This document contains summaries of students' capstone change projects in NR 451 on various topics like promoting breastfeeding and using chlorhexidine pre-operatively. It provides guidelines for students to complete milestone assignments on identifying a practice problem, conducting an evidence review, and developing a proposal to address the problem. The proposal should use the ACE Star model, identify stakeholders, recommend evidence-based solutions, propose an action plan with outcomes, and summarize how the change will be implemented and maintained.

1. NR 451 Week 1 DiscussionTypes of Nursing Models and
Frameworks of EBP
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Types of Nursing Models and Frameworks of EBP
What are some of the models and frameworks of EBP currently in
use? How does the strength of the evidence determine translation into
practice? Why is it important to integrate both evidence-based practice
and patient and family preferences? What is the nurse's responsibility
when EBP and patient and family practice do not match?
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NR 451 Week 2 DiscussionThe Clinical Question
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The Clinical Question

2. Your capstone change project begins this week when you identify a
problem that you judge needs to experience a change in order to
produce better patient outcomes
• Formulate a significant clinical question that will be the basis for
your capstone change project
• Relate how you developed the question
• Describe the importance of this question to your clinical practice
• Define meta-analysis.and explain how this relates to evidence -based
practice (EBP)
• Describe what a research-practice gap is
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NR 451 Week 3 Capstone Project Milestone 1 Practice Issue
And Evidence Summary Guidelines (Chlorhexidine Pre-
Operatively)
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Capstone Project Milestone 1:
Practice Issue and Evidence Summary Worksheets
Directions
Refer to the guidelines for specific details on how to complete this
assignment.
Type your answers directly into the worksheets below.
Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m.
MT.
Post questions about this assignment to the Q & A Forum. You may
also email questions to the instructor for a private response.
Practice Issue Worksheet
What is the Practice Issue?
Define the scope of the Practice Issue:
What is the practice area?

4. _✔__ ___
___
(list)_________________________________
How was the practice issue identified?
___
Describe the rationale for your checked selections:
What evidence must be gathered? (Check all that apply)
Describe the rationale for your checked selections:
Evidence Summary Worksheet
Directions: Please type your answers directly into the worksheet.

5. 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.
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.

6. 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.
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NR 451 Week 3 Capstone Project Milestone 1 Practice Issue
And Evidence Summary Guidelines (Promoting
Breastfeeding)
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Capstone Project Milestone 1:
Practice Issue and Evidence Summary Worksheets
Directions
Refer to the guidelines for specific details on how to complete this
assignment.

7. Type your answers directly into the worksheets below.
Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m.
MT.
Post questions about this assignment to the Q & A Forum. You may
also email questions to the instructor for a private response.
Practice Issue Worksheet
What is the Practice Issue?
Define the scope of the Practice Issue:
What is the practice area?
_✔__ ___
___
(list)_________________________________
How was the practice issue identified?
___

8. Describe the rationale for your checked selections:
What evidence must be gathered? (Check all that apply)
Describe 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:

9. Define the search terms for your systematic review:
Identify the objectives of the article.
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.
==============================================

10. NR 451 Week 3 DiscussionFeasibility of Your Design
Proposal and Importance of Communication
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Feasibility of Your Design Proposal and Importance of
Communication
Now that you have identified your capstone change project. it is time
to look its feasibility
• What tangible and intangible resources will be needed to implement
your project?
• What improved outcomes do you anticipate will occur that could
indicate the project produced a successful return on investment (ROI)
of these resources?
• How will you communicate your plan for change with key decision
makers so that they will support the allocation of the resources you are
seeking?

11. ==============================================
NR 451 Week 4 Assignment 2: Capstone Project Milestone #
2 Design for Change Proposal Paper (Chlorhexidine Pre-
Operatively) Set 2 – Promoting Breastfeeding
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Create a proposal for your Design for Change Capstone Project. You
will include the information from Milestone 1, your practice issue and
evidence summary worksheets, as you compose this proposal. Your
plan is to convince your management team of a practice problem you
have uncovered that is significant enough to change current practice.
The format for this proposal will be a paper following the Publication
manual of APA 6th
The paper is to be four- to six-pages excluding the Title page and
Reference page.
As you organize your information and evidence, include the following
topics.
Introduction: Write an introduction but do not use “Introduction” as a
heading in accordance with the rules put forth in the Publication
manual of the American Psychological Association (2010, p. 63).

12. Introduce the reader to the plan with evidence-based problem
identification and solution.
Change Model Overview: Overview of ACE Star model; define the
scope of the EBP; identify the stakeholders, and determine the
responsibility of the team members.
Evidence: Conduct internal and external searches of evidence;
integrate and summarize the evidence summary worksheet from
Milestone 1; develop a recommendation for change.
Translation: develop a hypothetical action plan; include measurable
outcomes, reporting to stakeholders; identify next steps and
disseminate the findings.
Conclusion: Provide a clear and concise summary, inclusive of the
problem issue, the five points of the ACE Star change model; and ways
to maintain the change plan.
Citations and References must be included to support the information
within each topic area. Refer to the APA manual, Chapter 7, for
examples of proper reference format. In-text citations required. Ask
yourself, “How do I know this?” and then cite the source. Scholarly
sources required, use peer-reviewed journals and credible websites.
Tables and Figures may be added as appropriate to the project. They
should be embedded within the body of the paper (see your APA
manual for how to format and cite). Creating tables and figures offers
visual aids to the reader and enhances understanding of your
literature review and design for change.
==============================================

13. NR 451 Week 4 Assignment 2: Capstone Project Milestone #
2 Design for Change Proposal Paper (Promoting
Breastfeeding)
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Create a proposal for your Design for Change Capstone Project. You
will include the information from Milestone 1, your practice issue and
evidence summary worksheets, as you compose this proposal. Your
plan is to convince your management team of a practice problem you
have uncovered that is significant enough to change current practice.
The format for this proposal will be a paper following the Publication
manual of APA 6th
The paper is to be four- to six-pages excluding the Title page and
Reference page.
As you organize your information and evidence, include the following
topics.
Introduction: Write an introduction but do not use “Introduction” as a
heading in accordance with the rules put forth in the Publication
manual of the American Psychological Association (2010, p. 63).
Introduce the reader to the plan with evidence-based problem
identification and solution.

14. Change Model Overview: Overview of ACE Star model; define the
scope of the EBP; identify the stakeholders, and determine the
responsibility of the team members.
Evidence: Conduct internal and external searches of evidence;
integrate and summarize the evidence summary worksheet from
Milestone 1; develop a recommendation for change.
Translation: develop a hypothetical action plan; include measurable
outcomes, reporting to stakeholders; identify next steps and
disseminate the findings.
Conclusion: Provide a clear and concise summary, inclusive of the
problem issue, the five points of the ACE Star change model; and ways
to maintain the change plan.
Citations and References must be included to support the information
within each topic area. Refer to the APA manual, Chapter 7, for
examples of proper reference format. In-text citations required. Ask
yourself, “How do I know this?” and then cite the source. Scholarly
sources required, use peer-reviewed journals and credible websites.
Tables and Figures may be added as appropriate to the project. They
should be embedded within the body of the paper (see your APA
manual for how to format and cite). Creating tables and figures offers
visual aids to the reader and enhances understanding of your
literature review and design for change.
==============================================

15. NR 451 Week 4 DiscussionEvaluating Quality Patient
Outcomes
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Evaluating Quality Patient Outcomes
How can data provide information to evaluate quality patient
outcomes? Give an example of data that can reflect poor quality in
care How can quality improvement be a daily task in patient care?
Why does continuous quality improvement need to be associated with
change?
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NR 451 Week 5 DiscussionCore Competencies for Nurses
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Core Competencies for Nurses

16. Explore the website for the Quality and Safety Education for Nurses
(QSEN) initiative at http://www qsen org How can the QSEN
competencies for nurses be implemented into your workplace or
professional nursing setting? If you are not currently employed as a
nurse, consider a previous work setting that would have benefited from
implementation of the QSEN competencies
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NR 451 Week 6 Capstone Project Milestone 3 Educating
Staff: Implementing Change Guidelines Purpose
(Chlorhexidine Pre-Operatively) Set 2 – Promoting
Breastfeeding
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The purpose of this assignment is to create the Educating Staff:
Implementing Change Project PowerPoint presentation. Your plan is
to educate the staff that will be involved in the pilot program. You will
need to educate them on the problem, show the supporting evidence,
and how your pilot plan will be implemented.
Create an educational presentation for staff before the launch of your
change project.This should inform the staff of the problem, your
potential solution, and their role in change project.

17. The format for this proposal will be a PowerPoint presentation.
The length of the PowerPoint presentation should be 15-20 slides;
excluding the title and reference slides.
Below are the topics for the slides:
a. Title slide
b. Description of the change model used
c. PICO question—include the elements
d. Scope of the problem—use statistics
e. Your team/stakeholders
f. Evidence to support your need for change—from research
g. Action Plan
h. Timeline for the plan
i. The nurses role and responsibility in the pilot program
j. Procedure
k. Forms that will be used (if applicable)
l. Resources available to the staff—including yourself
m. Summary
n. References
Citations and References must be includedg. Action Plan
h. Timeline for the plan
i. The nurses role and responsibility in the pilot program

18. j. Procedure
k. Forms that will be used (if applicable)
l. Resources available to the staff—including yourself
m. Summary
n. References
5. Citations and References must be included to support the
information within each topic area. Refer to the APA manual, Chapter
7, for examples of proper reference format. Citations are to be noted
for all information contained in your paper that is not your original
idea or thought. Ask yourself, “How do I know this?” and then cite the
source. Scholarly sources are expected, which means choose peer-
reviewed journals and credible websites.
Guidelines
• Application: Use Microsoft PowerPoint 2010.
• Length: The PowerPoint slide show is expected to be between 15-20
slides in length (not including the title slide and reference list slide).
• Submission: Submit your files via the basket in the Dropbox:
“Educating the Staff: Implementing the Change Project” by 11:59
p.m. Sunday of Week 6.
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NR 451 Week 6 Capstone Project Milestone 3 Educating
Staff: Implementing Change Guidelines Purpose (Promoting
Breastfeeding)

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The purpose of this assignment is to create the Educating Staff:
Implementing Change Project PowerPoint presentation. Your plan is
to educate the staff that will be involved in the pilot program. You will
need to educate them on the problem, show the supporting evidence,
and how your pilot plan will be implemented.
Create an educational presentation for staff before the launch of your
change project.This should inform the staff of the problem, your
potential solution, and their role in change project.
The format for this proposal will be a PowerPoint presentation.
The length of the PowerPoint presentation should be 15-20 slides;
excluding the title and reference slides.
Below are the topics for the slides:
a. Title slide
b. Description of the change model used
c. PICO question—include the elements
d. Scope of the problem—use statistics
e. Your team/stakeholders
f. Evidence to support your need for change—from research

20. g. Action Plan
h. Timeline for the plan
i. The nurses role and responsibility in the pilot program
j. Procedure
k. Forms that will be used (if applicable)
l. Resources available to the staff—including yourself
m. Summary
n. References
Citations and References must be includedg. Action Plan
h. Timeline for the plan
i. The nurses role and responsibility in the pilot program
j. Procedure
k. Forms that will be used (if applicable)
l. Resources available to the staff—including yourself
m. Summary
n. References
5. Citations and References must be included to support the
information within each topic area. Refer to the APA manual, Chapter
7, for examples of proper reference format. Citations are to be noted
for all information contained in your paper that is not your original
idea or thought. Ask yourself, “How do I know this?” and then cite the
source. Scholarly sources are expected, which means choose peer-
reviewed journals and credible websites.

21. Guidelines
• Application: Use Microsoft PowerPoint 2010.
• Length: The PowerPoint slide show is expected to be between 15-20
slides in length (not including the title slide and reference list slide).
• Submission: Submit your files via the basket in the Dropbox:
“Educating the Staff: Implementing the Change Project” by 11:59
p.m. Sunday of Week 6.
==============================================
NR 451 Week 6 Discussion Implementing Change Despite
Resistance
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Implementing Change Despite Resistance
Change can be difficult to implement Now that you are almost finished
with your change project, if you were to implement your project in
your clinical practice, what type of resistance do you expect from
staff? List at least three ways that you can lessen the resistance you
may encounter to help ensure the success of your project

22. • Why is it important to be aware of changes in healthcare policy?
• Why do you believe we spend more on healthcare than any other
country but have the worst outcomes?
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NR 451 Week 7 Discussion
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Please go to www whitehousegov/blog/2016/03/23/look-six-years-
affordable-care-act to read the latest about the Affordable Care Act
from the White House
Respond to the questions below
• What are some benefits of the healthcare reform that has been
prompted by the Affordable Care Act (ACA)?
• Why is it important to be aware of changes in healthcare policy?

23. • Why do you believe we spend more on healthcare than any other
country but have the worst outcomes?
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NR 451 Week 8 DiscussionThe Future of Affordable, Safe,
and Quality Healthcare
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The Future of Affordable, Safe, and Quality Healthcare
What does the following statement mean to you?
In order to meet the challenges of taking care of older and sicker
patients, incorporate patient safety and quality of care into practice,
and understand economics and its effect on the workforce, nurses
must take a leading role in the future of healthcare and remain
current in their profession by means of engagement in lifelong
learning
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