Capstone in Evidence-Based Professional Nursing Practice

Course Description

Students review and build upon leadership and management principles. Emphasis is placed on understanding the health care system and social forces affecting care delivery, effective leadership, patient outcomes, project management, health care policies, basic accounting principles, and entrepreneurship. Students use evidence-based resources, address health competencies and analyze an identified issue while developing a plan of interventions that incorporates current evidence for management of the identified issue. Students will present their capstone work via a poster or podium presentation. Presentation forums may be at their selected venue, at a professional conference, or conducted virtually.

Course Learning Outcomes

Upon completion of the course, the student will be able to:

1. Use information and technologies to monitor and provide quality patient care. (PLO 1)
2. Demonstrate cultural competence in nursing practice. (PLO 2)
3. Provide competent, evidence-based nursing care. (PLO 3)
4. Document nursing information and activities in support of safe patient care. (PLO 4)
5. Speak clearly and concisely in conveying healthcare information. (PLO 5)
6. Collaborate effectively with healthcare team members. (PLO 6)
7. Apply empirical research to nursing practice. (PLO 7)
8. Apply the Code of Ethics for Nurses in professional nursing practice. (PLO 8)
9. Objectively analyze and evaluate data to inform decision-making in nursing practice. (PLO 9)

Welcome to Nurs 499 Capstone in Evidence-Based Professional Nursing Practice

The student will provide a proposal on the approved topic from NURS 378 using Evidence-Based Project in healthcare and their respective community setting.  You will develop a protocol supported by evidence, review and critically appraise the literature regarding this topic, and develop a project proposal. The proposal should include the plan for implementation, and evaluation.  During week 8, the student will present his/her EBP project and finally, create a poster suitable for presentation at a nursing conference or for publication. The Project must focus on the RN/BSN practice. Please consult your practicing state’s Nurse Practice Act. Your project proposal must not focus on interventions carried out by an Advanced Practice Nurse.

Concepts studied during your progression through the RN-BSN program should be clearly integrated into this assignment.  This presentation demonstrates your achievement of the outcomes of the Essentials of Baccalaureate Education for Professional Nursing Practice as defined by the American Association of College of Nursing

There are eight modules in this course.

Module 1:  Evidence-Based Practice (EBP) topic proposal from the identified health concern (approved topic)  in NURS 378 (due week 1)

Module 2:  Evidence-Based Practice Timeline and Plan (due by Week 2)

Module 3:  Literature Review (due end of Week 3)

Module 4:  Stakeholder Analysis (due end of Week 4)

Module 5:  Stakeholder Communication (due end of Week 5)

Module 6:  Evidence-Based Practice Design Paper (due end of Week 6)

        Evidence-Based Practice Design Paper

• Background: Community Health Concern and Identification
• Facilitators and Barriers to EBP Implementation
• Organizational Culture
• Proposal for the next steps to address the identified health concern

Module 7:  Evidence-based Practice Presentation, Part I

• Presentation in synchronous class session (TBA, Week 7)
• Instructor will schedule presentation date and time

Module 8:  Evidence-based Practice Poster Presentation, Part II

• Poster presentation, voice-narrated powerpoint.

• Welcome to Week 3
• Week three will focus on framing your clinical question, conducting an evidence-based literature review and discussing levels of evidence used for evaluation of practice guidelines/protocols.
• Week 3: Lecture – Evidenced-Based Practice

• The theory of EBP and to explain how theory can be put to practice in the day-to-day work of caring for patients.   The “5A’s Cycle” of EBP that include assessing the patient and prioritizing questions about his/her care, asking a focused clinical question, acquiring the evidence to answer the question, appraising the research, applying the research findings to patient care, and finally auditing your performance. The cycle begins again with an assessment of the patient and the patient’s care (Guyat, G. H. et al.)
• The focus is largely on efficient literature searching and therefore on asking questions and acquiring the best evidence.  In particular, it suggests specific strategies for finding evidence from primary studies, systematic reviews and meta-analyses using EBP tools.  Appraisal is also touched upon, with suggestions for scanning search results to identify articles more likely to yield robust, applicable evidence.
• At end of this lecture, you should be able to:
  • Formulate a clinical question using the PICO framework;
  • Identify five common categories of clinical questions;
  • Identify which research methodologies provide the best evidence for your question type
  • Distinguish between systematic reviews, meta-analyses and narrative or clinical topic reviews
  • Search Medline/PubMed effectively for studies likely to provide the current best evidence by
  • Identifying appropriate search terms, including Medical Subject Headings (MeSH) terms; and
  • Employ evidence resources such as PubMed, Pro Ques, etc.
  • Identify articles from your PubMed search results that are most likely to provide current, valid, reliable and relevant evidence to answer your question.
• There are many excellent online and print guides that address the critical appraisal of a research report and the application of evidence to an individual patient’s care. You will find links to selected resources that provide especially rich content in these areas in the Appraise and Apply modules of this tutorial.
• It is best to work systematically through the various modules, starting with Introduction:
• About Evidence-Based Practice, and then the five modules.

References:

1. Guyatt, G.H., Haynes, R.B., Jaeschke, R.Z., & Cook, D.J. (2000). Users’ guides to the medical literature: XXV. evidence-based medicine: principles for applying the users’ guides to patient care. JAMA, 284, 1290-1296.
2. Sackett, D., Rosenberg, W., Gray, J., et al. (1996). Evidence based medicine: what it is and what it isn’t: it’s about integrating individual clinical expertise and the best external evidence. BMJ, 312, 71-72.

ASSIGNNENT

This section of your Evidence Based Project Proposal identifies and critically evaluates the evidence on your RN practice topic.  It provides a discussion enabling the clinician a to determine the best available research evidence on which to base practice. This is a process of examining the key components or themes in the literature and identifying how they fit together. The evidence review also reviews the theoretical foundation of your Evidence Based Project. Included in this review is a critique or appraisal of the quality of the evidence you are reviewing.  This section will form a foundation of support for your proposal.

Directions:   

In the background, introduce your health concern (NURS 378 approved topic) and the context that led you to identify your health concern. You will explore the relevant background literature and theory related to your topic. Discuss its relevance to your local community health setting, organizational, metropolitan, state, national, and international levels as applicable. You will discuss the potential benefits and challenges of addressing the community health topic in your local setting, and explore the larger contextual impact related to this problem. The conclusion of this design is the proposal for the next steps to address the identified health concern.

1. Identify a minimum of 6-8 references that support your project. 
2. Review this literature in terms of
   1. Theoretical Underpinnings
   1. Identification of ‘Themes” to contextualize the analysis
   1. Discussion of how these themes fit together to support your project.