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2017-03-06 00:21 Chamberlain College of NursingNR 451RN Capstone CourseCapstone Project Milestone 1:Practice Issue and Evidence Summary GuidelinesPurposeClear 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 for your change project.Course OutcomesThis 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 DatesMilestone #1 consists of the completion of two worksheets (Practice Issue Worksheet) and (Evidence Summary Worksheet). Submit the completed worksheets to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 3.Points Milestone #1 is worth 175 points (75 points for the Practice Issue and 100 points for the Evidence Summary).Practice Issue Worksheet Directions1. Practice Issue Worksheet: a. Read the guidelines including the grading rubrics below.  You will use this worksheet to document 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 Worksheet Directions2. 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 be peer-reviewed and include a narrative 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’ with your 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 a narrative summary to complete your worksheet.   d. Please type your answers directly into the worksheet.Grading Criteria: Practice issueCategoryPoints%DescriptionPractice issue statement, scope of practice, practice area2027%Identifies a Practice issue statement that is an independent nursing decision. Describes the scope of practice issues.Example: The number of falls in your facility has been increasing, especially during shift change. What do you believe may be causing this? Are there any new interventions that could be put into place that would lessen or eliminatethe falls? This is where you begin your initial search into the problem or practice issue identified. Identifies the practice area.Practice issue identification, rationale for selections3546%Identifies how rationale behind how the practice issue was selected as a practice issue/problemDocuments the practice issue in a logical manner.Types of evidence to gather, rationale for selections2027%Identifies and documents types of evidence that must be gathered for review of the Practice Issue.Describes rationale for each type of evidence that is selected.Total75 points100%Grading Rubric: Practice IssueAssignment CriteriaA (100%)ExceptionalOutstanding or highest level of performanceB (88%)ExceedsVery good or high level of performanceC (80%)MeetsCompetent or satisfactory level of performanceNI (38%)Needs ImprovementPoor or failing level of performanceF (0%)DevelopingUnsatisfactory level of performancePractice issue statement, scope of practice, practice area20 pointsPractice issue is identified. Practice issue is an independent nursing decision.Scope of practice issue is fully described. Practice area identified. 20 points ☐Practice Issue is identified but is not clear.Practice issue is an independent nursing decision. Scope of practice issue is described in simple terms. Practice area identified.18 points ☐Practice Issue is identified but is not clearly related to a nursing practice issue. Practice Issue isnot an independent nursing decision.Scope of practice issue is described but is not logical in comparison to Practice Issue described.Practice area identified. 16 points ☐Practice Issue is unclear.Practice Issue is not an independent nursing decision.Scope of practice issue is not described. Practice area identified. 8 points ☐Practice Issue isnot identified; practice issue is not an independent nursing decision; scope of practice issue is not described; practice area is not identified.0 points ☐Practice issue identification, rationale for selections35 pointsDocuments how the practice issue was identified. Rationale for responses islogical anddescribed thoroughly. 35 points ☐Documents howthe practice issue was identified. Rationale for responses islogical and brieflydescribed.33 points ☐Documents howthe practice issue was identified. Rationale for responses issomewhat logical and vaguely described.30 points ☐Vaguely describes how the practice issue was identified. Rationale for responses issomewhat logical and vaguely described. 15 points ☐Does not document how the practice issue was identified. Rationale is not completed.This section of the form is blank.0 points ☐Types of evidence to gather, rationalefor selections20 points Identifies and documents what types of evidence is needed for review. Thoroughlydescribes rationale for all checked types of evidence selected.20 points ☐Identifies and documents what types of evidence is needed for review.Briefly describesrationale for all checked types of evidence selected. 18 points ☐Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence. 16 points ☐Does not document more than one type of evidence that is needed for reviewand does not include rationale for selected type of evidence. 8 points ☐Does not document types of evidence orrationale. 0 points ☐Total Points Possible = 75 pointsGrading Criteria: Evidence SummaryCategoryPoints%DescriptionPractice Problem 1010%States practice problem in own words, with reference to the population, setting, and magnitude and in measurable terms.Describes practice setting in measureable termsExample: 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 be causing this? What can be done to lessen or eliminate the falls? How does this number of falls relate to other months that have been tracked?Source of evidence2020%Identifies a source of evidence that is a nursing topic that is the subject of a systematic review article. Identifies search terms.Provides a complete reference for the systematic review article.Objectives of the article/Statement of questions2020%Identifies the objectives of the article.Identifies questions being addressed by author/s.Explains relationship to your practice issue.Interventions/Main findings summary3030%Summarizes, in own words, suggested interventions by the author/s to improve patient outcomes.Summarizes main findings of the author/s including strength of evidence for each main outcome.Describes the relevance to the Milestone 2 paper.Evidence-based solutions and limitations2020%Outlines evidence-based solutions to consider for the capstone project.Discusses any limitations to the studies included in the systematic review that you believe may impact use of the evidence provided in your project.Total100 points100%Grading Rubric: Evidence SummaryAssignment CriteriaA (100%)ExceptionalOutstanding or highest level of performanceB (88%)ExceedsVery good or high level of performanceC (80%)MeetsCompetent or satisfactory level of performanceNI (38%)Needs ImprovementPoor or failing level of performanceF (0%)DevelopingUnsatisfactory level of performancePractice Problem10 points-Practice problem is in own words, with reference to the population of interest.-Setting of the problem is identified-Magnitude of problem is discussed.-The practice issue is stated in measurable terms.Met all objectives as stated above10 points ☐-Practice problem is in own words, with reference to the population of interest.-Setting of the problem is not discussed.-Magnitude of problem is discussed.-The practice issue is stated in measurable terms. Met 3 out of 4objectives9 points ☐-Practice problem is in own words, with reference to the population of interest.-Setting of the problem is not discussed.-Magnitude of problem is not discussed.-The practice issue is stated in measurable terms. Met 2 out of 4objectives8 points ☐-Practice problem is in own words, with reference to the population of interest.-Setting of the problem is not discussed.-Magnitude of problem is not discussed.-The practice issue is stated but notmeasurable.Met only 1 out of 4 objectives4 points ☐-Practice problem is not in own words-There are no references to the population of interest.-Setting and magnitude of problem is not discussed-The practice issue is not stated in measurable terms. Did not meet anyobjectives0 points ☐Source of evidence20 points-Source of evidence is nursing topic.-Source is aSystematic Review article. -Search terms are identified.-Complete reference is given for Systematic Review article.Met all 4objectives as above20 points ☐-Source of evidence is nursing topic.-Source is a Systematic Review article. -Search terms are identified.-Complete reference is not given for Systematic Review article.Met 3 out of 4objectives18 points ☐-Source of evidence is nursing topic.-Source is not aSystematic Review article. -Search terms are identified.-Complete reference is not given for Systematic Review article.Met only 2 out of 2 objectives16 points ☐-Source of evidence is not nursing topic.-Source is a Systematic Review article. -Search terms arenot identified.-Complete reference is not given for Systematic Review article.Met only 1 out of 4 objectives8 points ☐-Source of evidence is not nursing topic or Systematic Review article.-Search terms arenot identified.-Reference is missing.No objectives were met.0 points ☐Objectives of the article/ Statement of questions20 points-Objectives of article are identified.-Questions being addressed by author/s are thorough. -Relationship to 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. 18 points ☐-Objectives of article are identified.-Questions being addressed by author/s are not thorough. -Relationship to your practice issue is vague. 16 points ☐-Objectives of article are identified.-Questions being addressed by author/s is missing. -Relationship to your practice issue is not explained. 8 points ☐-Objectives of article are 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.-Thoroughly summarized main findings of the author/s.-Included strength of evidence for each main outcome.30 points ☐-Briefly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.-Briefly summarized main findings of the author/s.-Included strength of evidence for each main outcome.27 points ☐-Vaguely summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.-Vaguelysummarized main findings of the author/s.-Included strength of evidence for most of main outcomes.25 points ☐-Summary of interventions is not in own words.-Summarized main findings of the author/s is not apparent. -Did not include strength of evidence for any of the main outcome.12 points ☐-Summary of the interventions the author(s) suggest to improve patient outcomes is missing. -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-Outline of evidence-based solutions considered for project is documented and clear.Discussed any limitations to the studies performed.Documents limitationsbelieved may impact use in project.20 points ☐-Outline of evidence-based solutions beingconsidered for project is documented but not clear.Discussed any limitations to the studies performed.Documents limitations believed may impact use in project.18 points ☐-Outline of evidence-based solutions considered for project is documented but not clear.Discussed most limitations to the studies performed.Documents limitations believed may impact use in project.16 points ☐-Outline of evidence-based solutions being considered for project is not documented.-Discussed mostlimitations to the studies performed.Documents limitations believed may impact use in project.8 points ☐-Outline of evidence-based solutions, limitations of studies and potential impact to project is missing.0 points ☐Total Points Possible = 100 pointsNR451 W3 Milestone1 Practice Issue & Evidence Summary Guidelines 2/16/17    GH3 This is the guidelines 2017-03-06 00:23Chamberlain College of NursingNR451 RN Capstone CourseCapstone Project Milestone 1:Practice Issue and Evidence Summary WorksheetsStudent Name: Date:Directions1. 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 WorksheetWhat 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 rationale for 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)___ OtherDescribe the rationale for your checked selections: 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:Find a source of evidence that is a systematic review article on a nursing topic that is relevant to your practice problem. Write the complete APA reference for the systematic review article you selected:Define the search terms for your systematic review:Identify the objectives of the article.Provide a statement of the questions being addressed in the work and how they relate to your practice 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 the Milestone 2 project paper.Outline evidence-based solutions that 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.NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets  2/16/17    GH3Clinical 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 PatientsI-(Intervention)-Follow up phone call at 48 and 72 hours post dischargeC-(Comparison with current practice)-No follow up telephone calls for support.O-(Desired outcome)-Reduce the number of Readmissions