In collaboration with the approved clinical preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which

In collaboration with the approved clinical preceptor, students will identify a specific evidence-based topic for the capstone project change proposal

Benchmark – Capstone Project Topic Selection and Approval

In collaboration with the approved clinical preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The selected problem should encourage the student to engage in interprofessional collaborative practice.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

This project is only a proposal and will not be implemented in a practice setting.

Write a 750-1000-word description of your proposed capstone project topic. Include the following:

1. Describe the problem or issue that will be the focus of the change proposal. Explain with which category (leadership or community) the selected topic would best align.
2. Discuss the setting or context in which the problem or issue can be observed and describe the population affected by this problem or issue.
3. Discuss the implications this clinical practice problem or issue has on nursing practice.
4. Based on your needs assessment in Topic 1, describe why this is a priority for the community/clinical site or affected clinical population.
5. Briefly describe the organizational structure (mission, vision, values, leadership structure, etc.) of the practicum site. What internal and external processes will impact care coordination for the selected population or community?
6. How effective has the organization been in addressing the identified problem or issue?

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

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

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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.

Expert Answer and Explanation

Capstone Project Topic Selection and Approval

Nurses play an instrumental role in identifying clinical issues and putting in place interventions to help solve them. Quality improvement interventions start from need identification and understanding of the key factors surrounding the identified clinical issue for an approximate intervention to be established. This paper will elaborate on an identified clinical issues, why it is a priority, its implication on nursing, and the organization structures that can help in care coordination and solving of the identified clinical issue.

Clinical Issue of Focus

Patient falls are among the most common public health challenges, with over 680,000 fatal falls occurring each year. This makes falls the second leading cause of unintentional injury death (Ekemiri et al., 2024). Unfortunately, some falls occur within healthcare facilities, making it a serious healthcare concern directly affecting patient outcomes. However, falls are a healthcare risk that is easily preventable with the right strategies in place. This capstone will focus on preventing inpatient falls using fall-risk assessments conducted during patient admission.

Inpatient falls are a leadership problem. In clinical settings, the departmental health and unit leaders are responsible for ensuring patient safety and care quality. Inpatient falls reflect the level of safety interventions and policies implemented to prevent them. The leadership is responsible for conducting training, implementing mitigation strategies, and implementing policies that prevent falls within healthcare facilities.

Setting in Which the Problem is Observed

Patient falls can occur in diverse settings, including community and healthcare facilities. However, this capstone will specifically focus on patient falls within healthcare facilities. Geriatric facilities, detox centers, long-term care facilities, and acute care facilities are some of the common healthcare settings that are susceptible to falls due to the nature of conditions and patients being treated in those facilities. Different population groups have a higher risk of experiencing falls compared to others.

For example, the elderly population is amongst the highest population groups with a significant risk of experiencing falls due to various reasons, including muscle degeneration and polypharmacy (Jehu et al., 2021). Another at-risk population is patients with substance or drug abuse problems. Working in a detox center, it is common to engage with patients with multiple risk factors that expose them to a higher risk than others in experiencing falls. Thus, there is a need for assessment and prioritization to ensure enhanced safety and care when handling such patients.

Implications of the Clinical Issue on Nursing Practice

Patient falls have significant implications in nursing practice since they highlight the nurse’s role in ensuring patient safety. Fall prevention should be a priority for all nurses to ensure that they safeguard positive patient outcomes. With the value-based care model in place, where nurses are reimbursed based on the quality of care they provide to the patients (Pittman et al., 2021), it is critical for the nurses to put in place interventions that ensure positive outcomes are achieved; this includes fall prevention measures.

Therefore, the clinical issue has implications for the reimbursement of care providers. Falls also impact the cost of patient care, with increased cases leading to a high cost of care. Therefore, patient falls should be prevented as a way of reducing care costs.

Why the Issue is a Priority

The clinical issue is a priority for the organization and affected populations, given its implications for patient outcomes and for reducing the cost of care and reimbursements received for services offered. Falls are among the main causes of sentinel events within healthcare settings and in the identified facility, specifically. Therefore, implementing interventions to mitigate this risk will go a long way toward meeting the facility’s strategic goals, specifically improving care quality and safety.

Organizational Structure and Internal and External Processes Impacting Care

The organization’s mission and vision are centered around providing quality and safe patient-centered care. The values driving the facility include respect, integrity, professionalism, diversity, and excellence.  These aspects of the organization will support the interventions proposed to mitigate falls within the facility. The internal and external processes that will impact the coordination of care among the targeted population include leadership, for example, their stance on the proposed intervention. Another aspect is communication.

Proper coordination is founded on good and effective communication, which will be a key factor during the implementation of the intervention (Sheehan et al., 2021). Another aspect is stakeholder management, for example, the inclusion of the patients and their loved ones, including their family members, in supporting their care and being part of the care coordination team.

Organization Effectiveness in Addressing Falls

While the organization has been implementing other quality improvement initiatives to address patient falls, including installing guardrails for the patients, there is still a lot that could be done to mitigate falls that occur within the facility. Over the years, due to the various interventions put in place, the facility has seen a drop, with the latest figures indicating a close to a 10% reduction in falls within the last year alone. It is anticipated that with the proposed intervention in place, there will be a further reduction of fall incidents within the facility.

Conclusion

This capstone will focus on implementing fall-risk assessments to mitigate falls within the practicum site. Falls have been identified as one of the issues contributing to poor care quality and safety within the facility. While measures have been put in place to mitigate the clinical issue, much more can still be done to enhance patient outcomes. With backing from the leadership, the organizational structure in place will provide great support towards achieving the intended goals for the capstone project in improving patient care within the facility.

References

Ekemiri, K., Ekemiri, C., Ezinne, N., Virginia, V., Okoendo, O., Seemongal-Dass, R., Staden, D. V., & Abraham, C. (2024). Global burden of fall and associated factors among individual with low vision: A systematic-review and meta-analysis. PLOS ONE, 19(7), e0302428. https://doi.org/10.1371/journal.pone.0302428

Jehu, D., Davis, J., Falck, R., Bennett, K., Tai, D., Souza, M., Cavalcante, B., Zhao, M., & Liu-Ambrose, T. (2021). Risk factors for recurrent falls in older adults: A systematic review with meta-analysis. Maturitas, 144, 23-28. https://doi.org/10.1016/j.maturitas.2020.10.021

Pittman, P., Rambur, B., Birch, S., Chan, G. K., Cooke, C., Cummins, M., Leners, C., Low, L. K., Meadows-Oliver, M., Shattell, M., Taylor, C., & Trautman, D. (2021). Value-based payment: What does it mean for nurses?. Nursing Administration Quarterly, 45(3), 179–186. https://doi.org/10.1097/NAQ.0000000000000482

Sheehan, J., Laver, K., Bhopti, A., Rahja, M., Usherwood, T., Clemson, L., & Lannin, N. A. (2021). Methods and effectiveness of communication between hospital allied health and primary care practitioners: A systematic narrative review. Journal of Multidisciplinary Healthcare, 14, 493–511. https://doi.org/10.2147/JMDH.S295549

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