Requirements:
Chapter 1: Introduction
A. Provide an introduction (suggested length of 4–6 pages) that explains the rationale for your project by doing the following:
1. Explain the background of the problem.
2. Provide your problem statement.
3. Summarize the scope of the project by doing the following:
a. Describe the practice change, quality improvement, or innovation.
b. Provide a rationale for the practice change, quality improvement, or innovation.
Chapter 2: Literature Review
B. Provide a thorough and well-organized literature review on your topic by doing the following:
1. Review a minimum of 30 credible sources that were published within the last five years.
Note: In order to prove that you have reviewed 30 credible sources, you will need to provide a list, in APA format, of the sources you reviewed for part B1.
2. Identify best practices for your topic based on the review of literature.
3. Provide an evidence summary of the literature relevant to the topic you have chosen.
C. Recommend a practice change, quality improvement, or innovation based on the findings of the literature review and evidence summary from parts A and B.
D. When you use sources, include all in-text citations and references in APA format. All within the last five years.
Chapter 3: Implementation
Project Launch
A. Evaluate how you implemented your capstone project by doing the following:
1. Describe the actual steps taken to implement your capstone project.
2. Discuss any changes that occurred to the original implementation plan during this process.
3. Discuss any barriers associated with the implementation of your capstone project.
a. Explain how you overcame the barriers discussed in part A3.
Collaboration
B. Identify interprofessional relationships that promoted implementation of your capstone project.
1. Discuss how the relationships identified in part B facilitated the implementation of your project.
Chapter 4: Postcapstone Project Considerations
Evaluation
C. Discuss the most successful aspects of your capstone project.
1. Explain how the successes of your project can help to inform future projects.
D. Discuss aspects of your project that did not go as well as anticipated.
1. Explain how understanding of what did not go well can help to inform future projects.
E. Explain how your capstone project bridged the gap between evidence and current practice.
Organizational Sustainability
F. Discuss the organization’s plan to support the postimplementation of the capstone project, including plans for short- and long-term maintenance.
G. Discuss the resources needed for postimplementation support.
Chapter 5: Reflection
H. Discuss how you integrated two MSN program outcomes into your capstone project.
I. Submit your completed capstone report, including the abstract and chapters 1–5.
Abstract
J. Create an abstract for your capstone project, including:
• problem identification
• plan for addressing the problem under investigation
• implementation process
K. When you use sources, include all in-text citations and references in APA format.
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This is an instructional template only. Please use this to guide you as you work in the MSN Capstone Template. Complete this Title Page by adding your Running head, title of your project, and your name.
Title of Capstone Project
Author Name (First, Middle Initial, and Last)
College of Health Professions
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Abstract
1. Problem identification
2. Plan for addressing the problem under investigation
3. Implementation process
** Note: Abstract length – single paragraph, do not indent, maximum of 250 words.
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Acknowledgements
(Inclusion of acknowledgements is optional)
This area is to acknowledge family, preceptor, faculty, friends, or anyone you would like to acknowledge.
Table of Contents
** Note: You MUST add any additional subtitle headings to this Table of Contents as well as the page numbers.
Abstract……………………………………………………………………………………..2
Acknowledgements…………………………………………………………………………3
Chapter 1: Introduction……………………………………………………………………..
Problem Statement………………………………………………………………………
Problem Background…………………………………………………………………….
Rationale for the Practice Change, Quality Improvement, or Innovation………………
Chapter 2: Review of the Literature…………………………………………………………
Credible Sources………………………………………………………………………….
Best Practices Identification……………………………………………………………..
Evidence Summary………………………………………………………………………
Recommended Practice Change, Quality Improvement, or Innovation…………………
Chapter 3: Implementation…………………………………………………………………..
Capstone Project Steps……………………………………………………………………
Changes to original implementation plan……………………………………………..
Barriers associated with implementation……………………………………………..
Overcoming barriers…………………………………………………………………..
Transprofessional Relationships…………………………………………………………
How relationships facilitated implementation……………………………………….
Chapter 4: Post Capstone Project Considerations…………………………………………..
Capstone Successes……………………………………………………………………….
Successful aspects…………………………………………………………………….
Impact on future projects…………………………………………………………….
Capstone Challenges……………………………………………………………………..
Aspects that did not go well…………………………………………………………..
Impact on future projects……………………………………………………………..
Evidence and Current Practice…………………………………………………………..
Post-Implementation……………………………………………………………………..
Resources Required for Post-Implementation Support…………………………………..
Chapter 5: Reflection…………………………………………………………………………
Integration of MSN Program Outcomes………………………………………………….
References…………………………………………………………………………………….
Appendix A: Credible Sources…………………………………………………………………
Appendix B: Organization Approval Letter……………………………………………………
Appendix C: Preceptor Agreement…………………………………………………………….
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Chapter 1: Introduction
Note: You will write Chapter 1 after successful completion of Task 1 in the Field Experience Course. You may refer to Task 1 to complete your Introduction. Please DO NOT copy/cut and paste into the MSN Capstone Template as the formatting will be altered.
The Introduction to Chapter 1 provides a brief discussion about the topics that will follow in Chapter 1. Therefore, this section should include a brief introduction of the problem your project will address, a brief discussion about the practice change, quality improvement, or innovation you have selected to address the problem, and the reason (rationale) you believe your practice change, quality improvement, or innovation is necessary to address the problem.
Problem Statement
This section involves the nursing problem you plan to address. The Problem Statement should be clear and concise. You should describe the scope of your problem, the population effected by the problem, and location where the problem exists, and other key issues specific to your problem. This section involves a nursing problem statement, not a clinical PICO or research question. Here are several examples of a Problem Statement: 1) A high incidence of alcohol-related injuries and accidents at a local high school, 2) High RN turnover rates in a specific facility or organization, 3) Staff on a nursing unit are not currently using or following credible evidence-based practice guidelines around a specific nursing practice, 4) Staff nurses on a specific unit or facility desire more autonomy related to their work schedules, or 5) Staff nurses on a specific unit or facility have a knowledge deficit about a new procedure, policy, or patient care protocol. Your nursing problem should reflect your specialty track (nursing education or nursing leadership and management).
Problem Background
In a detailed discussion, you should include factors, issues, or phenomenon that helped create or contribute to the problem. How did this problem begin and how long has it been a problem? Are there people (individual or groups) and/or conditions that contribute to the problem? Be sure to provide substantial detail to support the background information.
Description of the Practice Change, Quality Improvement, or Innovation
This section will include a detailed discussion of each of the action steps that you will actually complete (or have completed) in support of your practice change, quality improvement, or innovation. You will need to be specific. For example, your organization may be interested in changing the policy or approach to the triage process in your emergency department. However, this policy change/process improvement will take several months and system wide resources to complete. You will not have sufficient time or resources to complete the entire policy change/process improvement within the scope of your Capstone project. Also, due to organizational constraints or your position in the organization, you may not have the capacity to effect the policy/process improvement in its entirety. Nevertheless, you are in a position to influence change by developing a specific component in support of changing the triage process. Therefore, your project will involve a smaller scope, which you must fully develop. Your part of the project may involve the following: 1) Developing a schematic for the new triage process, 2) Developing a new policy for implementing the new triage process, 3) Developing a new educational offering about the new triage process, and/or 4) Providing a presentation of the evidence that supports changing the triage process to stakeholders that are in a position to effect the change that you are advocating. Your Capstone project will then focus on what you will do (or did) to influence change within your organization; your specific component of the larger change that is taking place within your organization. The goal is for you to be succinct, yet provide sufficient detail to ensure readers have a clear understanding of what your specific contribution to the organization’s practice change, quality improvement, or innovation is all about. Information about your action items, timeline, interactions with stakeholders, and utilization of resources will enhance this discussion.
Rationale for the Practice Change, Quality Improvement, or Innovation
This section will provide an explanation of why the practice change, quality improvement, or innovation is being recommended. Explain the importance of the practice change, quality improvement, or innovation. Why is your project desired, needed, or required? This section should also clearly explain the rationale for selecting your specific component of the organization’s practice change, quality improvement, or innovation. For example, providing a schematic for the new triage process will be necessary if the usual flow or room assignment in the Emergency Department will be changed by the new triage process. In short, provide a clear a rationale for the key steps involved with your Capstone project (your specific component of the organization’s practice change, quality improvement, or innovation that is being recommended)
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Chapter 2: Review of the Literature
Credible Sources
This section requires a general narrative discussion indicating that 30 credible sources (related to your project), published within the last five years were reviewed. You should indicate a brief statement in this narrative, indicating that your review will include the source’s applicability, the evidence grade assigned, a general appraisal of the findings, and a determination of whether the source will be included or excluded from the final list of sources that will be used to inform your Capstone project. You should refer your readers to Appendix A at the end of your narrative discussion. For example: See Appendix A Credible Sources.
You will accomplish the actual review of your sources by completing Appendix A – the Credible Sources table (located in the Appendix section of this template). Recall, the purpose of your review is to evaluate each source (article) and make an appraisal of the source, based on the following criteria: 1) Database where source was located, 2) Peer-reviewed (yes/no), 3) Applicability to your project, 4) Evidence grade assigned (strength and hierarchy), 5) General appraisal (brief summary of findings/information and how the findings inform your project), 6) Inclusion (whether you intend to use the source to bolster the credibility of your project) or Exclusion (source does not bolster the credibility of your project). Each of the sources that meet criteria for inclusion, based upon your review, must be utilized in the body of your paper (sources will be identified using in-text citations). All sources identified with in-text citations in the body of the paper must be included in your References section.
Best Practices Identification
This section involves a narrative discussion. You will identify specific best practices identified or discussed in the sources that met your inclusion criteria (from Appendix A – Credible Sources Table).
Remember, the best practices, which are identified in your review of the literature, form the foundation and support the development of your Capstone project. In-text citations MUST be used to support your identified best practices. If you note a lack of evidence or a gap in the literature, you will need to discuss the gaps or deficits in this section too. As a cautionary note, be sure there is adequate evidence to support your recommended project, if you are proposing to implement an evidence-based practice procedure or protocol. If there is truly a dearth of evidence or significant gaps in the available literature, then you will need to frame your project as an innovation. Innovations in practice settings are rare and will require substantial buy in from stakeholders. The burden for justifying an innovation in the practice setting is quite high. If existing credible evidence that runs contrary to the recommended innovation is discovered, then the innovation must be abandoned in favor of the evidence. In this case, science (evidence) trumps opinion (innovation), or politics (what an organization wants you to do).
Evidence Summary
This section is based on the sources that met your inclusion criteria in Appendix A – Credible Sources table. This section provides a summary (synthesis) of the findings, conclusions, or recommendations identified in the sources that were “included”. The Evidence Summary should not be an Annotated Bibliography (separate critique) of the “included” sources. Instead, it should identify the areas where consensus among the various authors of the “included” sources exists. The findings, positions, and recommendations included in your Evidence Summary should be consistent with the recommendations you are proposing for your Capstone project. Use of subheadings in this section, greatly facilitates organization of your Evidence Summary. You MUST include an APA style in-text citation for every source that met your inclusion criteria in Appendix A – Credible Sources table. Each “included” source will be incorporated into the discussion in your Evidence Summary. You are encouraged to cite more than one source (as applicable) when discussing the topics in your evidence summary. Each APA style in-text citation must be included in your References section.
Subheading (usually required). When you are discussing your findings, positions and recommendations identified in the literature, it is helpful to organize your discussion by concept, topic, or idea. The use of subheadings will provide both you and the reader, a good flow of information. Remember to give your Subheadings a title and to add them to your Table of Contents.
Subheading (usually required). Type here.
Subheading (usually required). Type here.
Recommended Practice Change, Quality Improvement, or Innovation
In this section, you will provide a brief restatement of your problem from Chapter 1: Introduction, followed by the information contained in your evidence summary to make a recommendation for a practice change, quality improvement, or innovation. Your recommendation must be supported by the evidence (or lack of evidence) you identified in the literature review.
Chapter 3: Implementation
Capstone Project Steps
This chapter is intended for you to provide a reflection on the actions steps that you took to complete your project. As a reminder, this will include a detailed discussion of each of the action steps that you actually completed in support of your specific component of the organization’s practice change, quality improvement, or innovation. Your reflection will then focus on what you were able to do to influence change within your organization. In short, you will need to describe what you actually did. Information about your completed action items, timeline, interactions with stakeholders, and utilization of resources will enhance this discussion.
Changes to original implementation plan. This section will include a detailed discussion of any changes you made in your original implementation plan. Be sure to include a detailed discussion of each of these changes in relation to your original plan. For example, adjustments to your timeline may have been required for a variety of reasons. You should identify the change to your original timeline and include the rationale for the change. Other changes may have been required due to constraints or changes within the organization that is supporting your practice change, quality improvement, or innovation. If no changes were made to your original plan, you should indicate this fact.
Barriers associated with implementation. In this section, you will provide a detailed discussion of any barriers you encountered during the implementation of your evidence-based practice change, quality improvement, or innovation. Potential barriers might include: 1) Lack of staff support, adherence, acceptance, participation, etc., 2) Unable to procure or obtain required equipment, supplies, resources, 3) Unable to secure required funds or other financial constraints, 4) Temporal components (insufficient time to fully implement, time delays due to staffing, etc.). If no barriers were encountered, you should indicate this fact.
Overcoming barriers. This section will include a detailed discussion of how each of the barriers was overcome. If you were not able to overcome barriers, you should include a detailed discussion of the measures that were attempted to overcome the barriers. If no barriers were encountered, you should indicate this fact.
Transprofessional Relationships
This section will include a list of transprofessional team members that contributed to the implementation of your project. Keep in mind that a transprofessional team is developed by the merging of professional boundaries. Some examples of these team members may include your stakeholders, ancillary staff, and physicians.
How relationships facilitated implementation. Provide a detailed discussion of how each of the identified transprofessional relationships facilitated implementation of your practice change, quality improvement, or innovation Capstone project.
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Chapter 4: Post Capstone Project Considerations
Capstone Successes
Successful aspects. This section will include a detailed discussion of the successful aspects of your Capstone practice change, quality improvement, or innovation project. Provide a description of the aspects of your project that went well. This may include a description of how you were able to influence change within your organization. Some examples may include, but are not limited to, improvements in awareness or understanding around your topic within the organization, improved communication among stakeholders, or a readiness within the organization leadership and/or staff members to commit to the practice change, quality improvement, or innovation.
Impact on future projects. This section will include a detailed discussion about how this project can be used to inform or facilitate future practice changes, quality improvements, or innovation projects within the organization or in other organizations. Was your project just the “beginning,” with future steps required for sustainment after your project implementation? Will your project provide a foundation for future evidence-based practice changes, quality improvements, or innovations? Did your project create a blueprint for other change agents within your organization? Bottom line: What did you learn from the successes of the Capstone project that would inform future projects?
Capstone Challenges
Aspects that did not go well. This section will include aspects of your Capstone practice change, quality improvement, or innovation that did not go as planned. Provide a detailed discussion of each of these aspects. If there were no aspects of your project that did not go as planned, you should indicate this fact.
Impact on future projects. This section will include a detailed discussion of each of the aspects identified that did not go well and how this may impact future practice changes, quality improvements, or innovation projects within your organization or in other organizations. If there were no aspects that did not get well, you should indicate this fact.
Evidence and Current Practice
In this section you will provide a detailed discussion of how the evidence you found for your practice change, quality improvement, or innovation project enhanced the development and implementation of your project. This will require a detailed discussion about how the current practice was changed, based on the evidence. If there is truly a dearth of evidence or significant gaps in the available literature, then you will need to discuss how your innovation can lay the foundation for new knowledge to be developed around your implementation. This new knowledge can be examined and/or tested with future nursing research.
Post-Implementation
In this section you will provide a detailed discussion of both the short and long term maintenance plans your organization will use for your project’s continued success. This might include a discussion about are variety of organizational plans including, but not limited to, creation of working groups, development of administrative support structures (policies, procedures, staffing adjustments, or modifications in the organization structure).
Resources Required for Post-Implementation Support
This section will include a detailed explanation of the resources needed for sustaining the project. This might include a discussion about a variety of issues, such as continued education, allocation of funds or additional resources, and ongoing meetings to discuss strategies to sustain the project. ?
Chapter 5: Reflection
Integration of MSN Program Outcomes
This final chapter of your Capstone written project provides the opportunity to discuss how the Capstone project allowed for integration of the WGU MSN program outcomes. You should select two of the program outcomes were most relevant to your project. Please refer to the MSN program outcomes (listed below). There are nine WGU MSN program outcomes. Address two of the outcomes integrated in your Capstone project.
The following example of a Subheading utilizes keywords from the first WGU MSN program outcomes:
Patient-care technologies and information management strategies. You would then discuss how your project allowed for integration of this program outcome.
Subheading (usually required). Type here.
Subheading (usually required). Type here.
WGU Master of Science in Nursing program outcomes (This section is not included in the MSN Capstone Template and is intended to be utilized for your reference only.)
The WGU Master of Science in Nursing program graduate will:
1. Employ appropriate patient-care technologies and information management strategies to improve quality care outcomes.
2. Integrate clinical reasoning with organizational, patient-centered, culturally appropriate strategies to plan, deliver, and evaluate evidence-based practice.
3. Design innovative nursing practices to impact quality outcomes for individuals, populations, and systems congruent with ethical, professional, and legal standards.
4. Assemble scientific findings from nursing, biopsychosocial fields, genetics, public health, and organizational sciences for the continual improvement of nursing care across diverse settings.
5. Utilize applied research outcomes within the practice setting, navigating and integrating care services across healthcare systems.
6. Design organization and leadership systems that promote high quality patient-care delivery and advance life-long learning.
7. Construct interprofessional teams to communicate, coordinate, collaborate, and consult with other health professionals to advance a culture of excellence.
8. Integrate scientific knowledge including that from genetics and genethics in the continual improvement of nursing care across diverse settings and populations.
9. Provide oversight and guidance in the integration of technology to manage care, identify performance measures and standards that improve quality and safety outcomes.
References
(Please note that this document outline is only a guide. The written paper, including all in-text citations, must be written in proper APA style. All references (sources) that met your inclusion criteria should be identified using in-text citations in the body (narrative portion) of the paper. All of the included sources should be included in the References section.)
Finkler, S. A., Jones, C. B., & Kovner, C. T. (2013). Financial management for nurse managers and executives (4th ed.). St. Louis, MO: Elsevier.
Park, S. H., Blegen, M. A., Spetz, J., Chapman, S. A., & De Groot, H. (2012). Patient turnover and the relationship between nurse staffing and patient outcomes. Research in Nursing & Health, 35(3), 277-288. doi:10.1002/nur.21474
Park, S. H., Boyle, D. K., Bergquist-Beringer, S., Staggs, V. S., & Dunton, N. E. (2014). Concurrent and lagged effects of registered nurse turnover and staffing on unit-acquired pressure ulcers. Health Services Research, 49(4), 1205-1225. doi:10.1111/1475-6773.12158
Staggs, V. S., & Dunton, N. (2012). Hospital and unit characteristics associated with nursing turnover include skill mix but not staffing level: An observational cross-sectional study. International Journal of Nursing Studies, 49(9), 1138-1145. doi:10.1016/j.ijnurstu.2012.03.009
Sullivan-Havens, D., Jones, C. B., & Carlson, J. (2014). Chief nursing office retention & turnover, 2013: Is the crisis still brewing? Retrieved from https://www.aone.org/conference2014/Handouts/2014_Concurrent_Handouts/Additional%20Handouts/S330H_BN2.pdf
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Appendix A
Credible Sources
All sources that meet inclusion criteria must be incorporated into the body (narrative) part of the paper. For example, when you provide an evidence summary, you will identify the source (from your inclusion list) and include an in-text citation. You will also provide the full APA style citation in the References section.
If you obtained your sources from the WGU Library, you will not need to identify the database (See the example below).
Author(s)
Formatted as in-text citations Database
CINAHL, EBSCO, Cochrane, Pro-Quest
WGU Library Peer-Reviewed
Yes/No Applicability
Yes/No Evidence Grade
Strength/ Hierarchy Appraisal
Brief summary of findings: how findings informs your project Inclusion
Yes/No
Sample Source:
Staggs and Dunton (2012)
WGU Library
Yes
Yes
4/Cross-Sectional Controlling for hospital ownership, Magnet status, unit service line, and unit population age group, registered nurse skill mix is apparently more important than total nurse staffing level in predicting nursing turnover. My project focusses on implementing career ladders in support of Magnet Status application.
Yes
Strength of Evidence and Evidence Hierarchy:
Evidence/Strength Evidence Hierarchy
Level 1 Meta-analysis, Systematic reviews, Integrative reviews, Evidence-Based Practice Guidelines
(This level includes; research designs of Meta-Analyses, Systematic Reviews, Integrative Reviews, and EBP Guidelines which are developed from systematic reviews and housed in national repositories.)
Level 2 Randomized Controlled Trial (RCT) and Experimental designs (This level represents evidence from studies using a true experimental design.)
Level 3 Quasi-experimental designs (This level represents evidence obtained from experimental studies without randomization.)
Level 4 Non-experimental designs (This level represents evidence from well-designed non-experimental designs such as retrospective, case-control, cross-sectional, cohort-comparison, prospective, descriptive and correlational single studies.
Level 5 Meta-Synthesis (This level represents evidence from systematic reviews of studies using qualitative methods.)
Level 6 Single Qualitative Studies (This level represents single studies using a qualitative research approach.)
Level 7 Expert Opinion (This level represents materials from a variety of non-research based evidence and generally consists of reports of expert committees and/or opinions of authorities on the subject. The evidence from this level includes: specialists’ opinions, case studies, non-evidence-based practice guidelines, narrative reviews, editorials, regulations, legislation, and program outcome data/QI projects
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