NURS FPX 4900 Capella University Role Of Literature And Evidence In Capstone Project Presentation

BSN-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. After a patient care interaction, it is important to evaluate how well you addressed the criteria set for the nurse-patient interaction and consider future improvements. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

PREPARATION

This assessment requires you to prepare a 5–10 minute video reflection on your capstone clinical practicum experience. Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact

DisabilityServices@Capella.edu to request accommodations. If you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.

Complete the following preparatory activities:

  • If necessary, set up and test your microphone or headset per the manufacturer instructions.
  • Practice using the equipment to ensure the audio quality is sufficient.
  • Consult the Campus resource Using Kaltura [PDF] for guidance on recording and uploading your assessment in the courseroom.

Begin developing your reflection. Some questions you might address in your reflection video are:

  • What were your most important outcomes or findings?
  • What challenges did you overcome throughout your project?
  • How did your initial research and evidence base help you plan and execute your capstone project?
  • How were the outcomes similar to and different from your expectations? 
  • How did you feel your professional product turned out?
  • What impacts of the implementation of your professional product did you observe?
  • To what degree were you successful in using technology in your capstone project?
  • How did organizational or governmental health policy impact the way in which you approached your project?
  • What contributions did you make to your organization’s policies throughout the course of your project?
  • In which areas do you feel you grew the most?

How will your learning affect your professional practice and ability to implement ethical care in accordance with professional codes of conduct?

  • What would you do differently if you could do the capstone project or program again?
  • What accomplishment are you most proud of, within the context of the capstone or the program as a whole?
  • Examine your capstone project through the lens of your initial plan and literature review.

INSTRUCTIONS

Use Kaltura to record a 5–10 minute video reflection addressing the following scoring guide grading criteria. Please study the scoring guide carefully so you know what is needed for a distinguished score:

  • Reflect on how evidence and the literature were utilized to plan and implement a capstone project, as well as how project outcomes compared to initial predictions based on a review of the literature.
  • Reflect on the degree to which health care technology was successfully used to improve outcomes or communication to relevant stakeholders in the capstone project.
  • Reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project as well as any contributions to policy development that the project made.
  • Reflect on personal and professional growth throughout the capstone project and the

BSN program, paying special attention to growth related to the provision of ethical care and demonstration of professional standards.

  • Communicate audibly and professionally, using proper grammar and including a reference list formatted in current APA style.

Important Note: You do not need to submit the transcript of your video, but do address each scoring guide criterion in the video, including a discussion of authors in the literature who support the ideas presented. Please submit a separate APA-formatted reference list for the resources discussed in your reflection.

Assessment 4 Instructions: Capstone Reflection

Develop a 5-10 minute video in which you reflect on your capstone experience. Complete this assessment fourth.

For this assessment, you will reflect on various aspects of your capstone experience. This will give you a chance to discuss elements of the project of which you are proud and aspects of the experience that will help you grow in your personal practice and nursing career.

Demonstration Of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 2: Make clinical and operational decisions based upon the best available. 

  • Reflect on how evidence and the literature were utilized to plan and implement a capstone project, as well as how project outcomes compared to initial predictions based on a review of the

Competency 4: Apply health information and patient care technology to improve patient and systems

  • Reflect on the degree to which health care technology was successfully used in the capstone project to improve outcomes or communication to relevant

Competency 5: Analyze the impact of health policy on quality and cost of

  • Reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project, as well as any contributions to policy development made by the

Competency 8: Integrate professional standards and values into

  • Reflect on personal and professional growth throughout the capstone project and the BSN program, with special attention to growth related to ethical care provision and demonstration of professional
  • Communicate professionally and audibly, using proper grammar and current APA

Important: You must complete all of the assessments in order for this course.

Professional Context

BSN-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. After a patient care interaction, it is important to evaluate how well you addressed the criteria set for the nurse-patient interaction and consider future improvements. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

Preparation

This assessment requires you to prepare a 5–10 minute video reflection on your capstone clinical practicum experience. Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact

DisabilityServices@Capella.edu to request accommodations. If you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.

Complete the following preparatory activities:

  • If necessary, set up and test your microphone or headset per the manufacturer
  • Practice using the equipment to ensure the audio quality is
  • Consult the Campus resource Using Kaltura [PDF] for guidance on recording and uploading your assessment in the
  • Begin developing your Some questions you might address in your reflection video are:
  • What were your most important outcomes or findings?
  • What challenges did you overcome throughout your project?
  • How did your initial research and evidence base help you plan and execute your capstone project?

How were the outcomes similar to and different from your expectations? 

  • How did you feel your professional product turned out?
  • What impacts of the implementation of your professional product did you observe?
  • To what degree were you successful in using technology in your capstone project?
  • How did organizational or governmental health policy impact the way in which you approached your project?
  • What contributions did you make to your organization’s policies throughout the course of your project?
  • In which areas do you feel you grew the most?
  • How will your learning affect your professional practice and ability to implement ethical care in accordance with professional codes of conduct?
  • What would you do differently if you could do the capstone project or program again?
  • What accomplishment are you most proud of, within the context of the capstone or the program as a whole?
  • Examine your capstone project through the lens of your initial plan and literature

Instructions

Use Kaltura to record a 5–10 minute video reflection addressing the following scoring guide grading criteria. Please study the scoring guide carefully so you know what is needed for a distinguished score:

  • Reflect on how evidence and the literature were utilized to plan and implement a capstone project, as well as how project outcomes compared to initial predictions based on a review of the
  • Reflect on the degree to which health care technology was successfully used to improve outcomes or communication to relevant stakeholders in the capstone
  • Reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project as well as any contributions to policy development that the project
  • Reflect on personal and professional growth throughout the capstone project and the

BSN program, paying special attention to growth related to the provision of ethical care and demonstration of professional

  • Communicate audibly and professionally, using proper grammar and including a reference list formatted in current APA

Important Note: You do not need to submit the transcript of your video, but do address each scoring guide criterion in the video, including a discussion of authors in the literature who support the ideas presented. Please submit a separate APA-formatted reference list for the resources discussed in your reflection.

Plan Proposal Sample

Proposed Plan

Many unnecessary deaths and higher healthcare expenses are brought on by adverse drug reactions. One tactic that can be used in the healthcare setting to lower the likelihood of adverse responses is medication reconciliation. The prevention of hazardous drug reactions also depends on the patient’s comprehension of medicine and adverse drug reactions. This project plan focuses on developing a medication reconciliation process and educating elderly patients within the healthcare organization to reduce the possibility of drug interactions. 

The project targets older patients 65 years and above admitted in the healthcare organization in a bid to reconcile their records for improved medication monitoring and improve their knowledge on adverse drug reactions. The project will reduce medication errors, misinformation about drugs, and drug abuse.

The project will be implemented in the hospital where the learner is currently undertaking their clinical practicum and hence the learner will be the project leader for this particular intervention. The reconciliation will only capture a section of the in-patient population owing to the scope of this project. Older adults are more likely to encounter polypharmacy due to high comorbidities in the population (Lavan & Gallagher, 2016). 

Therefore, they are the primary target for the medication reconciliation and education program. This context of project implementation is the primary clinical practice departments where the learner is attached. By testing the effectiveness and results of the project on older adults, it will be possible to expand medication reconciliation and education to other populations and implement the project in a larger scope and more effectively with the entire patient population.

The project will be implemented through nurses’ involvement in interviewing patients and comparing their medication history with the medical chart. One of the major causes of drug reactions is the lack of knowledge on the part of the practitioner, mainly due to out-of-date records that may misguide them (Pedrós, Formiga, Corbella, & Arnau, 2016). This process will, therefore, be an intervention to update records using the latest drug and medication information of patients. 

Nurses will interview patients to gather information on their history of medication. This information will then be compared with the medical chart and nurses will identify any drug-related problem and potential risks with medications in the future. This process will require the presence or consent of caregivers for older adults who cannot properly communicate, and patients whose medical condition may limit their communication or cognitive functioning. This intervention will basically be a process of data collection and reconciliation with the existing records for better insight on patient medication.

Drug therapy in the hospital setting may work in the short-term but may fail in the long-run without the necessary collaboration and coordination of care. Medication reconciliation is a process of instituting practices and guidelines which will maintain proper medication while in the hospital and after discharge of the patient. The program, therefore, assists in avoiding medication errors and institutes a proactive approach to drug therapy to avoid negative outcomes (Redmond et al., 2018). 

The project, therefore, will reduce the incidence of medication errors and drug reactions which can be deadly in some instances. This project is thus necessary since it provides an opportunity to reduce instances of drug reactions and other adverse events caused by medications by updating records and keeping the patients aware of the medication they take and the reactions from the same.

The project implementation will include a process of consulting with patients to understand the medication they are taking and maintain a medication log sheet for them. Nurses will use the medication chart to review current and previous medications that patients have been taking. This will help the patients in learning potential effects of the medication they have and contribute in building log sheets for their medication to effectively monitor them.

This collaborative effort will allow clarity and set up a platform for older patient education. Brief educational sessions will be held with each patient and additional material such as pamphlets will be provided for patients’ reference.

Technology

As in any other healthcare process, medication reconciliation utilizes several technological tools to aid in the process. One tool that has been presented is the use of telehealth as a means of collecting information. The article by Castelucci (2019) proposes that the use of telehealth can speed the process and hence reduce the hassle of personally visiting every patient. This tool presents the potential for remote connection with patients who are at their homes and conducting interviews on medication for improved decision-making. 

Telehealth is also useful in keeping patients updated by communicating with them remotely and sending educational content for them to be educated on medication reconciliation. When compared to other tools, this is just a mediation technology to connect remote patients with their nurses and physicians without the need for them to visit the hospital. This tool has been supported by the literature as

Castelucci (2019) claims that it has been effectively implemented in New York-Presbyterian/Weill Cornell Medical Center, Queens, Columbia, and Allen Branches. The major barrier of this tool is that it may not be available for many outpatients and hence it is hard to implement in the general operations of the hospital.

In addition to using telehealth with remote patients attending the hospital, tablet computers will be used to record and maintain records of medication during the medication reconciliation process. 

The aim of using tablet computers is to effectively collect data from the patients and harmonize it to produce a compiled log sheet for the patient’s medication records purposes. Tablet computers can be used in the hospital setting to increase patient engagement. Research by Green et al. (2016) showed that bedside training using tablet computers is effective in helping older adults to engage more with personal health records and processes. 

Tablet computers will thus be used for not only record taking but also educating patients on medications and medication reconciliation. The basic approach to using the computers will be that they will be available to the nurse for them to easily take notes and also display certain aspects of patient medication to the patient during education.

When comparing tablet computers with conventionally using phone calls for telehealth, this technology seems to be more expensive to launch and utilize as well as maintain in the hospital. Vaportzis, Clausen, and Gow (2017) highlight challenges in the use of tablet computers by highlighting that older adults may not be savvy with this technology and hence it may not be of much help to them. These opposing viewpoints present the major barrier of technology awareness and access for older adults. 

This barrier is in telehealth whereby patients may not know how to use interactive technology such as Skype and hence communicating remotely with them may be a challenge. Therefore, although the proposed technology may be very helpful in medical reconciliation and older adult education, barriers to access and usage should be expected.

Impact of Policies

This project will be affected by organizational and government policies regarding accessing patient records. Since the project targets the general in-patient population, there are no pertinent population-related policies that should be paid attention. However, the Health Insurance Portability and Accountability Act (HIPAA) provides several regulations on how to access and use patient information. 

According to Tovino (2016), HIPAA presents definitions for protected health information (PHI) and the access to and sharing of this information are restricted under the law. PHI presents a range of information that can tie data to specific individuals and includes information such as names, addresses, social security numbers, and others. The main issue with this policy is how practitioners access and use data in their research. 

Tovino (2016) highlights the issue of authorization and the use of information only for medical purposes. PHI should be accessed by only authorized medical personnel and sharing it with third parties should be a basis for treatment of the patient with their consent.

The restrictions on PHI will affect this project by determining the people authorized to access patient data, the process of gaining authorization, and processes through which information and data are put. Under the Privacy Rule of HIPAA, patient information may be used for health care operations and hence medical trainees and nursing students are granted access to this information (Tovino, 2016). 

Generally, obtaining information from the patients by the learner will be authorized by the supervisor but they have to adhere to hospital policies and the HIPAA Privacy Rule as well. Therefore, the learner has to maintain confidence and privacy of patient information and only use it for the project process alone.

The HIPAA Privacy Rule which is applicable to this project has been lauded as effective although several flaws have been exposed. First, the rule presents a legal basis for protecting patient data from third parties that may benefit from it. Therefore, the rule has been effective in maintaining patients’ privacy. On the other hand, when compared to the European Union’s General Data Protection Regulation, the regulation falls short of the expectations on patient privacy protection. 

According to McKinstry (2018), the regulation has only gone so far to protect confidentiality of patients but the privacy of their data is faced with flaws. The inability of the regulation to effectively protect the privacy of data makes it flawed and produces the need for more effective systems in performing this role. However, this regulation minimally affects the project and hence its effectiveness may not be of much concern to this proposal.

Moreover, this project proposal relies on the influential role of nurses on policy-making and leadership to improve health outcomes and performance in the organization. For nurses to be influential, they have to see themselves as professionals with the responsibility to direct and influence care towards improvement. Salmond and Echevarria (2017) view the nurse as instrumental because they have direct contact with the patient and hence should be involved in collaborative policy-making. 

The role of the nurse is to provide feedback from the practice to ensure that policies align with the needs of healthcare and patients. In addition, the nurse leader is a force of change in the organization as they direct models of care, patient handling, and multi-disciplinary teams. The nurse leader links the worker to the management and administration of the organization. They are thus the link between administration and healthcare floor work by the nurses.

The nurse leader thus transmits information between the two levels for organizational improvement. Through their leadership in nursing, they identify relevant improvement opportunities and provide these ideas to the administration as proposals. That way, they can propel better patient outcomes by communicating patient and employee needs and also improvement needs of the organization.

Strategies for Communicating and Collaborating

Communication and collaboration with stakeholders are crucial in making this project a success. This project integrates several stakeholders whose cooperation and collaboration is required for effective patient outcome improvement. First, the patients will be directly involved in the project since they will provide information on their medication history. 

Therefore, they are the core sources of data and information and their collaboration and communication are essential. Secondly, nurses and other nursing students will also be involved in interviewing patients who will be involved in this project. The nurse learner will be counting on the collaboration of other nurses and the patients in creating and maintaining the medication log sheets as well as educating older adults on medication reconciliation.

Stakeholder input in improving care is critical for this project due to the quality of outcome and the success in data comparison. When stakeholders are involved in decision-making and their input considered during the project, they are likely to own the work more and contribute more to the project. 

Auvinen (2017) claims that involvement of stakeholders is essential because it increases the potential for innovation and also raises the quality of decisions that are made during the project. Therefore, involving stakeholders will improve the project by integrating elements of collaboration that not only boost outcomes but also make the project work more efficiently. The input of stakeholders is thus identified as central to the project implementation.

The literature on communication and collaboration in healthcare provides various best practices for enhancing patient outcomes in clinical practice. The first principle is that the practitioners should effectively define their collaborative approach in healthcare. According to Foronda,

MacWilliams, and McArthur (2016), before collaboration begins, the healthcare collaborative team has to be well-defined with the roles and expectations having been highlighted as well. Additionally, it is crucial to assign roles and define the basic communication approaches. For instance, every team member has to know the specific actions they will be undertaking and how to communicate with other members. 

Lastly, for effective communication and collaboration, a reflective approach to the project should be used. The team should review their progress and how the project is going on to make improvements and adjustments for the better.

References

  • Auvinen, A. M. (2017). Understanding Stakeholders as a Success Factor for Effective Occupational Health Care. Occupational Health, 25-43.
  • Castelucci, M. (2019, Mar. 2). Using telehealth to conduct medication reconciliation. Modern Healthcare. Retrieved from https://www.modernhealthcare.com/care-delivery/using-telehealth-conduct-medication-re conciliation
  • Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse education in practice, 19, 36-40.
  • Greysen, S. R., Mendoza, Y. M., Rosenthal, J., Jacolbia, R., Rajkomar, A., Lee, H., & Auerbach, A. (2016). Using tablet computers to increase patient engagement with electronic personal health records: protocol for a prospective, randomized interventional study. JMIR research protocols, 5(3), e176.
  • Lavan, A. H., & Gallagher, P. (2016). Predicting risk of adverse drug reactions in older adults. Therapeutic advances in drug safety, 7(1), 11-22.
  • McKinstry, C. J. (2018). The HIPAA Privacy Rule: Flawed Privacy Exposed When Compared with the European Union’s General Data Protection Regulation. Journal of Health Care Finance.
  • Pedrós, C., Formiga, F., Corbella, X., & Arnau, J. M. (2016). Adverse drug reactions leading to urgent hospital admission in an elderly population: prevalence and main features. European Journal of Clinical Pharmacology, 72(2), 219-226.
  • Redmond, P., Grimes, T. C., McDonnell, R., Boland, F., Hughes, C., & Fahey, T. (2018). Impact of medication reconciliation for improving transitions of care. Cochrane Database of Systematic Reviews, (8).
  • Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12.
  • Tovino, S. A. (2016). The HIPAA Privacy Rule and the EU GDPR: illustrative comparisons. Seton Hall L. Rev., 47, 973.
  • Vaportzis, E., Giatsi Clausen, M., & Gow, A. J. (2017). Older adults perceptions of technology and barriers to interacting with tablet computers: a focus group study. Frontiers in psychology, 8, 1687.