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2017-03-06 00:21
CapstoneProjectMilestone 1:
Practice Issue andEvidenceSummaryGuidelines
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 foryour 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. (PO #4)
CO8: Selects evidence for best practice when planning professional nursing care for individuals families aggregates and communities. (PO #8)
Due Dates
Milestone #1 consists of the completion oftwoworksheets (Practice Issue Worksheet) and (Evidence Summary Worksheet). Submit the completed worksheetsto the Dropbox by Sunday 11:59 p.m. MT at the end ofWeek 3.
Points
Milestone #1 is worth175 points(75 points for the Practice Issue and 100 points for the Evidence Summary).
Practice Issue WorksheetDirections
1.Practice Issue Worksheet:
a.Read the guidelines including the grading rubrics below.You will use this worksheet todocument the practice issue presented and approved by your instructor in the Week 2 Discussions.
i.Your practice issue will be the same for all three Milestone assignments in this course.
b.Please type your answers directly into the worksheet.
Evidence Summary WorksheetDirections
2.Evidence Summary Worksheet:
a.Read the guidelines including the grading rubrics below. You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
b.Find a systematic review article in the Chamberlain library on your topic. Your Systematic Review Article must bepeer-reviewedand include anarrative summary.
i.Go to the Chamberlain Library click on RNBSN; NR451 Capstone course.You can find systematic reviews from many databases within the library or by searching from the library homepage main search bar.
ii.To search combine the phrase ‘systematic review’ withyour topic using the Boolean search operator AND. For example if you are looking for a systematic review on fall prevention you would use this Boolean search phrase: systematic review AND fall prevention.
c.Type in your practice issue in the search tab; choose a systematic review article with anarrative summaryto complete your worksheet.
d.Please type your answers directly into the worksheet.
Grading Criteria:Practice issue
Category
Points
%
Description
Practiceissue statement scope of practice practice area
20
27%
Identifies a Practice issue statement that isan independent nursing decision.
Describes thescope ofpractice issues.
Example: The number of falls in your facilityhas been increasingespecially during shift change.What do you believe may be causing this? Are there any new interventions that could be put into place that would lessenoreliminatethe falls?Thisis where you begin your initialsearchinto the problem or practice issue identified.
Identifies the practice area.
Practice issue identification rationaleforselections
35
46%
Identifies howrationale behind howthepractice issue was selectedas apractice issue/problem
Documents the practice issue in a logical manner.
Types of evidenceto gather rationaleforselections
20
27%
Identifies anddocumentstypes of evidence that must be gatheredforreviewof the Practice Issue.
Describesrationale for each type of evidence that is selected.
Total
75 points
100%
Grading Rubric:Practice Issue
Assignment Criteria
A (100%)
Exceptional
Outstanding or highest level of performance
B (88%)
Exceeds
Very good or high level of performance
C (80%)
Meets
Competent or satisfactory level of performance
NI (38%)
Needs Improvement
Poor or failing level of performance
F (0%)
Developing
Unsatisfactory level of performance
Practiceissue statement scope ofpractice practice area
20 points
Practice issueis identified.
Practice issueis anindependent nursing decision.
Scope of practice issue isfully described.
Practice area identified.
20points
Practice Issueis identifiedbut is not clear.
Practice issueis an independent nursing decision.
Scope of practice issue is described in simple terms.
Practice area identified.
18points
Practice Issueis identifiedbut is not clearlyrelated to a nursing practice issue.
PracticeIssue isnot anindependent nursing decision.
Scope of practice issue is described but is not logical in comparison to Practice Issue described.
Practice area identified.
16points
Practice Issueisunclear.
Practice Issueis not an independent nursing decision.
Scope of practice issue is not described.
Practice area identified.
8 points
Practice Issueisnotidentified; practice issue isnot an independent nursing decision; scope of practice issue is not described; practice area is not identified.
0 points
Practice issue identification rationaleforselections
35 points
Documents how the practice issue was identified.
Rationale for responsesislogical anddescribed thoroughly.
35 points
Documents howthe practice issue was identified.
Rationale for responsesislogical and brieflydescribed.
33 points
Documents howthepractice issuewas identified.
Rationalefor responsesissomewhat logical and vaguelydescribed.
30points
Vaguely describes howthepractice issuewas identified.
Rationalefor responsesissomewhat logical and vaguely described.
15 points
Does not document how the practice issuewas identified.
Rationale is not completed.
This section of the form is blank.
0 points
Types of evidenceto gather rationaleforselections
20 points
Identifies anddocuments what types ofevidence is needed for review.
Thoroughlydescribesrationale for all checkedtypes of evidence selected.
20points
Identifies and documents what types ofevidence is needed for review.
Briefly describesrationale forallchecked types of evidence selected.
18points
Identifies and documents what types ofevidence is needed butincludesonlya minimum description forrationalefor selected evidence.
16points
Does notdocumentmore than onetype ofevidence that is neededfor reviewand doesnot include rationale forselected type of evidence.
8points
Does not document types ofevidenceorrationale.
0 points
Total Points Possible = 75 points
Grading Criteria: Evidence Summary
Category
Points
%
Description
Practice Problem
10
10%
States practice problem in own words with reference to the population setting and magnitude and inmeasurable 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 becausing this? What can be done to lessen oreliminate the falls? How does this number of falls relate to other monthsthat have been tracked?
Source of evidence
20
20%
Identifies a source of evidencethatisanursing topic that is the subject of a systematic reviewarticle.
Identifies search terms.
Provides a complete reference for the systematic reviewarticle.
Objectivesof the article/Statement of questions
20
20%
Identifies the objectives ofthe article.
Identifies questions being addressed by author/s.
Explainsrelationship to your practice issue.
Interventions/Main findingssummary
30
30%
Summarizes in own words suggested interventions by the author/s to improve patient outcomes.
Summarizesmain findings of the author/s including strength of evidence foreach main outcome.
Describes the relevance tothe Milestone 2 paper.
Evidence-based solutions and limitations
20
20%
Outlinesevidence-based solutionstoconsider forthe capstone project.
Discussesany limitations to the studiesincluded in the systematic reviewthat you believe may impact useof the evidence providedin your project.
Total
100 points
100%
Grading Rubric: Evidence Summary
Assignment Criteria
A (100%)
Exceptional
Outstanding or highest level of performance
B (88%)
Exceeds
Very good or high level of performance
C (80%)
Meets
Competent or satisfactory level of performance
NI (38%)
Needs Improvement
Poor or failing level of performance
F (0%)
Developing
Unsatisfactory level of performance
Practice Problem
10 points
-Practice problem is in own words with reference to the populationof interest.
-Settingof the problem isidentified
-Magnitudeof problem is discussed.
-The practice issue is stated inmeasurable terms.
Metallobjectives as stated above
10 points
-Practice problem is in own words with reference to the population of interest.
-Setting of the problem isnotdiscussed.
-Magnitude of problem is discussed.
-The practice issue is stated in measurable terms.
Met3 out of 4objectives
9points
-Practice problem is in own words with reference to the population of interest.
-Setting of the problem isnotdiscussed.
-Magnitude of problem isnotdiscussed.
-The practice issue is stated in measurable terms.
Met 2 out of 4objectives
8points
-Practice problem is in own words with reference to the population of interest.
-Setting of the problem isnotdiscussed.
-Magnitude of problem isnotdiscussed.
-The practice issue is statedbut notmeasurable.
Met only 1 out of 4objectives
4points
-Practice problem isnotin own words
-There are noreferencesto the population of interest.
-Settingand magnitude of problem isnotdiscussed
-The practice issue isnotstated in measurable terms.
Did not meet anyobjectives
0 points
Source of evidence
20 points
-Source of evidence isnursing topic.
-Source is aSystematic Review article.
-Search termsareidentified.
-Complete reference is given for Systematic Review article.
Metall 4objectives as above
20 points
-Source of evidence isnursing topic.
-Source is a Systematic Review article.
-Search termsare identified.
-Complete reference isnotgiven for Systematic Review article.
Met 3out of 4objectives
18 points
-Source of evidence isnursing topic.
-Source isnot aSystematic Review article.
-Search terms are identified.
-Complete reference isnotgiven for Systematic Review article.
Metonly 2out of 2objectives
16 points
-Source of evidence isnotnursing topic.
-Source is a Systematic Review article.
-Search terms arenotidentified.
-Complete reference isnotgiven for Systematic Review article.
Met only 1 out of 4 objectives
8 points
-Source of evidence isnotnursing topicor Systematic Review article.
-Search terms arenotidentified.
-Reference ismissing.
No objectivesweremet.
0 points
Objectivesof thearticle/ Statement of questions
20 points
-Objectives of articleareidentified.
-Questions being addressed by author/sare thorough.
-Relationshipto your practice issue is explained.
20 points
-Objectives of article are identified.
-Questions being addressed by author/s are explained but not thorough.
-Relationship to your practice issue is explained.
18points
-Objectives of article are identified.
-Questions being addressed by author/s are not thorough.
-Relationship to your practice issueisvague.
16points
-Objectives of article are identified.
-Questions being addressed by author/sis missing.
-Relationship to your practice issue isnotexplained.
8points
-Objectives of articleare not identified.
-Questions being addressed in article and relationship toown practice is not identified.
0 points
Interventions/ Main findings summary
30 points
-Thoroughly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.
-Thoroughlysummarizedmain findings of the author/s.
-Includedstrength of evidence for each main outcome.
30 points
-Briefly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.
-Brieflysummarized main findings of the author/s.
-Included strength of evidence for each main outcome.
27points
-Vaguely summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.
-Vaguelysummarized main findings of the author/s.
-Includedstrength of evidence formost ofmainoutcomes.
25points
-Summary of interventions is not in own words.
-Summarized main findings of the author/s is not apparent.
-Did notinclude strength of evidence forany of themain outcome.
12points
-Summaryof the interventions the author(s) suggest to improve patient outcomes ismissing.
-Summary of the main findings of the author is missing.
-The strength of the evidence for outcomes are missing.
0 points
Evidence-based solutions and limitations
20 points
-Outlineofevidence-based solutions consideredforprojectis documented and clear.
Discussedany limitations to the studies performed.
Documents limitationsbelievedmay impact usein project.
20 points
-Outline of evidence-based solutionsbeingconsideredforproject is documentedbut notclear.
Discussed any limitations to the studies performed.
Documents limitations believed may impact use in project.
18points
-Outline of evidence-based solutions consideredforprojectis documentedbut notclear.
Discussedmostlimitations to the studies performed.
Documents limitations believed may impact use in project.
16points
-Outline of evidence-based solutionsbeingconsideredforproject isnotdocumented.
-Discussedmostlimitations to the studies performed.
Documents limitations believed may impact use in project.
8points
-Outline of evidence-based solutions limitationsofstudies and potential impact to project is missing.
0 points
Total Points Possible = 100 points
NR451 W3 Milestone1Practice Issue & Evidence Summary Guidelines2/16/17 GH
3
This is the guidelines
2017-03-06 00:23
CapstoneProjectMilestone 1:
Practice Issue andEvidenceSummaryWorksheets
Student Name:Date:
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
What is the Practice Issue?
Define the scope of the Practice Issue:
What is the practice area?
___ Clinical
___ Education
___ Administration
___ Other (list)_________________________________
How was the practice issue identified?(check all that apply)
___ Safety/risk management concerns
___ Unsatisfactory patient outcomes
___ Wide variations in practice
___ Significant financial concerns
___ Difference between hospital and community practice
___ Clinical practice issue is a concern
___ Procedure or process is a time waster
___ Clinical practice issue has no scientific base
__ Other:
Describe the rationalefor your checked selections:
What evidence must be gathered?(check all that apply)
___Literature search
___ Guidelines
___ Expert Opinion
___ Patient Preferences
___ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory professional community)
___ Other
Describe the rationalefor your checked selections:
EvidenceSummaryWorksheet
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:
Find a source of evidence that is a systematic review article on a nursing topic that is relevant to your practice problem.Write thecomplete APA reference for the systematic review article you selected:
Define the search terms for your systematic review:
Identify theobjectives of the article.
Provide a statement of the questions being addressed in the workand how they relateto yourpractice issue:
Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.
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 theMilestone 2project paper.
Outline evidence-based solutionsthat you will consider for your project.
Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project.
NR451W3 MS1Practice Issue and Evidence SummaryWorksheets2/16/17 GH
3
Clinical question
The thoughtful development of a well-structured EBP question is important because the question drives the strategies used to search for evidence. (Dearholt & Dang 2012 p.64). My question is: Will Congestive Heart Failure patients discharged from the hospital increase the chance of not being readmitted within 30 days with follow up care that includes post discharge telephone calls for support?
P- (Patient Population)-Congestive Heart Failure Patients
I-(Intervention)-Follow up phone call at 48 and 72 hours post discharge
C-(Comparison with current practice)-No follow up telephone calls for support.
O-(Desired outcome)-Reduce the number of Readmissions