Capstone Project Change Proposal

Capstone Project Change Proposal ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Capstone Project Change Proposal In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Capstone Project Change Proposal Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Problem statement Purpose of the change proposal PICOT Literature search strategy employed Evaluation of the literature Applicable change or nursing theory utilized Proposed implementation plan with outcome measures 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 Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting. ( see attached) 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 Capstone Project Change Proposal topic_paper__1_.docx picot__1_.docx literaturetable__1_.docx literaturepaper__1_.docx rubric_9.docx Running head: NURSING DEPARTMENT ISSUES Nursing Department Staffing and Communication Issues NRS-490 09/28/2018 1 NURSING DEPARTMENT ISSUES 2 Nursing Department Staffing and Communication Issues The effectiveness of any team of employees is based on their ability to engage in responsibilities within a particular organization. Consequently, the employer bears the responsibility of ensuring that the working environment is suitable enough for appropriate performance, contrary to which the employees may not be in a position to perform as is necessary. The issues experienced at Skylar Healthcare Center include an understaffed team of nurses, and difficulties in accessing necessary information for decision-making purposes. Consequently, the nurse practitioners are often left to make decisions pertaining to their activities in relation to the health process, which often elicits review from the management at the hospital. Context of the Issue Clearly, the issues experienced within the organization are primarily related to appropriate management of the human resource team. It reflects the existence of challenges in the human resource management department as a converse situation would include appropriate handling of the nurses within the facility (Birken et al., 2015). In this case, the department has limited knowledge or has not been active enough in taking the necessary action to improve the welfare of the nurse practitioners, which has left the levels of fatigue relatively high (SmithMiller, Shaw-Kokot, Curro. & Jones, 2014). According to research, such exhaustion of employees has been known to create challenges in their performance effectiveness (Lee, Yen, Fetzer, & Chien, 2015). At the current rate of patient to nurse ratio, the chances of the services reducing in quality significantly are relatively high. Impact of the Problem Poor communication within a healthcare facility may not be as adverse on its own, but the situation changes when the issue is compounded by other organizational adversities. In any NURSING DEPARTMENT ISSUES 3 case, the existence of an organizational culture helps the employees make suitable decisions even in the absence of support the management (Smyth & McCabe, 2017). However, with the management and organizational structure at Skylar not being keen enough to appropriately induct the employees into the organization, and the consequent lack of an organizational culture, most decisions made by the subordinate staff are often placed under review (De Bono, Heling, & Borg, 2014). Ultimately, such reduces the motivation among the nurses, which has resulted to a high rate of punctuality issues in coming to work. Significance of the Problem to Nursing Staffing has often been an issue of discussion in most research studies (Shield, Wetle, Teno, Miller, & Welch, 2005). Capstone Project Change Proposal However, it would be important to note that the issue often transcends the management department in most healthcare organizations, to include issues related to funding. Ultimately, although the human resource management could be the problem at Skylar, it would be important not to overlook the role played by the management in advancing the issues related to care delivery (Ginter, Duncan, & Swayne, 2018). As long as challenges exist in the management of the personnel within various department, the quality of service is bound to be relatively low. The solution to issues experienced at Skylar lies within the complete overhaul of the management at the hospital. Notably, managers within the health sector undergo significant training to guarantee that they are capable of providing the necessary services within various organizations (Eriksen et al., 2005). However, the current case indicates a situation in which the management has limited concern for the employees, irrespective of the integral role played in determining the quality of service provided. The issues currently experienced may not be solved NURSING DEPARTMENT ISSUES through training programs, as they stem from basic ignorance of the needs of employees and appropriate organization to achieve desired change. 4 NURSING DEPARTMENT ISSUES 5 References Birken, S. A., Lee, S. Y. D., Weiner, B. J., Chin, M. H., Chiu, M., & Schaefer, C. T. (2015). From strategy to action: How top managers’ support increases middle managers’ commitment to innovation implementation in healthcare organizations. Capstone Project Change Proposal Health Care Management Review, 40(2), 159. De Bono, S., Heling, G., & Borg, M. A. (2014). Organizational culture and its implications for infection prevention and control in healthcare institutions. Journal of Hospital Infection, 86(1), 1-6. Eriksen, H. R., Ihlebaek, C., Mikkelsen, A., Grønningsæter, H., Sandal, G. M., & Ursin, H. (2002). Improving subjective health at the worksite: a randomized controlled trial of stress management training, physical exercise and an integrated health programme. Occupational Medicine, 52(7), 383-391. Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons. Lee, H. F., Yen, M., Fetzer, S., & Chien, T. W. (2015). Predictors of burnout among nurses in Taiwan. Community mental health journal, 51(6), 733-737. Shield, R. R., Wetle, T., Teno, J., Miller, S. C., & Welch, L. (2005). Physicians “Missing in Action”: Family Perspectives on Physician and Staffing Problems in End?of?Life Care in the Nursing Home. Journal of the American Geriatrics Society, 53(10), 1651-1657. Smith-Miller, C. A., Shaw-Kokot, J., Curro, B., & Jones, C. B. (2014). An integrative review: fatigue among nurses in acute care settings. Journal of Nursing Administration, 44(9), 487-494. NURSING DEPARTMENT ISSUES Smyth, O., & McCabe, C. (2017). Think and think again! Clinical decision making by advanced nurse practitioners in the Emergency Department. International Emergency Nursing, 31, 72-74. 6 Running head: HOSPITAL LENGTH OF STAY Hospital Length of Stay NRS-490 10/06/2018 1 HOSPITAL LENGTH OF STAY 2 Hospital Length of Stay The hospital environment should be efficient enough in providing the appropriate environment for patient recovery from different health issues to all patients. However, Toh, Lim, Yap, & Tang (2017) conducted a research in different hospital environments, determining that the median age for patients with a prolonged length of stay at the health facilities was 85 years. Capstone Project Change Proposal The study puts the geriatric patients as the population most likely to the experienced length of stay within the facilities, prompting a change in the practices of caregivers, towards an improvement in the attendance to the geriatric population within such environments. Picot Question P-Geriatric patients are the population most vulnerable to lengthy stays within hospital settings. I-nutritional status and comorbidity of diseases, C-proper care by healthcare professionals including individualized attention. O-a significant reduction in the length of stay in hospitals. An analysis of research conducted on geriatric hospital stay would be highly consequential in the development of an ideal solution to the extended stay of patients in healthcare facilities. Such creates the basis of evidence-based practice within healthcare facilities, whose adaptation would not only help patients recover and return to their families fast enough, but it would also aid the healthcare facilities, and the government at large, to save a significant amount of resources. Toh et al. (2017) posit that a possible improvement in discharge planning would be an effective way to improve the length of stay among the geriatric patients. In essence, the greater the effectiveness in the healthcare facility’s management of discharge information, the easier it would be to discharge the patients fast enough. Such an intervention practice guarantees a HOSPITAL LENGTH OF STAY 3 significant reduction in the time taken to clear the patient for discharge, essentially reducing the time spent in the hospital. Additionally, an improvement and oversight of patient nutritional aspects would be consequential to addressing the issue. Developing a program that would actively involve the patient and the caregiver in the maintenance of the former’s nutritional factors at an optimal level would guarantee ease in fighting the disease-causing pathogens, irrespective of the challenges faced (Cereda et al., 2015). Ultimately, such would require significant input from the hospital as an agency as the patients may not necessarily have the necessary knowledge to provide all the information necessary. Therefore, the inclusion of additional practitioners to deal with the geriatric patients in addition to the nurse practitioners would be highly consequential to the recovery process. Ultimately, the research herein intends to achieve positive change in nursing practice, one which focuses on geriatric patients as a cohort in need of additional attention based on the distinct nature of the issues affecting their stay in hospitals. According to research, factors such as constant observation levels influence the length of stay among the geriatric patients unlike among patients of other ages (Ismail, 2012). As long as the general practice in healthcare takes note of such differences, and effectively outs to practice different measures intended to provide health care to the patients, it would be possible to efficiently address the elderly’s length of stay in hospitals. Capstone Project Change Proposal Evidence based practice is primarily focused on using research findings as the basis of intervention son various issues highlighted as being detrimental to a particular industry, and based on the findings from the research herein, it will be possible to develop appropriate intervention measures to the issue in question. HOSPITAL LENGTH OF STAY 4 References Cereda, E., Klersy, C., Pedrolli, C., Cameletti, B., Bonardi, C., Quarleri, L., … & Caccialanza, R. (2015). The Geriatric Nutritional Risk Index predicts hospital length of stay and inhospital weight loss in elderly patients. Clinical Nutrition, 34(1), 74-78. Ismail, Z., Arenovich, T., Grieve, C., Willett, P., Sajeev, G., Mamo, D. C., … & Mulsant, B. H. (2012). Predicting hospital length of stay for geriatric patients with mood disorders. The Canadian Journal of Psychiatry, 57(10), 627-634. Toh, H. J., Lim, Z. Y., Yap, P., & Tang, T. (2017). Factors associated with prolonged length of stay in older patients. Singapore medical journal, 58(3), 134-138. Literature Evaluation Table Student Name: Change Topic (2-3 sentences): Criteria Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Article 1 Barreca M, Renzi C, Tankel J, Shalhoub J, Sengupta N. https://www.ncbi.nlm.n ih.gov/pubmed/258923 43 Article Title 2016 and Year Published Research Questions (Qualitative )/Hypothesi s (Quantitati ve), and Purposes/Ai m of Study Article 2 Article 3 Article 4 Cooley, M. https://www.ncbi.nlm.n ih.gov/pubmed/279026 60 Dogan K, Kraaij L, Aarts EO, Koehestanie P, Hammink E, van Laarhoven CJ, Aufenacker TJ, Janssen IM, Berends FJ. https://www.ncb i.nlm.nih.gov/pu bmed/24993524 2015 Johnston MJ, Davis RE, Arora S, King D, Reissis Y, Darzi A. https://ww w.ncbi.nl m.nih.gov/ pubmed/2 6013208 2015 Nurse involvement in both perioperative and postoperative operations reduces hospitalization time and complication rates. Nurses being a primary participant in both postoperat ive and perioperati ve are important because it offers an opportunit y for patients to effectively solicit care. 2017 Nurse involvement; in The critical role of postoperative nurses in postoperative treatments as primary gastric bypass care providers are more feasible as compared to when nurses are involved as secondary care providers. © 2015. Grand Canyon University. Capstone Project Change Proposal All Rights Reserved. Design Quantitative (Type of descriptive design Quantitativ e, or Type of Qualitative) Setting/Sam University teaching ple hospital, United Kingdom Methods: Tests Interventio n/Instrume nts Qualitative case study Bariatric Patient Observational Quantitative descriptive design Quantitati ve 75 consecutive morbid obese patients Tests Three London hospitals Questionn aires a crosssectional study conducted by Johnston et al (2015) where a total of 155 surgical patients from three hospitals were subjected to similar questionna ires to examine their willingnes s to call for help from nurses as compared to doctors. The involveme Analysis Meta-Analysis study conducted by Barreca et al (2016) where sample population of 278 members was examined before and after undergoing a bariatric surgery. a systematic study conducted by Cooley (2017) to examine the critical role of nurses in postoperative gastric bypass. randomized controlled study where two groups of 75 consecutive morbidly obese patients were subjected to LRYGB Key Findings Nurses’ involvement in both perioperative and Postoperative care is also important because The reduced hospitalization © 2017. Grand Canyon University. All Rights Reserved. postoperative gastric bypass reduces readmission rates. Recommen dations it assists in early detection and prevention. originates from the fact that nurse involvement in a multidisciplinar y team in postoperative nursing care help in rendering effective care to patients. Nurses should be Involvement of nurses Nurse in the nurse gastric involvement in involved in the bypass after follow-ups both is essential in avoiding perioperative postoperative acute pain in patients and postoperative treatments as primary operations reduces care providers in which hospitalization time and case their involvement complication rates. Capstone Project Change Proposal will boost the recovery nt of nurses makes it easier for patients to access care. The nurses help is imperative to patients and as such it is imperative that nurses are involved in a bid to nurse’s makes it days of the patients as easier for well as the satisfaction patients to indexes. access care. Explanatio n of How the Article Supports EBP/Capst one Project The article is relative to the Capstone project as it is relative to the obese people who are being surgically treated for weight loss. This relates directly to the PICOT statement under assessment The article is important as it examines the critical role of nurses in postoperative gastric bypass, elements that are essential in studying of the obese people who are being surgically treated for weight loss The article supports the EBP/Capstone Project in that the data is relative to the PICOT statement established on obese patients © 2017. Grand Canyon University. All Rights Reserved. The article is relative to the capstone projects as it projects the impact of surgeries on patients owing to the fact that the project is surgery for obese patients. Criteri a Author , Journal (PeerReview ed), and Permal ink or Workin g Link to Access Article Article 5 Mihir M. Shah Ben W. Hunter John F. Sweeney Edward Lin Sebastian D. Perez Cheryl Parker Steven Scott DavisJr. https://www.lieber tpub.com/doi/abs/ 10.1089/bari.2017 .0010 Article 6 Article 7 Article 8 van der Beek, E. S., Monpellier, V. M., Eland, I., Tromp, E., & van Ramshorst, B. https://www.n cbi.nlm.nih.go v/pubmed/253 30868 Julie A. Campbell Ratcliffe, Denise; Doyle, Jacqueline; Sogg, Stephanie; Rassool, Sara. https://search.proquest.co m/openview/5398bbe9a5 c298be2c449e33bd53b02 8/1?pqorigsite=gscholar&cbl=5 5143 Article Title and Year Publish ed 2017 2015 Resear ch Questio ns (Qualit ative)/ Hypoth Surgical times (STs) and total operation times (ORT) are reduced when nurses are involved in the Nutritional deficiencies originate from poor management of patients conditions Douglas Ezzy Amanda Neil Martin Hensher Alison Venn Melanie J. Sharman Andrew J. Palmer https://onlinelibr ary.wiley.com/do i/abs/10.1002/hec .3776 2018 2016 The importance of psychological support pre and post bariatric surgery doesn’t ameliorate or negatively affect weight loss and could thus could be unnecessary. © 2017. Grand Canyon University. Capstone Project Change Proposal All Rights Reserved. esis postoperative and (Quanti perioperative tative), operation and Purpos es/Aim of Study after undergoing gastric bypass Design Quantitative (Type correlational of Quantit ative, or Type of Qualita tive) Qualitative Ethnographi c studies Qualitative Phenomenolog y Qualitative case study Setting/ One hundred Sample seventy-nine consecutive LRYGB cases Method Tests s: Interve ntion/I nstrum ents 427 gastric Focus group data bypass patients bariatric rehabilitation services (BRS) Observation Focus groups observational Analysi s A study Metaanalysis study conducted by Van der Beek et al (2015) where a group of 427 gastric bypass patients was subjected to same conditions impacts of bariatric surgery on health economic for obese patients and effects of improved practice in health economics Importance of the psychological support offered pre and post bariatric surgery The article offers a randomized controlled study conducted by Shah et al (2017) where sample population of 179 consecutive LRYGB cases was analyzed, it was concluded that surgical times (STs) and total operation times (ORT) are reduced when © 2017. Grand Canyon University. All Rights Reserved. nurses are involved in the postoperative and perioperative operation. Appropriate and Key Finding s accurate nursing care and interventions help in reducing the Nutritional deficiencies originate from poor management of patients conditions after undergoing gastric bypass Emotional capital and financial distress were recognized BRS intervention was not relative to greater weight loss 12 months after surgery was done on a obese patient. It is important to consider the preoperative and postoperative assessments in treating patients while taking account of the nutritional deficiencies of patients undergoing gastric bypass surgery. The article is important for the capstone project as it reflects the effects of surgery on obese patients It may be imperative to integrate a mixed?method technique in the assessment of the economic aspect that bariatric surgery poses. Psychological support should be removed from the NICE guidelines The article projects the impact of economic bariatric surgery on obese patients The article is relative to the capstone project as it projects the impact of Psychological support on bariatric surgery hospital stay. Recom mendat ions It is imperative to integrate accurate nursing care and interventions in a bid to help in reducing the hospital stay. Explan ation of How the Article Suppor ts EBP/C apstone The article is relative to the capstone project as it emphasized on the need for nursing care after surgery in such a manner that the obese patients are catered to. © 2017. Grand Canyon University. All Rights Reserved. © 2017.Capstone Project Change Proposal Grand Canyon University. All Rights Reserved. Running Head: LITERATURE REVIEW 1 Literature Review NRS 490 October 26, 2018 LITERATURE REVIEW 2 Literature Review The most important thing in the care of the geriatric population is understanding the physiology and pathology of aging this is informed by the fact that the human body undergoes a multiplicity of physiological changes each second. Also, the consideration of social, psychological, cognitive, and economics of the aging is paramount to meet the needs of the aging population. Sadly, most elderly people feel that they have no control over their emergencies and fixed incomes. These factors more often than not lead to depression and decreased efficiency. This paper will mainly focus on the hospital length of stay for getriatic patients this is informed by a research made by Toh, Lim, Yap, & Tang in 2017 that revealed that geriatric patients are more likely to experience length of stay within health facilities and this should definitely prompt a change in the practices of caregivers to the popul … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10