CHANGE PROPOSAL OUTLINE 2 Change Proposal Outline Time and Resource Allocation Several factors must be considered in the process of implementing the proposed change of bedside shift report (BSR). Time and availability of resources are the most important factors that should be considered. The success of implementing BSR as per the change proposal depends on customized planning and the resources available for use. Selecting the appropriate timeline allows the change management teams to pull together the necessary resources. It also promotes the participation of key stakeholders in the change implementation process. The resources required for the implementation of the proposed change include digital telehealth equipment, additional manpower, as well as financial resources. Resources to facilitate extensive research are also required for the change implementation process. Financial resources are the most crucial in this process because everything else depends on the availability of sufficient funds. However, the required resources must be verified and approved by the board of directors at the facility before the change implementation process is officiated. For this reason, the timeframe must be designed to accommodate consultation with key stakeholders. The most appropriate timeframe, therefore, is six months beginning from the approval date for the change implementation project. Below is a detailed schedule of the activities to be undertaken, the resources and the time allocated for each activity. Stage Activity Resources Timeframe Unfreezing Planning 3 specialists 1 week Research to identify the appropriate implementation strategy. 2 specialists 5 nurse leaders 2 weeks Nurse and Patient education 3 nurse leaders 4 trainers 4 weeks Changing Policy Formulation to accommodate BSR. 5 contracted specialists. 1 week Acquisitions for the required digital devices and contracting. 10 laptops 50 telehealth devices 2 weeks Pilot Project; testing the proposed BSR reimplementation change on a small population. 2 Nurse leadership teams. 10 Volunteers (Patients and relatives). 5 weeks Change implementation; implementing BSR in the entire facility. 5 Nurse leadership teams. 50 Volunteers (Patients and relatives). 8 weeks Refreezing Policy formulation to prevent reverting to old habits. 4 contracted specialists. 2 board members 5 nurse leaders. 1 week Monitoring and evaluation to ascertain the effectiveness of BSR. Financial resources 5 nurse leaders 2 weeks Policy adjustments to promote the effectiveness of the re-implemented BSR. 3 nurse leaders 4 contracted specialists 1 healthcare manager 1 week Project closing. 5 nurse leaders 2 Healthcare managers 1 board member. 1 week Conclusion In conclusion, the proposed change concerns the re-implementation of bedside shift reporting to enhance the quality of services offered to patients. The proposed change is consistent with modern nurse informatics systems thus it’s very relevant. Also, the propos.

1. CHANGE PROPOSAL OUTLINE 2
Change Proposal Outline
Time and Resource Allocation
Several factors must be considered in the process of
implementing the proposed change of bedside shift report
(BSR). Time and availability of resources are the most
important factors that should be considered. The success of
implementing BSR as per the change proposal depends on
customized planning and the resources available for use.
Selecting the appropriate timeline allows the change
management teams to pull together the necessary resources. It
also promotes the participation of key stakeholders in the
change implementation process.
The resources required for the implementation of the proposed
change include digital telehealth equipment, additional
manpower, as well as financial resources. Resources to
facilitate extensive research are also required for the change
implementation process. Financial resources are the most
crucial in this process because everything else depends on the
availability of sufficient funds. However, the required resources
must be verified and approved by the board of directors at the
facility before the change implementation process is officiated.
For this reason, the timeframe must be designed to
accommodate consultation with key stakeholders. The most
appropriate timeframe, therefore, is six months beginning from
the approval date for the change implementation project. Below
is a detailed schedule of the activities to be undertaken, the
resources and the time allocated for each activity.
Stage
Activity
Resources
Timeframe
Unfreezing

2. Planning
3 specialists
1 week
Research to identify the appropriate implementation strategy.
2 specialists
5 nurse leaders
2 weeks
Nurse and Patient education
3 nurse leaders
4 trainers
4 weeks
Changing
Policy Formulation to accommodate BSR.
5 contracted specialists.
1 week
Acquisitions for the required digital devices and contracting.
10 laptops
50 telehealth devices
2 weeks
Pilot Project; testing the proposed BSR reimplementation
change on a small population.
2 Nurse leadership teams.
10 Volunteers (Patients and relatives).
5 weeks
Change implementation; implementing BSR in the entire
facility.
5 Nurse leadership teams.
50 Volunteers (Patients and relatives).
8 weeks
Refreezing
Policy formulation to prevent reverting to old habits.

3. 4 contracted specialists.
2 board members
5 nurse leaders.
1 week
Monitoring and evaluation to ascertain the effectiveness of
BSR.
Financial resources
5 nurse leaders
2 weeks
Policy adjustments to promote the effectiveness of the re-
implemented BSR.
3 nurse leaders
4 contracted specialists
1 healthcare manager
1 week
Project closing.
5 nurse leaders
2 Healthcare managers
1 board member.
1 week
Conclusion
In conclusion, the proposed change concerns the re-
implementation of bedside shift reporting to enhance the quality
of services offered to patients. The proposed change is
consistent with modern nurse informatics systems thus it’s very
relevant. Also, the proposed change will be implemented as per
Lewin's theory of change management to ensure that the process
runs smoothly. The anticipated outcome is an improvement in
the communication between nurses, patients, and their relatives.
The implementation process is scheduled to be completed by the
end of 6 six months from the approval date.

4. Reimplementation of a bedside shift report 1
Reimplementation of a bedside shift report 8
Reimplementation of a bedside shift report
Student Name
Institution
Course
Instructor
Date
Change Proposal: Reimplementation of a Bedside Shift Report
The identified clinical problem that is relevant to nurses in the
workplace is the bedside shift report (BSR). The bedside shift
report may be used to help the development of teamwork,
ownership, and accountability thus increasing the satisfaction of
the nurses. The reason for selecting the reimplementation of a
bedside shift report is because; at a targeted facility the
implementation of the bedside shift report is becoming poor.
This has led to the poor compliance with the standards of
practice, and increase costs in the facility. Also,
reimplementation of BSR will reduce operational costs by
eliminating overtime pay and unnecessary legal fees that arise
from preventable compliance errors.
The reimplementation of a bedside shift report is important
for the nurses practicing in the organization. Bedside shift
report assists in improving the experience of the client and
improving the handoff care between the nurses through

5. including the family and client in the delivery of care. Bedside
shift report is leading to the introduction of a change in the
nursing culture i.e. introduction of various methods of
communicating patient-specific care at a shift transformation.
Shift reports given at the bedside is helping in changing the
manner in which nurses are communicating and practicing
(Clark et al., 2020).
At the targeted facility, the execution of the bedside shift
report is poor and this is associated to the lack of knowledge
concerning the role of bedside shift reporting on the patient
outcome. The healthcare providers at the facility are not
directly engaged in the provision of healthcare. There is poor
communication of the goals of the bedside shift reporting and
their importance about the positive outcomes and benefits that
are involved in the change (Clark et al., 2020).
According to the study by Gregory et al., (2014), the
process of assessing the transformation in practice that involves
transitioning of the bedside nurse shift handoffs is important.
The evaluation process is helpful in the re-implementation plan
to help in improving the areas of weaknesses. The evaluation
process of the success in the implementation in the practice is
assessing the perception of the nurses about the proposed
changes i.e. the re-implementation plans. There is evidence
showing the positive impacts of the bedside shift report in the
safety of the patient, the control of the pain, the satisfaction of
the patients, and improvement in the nurse to patient or nurse to
nurse communication (Gregory et al., 2014).
A study by Dempsey et.al. (2014) highlights the necessity
of looking at nurse-sensitive indicators such as the impact of
nurses’ communication on patient satisfaction, in the process of
improving bedside shift reporting. The success of the
reimplementation of the bedside shift reporting also depends on
the education that is being provided to the nurses. Most of the
cases of poor bedside shift reporting in the facility were
associated with lack of understanding on its benefits and
reasons for its implementation. Since there is no clear

6. understanding of the need for the implementation, most of the
nurses are not prepared to fully implement the procedure.
Conclusion
The poor process of implementing bedside shift reporting
is associated with a lack of understanding of the importance of
such practices. This leads to poor compliance with the
necessary set of standards of practice and increases in the cost
of healthcare. Therefore, the reimplementation of the bedside
shift reporting is necessary to ensure that nurses are informed
about the importance of such practices. It also helps in
equipping nurses with the knowledge needed towards the
implementation of the bedside shift reporting.
My present work environment complies with The Joint
Commission principles concerning patient-focused care yet the
facility is struggling to improve patient fulfillment scores based
on Press Ganey overviews. Several patients treated at the
facility indicate that they are not satisfied with the services
offered to them. For this reason, my proposal is meant to
alleviate the situation through implementation of bedside shift
reporting. The proposed change will facilitate effective
interaction and coordination between nurses, patients and
relatives. By so doing, patients’ experiences and satisfaction
scores will improve in the long run. The reason for
implementing the bedside shift report is basically to meet
patients' satisfaction by monitoring their wellbeing conditions
since they listen to their wellbeing report as medical caretakers
change shifts; reduced expenses by removing additional time
pay and scrubbing off legal errors which bring about lawful
charges, and improving quality of health care by allowing
patients and relatives to contribute their emotions on their
wellbeing and that of their friends and family (Meyers, 2020).
Justification of Need
During the change of shift report, lack of proper communication
has resulted in about 65% of sentinel events (Joint Commission,
2016). With healthcare's focus shifted to patient-centered care,
many concepts and proposals have come about to improve the

7. patient experience. With my facility needing to improve upon
patient experience and satisfaction, the goal for my clinical
practice project was to implement a change that would
positively affect all involved, including the patient and their
families, nurses, and the organization.
Pre-Implementation Plan
In this proposal, I decided to use Lewin's theory of planned
change to ensure that my project implementation will be
successful and achieve its primary purpose. Lewin's Theory of
Change is straightforward and execute as it centers on changing
people's behaviors. Also, this theory is excellent to influence a
change of mentality among employees at the facility. Lewin’s
theory of planned change creates awareness about the
advantages of accepting change thus it will be effective to
promote the reimplementation of BSR. Support from the
organization group and key leaders to the nursing staff during
the moving and refreezing stages is fundamental for the
viability and consistency of the change. As per Lewin’s theory,
the first step of implementing the proposed change will be
unfreezing. This phase involves creating awareness about the
negative implication of the current procedures at the facility.
Implementing the proposed change, in this case a
reimplementation of BSR, will be the next step. Finally, the last
step involves reinforcing the implemented change. This will be
done by formulating relevant policy to support the BSR and
prevent reverting change. It is an excellent method to bring
about a mentality change among employees and creating
awareness of the advantages of change.
Our facility's mission is to care, serve, and heal with a mission
to provide world-class care to our patients and community.
Right now, there is no standard in nurse handoffs or changes in
inpatient care. Every unit unexpectedly performs shift change
handoffs. During transitions in care, research shows that
patients are being ignored and left unattended (Grimshaw et al.,
2016).Patients are avoided from accessing their plan of care,
frequently not realizing what prescriptions they are on, what

8. they are going after, where their treatment plan is going. My
proposed solution to improve patient perception, experience,
and fulfillment was to execute mandatory bedside shift
reporting for medical attendants. The objective of the bedside
shift is to promote a more patient-centered approach to care
(Meyers, 2020).
To implement the plan, education and tip sheets will be
provided to every nurse and then each nurse will participate in
bedside shift reporting for both day and night shifts.The nursing
staff will observe, and assess the impact of implementing
bedside shift reporting in both night and daytime shifts. Direct
feedback on how the patients felt about the new adjusting
process, their preferences of the procedure, and what should be
possible contrastingly to improve their experience during a
move change has to be recorded. Lastly, I must assess the staff's
thoughts and emotions on bedside reporting and evaluate
criticism from the patients with the team and make changes
accordingly.
My proposal will engage different healthcare professionals such
as case managers, social workers, physical therapists,
physicians' assistants, nurse practitioners, and physicians. My
central organizational resource will be the Agency for
Healthcare Research & Quality (AHRQ). The agency will align
with my hospital's mission of providing quality care, safer
healthcare, affordable, accessible, and equitable care. Also, my
plan should comply with standards highlighted by other
stakeholders such as the U.S department of health and human
services to ensure evidence-based care is the ultimate aim of the
program (Grimshaw et al., 2016).
Factors likely to affect the implementation of my recommended
activities
Several factors need to be considered when reimplementation of
bedside shift report is taking place. One primary thing
considered here is the quality of healthcare provided in the
facility where the project will roll out. To minimize the number
of medical errors, educating, and training all stakeholders

9. within the facility is essential as it will improve hospital
operations' effectiveness. Technology integration and raising
funds are other necessary factors need considerations.
Evidence-based rationales to propose how I will address them,
incorporating my identified change theory.
With the facility needing to improve upon patient experience
and satisfaction, the goal for my clinical practice project is to
implement a change that would positively affect all involved,
including the patient and their families, nurses, and the
organization. Compliance and rounding monitoring will be
conducted following evidence-based protocols alongside side
Lewin’s change three-stage model. This will sustain the new
practice of standardized nurse bedside shift report (Gregory et
al., 2014).
Technological challenges
My target floor for my project implementation is within the
acute care rehabilitation centers. Patients in acute care
rehabilitation centers require adequate follow-up care with their
health provider team. Technological devices such as telehealth
will be used to facilitate care by enhancing follow-up appoints
and communication across departments. Telehealth devices are
very important to the implementation of the BSR because they
facilitate effective communication between patients, nurses, and
relatives. Patients in the acute care rehabilitation centers will
utilize the devices to present their concerns to their care givers.
On the other hand, nurses will utilize the devices to relay
crucial information to other attending nurses as well as
relatives. Therefore, nurses receiving this project must learn
and remain competent with telehealth technological services.
Finding a group of health care providers that are willing to start
treating patients this way is the first step.
Institutional structures
I do understand that implementing BSR changes is not an easy
thing, and sometimes changes to take effect takes longer.
However, the BSR program will ensure that nurses and other
stakeholders are educated on how the new program will operate

10. and how it will benefit patients and their families in reducing
BSR medical errors. However, for changes to take effect,
approval must be granted by different agencies. Once
certification is given, all involved medical staff must receive a
copy of the project plan document. Some of the concerned
committees are audit and compliance committee, strategic
planning, safety and quality, and finance department (Dempsey
et al., 2014).
Strategies for building buy-in-among different stakeholders,
including nursing
During the change process, case managers, social workers,
physical therapists, physician assistants, nurse practitioners, as
well as doctors, must be on board. Historically, nurses are
stakeholders involved with resistance to change mostly
(Gregory et al., 2014).
Financial trends & anticipation of the availability of human
resources & project funding.
There will be a financial constraint in implementing telehealth
and electronic health record systems during BSR
implementation. Mostly, training and educating both nurses and
patients will cost money, which the organization will have to be
prepared to put into their budget. It would be a financial benefit
when the institution strives to remove the cost of readmissions
in their plan (Joint Commission, 2016).
Hospital or governmental policy constraints
It would be difficult for patients to work on their insurance
policies while still under Medicare or Medicaid programs. It
takes a long time while in the hospital to get a policy set into
place.
Regulatory requirements
Regulatory acts that need some attention in this project would
be the Medicare Access and CHIP Reauthorization Act of 2015
and The Health Information Technology for Economic and
Clinical Health Act (HITECH) (Joint Commission, 2016). These
two acts will be beneficial in balancing patient’s quality of care
with the payment model as they will minimize readmissions rate

11. that will automatically help with reimbursement (Meyers,
2020).
Patient diversity
Some factors have to be considered when educating patients
about their well-being. Quality of care, according to Meyers
(2020), is improved when nurses reduce the readmission rates
for a specific population. It means, considering the technology
used, family support, language spoken, and reading levels will
determine how training and education will be conducted.
References
C. Clark, A., Wolgast, K. A., Mazur, N., & Mekis, A. (2020).
Leading Change in Nurse Bedside Shift Report. Nursing
Clinics, 55(1), 21-28.
Dempsey, C., Reilly, B., & Buhlman, N. (2014). Improving the
patient experience: Realworld strategies for engaging nurses.
Journal of Nursing Administration, 44(3), 142-151.
Gregory, S., Tan, D., Tilrico, M., Edwardson, M., & Gamm, L.
(2014). Bedside shift reports: What does the literature say.
Journal of Nursing Administration, 44(10), 541-545.
Grimshaw, J., Hatch, D., Willard, M., & Abraham, S. (2016). A
qualitative study of the change-of-shift report at the patients'
bedside. The health care manager, 35(4), 294-304.
Joint Commission. (2016). Guide to Patient and family
engagement in hospital quality and safety.
Meyers, S. (2020). Bedside Shift Report Improves Patient
Safety.

12. NUR 490 Capstone Project Guidelines and Rubric
Overview
As the final stop in your journey toward your Bachelor of
Science in Nursing degree, you will complete a capstone that
integrates the knowledge and skills you
have developed in previous coursework. Over the duration of
the capstone course, you will create a proposal for change
designed to address a specific
healthcare-related need in the organization where you currently
work or a place where you have previously worked, or an issue
of local, state, or national
importance, subject to instructor approval. You will also reflect
on your journey through the Bachelor of Science in Nursing
program and how you plan to
position yourself professionally by developing a brief
philosophy of nursing statement. This statement will be an
important tool for discussing the knowledge,
skills, and abilities that you have gained from the RN-BSN
program and your own nursing values with potential employers
or graduate school admissions officers.
Together, these capstone artifacts will set you apart from other
workforce and/or graduate school applicants by showcasing
your unique abilities and talents.
The artifacts will demonstrate your current knowledge,
theoretical foundations, and expertise in the nursing profession
and your ability to improve your own
performance and that of your organization through thoughtful
reflection on your own practice.
Evaluation of Capstone
This capstone will be assessed somewhat differently than other

13. courses you have taken online at SNHU. There are two separate
components that operate
together to comprise the whole capstone experience and are not
assessed separately. You will be evaluated on both artifacts as a
one cohesive unit in
determining whether you have demonstrated proficiency in each
outcome. Your instructor will guide you through this process
and will maintain a running
narrative of your strengths and areas for development in relation
to the outcomes as you progress through the class. Your work is
expected to meet the highest
professional standards.
This assessment will evaluate your mastery with respect to the
following outcomes:
• Apply skills in using patient care technologies, information
systems, and clinical decision support tools to promote safe
nursing practice and quality
patient outcomes
• Utilize evidence-based practice in planning, implementing,
and evaluating outcomes of care
• Formulate strategies to promote health and prevent disease in
individuals and populations across the life span
• Implement patient safety and quality initiatives within the
complex clinical microsystem using leadership and
communication skills
• Analyze trends in healthcare policy, finance, and regulatory
environments and their implications for healthcare access,

14. equity, and affordability
• Evaluate life-long learning and nursing engagement to
promote personal and professional transformation
Prompt
Your capstone assessment will consist of two components. The
first component consists of a change proposal that
comprehensively addresses a nursing- related
concern—either in an organization where you work or have
worked, or more broadly at the local, state, or national level.
Your instructor should approve
your change proposal topic early in the course. Because change
does not happen in isolation and often has far-reaching impacts,
your proposal will need to
incorporate multiple aspects of health practice in suggesting
strategies to improve the target populations’ health. You will
need to address patient and nurse
safety; appropriate use of technology; health literacy; policy,
regulatory, and financial constraints; and strategies for building
support for proposed changes.
In addition to the change proposal, you will also create a brief
statement that expresses your philosophy of nursing practice. To
do this, you will reflect on what
you have learned, relevant theories of nursing practice, and the
importance of professional integrity, ethics, and self-reflection
in caring for patients. Your goal is
to articulate how your philosophy of nursing has evolved as a

15. result of the experiences and knowledge you gained in the RN-
BSN program.
Change Proposal
In first portion of your capstone, you will create a
comprehensive change proposal designed to promote health and
to prevent disease in your selected health
care environment (current employer, previous employer, or
within the broader nursing community, subject to instructor
approval). This artifact will showcase
your abilities as a nursing professional capable of leading
change in a complex healthcare environment.
As a practicing RN-BSN, you will be expected to bring clinical
expertise to your work and take on a leadership role in
continually improving patient care. Your
change proposal should be geared toward convincing an
audience of administrative decision-makers that change is
needed and that your plan is
desirable and viable. It should clearly and concisely lay out the
problem you are seeking to address and suggest specific
evidence-based changes, including a plan
for implementing and evaluating those changes. You should also
specify and approximate a timeframe for carrying out your plan
and the resources you will
need. (Note: You do not need to actually implement the change
and evaluate it, just create a plan for how you would do so.)
Remember that in order for you to gain support for your
proposal, it will need to be succinct, clear, and well-supported
throughout by credible research and
evidence.

16. Your proposal should contain the following sections:
I. Introduction
A. Identify a clinical or nonclinical problem that is relevant to
nurses in your workplace or former workplace or is a recognized
issue in the local,
state, or national nursing community from which you can act as
a change agent and propose a change.
B. Explain why you selected the issue, identifying the
significance to nursing practice and the expected outcomes from
the change.
II. Justification of Need
A. Explain the current situation of the targeted organization for
your proposed change.
B. Develop arguments with evidence that support this need for
change.
III. Pre-Implementation Plan
A. Identify a specific change theory that will assist you with
planning stages of your change proposal
B. Identify activities needed prior to implementing your change,
making theory-to-practice connections with each key element
and impact of
change to the element
C. Discuss a plan for activities needed to leverage this element
to promote change and identify the stakeholders that may be
involved in these

17. activities. The activities you propose must cover multiple
aspects of health practice surrounding the problem, including
but not limited to:
a. Patient and Nurse Safety
b. Information Management Systems
c. Health Literacy
d. Administrative Policies
e. Ethical Considerations (i.e.; equity of access and treatment,
etc.)
IV. Implementation Plan
A. Assess the factors that are likely to affect the implementation
of your recommended activities
B. Identify evidence-based rationales to propose how you will
address them, incorporating your identified change theory. Your
plan should
encompass the following with evidence to support your
rationale:
a. Technological challenges
b. Institutional structures
c. Strategies for building buy-in among different stakeholders,
including nurses
d. Financial trends and anticipation of the availability of human
resource and project funding
e. Hospital or governmental policy constraints
f. Regulatory requirements
g. Patient diversity

18. V. Evaluation plan:
A. Propose steps for evaluating your suggested changes based
on your change theory and evidence on existing best practices.
Include the indicators
that you will use to measure success, both in implementing the
change itself and in ensuring quality outcomes for diverse
patients.
B. Identify appropriate benchmarks from which to measure the
effectiveness of the change.
C. Discuss the processes you will use for gathering feedback
from relevant stakeholders—including nurses, patients, and
their families—on what is
and is not working in order to support continuous improvement.
VI. Time and resource allocation:
A. Give an approximate timeframe for the different stages and
activities in your proposal
B. Estimate the human and other resources that will be needed
to carry out your proposal. You do not need to include specific
dollar amounts, but you
should anticipate what each activity requires in terms of
resources in general terms. For example, you might need a
certain number of full- or part-time
staff or the services of a contracted firm, specific software,
hospital supplies, laptops, publicity materials, and so forth. You
may find it useful to use an
Excel spreadsheet or other table for presenting this information.

19. VII. Conclusion
A. Summarize the proposed change, its significance, and
expected outcomes as a result of implementing the proposed
change.
Change Proposal Timeline:
Draft Deliverable Module Due Grading
1 Rough draft of Introduction section One Draft graded; receive
feedback from
instructor and peers
2 Rough draft of Justification of Need and
Pre-Implementation plus revisions from
Module One
Two Draft graded; receive feedback from
instructor and peers
3 Rough draft of implementation plan plus
revisions from previous weeks
Three Draft graded; receive feedback from
instructor and peers

20. 4 Rough draft of evaluation plan plus
revisions from previous weeks
Four Draft graded; receive feedback from
instructor and peers
5 Rough draft of time and resource
allocation plan plus revisions from
previous weeks
Five Draft graded; receive feedback from
instructor and peers for final submission in
Module Seven
Philosophy of Nursing Statement
For the second and final component of your capstone, you will
write a 3–5-page statement in which you construct your own
philosophy of nursing practice. This
philosophy should include, but is not limited to, a discussion of
the theoretical foundations and assumptions that are
foundational to your practice, as well as
how your coursework and capstone project impacted your own
philosophy of nursing and contributed to your personal and
professional transformation. This
reflection is a professional, yet personal, statement of why you
think being a nurse is important and the principles that guide
your practice. It is also a valuable
tool for sharing the knowledge, skills, and abilities that you
have gained from the RN-BSN program and your own nursing
values with potential employers or
graduate school admissions officers.
Your philosophy of nursing statement should include the

21. following:
1. Introduction: Open your statement with a few sentences about
the importance of a philosophy of nursing practice. How does
such a philosophy shape
your identity and role as a nurse?
2. Assumptions: Discuss your assumptions about patients,
health, environment, and nursing and the relationships among
these variables. How does your
nursing philosophy guide your interaction with patients, their
families, and other healthcare professionals? How do
professional integrity, equity, ethics,
and the potential for bias factor into your assumptions?
3. Theoretical Foundation(s): Highlight the theoretical
foundations that are important in your philosophy of nursing
practice. You may have one or several.
How do these foundations translate into your practice?
4. Experiences: Evaluate how new experiences and knowledge
shape your nursing philosophy. Specifically, you should address
how your RN-BSN
coursework, this capstone, and other experiences have
influenced how you view your nursing practice. What role does
self-reflection play in personal

22. and professional transformation? How do activities like the
change proposal help you develop as a lifelong learner and act
as an agent of change in
improving both personal and professional practice? In addition,
you may want to discuss challenges that you have faced and
what you would change or
do differently in addressing those challenges, since the ability
to effectively and creatively solve problems is a highly valued
job skill.
5. Conclusion: Reflect on how your nursing philosophy and
experiences at SNHU relate to your plans for further education
and how this will impact your
future nursing practice.
Philosophy of Nursing Timeline:
To help you develop your philosophy of nursing, you will
collaborate with your instructor through a series of reflection
journals in which you will reflect on your
learning and create drafts related to the sections of philosophy
outlines above.
Draft Deliverable Module Due Grading
1 Introduction and Assumptions rough
draft
One Graded separately; Reflection Journal Rubric
2 Theoretical Foundation(s) and
Experiences rough draft

23. Three Graded separately; Reflection Journal Rubric
3 Revised draft of previous sections and
Conclusion rough draft
Six Graded separately; Reflection Journal Rubric
Final Project Rubric
This rubric will be applied to both the Change Proposal and the
Philosophy of Nursing assignments as a whole, and neither
component will be assessed on its own.
The “Possible Indicators of Success” are examples for you and
the instructor of the types of concepts to look for to
demonstrate proficiency. They are neither
exhaustive nor proscriptive and should be used as guides for
illustrating how your capstone embodies the outcome. All
outcomes are weighted equally.
Guidelines for Submission: Your change proposal should
include a title page and table of contents and should conform to
the latest APA writing conventions and
citations. It should be approximately 10–15 pages, not including
the reference list or optional appendices, double-spaced, and in
12-point Times New Roman font.
Your references must include at least 3 peer-reviewed nursing
sources. You may include optional illustrations, photographs,
graphs and charts, and other non-
textual materials as needed to support your proposal.
Your nursing philosophy should be approximately 3–5 pages,

24. double-spaced, and in 12-point Times New Roman font. You
will submit both components in one
document.
NUR-490-01: Apply skills in using patient care technologies,
information
systems, and clinical decision support tools to promote safe
nursing practice
and quality patient outcomes
Proficient
100%
Not Proficient
0%
Possible Indicators of Success
Does the capstone demonstrate the student’s ability to assess
technological and information infrastructures for their
contribution
to patient safety and outcomes?
Does the capstone demonstrate the student’s ability to propose
appropriate technology and other tools to support improvements
in nursing practice and patient outcomes?
Does the capstone demonstrate the student’s ability to assess
staff’s training, technology, and information needs to ensure
quality
patient-centered outcomes?
Does the capstone demonstrate the student’s ability to anticipate
and plan for potential technological challenges and limitations
associated with change activities and propose solutions?
Does the capstone demonstrate the student’s ability to suggest

25. appropriate procedures for collecting, recording, and analyzing
information to evaluate the effectiveness of change activities?
Does the capstone demonstrate the student’s ability to select
appropriate clinical decision support tools in addressing a
specified
health problem?
NUR-490-02: Utilize evidence-based practice in planning,
implementing, and
evaluating outcomes of care
Proficient
100%
Not Proficient
0%
Possible Indicators of Success
Does the capstone demonstrate the student’s ability to justify
the need for change in the identified area based on clinical and
research-based evidence?
Does the capstone demonstrate the student’s ability to apply a
change theory in planning, implementing, and evaluating
activities
to improve a targeted aspect of care?
Does the capstone demonstrate the student’s ability to
support proposed change proposal activities from planning
through
evaluation with credible research and evidence?
Does the capstone demonstrate the student’s ability to draw
connections between activities proposed and quality patient
outcomes?
Does the capstone demonstrate the student’s ability to propose
appropriate indicators for measuring the effectiveness of change
activities and their impact on patient outcomes based on

26. existing best practices?
Does the capstone demonstrate the student’s ability to describe
the underlying theoretical foundation(s) in his or her nursing
practice?
NUR-490-03: Formulate strategies to promote health and
prevent disease in
individuals and populations across the life span
Proficient
100%
Not Proficient
0%
Possible Indicators of Success
Does the capstone demonstrate the student’s ability to propose
clinical and/or nonclinical strategies that address an identified
concern in meeting the health needs of individuals or target
populations?
Does the capstone demonstrate the student’s ability to plan
appropriate health literacy activities for diverse populations and
age
groups?
Does the capstone demonstrate the student’s ability to assess
how differences in health needs across individuals from
different
age groups and backgrounds may affect the effectiveness of
planned interventions?
Does the capstone demonstrate the student’s ability to support
continuous improvement in health promotion and disease

27. prevention by incorporating patient/family feedback in
designing, implementing, and evaluating health initiatives?
Does the capstone demonstrate the student’s ability to specify
appropriate resources needed to effectively carry out health
improvement activities?
Does the capstone demonstrate the student’s ability to assess
how assumptions and potential for bias may affect care in
different
populations?
NUR-490-04: Implement patient safety and quality initiatives
within the
complex clinical microsystem using leadership and
communication skills
Proficient
100%
Not Proficient
0%
Possible Indicators of Success
Does the capstone demonstrate the student’s ability to identify
relevant clinical guidelines or institutional policies and
procedures
in designing quality improvement projects?
Does the capstone demonstrate the student’s ability to exercise
leadership by proposing improvements to policy and procedures
designed to ensure safety and promote quality?
Does the capstone demonstrate the student’s ability to
accurately identify direct and indirect stakeholders in proposing
safety
and/or quality improvements?
Does the capstone demonstrate the student’s ability to navigate
complex stakeholder relationships in suggesting potential

28. strategies for building buy-in?
Does the capstone demonstrate the student’s ability to address
stakeholder concerns in communicating the necessity and
feasibility of proposed activities?
Does the capstone demonstrate the student’s ability to identify
institutional structures that help or hinder proposed change?
Does the capstone demonstrate the student’s ability to analyze
how relationships between patients, health, environment, and
nursing interact in complex systems to affect care?
NUR-490-05: Analyze trends in healthcare policy, finance, and
regulatory
environments and their implications for healthcare access,
equity, and
affordability
Proficient
100%
Not Proficient
0%
Possible Indicators of Success
Does the capstone demonstrate the student’s ability to assess
how the policy environment affects a healthcare organization’s
ability to provide quality care to underserved populations?
Does the capstone demonstrate the student’s ability to analyze
complex healthcare environments in identifying opportunities
for
improved care?
Does the capstone demonstrate the student’s ability to suggest

29. procedures for guaranteeing affordable and equitable care for
diverse patient groups within the current healthcare context?
Does the capstone demonstrate the student’s ability to anticipate
financial trends in the organization and/or the broader
healthcare context that may impact available resources?
Does the capstone demonstrate the student’s ability to analyze
how institutional and/or government policy can constrain what
changes are feasible in addressing identified healthcare needs?
Does the capstone demonstrate the student’s ability to suggest
changes for improving healthcare access, safety, and delivery
that
comply with relevant regulatory requirements?
Does the capstone demonstrate the student’s ability to designate
time frames for carrying out activities that comply with
institutional and regulatory requirements?
NUR-490-06: Evaluate life-long learning and nursing
engagement to promote
personal and professional transformation
Proficient
100%
Not Proficient
0%
Possible Indicators of Success
Does the capstone demonstrate the student’s ability to promote
personal and professional improvement by working to engage
nurses in developing and carrying out change activities?
Does the capstone demonstrate the student’s ability to
incorporate nurse and patient/family feedback in evaluating
change and
improving professional care?
Does the capstone demonstrate the student’s ability to articulate

30. ways in which self-reflection contributes to personal and
professional transformation?
Does the capstone demonstrate the student’s ability to
distinguish between underlying core values and ideas that
evolve with
experience in developing a philosophy of nursing?
Does the capstone demonstrate the student’s ability to promote
his or her own future development based on a clearly stated
philosophy of nursing practice?
Does the capstone demonstrate the student’s ability to assess the
role of the nurse as an agent of change in improving
professional
practice?