Capstone Change Project Evaluation Plan

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Jane Chima

NEWBenchmark-ProfessionalCapstoneandPracticumReflectiveJournal (3).docx

Summary

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Running head: REFLECTIVE JOURNAL

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Reflective journal

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Introduction

This one-course practicum and reflective journal includes inquiry and leadership into the

current nursing practice since it applies to Practicum and Professional Capstone course. It

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reflects on personal skills and knowledge acquired during the 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 knowledgeable.

New practice approaches

The discipline of nursing has encountered great changes in the last few decades. One of

these changes is the adoption and implementation of evidence-based practice (EBP) in practice.

The continuous application of these approaches in nursing practice is revolutionizing healthcare

in numerous ways

Nurses should comply with these changes to remain pertinent in the duties to provide

high quality care to patients. One way to achieve this is by adopting EBP in their practice.

Nursing institutions are continually offering EBP courses. The continuous application of EBP

results in effective patient care which leads to better health outcomes.

Interprofessional collaboration

Interprofessional collaboration occurs when diverse healthcare professionals from

different specialties and professional backgrounds work together with patients, caregivers,

families and communities to deliver quality patient care. Interprofessional collaboration enables

providers to achieve better health outcomes in patients and optimal health status of the

populations 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 interprofessional collaboration is used by providers, it

enables them to work together to deliver better health outcomes, prevent medication errors,

improve patient experience and minimize healthcare costs. Interprofessional collaboration also

enable healthcare facilities to eliminate workflow redundancies and achieve operational

efficiencies.

Health care delivery and clinical systems

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patient-centered care is essential in the clinical settings. Healthcare delivery system is

categorized into individual patient, health team, patients’ family members and health institutions

such as clinics, nursing homes 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 incorporated

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 crucial for any healthcare professional. They are universal codes of

conduct as well as rules that offer a practical framework to help in the identification of the types

of motives, 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 and make good decisions and judgments regarding various healthcare issues while

maintaining these values.

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A healthcare delivery systems comprises of people, institutions and other resources that

are aimed to deliver quality services to meet the health needs of a specified population. A

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

aims to deliver cost-effective as well as safe health services that meet the quality standards put in

place (Kuziemsky, Abbas, & Carroll, 2018) . Adopting healthcare delivery systems based on

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 the nursing practice include

autonomy, justice, beneficence and non-maleficence. Autonomy offers patients the right to make

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their own decisions based on their values and beliefs. Beneficence offers providers 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 intrinsic attributes and supreme values possessed by all human

beings in virtue of their humanity. 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. Human dignity can be influenced by other factors such as attitudes,

perceived control level of independence and symptom management among nurses towards

people.

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. This can achieve this by treating all patients with

humanity, respecting all patients, treating patients with compassion and justice and involve them

in their care by allowing them to make decisions regarding their care. They should also uphold

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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 an interdisciplinary and customizable approach that helps the health

departments to integrate health policies into practice so that change can take place locally. The

population health approach makes use of the modern partnerships among various community

sectors to achieve positive results for population health (Navarro & Muntaner, 2020). Population

health concentrates on major health concerns and ways in which resources can be allocated to

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

Environmental make a positive change on how different environmental factors affect population

health. Examples of environmental factors affecting population health includes homelessness,

unemployment, neighborhood violence, and underemployment and food insecurity. Nurses

should address the major population concerns within their ability to ensure that people get the

best quality care.

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

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.

Health policy

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and preserve the integrity of human dignity when providing patient care (Schmidt & Brown,

Health policy are the decisions, actions and plans which are implemented to achieve

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

defining a vision for future, informing people, outlining expected roles of various groups,

defining priorities and building a consensus within society (Abel-Smith, 2018) . There are several

types of health policies such as global, public, health service, insurance health policies and so on.

Health policy enables health organizations to standardize their daily operational activities. These

policies provide guidance and clarity when facing critical issues, legal as well as safety liabilities

and regulatory requirements (Barr, 2016). Proper establishment and management of health

policies helps health facilities to develop powerful solutions to issues, improve efficiency and

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productivity and refrain from breaching regulations.

Leadership and economic models

Healthcare change is driven by factors such as healthcare access problems,

fragmentation, suboptimal patient results and unsustainable healthcare costs. The quality and

cost concerns along with transforming the social demographics as well as infection-type presents

the highest need for healthcare change (Needleman, 2016) . Caring for and paying for treatment

of chronic patients presents another major concern. The Affordable Care Act (ACA) consists of

programs such as Centers for Medicaid and Medicare services whose aim is enhancing cost and

quality control in healthcare. The great care coordination may improve quality patient care,

reduce healthcare spending and improve patient outcomes (Finkelman, 2017). Reducing the

unnecessary hospitalizations, 15unwarranted utilization of emergency units and negative drug

interactions can cut on costs, repeated medical history and multiple prescriptions. Healthcare

facilities takes incremental steps towards achieving high quality care and lower costs.

Health disparities

Health disparities exists due to numerous factors such as poverty, environmental threats,

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

healthcare services. They may also be caused by race and ethnicity of a population or

community. Health disparities can also be as a result of disability status and socioeconomic

status (Wheeler & Bryant, 2017) . These differences shapes the ability of population to attain

optimal health.

After taking leadership roles, nurses can improve the health of a population by

prioritizing health equity needs as well as integrating strategies to help them eradicate health

disparities into health programs (Thornton, et al., 2016) . In addition, all healthcare professionals

should acquire training on how to address the social determinants of health so as to promote

equitable health outcomes for all patients, their families and communities.

Conclusion

Nursing practice is defined by supportive and continuous learning and integrating the

knowledge acquired from learning into educational experience in the learning and clinical

settings using reflection. This reflective journal provides an overview of the knowledge and

skills that nursing students acquired during the Professional Capstone and Practicum course. The

course enabled students to acquire knowledge and skills related to nursing.

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Kuziemsky, C., Abbas, R. M., & Carroll, N. (2018). Toward a Connected Health Delivery

Framework. 2018 IEEE/ACM International Workshop on Software Engineering in

Healthcare Systems (SEHS), 46-49.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing research: methods and critical appraisal for

evidence-based practice. Elsevier Health Sciences.

Navarro, V., & Muntaner, C. (2020). Political And Economic Determinants of Population Health

and Well-Being:: Controversies and Developments. Routledge.

Needleman, J. (2016). The Economic Case for Fundamental Nursing Care. Nursing Leadership

(Toronto, Ont.), 29(1), 26-36.

Ring, J., Nyquist, J., & Mitchell, S. (2018). Curriculum for culturally responsive health care:

The step-by-step guide for cultural competence training. CRC Press.

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Abel-Smith, B. (2018). An introduction to health: policy, planning and financing. Taylor &

Francis Books Limited.

Barr, D. A. (2016). Introduction to US Health Policy: the organization, financing, and delivery

of health care in America. JHU Press.

Blais, K., Hayes, J. S., Kozier, B., & Erb, G. L. (2016). Professional nursing practice: Concepts

and perspectives. Upper Saddle River, NJ: Pearson Education.

Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Macmillan International

Higher Education.

Finkelman, A. (2017). Professional nursing concepts: Competencies for quality leadership.

Jones & Bartlett Learning.

Grove, S. K., & Gray, J. R. (2018). Understanding Nursing Research: Building an Evidence-

Based Practice. Elsevier Health Sciences.

Grove, S. K., & Gray, J. R. (2018). Understanding Nursing Research: Building an Evidence-

Based Practice. Elsevier Health Sciences.

Jolley, J. (2020). Introducing research and evidence-based practice for nursing and healthcare

professionals. Routledge.

Kadivar, M., Mardani-Hamooleh, M., & Kouhnavard, M. (2018). Concept analysis of human

dignity in patient care: Rodgers' evolutionary approach. Journal of medical ethics and

history of medicine, 11.

Sabeghi, H., Nasiri, A., Zarei, M., Tabar, A. K., & Golbaf, D. (2017). Respecting for human

dignity in elders caring in perspective of nurses and elderly patients. Medical Ethics

Journal, 9(32), 45-70.

Schmidt, N. A., & Brown, J. M. (2017). Evidence-based practice for nurses: Appraisal and

application of research. Jones & Bartlett Learning.

Thornton, R. L., Glover, C. M., Cené, C. W., Glik, D. C., Henderson, J. A., & Williams, D. R.

(2016). Evaluating strategies for reducing health disparities by addressing the social

determinants of health. Health Affairs, 35(8), 1416-1423.

Wheeler, S. M., & Bryant, A. S. (2017). Racial and ethnic disparities in health and health care.

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Woolf, S. H., Purnell, J. Q., Simon, S. M., Zimmerman, E. B., Camberos, G. J., Haley, A., &

Fields, R. P. (2015). Translating evidence into population health improvement: strategies

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Zerwekh, J., & Garneau, A. (2017). Nursing Today: Transition and Trends. Elsevier Health

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