Change Proposal Paper

 

Evidence Summary Worksheet

Directions: Please type your answers directly into the worksheet.

 

Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms:

The practice problem is the worrying number of preventable ER visits from school children and adolescents suffering from asthma. As a preventable issue (the ER visits), it is not right that health resources are continuously expended when they could be diverted towards other health endeavors. As such, the project seeks to improve the health outcomes for the population of interest even as it eases the existing strain on ER resources.NR451 RN –Design for Change Proposal Paper

Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Include the APA reference for any additional optional supplemental scholarly source related to the review you wish to use.

Rance, K. S. (2011). Helping patients attain and maintain asthma control: reviewing the role of the nurse practitioner. Journal of Multidisciplinary Healthcare4, 299–309. http://doi.org/10.2147/JMDH.S22966

Identify the objectives of the article:

The objective of the article was: to review the effectiveness of nurse-led asthma care provided by a specialized asthma nurse, a nurse practitioner, a physician assistant or an otherwise specifically trained nursing professional, working relatively independently from a physician, compared to traditional care provided by a physician. This objective would be achieved within the scope of outpatient asthma care offering in both hospital and primary care settings.NR451 RN –Design for Change Proposal Paper

Provide a statement of the questions being addressed in the work and how these relate to your practice issue:

The article sought to answer the question: Is nurse-led asthma care compared to the traditional care provided by a physician? In answering this question, the article sought to provide evidence to support calls for nurses to take on leadership positions in the provision of medical care for asthma patients. This relates to the current practice issue since it promotes the leveraged positioning of nurses as capable of taking on a primary role in care provision. It is acknowledged that preventing ER visits would be the best outcomes, with nurses uniquely position to oversee the prevention since the care teams they lead produce results that are comparable to those achieved by physician-led teams.

Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.

The authors suggest that nurse-led teams should be allowed to manage patients with well-controlled asthma. That is because their results are comparable to those achieved by physician-led teams.NR451 RN –Design for Change Proposal Paper

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper. (If an optional supplemental source is also used, include a statement of relevance to it as well.)

The authors suggest that nurse-led teams should be allowed to manage the care of patients with well-controlled asthma since their results are comparable to those achieved by physician-led teams. Still, their findings are accompanied by caution that the research results were based on a small number of studies. As such, a larger number of studies should be explored to verify the results and conclusion. Additionally, the authors acknowledge that the current study was conducted within a single setting to imply that the results are only applicable in that setting. More studies are necessary before the use of nurse-led teams can be recommended in these settings. Besides that, the question of cost is introduced since the recommendation would only be applicable if the cost of using nurse-led teams does not exceed the cost of using physician-led teams.

Outline evidence-based solutions that you will consider for your project.

The article acknowledges that nurses can lead care teams for asthma patients. As such, it is difficult to accept that nurses can be responsible for patient education and monthly follow-up with the intention of reducing ER visits.NR451 RN –Design for Change Proposal Paper

Discuss any limitations to the studies that you believe impacts your ability to utilize the research in your project.

The major limitation of the study is that it only explored five articles. This means that the results can only be partially trusted unless more studies are reviewed. As such, the article will inform the research on the possibilities available for solving the prevailing issue. NR451 RN –Design for Change Proposal Paper