Capstone Project Change Proposal Presentation for Faculty Review and Feedback AND Professional Capstone and Practicum Reflective Journal


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Jane Chima

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Reflective journal






The one-course reflective journal incorporates the inquiry and leadership into current

practice as it applies to the Practicum and Professional Capstone course. The journal reflects on


consider evidence-based approaches. The progressive application of evidence-based practices

leads to effective care which results in better patient outcomes.

Interprofessional collaboration

Interprofessional collaboration takes place when diverse healthcare providers from

various professional background and specialties work together with the patients, their families,

their caregivers as well as communities to deliver quality care. It is the collective involvement of

various healthcare workers works with patients, caregivers, families and communities to share

their perspectives concerning delivering highest quality of care (Reeves et. al., 2017).

Interprofessional collaboration helps healthcare professionals to achieve better patient outcomes

and optimal health status of patients and communities.

Healthcare providers such as nurses, physicians and others should collaborate across all

professions to provide highest quality care and improved patient outcomes. This involves

working with all people irrespective of their expertise or professional level to improve the overall

health outcomes (Grove & Gray, 2018) . All healthcare professionals should keep aside all their

differences and work together with a common goal for interprofessional collaboration to work

well in the healthcare setting. They should also improve their communication and develop good

working relationships to ensure that interprofessional collaboration works well with minimal or

no setbacks (Reeves et. al., 2017). When healthcare professionals use interprofessional

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individual knowledge and skills attained during the Practicum and Professional Capstone course

(Finkelman, 2017). Stress and burnout caused by work overloads in the nursing practice has

attracted the attention of nursing researchers and educators since they have recognized their

impacts on patient outcomes and satisfaction. The journal will also address the skills and

knowledge that I have acquired during the Practicum and Professional Capstone course and

during the placement. This knowledge and skills have helped me develop my nursing career

(LoBiondo-Wood & Haber, 2017) . Working under the supervision and mentorship of my

preceptor enabled me acquire additional practical skills that will enable me to provide the best

quality care to patients. The mentor assigned me various practical duties that made me more


New practice approaches

The nursing discipline has experienced significant alterations in the last years, one of

them being the utilization of evidence-based approaches or evidence-based practice (EBP) in

care delivery (LoBiondo-Wood & Haber, 2017) . The progressive application of evidence-based

approaches in the nursing practice is revolutionizing healthcare delivery in many ways.

Nurses must conform to modifications to remain pertinent in their responsibility to give

excellent nursing care to patients. One way that the nursing practice emphasizing the utilization

of EBP in nursing care is to that higher learning institutions are growingly acknowledging the

vitality of the current inclination and initiating modifications to the nursing courses offered to

collaboration, they can work together to prevent medication errors, deliver better patient

outcomes, improve patient experience and reduce healthcare costs. Interprofessional

collaboration also enable healthcare facilities to eliminate workflow redundancies and achieve

operational efficiencies.



actions and intentions values in the healthcare setting. The ethical values spells out the moral

principles that governs how an individual conduct themselves any time (Chadwick & Gallagher,

2016). Ethical considerations also cover the rights or wrongs, dos and don’ts and the decision-

making process of determining the consequences of the actions. Every person has their set of

moral and ethical principles (Blais, Hayes, Kozier, & Erb, 2016) . Ethical values in the healthcare

settings are essential because every healthcare provider must face ethical healthcare dilemmas

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Health care delivery and clinical systems

A healthcare delivery systems involves people, institutions and resources aimed at

delivering quality healthcare services to meet the health needs of a given population. A

healthcare delivery system enables patients and population to receive healthcare services. It also

aims at delivering cost-effective and safe health services that meet the quality standards

(Kuziemsky, Abbas, & Carroll, 2018) . The adoption of healthcare delivery systems on the basis

of patient-centered care is crucial in the clinical settings. It brings respect for nurses and

healthcare providers. Healthcare delivery system is classified into individual patient, health team,

patients’ family members and health institutions including nursing homes, clinics and hospitals

(Grove & Gray, 2018) . Clinical systems refers to information systems put in place for use in

healthcare settings.

Nurses are essential components in the healthcare delivery systems. They provide the

best and high quality health services to patients during nursing practice. Nurses are includes in

all health plan levels. They are also in all operating units to promote development, foster

direction and guide the implementation of patient-centered programs (Grove & Gray, 2018) .

Nurses use clinical systems to manage patient care in the best way possible in critical care

settings. The clinical systems enables nurses and other providers to connect to other departments

such as radiology, lab, and pathology and so on for easier access to patient records and for

accurate and complete patient care.

Ethical considerations in health care

Ethical values are essential for any healthcare provider. They are universal codes of

conduct and rules that provides a practical framework for identifying the types of motives,

and make good decisions and judgments regarding various healthcare issues while maintaining

these values.

To practice effectively with competence and integrity, nurses and other healthcare

professionals must have their own ethical values and follow healthcare-based ethical principles

to guide them in their practice (LoBiondo-Wood & Haber, 2017) . Healthcare is guided by four

major ethical values alongside other expected ethical principles such as honesty, integrity,

empathy, compassion, confidentiality etc. These ethical values in nursing include autonomy,

justice, beneficence and non-maleficence. Autonomy gives patients the right to make their

decisions based on their values and beliefs. Beneficence gives healthcare professionals a duty to

minimize harm, refrain from maltreatment and promote safety and good towards patients

(Chadwick & Gallagher, 2016) . Justice is the right for patients to be treated fairly and equally by

healthcare professionals. Lastly, non-maleficence is the patients’ right to no harm during

treatment. Nurses and all healthcare providers have a unique responsibility to themselves, their

profession and to patients to maintain ethical values.

Practices of culturally sensitive care

Culturally sensitive care is care that reflects the ability to respond appropriately to

feelings, attitudes and situations of groups of individuals sharing a distinctive and common


national, racial, linguistic, cultural and religious heritage. A culturally competent care is capable

of improving the quality of care and overall health outcomes. It can also lead to elimination of

racial, cultural and ethnic health disparities (Ring, Nyquist, & Mitchell, 2018) . The world is

ethnically and racially diverse. This calls for the need of culturally competent care. The racial

and ethnic minority groups and communities usually face sociocultural obstacles to quality care

such as lack of access to health insurance, language barriers, racial/ethnic discrimination, and

low literacy to understand the need for quality care and low income to afford health services.

Nurses and other healthcare providers can develop and adopt various strategies and

practices to enable them provide culturally competent care (Ring, Nyquist, & Mitchell, 2018) .

These practices includes providing training and education to increase cultural awareness and

knowledge, provide interpret services, work with minority staff, use community health workers

services, include community and family members in healthcare decision-making, improve

language and communication barriers, engage directly in cross-cultural interactions with patients

and conduct cultural competence self-assessment among all healthcare providers (Jolley, 2020) .

Healthcare providers should focus on providing culturally competent healthcare to all patients.

Ensuring the integrity of human dignity in the care of all patients

Human dignity is the inherent characteristics and supreme values possessed by all human

beings in virtue of their humanity. It is simply the acknowledgement that human beings have a

unique value intrinsic to their humanity and should be respected because they are human beings.

Human dignity manifests through show of respect for self and for others (Kadivar, Mardani-

Hamooleh, & Kouhnavard, 2018) . It is influenced by how other people treats an individuals.

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Human dignity can also be influenced by other factors including attitudes, level of independence,

perceived control and symptom management among nurses towards people.



population health such as education, homelessness, unemployment, racial discrimination and so

on (Woolf, et al., 2015) . Healthcare professionals should collaborate and work together to

improve the healthcare systems, livelihoods and health status of the communities where they

operate. This would address the major population health concerns and improve the overall health

of populations that they serve.

The role of technology in improving health care outcomes

Patient safety is a top priority and a first line consideration in the healthcare settings. It

involves avoiding, preventing and ameliorating negative results or injuries that originates from

healthcare processes. The Institute of Medicine (IOM) recommended the development and

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Observing human dignity and respect for life is part of the nursing profession ethics that

nurses should observe without focusing on the gender, race, culture, age, social status, economic

status or nationality of patients (Sabeghi, Nasiri, Zarei, Tabar, & Golbaf, 2017) . Nurses should

always preserve and respect human dignity by treating patients with humanity, respecting all

patients, treating patients with compassion and justice and involving patients in their care by

giving them a chance to make decisions regarding their care. Nurses should uphold and preserve

the integrity of human dignity when providing care to patients (Schmidt & Brown, 2017) . They

should ensure privacy and confidentiality of their records and treatment without considering

factors such as age, gender, race, nationality, ethnicity and socioeconomic status.

Population health concerns

Population health is a customizable and interdisciplinary approach that enables health

departments to connect healthcare practice to policy so that changer can occur locally. The health

approach utilizes modern partnerships among different community sectors to achieve positive

outcomes of population health (Navarro & Muntaner, 2020). Population health focuses on

significant health concerns and address various ways that resources can be allocated in the health

sector to overcome issues which are driving poor health conditions among the populations.

Environmental factors determines the health of populations. Nurses and population health

advocates can effective a positive change in how environmental factors affect population health.

Some of the environmental factors that affect population health includes unemployment,

homelessness, neighborhood violence, food insecurity and underemployment.

Nurses should strive to address the major population concerns within their ability to

ensure that people get the best quality care. Nurse leaders and management of health facilities

should lobby for external support to address some environmental and social concerns of

testing of new healthcare technologies to minimize medical error in 1999. The later

recommended the application of health information technology (HIT) as the initial step to change

and transform healthcare environment to achieve safer and better patient care.

Studies have shown that both advantages and disadvantages come with technology

adoption in healthcare such as potential for technical issues and security breaches. Privacy

overall is a major concern. Also, communication in the healthcare setting can be rapid and

emergent, giving room for error (Pompilio, 2019). Though the advantages that technology usage

in healthcare has provided is vast and improves patient outcomes, care has to be taken when

using technology to provide care. Healthcare workers should also be educated on what safety

modalities with incorporating technology when providing patient care.

Health policy

Health policy describes the actions, decisions and plans implemented with an aim of

achieving certain healthcare goals in the society. A well-defined health policy can achieve goals


such as informing people, defining a vision for future, defining priorities, outlining expected

roles of various groups and building a consensus within society (Abel-Smith, 2018) . Health

policy can be global health policy, public health policy, health service policy, insurance policy

and so on. Health policy helps in standardizing daily operational activities of a health

organization. These policies provide clarity when faced with critical issues, legal and safety

liabilities and regulatory requirements (Barr, 2016). Appropriate development and management

of health policies enables organization to formulate powerful solutions to issues and improve

productivity and efficiency of these facilities while refraining them from breaching regulations.

Nurses have a significant role in development, implementation, management and

enforcement of health policies. These policies guide the nursing practice and overall healthcare

(Barr, 2016). Since they are the main providers of health services, nurses should actively

participate in the process of developing, implementing, managing and enforcing these policies.

Nurses should follow health policies of their respective organizations to achieve the desired

health outcomes, guide decision making and guide their roles, duties and responsibilities (Abel-

Smith, 2018). Health policies is the foundation of the delivery of quality, holistic, safe and cost-

effective care.

Leadership and economic models

The aspects that are driving healthcare change includes healthcare access problems,

suboptimal patient outcomes, fragmentation and unsustainable healthcare costs. The cost and

quality concerns together with transforming the infection-type and social demographics created

the highest need for healthcare change (Needleman, 2016) . Another major concern is caring for

as well as paying for the medical treatments and interventions of patients with chronic

conditions. The Affordable Care Act (ACA) consists of programs such as Centers for Medicaid

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and Medicare services whose aim is enhancing cost and quality control in healthcare. The great

care coordination may reduce healthcare spending, improve quality patient care and improve

patient outcomes (Finkelman, 2017). Reducing the unnecessary hospitalizations, unwarranted

utilization of emergency units, repeated diagnostic testing, and adverse drug interactions can cut

on costs, repeated medical history and multiple prescriptions. Healthcare organizations takes

incremental steps towards achieving high quality care and lower costs.

Nursing has a pivotal contribution towards healthcare reforms and demands for quality,

safe, affordable, patient-centered and accessible healthcare system (Needleman, 2016) . Nurses

must understand how nursing practice should be unique in delivering the expected quality care

and proactively and passionately engaging in the change process for their healthcare facilities to

achieve these outcomes (Zerwekh & Garneau, 2017) . The healthcare changes may require

improved skills or new skill set of patient care and wellness with new emphasis on patient-

centered care, quality improvement, coordination and data analytics. The healthcare economic

models helps in reducing costs and improving the quality and accessibility of care to the entire

population. As a result, it required quality leadership from the nurse leaders to the senior

management to deliver quality healthcare services.

Health disparities

Health disparities occurs from many factors such as environmental threats, poverty,

educational inequalities, individual factors, behavioral factors and inadequate access to

healthcare services. Health disparities may also originate from the race and ethnicity of a

population or community. Other health disparities includes socioeconomic status and disability

status (Wheeler & Bryant, 2017) . These disparities shapes the ability of an individual or

population to attain optimal health.


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After assuming leadership roles, nurses can improve population health by prioritizing

health equity needs and integrating strategies to reduce and eliminate health disparities into

health programs (Thornton, et al., 2016) . In addition, all healthcare providers should be trained

on addressing social determinants of health with an aim of promoting equitable health outcomes

for all patients, their families and communities.


For one to understand the nursing practice, he/she needs to examine the mission, goals,

processes and leadership. The nursing practice involves promoting supportive learning and

integrating it into educational experience both in classroom and clinical environment using

reflection. The strategies includes clinical practice, practical knowledge and nurse involvement

in a learning settings. The practicum enables nurses to learn and acquire new skills and

knowledge in the emerging nursing field. It opens the mind of nurses to explore new


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 verb acquire (get, develop): acquire  gettechnologies and concepts in nursing care.


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