1 / 32

Designing and Sustaining the Capstone Project

Designing and Sustaining the Capstone Project. Linda Roussel, RN, DSN, NEA-BC, Professor, USA College of Nursing Tammy Lee, MSN, RN, CNL, Clinical Nurse Leader Coordinator, Carolinas Medical Center Terilee Gerry, BSN, RN, CNL Student, Maine Medical Center. Objectives.

natara
Download Presentation

Designing and Sustaining the Capstone Project

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Designing and Sustaining the Capstone Project Linda Roussel, RN, DSN, NEA-BC, Professor, USA College of Nursing Tammy Lee, MSN, RN, CNL, Clinical Nurse Leader Coordinator, Carolinas Medical Center Terilee Gerry, BSN, RN, CNL Student, Maine Medical Center

  2. Objectives • Describe overall expectations for the Clinical Immersion Experience, including the Capstone Project. (Linda) • Identify major aspects of planning a Capstone Project, including a doing a Needs Assessment, developing an evidence-base for practice change and outcome measures. (Terilee) • Review innovative role of CNL and how the CNL immersion experience and completed project help advance CNL skill set (Tammy)

  3. CNL Academic Experience • CNL White paper • Roles • Competencies • End of Program Expectations

  4. CNL Academic Experience • Assignments: • Needs Assessment • Work Flow • Gap Analysis • Clinical Experience • Role Socialization

  5. CNL Academic Experience • Clinical Experience • Making the Case • Cost-Benefit • IOM Aims • Outcomes Management • Evaluation

  6. Major Aspects of Project Management and the Clinical Immersion Experience The Student Perspective Terilee Gerry, BSN, RN, CNL Student, Maine Medical Center

  7. Academic Preparation • BS in Nursing • 2 yrs clinical experience • 5 semesters • Semester 1,2 course work • Semester 3,4 continue course work and begin clinical experience • Last semester course work and full clinical immersion

  8. Clinical Preparation • 3rd semester and the 40,000 ft view • Met people behind the scenes • Met future resources • 8 hrs clinical time/wk in 4th semester • Weekly meetings with CNL preceptor • Full clinical immersion during last semester

  9. Student Clinical Resources • Staff Development Specialist coordinated student experiences • 8 CNLs • Nursing Director • Student colleagues

  10. CNL Preceptor • Shadow different CNLs • Eventually assigned primary preceptor • Weekly meetings • Advisors • Offered help with research/capstone project • Shared experiences with us • Offered support/advice/suggestions

  11. Nursing Director • Project approval • Weekly meetings • Close communication • Leadership mentor

  12. The Capstone Project • Preliminary discussion in 1st semester • Establish a time line • Unit based • Needs Assessment • Director approved • Prepare for IRB submission

  13. My Project • Assigned unit in 3rd semester • Unit issues/needs unknown • Director meeting-input important • Possible project suggestions • Decision made • Began making contacts

  14. Project Begins • Literature Search • Begin contact/meetings with stakeholders • Communication with physicians • Work with faculty • Input from Nursing Research Dept.

  15. Project Continues • Paper written • Hospital and Univ. IRB approval obtained • Data collection now underway

  16. Director’s Input • Inform staff of project to demonstrate leadership • Attend staff meetings • Involvement on various committees • Meet key personnel

  17. Continued Support • CNL monthly meetings • Quarterly meetings with CNS group • Support of each other as needed

  18. Innovative Role of the CNL The CNL Perspective Tammy Lee, MSN, RN, CNL, Clinical Nurse Leader Coordinator, Carolinas Medical Center

  19. Innovative Role of CNL “We cannot solve our problems with the same thinking that created them.” Albert Einstein

  20. Projects • Simplistic to Difficult • Small to Enormous • Microsystem changes to House-wide changes

  21. My Capstone Project • As the result of my Capstone project an entire process was changed. • It’s benefits: decreased catheter related-blood stream infections and decrease number of healthcare dollars spent. • Other benefits was streamlining care for the nurses.

  22. Capstone Project Overview • Identification of the problem and population • Utilized a systematic research • The Cochrane Database • CINAHL • Medline • Expanded research to include: • Institute of Medicine • Institute of Healthcare Improvement • 5 Million Lives Campaign • CVL Bundle

  23. Capstone Project Overview • Joint Commission • CDC • Infusion Nursing Society • Review literature • Includes searching for evidence based practice protocols • How the financial aspect impacts the hospital, patient, and insurance companies • How other facilities combated the same problem and their successes

  24. Outcomes • December, 2007 • Implementation of the dressing change kit • Elimination of the 24 hour dressing change • Nursing care was streamlined • Improved patient outcomes as evidenced by the decrease in PICC Line associated infections

  25. Summary of Project • Lateral integration of care • Utilization of research and application to practice • Proposal to change protocol based on evidence • Implementing the ‘BioPatch’ and sterile dressing change kits • Staff Education • Improved patient outcomes

  26. Results • Initially, • September, 2007 • 18 CR-BSIs, 4 PICC Line related • Implemented ‘BioPatch’ • October, 2007 • Noted 72% reduction in CR-BSIs with 100% reduction in PICC Lines • Follow up, • Comparing first 6 months of 2007 (prior to project) to the first 6 months of 2008 • 50% reduction in CR-BSIs

  27. Examples of Other Projects • Development of hand-off communication tool between transport and nursing staff. • Development of dose calculation tools for pediatric codes. • Development of standardized documentation for nuclear medicine testing when nurses are involved.

  28. Here and Now • Coordinating new CNL Program • Utilizing the 12 Bed Model • 6 Med-Surg units (current) • Planning for future: adding 4 new units • Using Evidence Based Practice to find new and better ways of caring for patients • Utilizing the CNL White Paper

  29. Here and Now • Identification of Nurses for Educational Support: • Based on: • Clinical Performance • Attitudes and Vision of the power of Bedside Nursing • Committed to organizational values & mission

  30. Here and Now • PCL Model • To move toward CNL model as nurses complete education & certification • Must be enrolled in the CNL Masters curriculum

  31. Here and Now • Metrics • Physician, Patient, & Nurse Satisfaction • Decrease in falls • Decrease in hospital acquired • Pressure ulcers • Infections • PE/DVT • Improve D/C process • Other nurse sensitive indicators applicable to specific units

  32. Looking to the Future • There are many ways to discover what project needs undertaking: • Six Sigma • LEAN • Root Cause Analysis/ Microsystem Analysis • Windshield Survey • Consider: • Patients quality of care and safety • Buy-in from administration • Cost vs. Savings

More Related