Use template to write nursing proposal paper

In the attached file, there is 1, Instruction about how to write this nursing proposal.(Please read it very carefully before you start)2, 3 article website link related to this proposal for your reference. 3, My worksheet (please read it before you write the proposal)4, The template (use this template and all the material above to finish this proposal) 2, Please write this proposal according to the worksheets in my attached file, also I gave 3 articles website link in which you may find some good information about this topic.3, make make sure the turnitin is less than 15%. (template contents do not count)
_milestone1_worksheets_.docx

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RN Capstone Course
Practice Issue Worksheet
List the topic and include the citation for the systematic review you have selected from our
approved list (optional: an additional scholarly source of support):
My topic: Hospital Readmissions
Citation:
Gonçalves-Bradley, D. C., Lannin, N. A., Clemson, L. M., Cameron, I.D., & Shepperd, S. (2016). Discharge
planning from hospital. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD000313.
doi:10.1002/14651858.CD000313.pub5.
Chamberlain Library Permalink:
http://onlinelibrary.wiley.com.chamberlainuniversity.idm.oclc.org/doi/10.1002/14651858.CD000313.pub5/full
Sunil K., Theobald, C. N., Anctil, B., & Vasilevskis, E. E. (2013). Reducing hospital readmission rates:
current strategies and future directions. Annual review of medicine, 65, 471-485. Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104507/
What is the nursing practice issue you have identified related to the topic you have chosen?
In patients who have gastric ulcers and have been discharged from endoscopy unit (P), How do nurses
doing follow up call and giving patient continuous education every week for 1 month (I), compared to only
giving patients generalized paper discharge instructions(C), reduce hospital readmissions rate (O) within 1
year(T)?
Fully describe the scope of the practice issue:
I work in the endoscopy unit in the hospital. I see many patients come back to the hospital over and over
again. For example, if patients have been found with gastric ulcers in the procedure, if the patients are not
educated on how to take their medications or how to change their diet, the patients may not recover from
ulcers and come back again for worse gastric pain. Failure to recover may force the patients to revisit the
endoscopy hospital unit due to gastric pains. As nurses, it is important to reinforce good discharge planning
and good education to reduce the hospital readmission rates.
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
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RN Capstone Course
Many nurses in the unit do not make discharge planning and give patients proper education about their
diseases. The study focuses on how the nurses should improve the discharge planning system and
educate the patients about their diseases in order to reduce hospital readmission rates. The study will focus
on how the endoscopy unit nurses should effectively determine if the patients are ready to be discharged,
compile an accurate and comprehensive discharge summary, help to identify an effective post discharge
care setting, manage care with several settings and providers, involve the patient and caregivers in plan of
care and conduct post discharge follow-up phone calls. If the nurses in the endoscopy unit adopt the
mentioned planning strategies and provide education to their patients, the readmission rates in the hospital
will be reduced.
What is the practice area?
___x Clinical
__x_ Education
__x_ Administration
___ Other (List):
How was the practice issue identified?
(check all that apply)
___ Difference between hospital and community practice
_x__ Safety/risk management concerns
_x__ Clinical practice issue is a concern
_x__ Unsatisfactory patient outcomes
___ Procedure or process is a time waster
___ Wide variations in practice
___ Clinical practice issue has no scientific base
___ Significant financial concerns
__ Other:
Describe the rationale for your checked selections:
The study will provide an idea on how to reduce hospital readmission rates by explaining some of the
factors relating to discharge planning and patient education that should be put into consideration by the
endoscopy unit nurses. Lack of appropriate checking to determine if patients are ready for readmission,
failing to compile accurate discharge information and summary, lack of identifying proper post discharge
care settings, lack of family and patient involvement in the plan of care and failing to carry out follow-up
phone calls to the discharged patients raises the risk of patientâ??s safety. Failing to provide education
programs to the discharged patients also raises concern to patientâ??s safety. Failing to observe appropriate
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
DP
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RN Capstone Course
discharge planning process and patient education may cause the patient to miss out on relevant
information such as medicine prescriptions. This can cause the patient not to recover fully from their
diseases leading to cases of readmission after a short period of time. When patients revisits the hospital
due to failure of recovery from their illness, they become unsatisfied with the services offered to them by
the unit nurses and can even lose their trust in the hospital, and all these relating practice is a big concern
to the healthcare field.
What evidence must be gathered? (check all that apply)
__x_ Literature search
__x_ Clinical Expertise
___ Guidelines
___ Financial Analysis
___ Expert Opinion
___ Standards (Regulatory, professional, community)
__x_ Patient Preferences
___ Other
Describe the rationale for your checked selections:
Review of literature involves determining the findings of other studies whose topic of concern relates to
increased readmissions in hospitals due to inappropriate discharge planning processes and lack of
education programs to the patients that are being discharged from the hospital. Studies have indicated that
hospital readmission cases are highly contributed by inappropriate discharge planning procedures and lack
of educating the patients being discharged. Studies have indicated that in most hospital units, the
discharging planning process is ineffective in relation to how the nurses determine if the patients are ready
for discharge, how the patients compile the summary of the patientâ??s discharge and how they coordinate
care with multiple settings and provides. From some of the studies, hospital nurses do not involve patients
and their family members in the plan of care and fail to carry out follow-up calls to the discharged patients
to determine their health progress after being discharged. Research have indicated that failure to educate
the patients that are being discharged may cause them not to follow medical instructions as needed and
resulting to the patients not to fully recover from their diseases. This leads to increased rates of hospital
readmission cases. Clinical expertise can provide vital information relating to the strategies to improve the
discharge planning process of the hospital units and how effective education programs can be offered to
patients that are being discharged in order to reduce cases of hospital readmission rates. Patient
preferences will assist in determining the patientâ??s view on the hospital readmission process and education
programs after being discharged.
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
DP
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RN Capstone Course
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:
As nurses, it is important to reinforce good discharge planning and good education to reduce the
hospital readmission rates. Giving patient follow up calls and continuous education will help the patient
complying with the treatment and reduce hospital readmission rate. From the study that was carried
out by Sunil et al, (2013) on reducing hospital readmission through current strategies and future
directions, the authors found out that the number of readmitted patients that have been reduced in the
hospital where studies was carried out is approximately 13% in a period of six months after
implementing proper discharge planning processes and introducing patient education in the hospital.
Before the implementation of the strategies, one out of every three discharged patients came with
complains of still having the diseases even after being discharged. An approximate number of 20
patients, which is approximately 35% of the total number of patients reported on the similar case in
every month. After implementation of the strategy the number has reduced to 13% which is about 3
patients in a month.
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. Include the APA
reference for any additional optional supplemental scholarly source related to the review you
wish to use.
Gonçalves-Bradley, D. C., Lannin, N. A., Clemson, L. M., Cameron, I.D., & Shepperd, S. (2016).
Discharge planning from hospital. Cochrane Database of Systematic Reviews, Issue 1. Art. No.:
CD000313. doi:10.1002/14651858.CD000313.pub5.
Chamberlain Library Permalink:
http://onlinelibrary.wiley.com.chamberlainuniversity.idm.oclc.org/doi/10.1002/14651858.CD000313.pub
5/full
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
DP
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RN Capstone Course
Sunil K., Theobald, C. N., Anctil, B., & Vasilevskis, E. E. (2013). Reducing hospital readmission rates:
current strategies and future directions. Annual review of medicine, 65, 471-485. Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104507/
Identify the objectives of the article:
The objective of the article is to assess and analyze the effectiveness of discharge planning and timely
follow-up in order to reduce cases of patient readmissions and long stay in hospitals.
Provide a statement of the questions being addressed in the work and how these relate to your
practice issue:
In my unit, I saw many patient who come back to the hospital to repeat the same procedure
unnecessarily. It is because most of the time, nurses in my unit didn’t give patient enough education, or
conduct post discharge follow-up phone calls. Also, there is increased number of patient readmission
cases and long hospital stays due to ineffective collaboration and communication among the hospital
workers and lack of appropriate education programs for the discharged patients. That’s why I think it is
important for nurses to improve effective communication and discharge planning to reduce hospital
readmission rate.
We as nurses should make good discharge planning to reduce hospital length of stay and unplanned
readmission to hospital. Discharge planning can increase satisfaction with healthcare for patients and
professionals. Discharge planning is very important because it can review and make arrangements for
on-going healthcare needs across healthcare settings, so that the patient can get continuous good
health care and that will reduce the hospital readmission rate, and it will further reduce the medical
costs and resources.
Summarize (in your own words) the interventions the author(s) suggest to improve patient
outcomes.
The authors suggest that implementing education program plans to the patients that are being
discharged will assist in reducing the number of readmitted patients in hospital. The author further
suggest that effective discharge planning processes by the nurses such as carrying out phone calls
follow-up to the patients being discharged, compiling an appropriate summary of the patients being
discharged and involving the patients and their family members will assist to reduce cases of hospital
readmission.
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. (If an optional supplemental source is also used, include a statement
of relevance to it as well.)
From their study, the authors found out that ineffective discharge planning process and lack of
education programs to the patients are one of the main contributing factors of increased cases of
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
DP
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RN Capstone Course
hospital readmission. The authors found out that hospital nurses did not carry out follow up phone calls
to patients to determine their progress and nurses did not keenly inspect the patients needed to be
discharged before discharging them. These cases led to failure of some of the discharged patients to
fully recover from their illnesses ending up to be readmitted in the hospital.
The findings of the authors also indicate that there is increased number of patient readmission cases
and long hospital stays due to ineffective collaboration and communication among the hospital workers
and lack of appropriate education programs for the discharged patients. The authors also found out
that the costs that arise due to readmission cases and long hospital stays by the patients increases
with the number of readmitted patients.(Goncerlves-Bradley et al., 2016).
Outline evidence-based solutions that you will consider for your project.
From the limited information of the authors, coming up with appropriate discharge planning strategies
that will entail nurses appropriately identifying the patients that are to be discharged, nurses creating a
comprehensive and accurate summary of the patients being discharged, the patients being contacted
after being discharged to conduct an aftercare follow-up, a plan to involve the patients and their family
members in the care process and providing effective education programs to patients being discharged
will be a good basis for reducing hospital readmission cases due to inappropriate discharge planning
process and lack of patient education.
Discuss any limitations to the studies that you believe impacts your ability to utilize the
research in your project.
The limitation of the study is that there is no adequate data and information to assist in drawing a
conclusion from the study. The limited information that is available is biased and the time needed to
carry out a comprehensive research was also limited.
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
DP
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Instruction of how to write this proposal
My clinical question for Milestone 1:
In patients who have gastric ulcers and have been discharged from endoscopy unit , How do nurses
doing follow up call and giving patient continuous education every week for 1 month (this is going to be
the change I recommend in my proposal) , compared to only giving patients generalized paper
discharge instructions, reduce hospital readmissions rate within 1 year?
Three useful articles
(welcome to use more resources)
Please write this proposal according to the worksheets in my attached file, also I gave three articles
website link in which you may find some good information about this topic
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128446/
http://www.mhaonline.org/docs/default-source/presentations-and-talking-points/paul-arias-lifebridgehealth.pdf?sfvrsn=4.pdf?sfvrsn=2
Gonçalves-Bradley, D. C., Lannin, N. A., Clemson, L. M., Cameron, I.D., & Shepperd, S. (2016). Discharge
planning from hospital. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD000313.
doi:10.1002/14651858.CD000313.pub5.
Library Permalink:
http://onlinelibrary.wiley.com.chamberlainuniversity.idm.oclc.org/doi/10.1002/14651858.CD000313.pu
b5/full
Instruction
1, Create a proposal for your Design for Change Capstone Project. Open the recommended assignment
specific Milestone 2 Design Proposal Template (Links to an external site.)Links to an external site.. Use
this to write your paper. You will include the information from Milestone 1, your practice issue and
evidence summary worksheets, as you compose this proposal. Your plan is to convince your
management team of a practice problem you have uncovered that is significant enough to change
current practice.
2, The format for this proposal will be a paper following the Publication manual of APA 6 th edition.
3, The paper is to be four- to six-pages excluding the Title page and Reference page.
4, As you organize your information and evidence, include the following topics.
a, Introduction: Write an introduction but do not use “Introduction” as a heading in accordance with the
rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).
Introduce the reader to the plan with evidence-based problem identification and solution.
b, Change Model Overview: Overview of the ACE Star model (the model we have been discussing this
session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the
team members.
C, Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence
summary worksheet from Milestone 1; develop a recommendation for change.
D, Translation: develop a hypothetical action plan; include measurable outcomes, reporting to
stakeholders; identify next steps and disseminate the findings.
E, Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the
ACE Star change model; and ways to maintain the change plan.
5, Citations and References must be included to support the information within each topic area. Refer to
the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted
for all information contained in your paper that is not your original idea or thought. Ask yourself, “How
do I know this?” and then cite the source. Scholarly sources are expected, which means using peerreviewed journals and credible websites.
6, Tables and Figures may be added as appropriate to the project. They should be embedded within the
body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers
visual aids to the reader and enhances understanding of your literature review and design for change.
Running head: TYPE SHORT TITLE IN ALL CAPS
Title
Your Name
Term and Year
1
TYPE SHORT TITLE IN ALL CAPS
2
Your title here
This paragraph(s) is to introduce the paper. State the problem and potential solutions
backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly
APA assignment so you cannot use first person. Remember also that you will keep all the
bolded headings and just remove the non-bolded content when you start your paper.
Change Model Overview
In this first paragraph, provide an overview of the ACE Star model Evidence-Based
Practice Process. Feel free to state why nurses should use this model as a guide to facilitate
change. Under each of the second level headers listed below, you now link your identified topic
to the ACE Star model EBP Process.
Define the Scope of the EBP
Restate your practice issue. Why is this a problem? Give statistics and information to
back the scope of the problem at your facility/work area. How does this problem impact
healthcare on a broader scale?
Stakeholders
You will be the leader of the team since this is your project. Who will you also include in
your team? Make sure you choose relevant stakeholders. You should have no more than eight
members. Do not list your team members by name but instead by position (pharmacists, charge
nurse, etc.).
Determine Responsibility of Team Members
Why are the members chosen important to your project? What are their roles?
Evidence
TYPE SHORT TITLE IN ALL CAPS
3
Conduct internal/ external search for evidence. What type of evidence did you find in
addition to you Evidence Summary? EBP guidelines? Quality improvement data? Position
statements? Clinical Practice Guidelines? Briefly discuss the strength of this research. This is
not where you describe the results of your studies. This is done in the following steps.
Summarize the Evidence
In this section, you need to synthesize the information from the systematic review article.
What are some of the evidence-based interventions you discovered in your Evidence Summary
that do you plan to use? Be sure and cite all of your references, in proper APA format, …
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