NR 451 Week 3: Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet (graded)
Sample Answer for NR 451 Week 3: Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet (graded) Included After Question
NR 451 Week 3: Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet (graded)
Purpose
Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star Model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes. The evidence summary will be conducted through the 'breaking down' of a systematic review on your topic for your change project.
Course Outcomes
This assignment enables the student to meet the following course outcomes: CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes.
(PO4) CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO8)
Due Dates
Milestone 1 consists of the completion of ONE form with two worksheets called the Practice Issue and Evidence Summary Worksheets. (Links to an external site.)Links to an external site. Complete both worksheets and submit the form by Sunday, 11:59 p.m. MT at the end of Week 3.
Points
Milestone 1 is worth 175 points (75 points for the Practice Issue and 100 points for the Evidence Summary).
Practice Issue Worksheet Directions
1. A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.
2. Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the List of Approved Systematic
Reviews (Links to an external site.)Links to an external site..
3. Follow the grading criteria below to formulate your practice issue, which must be
based on the topic of the systematic review you have selected.
4. Use the worksheet to document the practice issue presented and approved by your
instructor in the Week 2 Discussions.
5. Your practice issue will be the same for all three Milestone assignments in this course.
6. Please type your answers directly into the worksheet.
Evidence Summary Worksheet Directions
1. Develop an evidence summary by following the grading criteria below.
2. Document this on the evidence summary portion of the worksheet.
3. You will use this worksheet to incorporate your evidence summary into your Week 4
Milestone 2 assignment.
4. Please type your answers directly into the worksheet.
**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.
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.
Please see the grading criteria and rubrics on this page.
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Rubric
NR451_Milestone1
NR451_Milestone1
Criteria Ratings Pts
This criterion is linked to a
Learning OutcomePractice
issue statement, scope of
practice, practice area
Identifies a Practice issue
statement that is an
independent nursing
decision, and is relevant to
20.0 pts
Practice issue
is identified
based on the
systematic
review topic
chosen.
Practice issue
is an
18.0 pts
Practice issue
is identified
but is not
clear, however
it is based on
the systematic
review topic
chosen.
16.0 pts
Practice issue is
identified but is
not clearly
related to a
nursing practice
issue, however it
is based on the
systematic
8.0 pts
Practice issue
is unclear.
Practice issue
is not based on
the systematic
review topic.
Practice Issue
is not an
0.0 pts
Practice issue
is not
identified;
practice issue
is not an
independent
nursing
decision;
20.0 pts
the systematic review topic
chosen from among the list
provided in the course.
Describes the scope of
practice issues. Example:
The number of falls in your
facility has been increasing,
especially during shift
change. What do you
believe may be causing
this? Are there any new
interventions that could be
put into place that would
lessen or eliminate the
falls? This is where you
begin your initial search
into the problem or practice
issue identified. Identifies
the practice area.
independent
nursing
decision.
Scope of
practice issue
is fully
described.
Practice area
identified.
Practice issue
is an
independent
nursing
decision. Scope
of practice
issue is
described in
simple terms.
Practice area
identified.
review topic
chosen. Practice
issue is not an
independent
nursing
decision. Scope
of practice issue
is described but
is not logical in
comparison to
Practice Issue
described.
Practice area
identified.
independent
nursing
decision.
Scope of
practice issue
is not
described.
Practice area
identified.
scope of
practice issue
is not
described;
practice area
is not
identified.
This criterion is linked to a
Learning OutcomePractice
issue identification,
rationale for selections
Identifies how rationale
behind how the practice
issue was selected as a
practice issue/problem
Documents the practice
issue in a logical manner.
35.0 pts
Documents
how the
practice issue
was identified.
Rationale for
responses is
logical and
described
thoroughly.
33.0 pts
Documents
how the
practice issue
was identified.
Rationale for
responses is
logical and
briefly
described.
30.0 pts
Documents
how the
practice issue
was identified.
Rationale for
responses is
somewhat
logical and
vaguely
described.
15.0 pts
Vaguely
describes how
the practice
issue was
identified.
Rationale for
responses is
somewhat
logical and
vaguely
described.
0.0 pts
Does not
document how
the practice
issue was
identified.
Rationale is
not completed.
This section of
the form is
blank.
35.0 pts
This criterion is linked to a
Learning OutcomeTypes of
evidence to gather, rationale
for selections
Identifies and documents
types of evidence that must
be gathered for review of
the Practice Issue.
Describes rationale for each
type of evidence that is
selected.
20.0 pts
Identifies and
documents what
types of evidence
is needed for
review.
Thoroughly
describes
rationale for all
checked types of
evidence
selected.
18.0 pts
Identifies and
documents
what types of
evidence is
needed for
review. Briefly
describes
rationale for all
checked types
of evidence
selected.
16.0 pts
Identifies and
documents
what types of
evidence is
needed but
includes only a
minimum
description for
rationale for
selected
evidence.
8.0 pts
Does not
document
more than one
type of
evidence that
is needed for
review and
does not
include
rationale for
selected type
of evidence.
0.0 pts
Does not
document
types of
evidence or
rationale.
20.0 pts
This criterion is linked to a
Learning OutcomePractice
problem
States practice problem in
own words, with reference
to the population, setting,
and magnitude and in
measurable terms.
Describes practice setting in
measureable terms.
Example: Consider the
example given in the
evidence summary above.
The setting is the long term
care facility where falls
have been increasing and a
trend has been identified
that it seems to occur
mainly during shift change.
What do you believe may
be causing this? What can
be done to lessen or
eliminate the falls? How
does this number of falls
relate to other months that
have been tracked?
10.0 pts
-Practice
problem is in
own words,
with reference
to the
population of
interest. –
Setting of the
problem is
identified –
Magnitude of
problem is
discussed. –
The practice
issue is stated
in measurable
terms.
9.0 pts
-Practice
problem is in
own words,
with reference
to the
population of
interest. –
Setting of the
problem is not
discussed. –
Magnitude of
problem is
discussed. –
The practice
issue is stated
in measurable
terms.
8.0 pts
-Practice
problem is in
own words,
with reference
to the
population of
interest. –
Setting of the
problem is not
discussed. –
Magnitude of
problem is not
discussed. –
The practice
issue is stated
in measurable
terms.
4.0 pts
-Practice
problem is in
own words,
with reference
to the
population of
interest. –
Setting of the
problem is not
discussed. –
Magnitude of
problem is not
discussed. -The
practice issue is
stated but not
measurable.
0.0 pts
-Practice
problem is not
in own words –
There are no
references to
the population
of interest. –
Setting and
magnitude of
problem is not
discussed -The
practice issue
is not stated in
measurable
terms.
10.0 pts
This criterion is linked to a
Learning OutcomeSource
of evidence
Identifies a source of
evidence that is a nursing
topic that is the subject of a
systematic review article.
Provides a complete
reference for the systematic
review article that was
chosen from the list
provided.
20.0 pts
-Source is a
Systematic
Review article
chosen from the
approved list. –
Complete APA
formatted
reference is
given for
Systematic
Review article
with no errors. –
The source must
be relevant to
the practice
issue identified.
18.0 pts
-Source is a
Systematic
Review article
chosen from
the approved
list. -A
reference is
given, but it
has APA
formatting
errors. -The
source must be
relevant to the
practice issue
identified.
16.0 pts
-Source is a
Systematic
Review article
chosen from
the approved
list. -No
reference is
provided. -The
source must
be relevant to
the practice
issue
identified.
8.0 pts
-Source of
evidence is a
research article
or systematic
review no on
the approved
list. -A
reference for
the article or
systematic
review is given.
-The source is
not relevant to
the practice
issue identified.
0.0 pts
-Source of
evidence is
not
provided, or
is not a
research
article or
systematic
review. –
Reference is
missing.
20.0 pts
This criterion is linked to a
Learning
OutcomeObjectives of the
article/Statement of
questions
Identifies the objectives of
the article. Identifies
questions being addressed
by author/s. Explains
relationship to the chosen
practice issue
20.0 pts
-Objectives of
article are
identified. –
Questions
addressed by
author/s are
thorough. –
Relationship to
your practice
issue is
explained.
18.0 pts
-Objectives of
article are
identified. –
Questions
addressed by
author/s are
explained but
not thorough. –
Relationship to
your practice
issue is
explained.
16.0 pts
-Objectives of
article are
identified. –
Questions
addressed by
author/s are
not thorough. –
Relationship to
your practice
issue is vague.
8.0 pts
-Objectives of
article are
identified. –
Questions
addressed by
author/s is
missing. –
Relationship to
your practice
issue is not
explained.
0.0 pts
-Objectives of
article are not
identified. –
Questions
addressed in
article and
relationship
to own
practice is not
identified.
20.0 pts
This criterion is linked to a
Learning
OutcomeInterventions/Main
findings summary
Summarizes, in own words,
suggested interventions by
the author/s to improve
patient outcomes.
Summarizes main findings
of the author/s including
strength of evidence for
each main outcome.
Describes the relevance to
the Milestone 2 paper.
30.0 pts
-Thoroughly
summarized
(in their own
words) the
interventions
the author(s)
suggest to
improve
patient
outcomes. –
Thoroughly
summarized
main findings
of the author/s.
-Included
strength of
evidence for
each main
outcome.
27.0 pts
-Briefly
summarized
(in their own
words) the
interventions
the author(s)
suggest to
improve
patient
outcomes. –
Briefly
summarized
main findings
of the author/s.
-Included
strength of
evidence for
each main
outcome.
25.0 pts
-Vaguely
summarized
(in their own
words) the
interventions
the author(s)
suggest to
improve
patient
outcomes. –
Vaguely
summarized
main findings
of the author/s.
-Included
strength of
evidence for
most of main
outcomes.
12.0 pts
-Summary of
interventions
is not in own
words. –
Summarized
main findings
of the author/s
is not
apparent. -Did
not include
strength of
evidence for
any of the
main outcome.
0.0 pts
-Summary of
the
interventions
the author(s)
suggest to
improve
patient
outcomes is
missing. –
Summary of
the main
findings of the
author is
missing. -The
strength of the
evidence for
outcomes are
missing.
30.0 pts
This criterion is linked to a
Learning
OutcomeEvidence-based
solutions and limitation
Outlines evidence-based
solutions to consider for the
capstone project. Discusses
any limitations to the
studies included in the
systematic review that
he/she believes may impact
use of the evidence
provided in their project
20.0 pts
-Outline of
evidence-based
solutions
considered for
project is
documented
and clear.
Discussed any
limitations to
the studies
performed.
Documents
limitations
believed may
impact use in
project.
18.0 pts
-Outline of
evidence-based
solutions being
considered for
project is
documented
but not clear.
Discussed any
limitations to
the studies
performed.
Documents
limitations
believed may
impact use in
project.
16.0 pts
-Outline of
evidence-based
solutions
considered for
project is
documented
but not clear.
Discussed most
limitations to
the studies
performed.
Documents
limitations
believed may
impact use in
project.
8.0 pts
-Outline of
evidence-based
solutions being
considered for
project is not
documented. –
Discussed most
limitations to
the studies
performed.
Documents
limitations
believed may
impact use in
project.
0.0 pts
-Outline of
evidence-
based
solutions,
limitations
of studies
and
potential
impact to
project is
missing.
20.0 pts
Total Points: 175.0
PreviousNext
Capstone Project Milestone 1:
Practice Issue and Evidence Summary Worksheets
Student Name: Date: 09/08/2017
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.
Practice Issue Worksheet
List the topic and include the citation for the systematic review you have selected:
The Hospital discharge planning for reduction of readmission of patients
The systematic review article that has been used is the article by Fox et al., (2013) on the
effectiveness of early discharge planning in acutely ill or injured old adults.
What is the practice issue you have identified related to the topic you have chosen?
The practice issue that has been put forward is the development of a training plan for the older
population regarding o the management of their condition after they are discharged. This is
related to the topic under study since the readmission rates can be reduced by ensuring that the
patients are able to manage their conditions at home.
Define the scope of the practice issue:
The scope of practice can be described by the use of the PICOT question as indicated below
P (Population)- Old patients in the healthcare facility having acute illness or having an injury
I (Intervention)- The development of an early discharge planning for the patients
C (Comparison)- The use of usual care plan
O (Outcome)- A reduction in the cases of readmission of older patients to the hospitals
T (Time)- 3 months
What is the practice area?
__x_ Clinical
___ Education
___ Administration
___ Other (List):
How was the practice issue
identified? (check all that apply)
_x__ Safety/risk management concerns
_x__ 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:
Describe the rationale for your checked selections:
The increasing cases of readmission of the elderly patients in hospitals have led to the increase
in concerns. Along these lines, the problem has been identified from the concerns on the risks
of readmission to the hospitals since it leads to an increase in costs of healthcare maintenance
of the patient. Moreover, the expectations of the patients while being discharged is to ensure
that there are no mistakes but the increase in the readmission has led to mistrust on the
outcomes. The increase in readmission of elderly patients is as well an issue of concern in the
medical practice.
What evidence must be gathered? (check all that apply)
__x_ Literature search
___ Guidelines
___ Expert Opinion
___ Patient Preferences
_x__ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
___ Other
Describe the rationale for your checked selections: There has been advance research on the
ways that can be used in reducing the cases of readmission of elderly patients. Along these
lines, the literature search will be a critical step that will help in collecting information on the
plan. Moreover, the clinical experts will help in the provision of information on the ways that
can be implemented to minimize readmission rates in the healthcare organizations.
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 increasing cases of readmission have mainly been identified to influence the elderly
patients. Along these lines, there is a need for the development of measures that can be
implemented in reducing the cases. The old population is mainly associated with longer stays
in the healthcare facilities and the need for the development of an early discharge plan for the
patients as elucidated by Fox et al., (2013) is a stepping stone for minimizing the cases of
readmission. Readmission has a variety of challenges include the fact that there is an increase
in the cost of managing the healthcare conditions of the elderly patient. Moreover, readmission
will put the quality of services offered in hospitals in question. As such, there will be a
reduction in the trusts that the patients will have in the healthcare organization due to the
readmission cases.
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.
Fox, M. T., Persaud, M., Maimets, I., Brooks, D., O’Brien, K., & Tregunno, D. (2013).
Effectiveness of early discharge planning in acutely ill or injured hospitalized older
adults: a systematic review and meta-analysis. BMC geriatrics, 13(1), 70.
Identify the objectives of the article.
The aim of the study by Fox et al., (2013) is to assess the effectiveness of early discharge
planning for the older patient show have been admitted with the acute illness or injuries.
Provide a statement of the questions being addressed in the work and how they relate to
your practice issue:
What is the effectiveness of early discharge plan on the older patient show have been admitted
with the acute illness or injuries?
Summarize (in your own words) the interventions the author(s) suggest to improve
patient outcomes.
The authors have presented that the intervention for minimizing readmissions on the
healthcare organization is the provision of an effective plan that will help the patients in the
transition after discharge. In this regard, the elderly patients are provided with a discharge plan
from the time of their admission. The authors deduce that the availability of an early plan for
the patients in comparison with the usual care helps in reducing the cases of readmission of the
elderly patients. This is attributed to the fact that the there is an improvement in the quality of
life of the patients who have had a discharge plan from the time of their admission.
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.
The findings indicate that many studies have indicated that an early discharge planning is
crucial at the time that the patients are in an acute state for the reduction of readmission.
Specifically, the findings are applicable for old patients and are performed by the nurses
within the first 24 hours before the patient is discharged. Along these lines, the patient does
not get enough information on the ways of managing their condition. The discharged plans
that have been identified to be supported by a variety of researchers include the assessment of
the needs of the elderly patients while at home.
Moreover, the other discharge plans include the provision of education to the patients o the
necessary adjustments that could help in reducing the cases or readmission and the transfer of
information to the community health provided on the management of the care of the elderly
patients. Additionally, the proposal of the follow-up plans is adduced to be of help in reducing
the cases of readmission. The results indicate that the reviews indicated that the follow-up
method that is identifiable include the use of telephone calls or a mobile phone application that
could provide a report on the patient conditions.
Outline evidence-based solutions that you will consider for your project.
Due to the intensity of the cases of readmission, the evidence based solution that will be
proposed for the project is the education of the patients on the ways of managing their
conditions before discharge. Along these lines, the patient should receive care from the nurses
from the time of their admission to help in ensuring that there is enough information on the
possible challenges that will be faced after their discharge. In addition, the patients should be
educated on the effects of readmission on the psychological well-being and the cost of
hospitalization. Moreover, the patients are trained on the use of technological devices such as
the mobile application that reports the vital signs of the elderly patient or a regular basis. This
will help the healthcare providers in monitoring the health of the patient.
Discuss any limitations to the studies performed that you believe impacts your ability to
utilize the research in your project.
One of the limitations of the review is that there are limited study methods for the research
topic. This is attributed to the fact that only nine studies have been used. The precision is as
well influenced by the sample size and the conclusion made by the researchers may be
affected by the fact that there is no heterogeneity. This will have an impact on the utilization
of the article since it can be asserted that the issue at hand may not have had enough research
studies in the past. As such, the process of discharge planning may receive a measurable
Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
|
Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in all of the following elements:
|
Presentation of information is unsatisfactory in one of the following elements:
|
Presentation of information is unsatisfactory in two of the following elements:
|
Presentation of information is unsatisfactory in three or more of the following elements
|
| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in the all of the following elements:
|
Presentation of information is unsatisfactory in one of the following elements:
|
Presentation of information is unsatisfactory in two of the following elements:
|
Presentation of information is unsatisfactory in three of the following elements
|
| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
|
Demonstrated 3 of the following:
|
Demonstrated 2 of the following:
|
Demonstrated 1 or less of the following:
|
||
| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
|
Failed to demonstrate the following:
|
||||
| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Also Read: NR 451 Week 2: The Clinical Question