3 CAPSTONE REFLECTIVE JOURNAL Capstone Reflective Journal Geordene D. Johnson Grand Canyon University: NRS 490 March 29th, 2019 Running head: ASSIGNMENT TITLE HERE 1 Running head: CAPSTONE REFLECTIVE JOURNAL Week 1 (January 21-27) As my BSN journey drew closer to the end I’m faced with the most anticipated class, my capstone project. As I entered into week 1, I spent a few hours in the classroom making sure I’m going through all my professors’ announcement and gathered all the necessary research information on Identifying two GCU Library scholarly databases that will assist me in finding the best research articles to support my EBP proposal for week 1 DQ. The ISP took hours to complete as it’s a planner for the next 10 weeks ahead. As nervousness sets in I promise myself to stay on path with the all the requirements of this course. I met with my mentor during the week and discussed what is expected throughout the course, she completed and signed all necessary forms needed for her approval, mentor was approved by instructor Week 2 (January 28- February 3) During week 2 our priority was to choose our PICOT and submit to individual forum for approval from instructor. The anticipation of presenting my PICOT was here as I’ve been formulating my PICOT statement on educating the adherence for patients who are receiving anticoagulation therapy in the home settings to prevent stroke, PE/DVT etc.. my instructor approved topic which was very exciting for myself and mentor. Prior to this approval I had to change my implementation and add a few things with the feedback from my professor. It was concluded to educate on effectiveness regarding in home adherence, including diet and blood monitoring for older adults receiving anticoagulation therapy over a 6 months period. GCU library was my source to gather much needed peer review articles for this weeks’ assignment and DQ’s. Met with my mentor and went through articles that I gathered to find the best fit for assignment. As I feel I’m getting a hang of what’s expected throughout this course, I reflect on intraprofessional collaboration and its importance in solving concerns associated with improving medicine and technology and increasing the demand for healthcare services. Health care tasks are mostly challenging, complex and multifaceted. One problem may require the input of many health professionals from diverse specialties. It is therefore very important for a nurse to understand that he/she cannot provide quality care alone. I have learned that inter professional collaboration extends further to educational contexts. Week 3 (February 4-10) Week 3 required me to submit six of the peer review articles previously researched along with the strength and weakness. We also discussed different methods of evaluating evidence with compare and contrast. The PICOT statement paper was also submitted which I did my best on but was a bit disappointed with the grades. I spoke with my mentor.

1. 3
CAPSTONE REFLECTIVE JOURNAL
Capstone Reflective Journal
Geordene D. Johnson
Grand Canyon University: NRS 490
March 29th, 2019
Running head: ASSIGNMENT TITLE HERE
1
Running head: CAPSTONE REFLECTIVE JOURNAL
Week 1 (January 21-27)
As my BSN journey drew closer to the end I’m faced with the
most anticipated class, my capstone project. As I entered into
week 1, I spent a few hours in the classroom making sure I’m
going through all my professors’ announcement and gathered all
the necessary research information on Identifying two GCU
Library scholarly databases that will assist me in finding the
best research articles to support my EBP proposal for week 1
DQ. The ISP took hours to complete as it’s a planner for the
next 10 weeks ahead. As nervousness sets in I promise myself to
stay on path with the all the requirements of this course. I met
with my mentor during the week and discussed what is expected
throughout the course, she completed and signed all necessary

2. forms needed for her approval, mentor was approved by
instructor
Week 2 (January 28- February 3)
During week 2 our priority was to choose our PICOT and
submit to individual forum for approval from instructor. The
anticipation of presenting my PICOT was here as I’ve been
formulating my PICOT statement on educating the adherence
for patients who are receiving anticoagulation therapy in the
home settings to prevent stroke, PE/DVT etc.. my instructor
approved topic which was very exciting for myself and mentor.
Prior to this approval I had to change my implementation and
add a few things with the feedback from my professor. It was
concluded to educate on effectiveness regarding in home
adherence, including diet and blood monitoring for older adults
receiving anticoagulation therapy over a 6 months period. GCU
library was my source to gather much needed peer review
articles for this weeks’ assignment and DQ’s. Met with my
mentor and went through articles that I gathered to find the best
fit for assignment. As I feel I’m getting a hang of what’s
expected throughout this course, I reflect on intraprofessional
collaboration and its importance in solving concerns associated
with improving medicine and technology and increasing the
demand for healthcare services. Health care tasks are mostly
challenging, complex and multifaceted. One problem may
require the input of many health professionals from diverse
specialties. It is therefore very important for a nurse to
understand that he/she cannot provide quality care alone. I have
learned that inter professional collaboration extends further to
educational contexts.
Week 3 (February 4-10)
Week 3 required me to submit six of the peer review articles
previously researched along with the strength and weakness. We
also discussed different methods of evaluating evidence with
compare and contrast. The PICOT statement paper was also
submitted which I did my best on but was a bit disappointed
with the grades. I spoke with my mentor to figure out where I

3. went wrong and came up with different ideas on how to
approach papers moving forward. Finding better peer review
articles was one of our solution along with narrowing them
down to what best fits my PICOT. I also spend some time
reflecting on Ethical consideration in Healthcare. Most of the
times, nurses struggle due to the ethical challenges associated
with patient care. Ethical concerns may come up within any
healthcare circumstance whereby moral questions of whether
one was right or wrong are asked. As a nurse, I was able to
acquire knowledge on the importance of ethical culture in the
health facility I was working. Ethical culture can be defined as
the way ethical circumstances that develop ethical problems are
addressed within a facility. Ethical practices in nursing can be
sustained by constantly engaging with ethical experts. The
experts play a key role in the collection of code of ethics that
have various guidelines and recommendations that indicate how
to effectively respond to ethical issues (Char, 2018).
Week 4 (February 11-17)
I had the opportunity to spend a few hours with my mentor in
the anticoagulation center. After completing what I was
assigned to do for the patients that day, my mentor and I looked
over the peer review I choose to complete the literature
evaluation table. DQ’s were also done. After a thorough and
meaningful research, we narrowed down to eight peer review
articles. I decided to reflect upon Health Policy this
week.Health policy can be defined as the decisions, plan and
actions incorporated to achieve various health care objectives in
the society. Health policy decisions in the United States are
made at the federal and congress level and also by other
healthcare organizations. As a nurse, I have learnt that nurses
play a significant role in the formulation of policies that will
have great benefits not only in the short run but also in the long
run. A majority of nursing agencies encourage nurses to
actively participate in policy formulation. As a nurse, I can
participate in the policy formulation process by analyzing

4. various healthcare policies and laws, advising policy makers
and the general public and also developing and proposing
various healthcare policies.
Week 5 (February 18-24)
This week was spent doing DQ’s and meeting up with my
mentor to discuss other ways to assist me as I move forward in
this course. As I approach the midway of my course my stress
levels are soaring high. A completion of 7 hours was logged, no
assignment schedule for this week so I took the opportunity to
read up on assignment for the following weeks ahead. This
week I chose to reflect on Population Health Concern.The main
determinant of the health of a community is the environmental
factors. Social determinants such as unemployment and food
insecurity also have a great impact on population health which
is a main component of the Affordable Care Act. As a nurse, I
have been able to recognize that social determinants have
always been part of nursing. Various nursing institutions have
identified the importance of social determinants in enhancing
healthcare and have begun developing nurse practitioner
programs which will ensure Social determinants of health are a
part of the curriculum.
Week 6 (February 25- March 3)
This week assignment requires me to reflect back on article
picked weeks ago. It was a challenge and the toughest week so
far. The literature review paper had its challenges and
complication, both my mentor and I were both confused and
how to complete this assignment. We struggled, and it was
evident with the grades I received. All DQ’s completed along
with other requirement for this week. I decide to reflect on
health care delivery and clinical system.Optimal health can only
be enjoyed by Americans when they benefit from health care
services which are high in quality and properly coordinated.
The health care sector in the United States is made up of
clinicians, hospitals, insurance plans and health care
professionals. Insurance plans play an integral part in healthcare
delivery systems because they ensure those who can/cannot

5. afford to pay for various health costs receive quality healthcare.
Insurance plans play a significant role in improving the health
outcomes of individuals through efficient preventive, screening
and chronic disease care. As nurse, I have learnt that clinical
perspective services such as medical procedures and tests also
play an integral part in healthcare delivery systems. The
services are useful in preventing ailments and enhancing health
of individuals.
Week 7 (March 4-10)
As I picked myself up from a hard week I decided to meet with
mentor at the anticoagulation center and help with the project at
hand. We prepared pamphlets and brochures and hand them out
to the patients at the INR clinical, patient teaching was also
done on an individual level. I felt satisfied to have helped to
educate them on the adherence to their therapy. DQ’s completed
and I started my planning ahead to meet week 9 assignments. I
reflected on Leadership and economic models. The current
health care system in the United States is unstainable. All
patients have a desire to receive the best care, but it needs to
cost less. The healthcare system must therefore be changed to
align with the interests of the public in order to regain public
trust. The various different stakeholders in the healthcare
system have developed challenges in enhancing the value of
care. Health care professionals such as doctors and nurses are in
a better position to enhance the value of care. As a nurse I have
identified servant leadership as the best way for health care
facilities to enhance value because it pays attention on the
strength of a team, creating trust and serving patients’ needs.
Week 8 (March 11-17)
No assignment due, I completed my DQ’s and truly believe I
have a better understanding with what’s expected from my
instructor. I spent a total of 6 hours this week on assigned work.
As the week drew closer to the end my anxiety level is at its
peak, along with work and family stressors. Health disparities is
what I reflected on.Despite the fact that it is the responsibility
of nurses to ensure health services are easily accessible to all

6. patient populations, enhancing health care equity agenda has
faced various barriers. For example, individuals are faced with
inequalities based on their race in assessing health care
services. Health disparities occur when a certain group of
individuals has better access to health care services than the
other. This is often illustrated in the differences in death rates
among various diverse populations in the United States. The
differences in the level of income for various individuals is the
main cause of health disparities. For instance, poor blacks may
find it difficult to access quality health care services compared
to medium class whites (National Center for Health Statistics,
2016). Nurses play a key role in evaluating various health
inequalities through a process called selection. Selection can be
defined as the tendency of people to group themselves
according to social gatherings, age or residential places.
Week 9 (March 18-24)
Even after I started reviewing weeks 9 assignment since week 7,
I still became overwhelmed. A mental breakdown was seeping
at my feet. I met with my mentor and discussed proposal change
necessary for my EPB. My mentor felt we were on the right path
with the amount of research completed for this assignment. We
also reviewed all feedback from instructor to help formulate this
paper in the right direction. A total of 15 hours spent in
completion of all tasks. DQ’s were interesting and informative.
I decide to reflect on New Practice Approaches. The field of
nursing has gone through major transformations in the past few
decades. To effectively be able to provide the best care to
patients, I have mastered the art of adapting to the
transformations. For example, the continuous incorporation of
evidence- based practice in nursing has been very crucial in
addressing various health conditions such as asthma and
diabetes. However, I have come into a conclusion that such
principles are not efficiently embraced in the health care
setting. The traditional setting paid key attention to improving
quality and patient safety through analyzing records to assess
the safety concerns of a patient. Currently, nursing has provided

7. key leadership for enhancing care through the employment of
the findings in practice. The continuous incorporation of
evidence- based practice in nursing has transformed healthcare
in various ways. Higher learning institutions have recognized
this trend and have begun changing various nursing programs to
incorporate evidence-based practice (Burstin, 2016). As a
nursing student pursuing a bachelor’s degree in Nursing, it is
important to have course materials that are not only meant to
enhance the knowledge base of a student but also to stress of
the importance of transparency in the profession.
Week 10 (March 25-31)
I took the opportunity to meet with my mentor for a few hours
and review the ISP along with other necessary forms due for
submission to conclude my capstone project. We had a thorough
discussion and reflect on the last 9 weeks and decided that new
approached need to understand ways to help patients on
anticoagulant therapy better adhere to improve their way of life.
As I reflect on the last 9 weeks, EBP may seem simple to many
but it requires extensive research and time to incorporate
findings among the needed population. I’m reflecting on the
role of technology in improving health care
outcome.Information technology is the basis of an efficient
healthcare system in the current and future generation. The
main focus in the development of new concepts in healthcare
technology is patient care. Technological advancement in
clinical applications has had a significant impact in the
healthcare system and will continue to have a key role in the
years to come (Gao, 2015). As a nurse, I have come to learn that
nursing documentation is a very important element of healthcare
information. Information systems are designed for nurses
whereby documentation can be used to enhance a nurse’s
knowledge regarding quality care. The field of nursing has
received significant knowledge on how to improve patient care
due to the new concepts that have been developed through
information technology

8. References
Burstin, H., Leatherman, S., & Goldmann, D. (2016). The
evolution of healthcare quality measurement in the United
States. Journal of internal medicine, 279(2), 154-159.
Char, D. S., Shah, N. H., & Magnus, D. (2018). Implementing
machine learning in health care—addressing ethical challenges.
The New England journal of medicine, 378(11), 981.
Gao, Y., Li, H., & Luo, Y. (2015). An empirical study of
wearable technology acceptance in healthcare. Industrial
Management & Data Systems, 115(9), 1704-1723.
National Center for Health Statistics (US. (2016). Health,
United States, 2015: with special feature on racial and ethnic
health disparities.