Bachelor of Science in Nursing Capstone: Change Proposal and Philosophy of Nursing Statement

Task:

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 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, equity, and affordability
• Evaluate life-long learning and nursing engagement to promote personal and professional transformation

Evaluation of Capstone

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 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.

Prompt

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 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
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 publicity materials, and so forth. You may find it useful to use an Excel spreadsheet or other table for presenting this information.