NRS 490 Capstone Project Topic Selection and Approval GCU Examples

NRS 490 Capstone Project Topic Selection and Approval GCU Examples

Identified Problem

During discussions with my approved course mentor and a review of the current challenges at my practicum site, we have identified nurse turnover as a significant problem. The practicum site I am working in is a long-term care and rehabilitation center primarily catering to geriatric patients aged 65 and older. The issue of nurse turnover is prevalent due to unfavorable working conditions, staff shortages, and better salary opportunities at other facilities.

Setting

My practicum site is a long-term care and rehabilitation center with a capacity for 99 residents, currently serving 92 residents aged 65 and older. High nurse turnover rates in such a facility can lead to inefficiencies in operations and negatively impact patient outcomes (Black, 2015).

Problem Description

Nurses at the facility often experience high levels of stress due to understaffing and heavy workloads (Foster, 2015). This stress leads to burnout as nurses are frequently required to work overtime to ensure adequate patient care. Additionally, nurses report a lack of necessary equipment, insufficient resources, unclear roles, and a lack of support from management (Jones, 2014).

Impact of the Problem

The high turnover of nurses can have a detrimental impact on patient care and outcomes. Nurse satisfaction decreases, which in turn affects their performance and contributes to an unhealthy working environment (Data, 2013). This problem holds significance for the nursing profession as it directly affects the quality of patient care and patient outcomes.

Proposed Solution

To address this issue, it is proposed to recruit and retain nurses. While the facility has introduced sign-on bonuses as an incentive, it is essential to explore other strategies to retain nursing staff. These may include providing management and leadership skills training to managers to better support and lead their teams (Maas et al., 2015) and ensuring an adequate nurse-to-patient ratio to reduce nurse workload (Sookyung, 2008).

References

Black, P. (2015). DEVELOPING AN ENHANCED PERSPECTIVE OF TURNOVER AND RETENTION OF NURSES AND HEALTH CARE AIDES IN LONG-TERM CARE HOMES. Perspectives: The Journal Of The Gerontological Nursing Association, 38(2), 25-30.

Sookyung, H., Bakken, S., Douglas, K., & Stone, P. W. (2008). Evidence-Based Staffing: Potential Roles for Informatics. Nursing Economic$, 26(3), 151-173.

Adams, Susan Louisa. 2016. “Influences of Turnover, Retention, and Job Embeddedness in Nursing Workforce Literature.” Online Journal Of Rural Nursing & Health Care 16, no. 2: 168-195.

Foster, S. (2015). Setting our sights on a Pathway to practice improvement. British Journal Of Nursing, 24(20), 1043.

Nelson, I. E. (2017). Nurse Manager Perceptions of Work Overload and Strategies to Address It. Nurse Leader, 406-408.

Maas, M. L., Specht, J. P., Buckwalter, K. C., Gittler, J., & Bechen, K. (2015). Nursing Home Staffing and Training Recommendations for Promoting Older Adults’ Quality of Care and Life Part 2. Increasing Nurse Staffing and Training. Research In Gerontological Nursing, 1(2), 134-152.

DATA BITS. Does Shift Length Affect Patient Outcomes and Nurse Satisfaction?. (2013). Kentucky Nurse, 61(4), 3.

Jones, T. L., Murry, N., & Hamilton, P. (2013). Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International Journal Of Nursing Studies, 52(6), 1121-1137.

NRS 490 Capstone Project Topic Selection and Approval at GCU – Example 2

Identified Problem

After consultation with the approved mentor and an assessment of the current challenges at my clinical practicum site, we have determined that Central Line Associated Bloodstream Infections (CLABSI) is a significant issue that requires attention. The facility has been struggling to achieve its goal of zero CLABSI cases.

Setting

My practicum site is a 640-bed multi-specialty, level 1 trauma center with an attached clinical setting. It also houses a level 4 neonatal intensive care unit (NICU). The hospital serves predominantly adult patients and is certified for stroke and primary heart attack care.

NURS 6630 Week8 Assignment 2: Evaluation and Treatment of Patients With Sleep/Wake Disorders

Problem Description

CLABSI cases are typically preventable and avoidable (Haddadin & Hariharan, 2019). In the United States alone, it is estimated that there are as many as 250,000 CLABSI cases each year, with an average treatment cost of approximately $46,000 per case (Haddadin & Hariharan, 2019). Over 30,000 of these infections occur in Intensive Care Units (ICUs) (Centers for Disease Control and Prevention [CDC], 2019).

Impact of the Problem

CLABSI cases significantly increase healthcare costs and lead to avoidable patient deaths (Haddadin & Hariharan, 2019). The Joint Commission has recognized CLABSI as a critical issue affecting patient health in the United States (Joint Commission, 2012). CLABSI cases also increase morbidity and mortality rates among hospitalized patients (CDC, 2019).

Significance of the Problem

CLABSI cases result in prolonged hospital stays and higher morbidity and mortality rates among patients (CDC, 2019). Longer hospital stays place an increased burden on nursing staff who continue to care for acutely ill patients. Nurses play a crucial role in preventing CLABSI by maintaining and sometimes placing central lines. Furthermore, CMS does not reimburse for CLABSI cases acquired in inpatient settings (CMS, 2018).

Proposed Solution

Addressing this problem will require a multi-faceted approach. Initiatives could include the use of alternative venous access devices when appropriate, the implementation of central line placement protocols and checklists, and the use of central line care bundles. Reducing the number of patients with central lines by removing them when no longer needed or by screening patients before placement can also significantly reduce CLABSI rates. Implementing protocols for nurse-led vascular access teams and requiring two nurses to be present during central line placement can enhance safety. Additionally, using central line care bundles and sterile dressing change kits can further reduce CLABSI rates.

References

Centers for Disease Control and Prevention (2019). Blood infection event (Central-line associated bloodstream infection and non-central line associated bloodstream infection). Retrieved from https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf

Haddadin, Y., & Hariharan, R. (2019). Central line associated blood stream infections. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430891/

Joint Commission (2012). New monograph aims to decrease central line associated bloodstream infections. Retrieved from https://www.pwrnewmedia.com/2012/joint_commission/clabsi/

Centers for Medicare and Medicaid (2018). Hospital acquired condition reduction program. Retrieved from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html