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Capstone Change Project Topics

 Work with your preceptor to perform a needs assessment of the organization and community for your practicum. Review the needs assessment to identify possible project topics. In preparation for the capstone change project proposal, compile a list of three to five possible topics for your project and submit to the assignment instructor in LoudCloud. 

Running head: CAPSTONE PROJECT: CHANGE PROPOSAL TOPIC 1

Capstone Project: Change Proposal Topic

GCU HLT-494

Dr. Chavarria

July 28, 2019

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CAPSTONE PRJOECT: CHANGE PROPSAL TOPIC

Capstone Project: Change Proposal Topic

Within the health care system in the United States there are many barriers or issues that

need to be addressed and medical errors are among the barriers that need to be resolved the most

by health care professionals. Medical and medication errors that are made to any degree are

factors that contribute negatively to the quality of care received by patients. The goal of any

health care organization should be to put the needs of their patients first by providing care that

improves patient health outcomes and elevates overall patient experience and satisfaction.

Medical errors have become a major concern recently since data that was collected in 2017

indicated that the number of deaths caused by medical errors annually, was over 250,000. This

total placed death caused by medical errors third on the list of most deaths, and could possibly be

higher than indicated (Andersen, 2017). The same study also highlighted that the number of

medical errors that are reported and recorded, come out to just under ten percent. When errors go

unnoticed or unrecorded, it takes away the opportunity for health care professionals and

managers to learn from their mistakes and to focus their resources on implementing positive

changes that promote high quality of care.

Based on the logic model, the topic of the proposal will be to accurately identify medical

errors, provide an effective solution or solutions to these problems, and the expected outcomes

after implementing necessary changes. Medical errors can occur in several different forms and

the severity of the mistake all range from minor to major. Some examples of the most common

mistakes made in the delivery of patient care include the misdiagnoses of a disease, nosocomial

infections, and medication errors (Makary, 2016).

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CAPSTONE PRJOECT: CHANGE PROPSAL TOPIC

Solution

Among some of the interventions and plans to offer up solutions to these problems

include the incorporation of proper training techniques and opportunities and the improvement in

health care education. By providing health care professionals with the opportunity to expand

their skillsets and to ensure that they know the responsibilities and tasks that they are

accountable for, can play an integral role in reducing the number of medical errors being made.

In order for training and the education of employees to improve and to meet the needs of an

organization, it is key that data collection and the processes and steps leading up to a medical

error are tracked thoroughly (Alex, 2016). When this can be accomplished, organizational

leadership will be able to take the results of the data into consideration so that training is more

focused and geared toward fixing specific issues.

Outcomes

The expectations of the implementation are that medical errors can be identified,

recorded accurately, and a new training and educational resources are provided to employees in

an effort to reduce the total number of medical errors. A project of this size requires the full

support of essential stakeholders so that the funding and resources become available to produce

the expected outcome of the plan. A positive outcome for this plan would allow organizations to

improve their level of patient care and will place themselves in positions to make even more

improvements that would contribute to high quality care.

Organizational Resources to Implement and Maintain Plan

The necessary resources to acquire for this project to be successful would be funding and

access to technology used used in patient cares, such as EHR systems. Funding will be necessary

to receive the services of outside help to determine areas of improvement as well as to build a

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CAPSTONE PRJOECT: CHANGE PROPSAL TOPIC

training program focused on techniques and practices that contribute to reducing medical errors.

Accessing the EHR system allows for data to be tracked appropriately and will serve as a tool

that can provide insight as to why, how, and where, medical errors are being made.

Stakeholders Needed to Support Change

There are many different stakeholders that need to be identified and their aid is needed in

order to support the changes being proposed. The most important stakeholders that would be

affected by these changes include health care professionals and patients. Gaining the support of

these individuals will be very important to ensure that the implementation of changes goes

smoothly and can be long-lasting (Alex, 2016). Patients will easily support any changes that

result in the improvement of the quality of care delivered, while on the other hand, health care

professionals may be difficult to persuade. In order to gain their support and cooperation, it needs

to be communicated that these changes are being made to ensure that they are properly trained

and well equipped to provide the proper care to patients, all while reducing the number of

medical errors made.

Impact of Change on Organization and Stakeholders

The impact that these changes will have on the both patients and health care professionals

within the organization are positiv. Employees and the health care professionals will benefit from

the implementation of new policies and practices since they will also be accompanied by a new

training program. With access to correct training and an investment by the organization to ensure

their staff are equipped with the knowledge and skill to provide high level patient care

(McGivern, 2017) Through these improvements patients will definitely benefit and there should

be an increase in patient outcomes and satisfaction.

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CAPSTONE PRJOECT: CHANGE PROPSAL TOPIC

Timeline

In order for the plan to be successful it important that a general timeline be established to

monitor the progress and effectiveness of the plan. The entirety of the project can be completed

in a three-month period, barring any unexpected setbacks. Observations can be made over the

period of a month while previous data can be reviewed and compared. Over the next month new

policies, standards of practices, and a training program will be determined based on the findings

presented in the data. The last month should serve as a period where the implementation of these

changes are monitored closely in order to determine if revision is needed.

Detail Implementation Plan

The plan for implementation. Based on these findings the new policies and standards of

practice will either be revised, removed, or added in order to improve care. These new policies

will also govern the training program for employees and what should be included to set them up

for success. Through this implementation of policies and training resources, employees will be

fully equipped with all the tools necessary to practice what they have learned and apply it to

patient care.

Steps of Implementation

Implementing the proposed changes and incorporating new training for employees

requires that they be incorporated appropriately. It is important that an effective communication

plan is drafted so that employees and other important stakeholders remain updated on the

progress of the plan and how it will affect them. Having meetings and posting throughout the

organization important dates of changes will also contribute to everyone remaining informed.

When this happens new policies and training can be introduced and monitored by tracking the

responses from employees and patients and through the tracking of medical errors.

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CAPSTONE PRJOECT: CHANGE PROPSAL TOPIC

Barriers

The biggest barriers that can be faced with this plan is opposition from staff and

management and the inability to acquire the funding necessary for this project to be successful.

Whenever there is discussion centered around change in policies there is always going to be

initial opposition faced. Many people get set in their ways and do not want to have to conform to

a new way of doing things which can be unsettling for organizational leaders (Stavor, 2017).

Additionally, leaders need to believe in this project for it to be successful by being willing to

invest financially. If funding and resources are unable to be acquired in full, changes cannot be

made.

Steps to Overcome Barriers

In an effort to overcome these barriers, there needs to be thorough research done prior to

introducing the plan to organizational leaders. This research must include data and research on

medical errors within the organization and the health care system as a whole, that is easily

observable. Presenting this data in numbers and statistics that illustrate how medical errors are

negatively affecting patient care and revenue for the organization will work in favor of

implementing changes by both leaders and employees. Clearly being able to communicate

throughout the process of the plan with stakeholders will also be important in overcoming any

other potential barriers.

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CAPSTONE PRJOECT: CHANGE PROPSAL TOPIC

References

Alex, S., Adenew, A. B., Arundel, C., Maron, D. D., & Kerns, J. C. (2016). Medication errors

despite using electronic health records: the value of a clinical pharmacist service in

reducing discharge-related medication errors. Quality management in health care, 25(1),

32-37.

Anderson, J. G., & Abrahamson, K. (2017). Your Health Care May Kill You: Medical Errors.

Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/2818600

Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the

US. Bmj, 353, i2139.

McGivern, L., Shulman, L., Carney, J. K., Shapiro, S., & Bundock, E. (2017). Death certification

errors and the effect on mortality statistics. Public Health Reports, 132(6), 669-675.

Stavor, D. C., Zedreck-Gonzalez, J., & Hoffmann, R. L. (2017). Improving the use of evidence-

based practice and research utilization through the identification of barriers to

implementation in a critical access hospital. JONA: The Journal of Nursing

Administration, 47(1), 56-61.

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Capstone Change Project Topics

Student: Preceptor: NRS-493

Work with your preceptor to perform a needs assessment of the organization and community for your practicum. Review the needs assessment to identify possible project topics. In preparation for the capstone change project proposal, compile a list of three to five possible topics for your project and submit to the assignment instructor in LoudCloud. You are not required to submit this assignment to LopesWrite.

The Covid-19 (Coronavirus) has done more harm than good since its ‘arrival’ at the later part of 2019. In the Union County of New Jersey, the number were staggering. About 16,320 people were infected (cdc.gov) and more than 1130 people were reported death. The overwhelming nature of the pandemic put a strain on healthcare in the county with its limited resources. One of the major needs of the community, aside the shortage or price gouging of Personal Protective Equipments (PPEs) is the need for Social Distancing (SD). This has become a worrisome issue in the community because of the over-population the area faces.

In this Capstone Change Project, the preceptor and the student have chosen to research on one of the following topics:

1. The effectiveness of Social Distancing (SD) in curbing the spread of the Coronavirus/ COVID-19. (Preferred topic)

2. The effectiveness of Facemask usage in preventing the spread of the Coronavirus pandemic.

3. Contact tracing and how it could help to stop the spread of the Coronavirus in over-populated communities.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/county-map.html

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Capstone Project Topic Selection 2

Capstone Project Topic Selection 4

Staffing, What Does It Cost?

Jane Doe

Grand Canyon University

Professional Capstone and Practicum

NRS-490

Professor Barbara Pridgen

August 25, 2017

Running head: Capstone Project Topic Selection 1

Staffing, What Does It Cost?

Nurses have a responsibility to their patients to deliver quality healthcare and to keep patients safe. According to a report conducted by the American Nurses Association (2015) there is a new emphasis placed on cost containment and the first group being affected by cost-cutting measures is staffing (p. 4). This is not a very good idea since the majority of patient care falls on nurses and “appropriate nurse staffing levels are essential to optimizing quality of care and patient outcomes in the era of value-based healthcare (American Nurses Association [ANA], 2015, p. 4). This writer would like to explore how staffing affects patient care in regards to quality, outcomes and level of satisfaction. In addition, this writer would also like to explore the affect short-staffing has on the nurse and how the organization benefits financially from cutting staff. In the end, this writer would like to seek creative, cost-effective solutions that would benefit the nurse, the patient and the organization.

Impact of Staffing

Organizations believe that by cutting staff they are saving money to help their bottom-line, which is not unreasonable because everyone has a responsibility to be cost-conscious in today’s world. However, the reality may differ from what the organization believes that they are gaining. Lower staffing can have detrimental effects on patient care and outcomes and increase the risk of patient harm. When staffing is not adequate to care for patients it increases the risk for hospital acquired infections, medication errors, falls, missed treatment, and even death.

When staff levels are low and nurses are expected to perform too many tasks with too little time in a twelve-hour shift, staff burnout is sure to happen which will lead to high staff turnover. With the push to have more registered nurses with their Bachelor’s degree on the belief that they can deliver better more efficient care, will more likely open the door for the nurse to seek employment elsewhere. In the end, the nurse does not like to put patient safety or their license on the line when put in this dangerous and exhausting position.

This is like a domino effect which will eventually cost the organization more out of pocket than maintaining adequate nurse to patient ratios in the first place. Once this effect begins it will be difficult to stop and the fallout will affect patient care which will affect the organizations bottom-line.

Solutions to staffing

There are several different models for staffing that could benefit all involved, and involve in depth coordination between management and staff nurses. The American Nurses Association (ANA) is working with individual states to develop The Registered Nurse Safe Staffing Act, which “promote legislation to hold hospitals accountable for the development and implementation of valid, reliable, unit-by-unit nurse staffing plans” ("Safe Staffing", 2015, p. 1). The American Nurses Association does not want this to be mandated staffing, but would like to see each hospital create new staffing models to deliver safe, effective patient care, while creating a safe work environment for nurses (“Safe Staffing”, 2015, p.1).

Conclusion

There is a bigger picture here than anyone wants to see, how one action affects another or the cause and effect dilemma, either way the patient is the one who is affected the most and they are the one paying the cost of the care. Creating a safe work environment for nurses and staffing appropriately using specific nurse to patient ratio’s according to the needs of each unit, can make a difference in the patient’s outcome and can make a difference in the success of the organization in the long run.

References

American Nurses Association. (2015). Optimal nurse staffing to improve quality of care and patient outcomes: Executive summary. Retrieved from http://www.nursingworld.org/DocumentVault/NursingPractice/Executive-Summary.pdf

Safe staffing. (2015). Retrieved from http://www.nursingworld.org/SafeStaffingFactsheet.aspx

Running head: Capstone Project Topic Selection

1

Staffing, What Does It Cost?

Jane Doe

Grand Canyon University

Professional Capstone and Practicum

NRS

490

Professor Barbara Pridgen

August 25, 2017

Running head: Capstone Project Topic Selection 1

Staffing, What Does It Cost?

Jane Doe

Grand Canyon University

Professional Capstone and Practicum

NRS-490

Professor Barbara Pridgen

August 25, 2017

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