Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date Week 8 Discussion: Your Nursing Destiny Professional Culture in Nursing Every profession develops a unique professional culture that reflects its core principles, ethics, and shared values. This culture serves as the foundation for guiding members’ behaviors, decisions, and professional growth. Professional organizations play a vital role in cultivating and sustaining this culture through advocacy, education, and networking opportunities. In nursing, such organizations not only champion the rights and interests of their members but also create spaces for continuous learning, peer collaboration, and professional certification (Matthews, 2012). Historically, the first professional nursing organization in the United States was the American Society of Superintendents of Training Schools for Nurses, established in 1893. This organization later evolved into the National League for Nursing (NLN), which remains a central body in nursing education and policy. Today, nurses can join a variety of national, state, and specialty organizations, including: NR 451 Week 8 Discussion: Your Nursing Destiny Organization Focus Area Key Benefits American Nurses Association (ANA) Advocacy, research, and policy Access to journals, legislative updates, professional networking National League for Nursing (NLN) Nursing education and leadership Faculty development, testing services, research grants National Student Nurses Association (NSNA) Support for nursing students Career resources, scholarships, mentorship programs American Red Cross Disaster response, community health Training in emergency preparedness, volunteer opportunities Hospice and Palliative Nurses Association (HPNA) End-of-life care Certification, educational resources, support networks My Current Professional Organization At present, I am actively engaged with the National Student Nurses Association (NSNA), an organization that has supported nursing students since 1969 (Matthews, 2012). The NSNA provides essential resources such as employment opportunities, educational journals, and leadership development programs tailored to students across various nursing degree programs. My membership has allowed me to expand my professional network, stay informed about evolving healthcare practices, and participate in skill-building workshops that complement my academic training. Future Professional Organization Participation In the future, I aspire to join the American Nurses Association (ANA). As the largest professional body representing registered nurses in the United States, the ANA offers both national and state-level engagement opportunities. The association’s comprehensive resources—such as an extensive online research library, professional development courses, and national conferences—would enhance my knowledge base and clinical competence. Additionally, ANA membership can strengthen my professional credibility, which is particularly valuable as I continue to seek competitive employment opportunities. Beyond the tangible benefits, ANA membership would also connect me with advocacy initiatives shaping nursing policy, enabling me to contribute to the advancement of the profession at a systemic level (American Nurses Association, 2023). Professional Certifications Under Consideration I am considering pursuing two advanced nursing certifications: Certified Registered Nurse Anesthetist (CRNA) and Certified Clinical Research Professional (CCRP). Certification Administering Body Primary Role Eligibility Requirements CRNA National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) Administer anesthesia during surgical and medical procedures RN license, graduate degree in nurse anesthesia, passing the NBCRNA exam CCRP Society of Clinical Research Associates (SoCRA) Conduct and manage clinical research studies Degree in nursing, medical technology, statistics, or related field; documented clinical research experience The CRNA role is highly specialized and requires advanced knowledge in anesthesia pharmacology, physiology, and surgical techniques. The CCRP credential, on the other hand, reflects expertise in research ethics, clinical trial management, and regulatory compliance, making it essential for nurses who wish to engage in medical research. Educational Plans and Career Alignment Continuing my education to earn a graduate degree is integral to achieving these certifications. For example, CRNA programs require a master’s or doctoral degree in nurse anesthesia, while the CCRP credential demands both academic qualifications and clinical research experience. By advancing my education, I will meet the minimum eligibility requirements, enhance my professional competence, and expand my career prospects. Furthermore, graduate education will provide me with advanced critical thinking skills, leadership competencies, and research literacy—qualities that are essential for both specialized clinical practice and evidence-based policy development in nursing. This alignment between education and certification will ultimately position me for leadership roles and open pathways for both national and international career opportunities. References American Nurses Association. (2023). Membership benefits. https://www.nursingworld.org/membership/ NR 451 Week 8 Discussion: Your Nursing Destiny Matthews, J. (2012). Role of professional organizations in advocating for the nursing profession. OJIN: The Online Journal of Issues in Nursing, 17(1), Manuscript 3. https://doi.org/10.3912/OJIN.Vol17No01Man03 Society of Clinical Research Associates. (2024). Certified Clinical Research Professional (CCRP®) certification. https://www.socra.org/certification/

Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date NR 451 Week 7 Discussion Utilization of CDC WONDER Resources in Nursing Practice The Centers for Disease Control and Prevention (CDC) Division of Informatics and Surveillance provides a wide array of public health data and resources through its CDC WONDER (Wide-ranging Online Data for Epidemiologic Research) platform. This resource is designed to facilitate access to epidemiologic and public health information, which nurses can integrate into evidence-based practice. One valuable dataset available on the CDC WONDER site relates to diabetes prevention and management. According to CDC data, approximately 34.2 million Americans (10.5% of the U.S. population) live with diabetes, with 26.9 million diagnosed and an estimated 7.3 million undiagnosed (CDC, 2020). This alarming statistic underscores the importance of early screening, education, and intervention. Nurses play a pivotal role in providing individualized guidance on diet modification, physical activity, medication adherence, and self-monitoring of blood glucose. For prediabetic patients, nurses can focus on primary prevention strategies—educating on nutrition, encouraging exercise, and promoting lifestyle adjustments to halt disease progression. The data from CDC WONDER can inform patient education materials, community health interventions, and targeted prevention programs. Application of CDC WONDER in Telehealth The shift towards telehealth during the COVID-19 pandemic has transformed the delivery of chronic disease management. The CDC WONDER platform can be integrated into telehealth services to provide patients with evidence-based educational resources without requiring in-person visits. Table 1 below summarizes potential uses of CDC WONDER in telehealth nursing practice: Telehealth Function Use of CDC WONDER Data Expected Benefit Patient Education Sharing CDC data on diabetes prevalence, complications, and management Enhances patient awareness and motivation Risk Assessment Using epidemiological data to identify at-risk groups Enables targeted screening and prevention Care Plan Development Applying national guidelines for diabetes management Improves care consistency and outcomes Remote Monitoring Guiding patients on self-tracking and reporting Supports timely interventions According to Paterson et al. (2020), telehealth reduces travel burdens, allows timely symptom management, and facilitates adjustments in care plans without physical appointments. For patients with diabetes—classified as high-risk for severe COVID-19—remote management can be lifesaving. Innovative Features of the CDC WONDER Platform The innovative aspect of CDC WONDER lies in its instant accessibility to comprehensive, up-to-date public health data. This resource empowers both healthcare professionals and the public to make informed decisions grounded in current epidemiological trends. The ability to filter data by demographics, location, and health condition allows nurses to tailor interventions to specific populations, enhancing precision in public health strategies. Knowledge accessibility is a cornerstone of innovation in healthcare. By providing open access to statistical data, CDC WONDER bridges the gap between research and practical application, supporting evidence-based decision-making at the point of care. Personal Nursing Innovation Ideas One innovation I have implemented in practice involves real-time translation technology to improve nurse-patient communication. In multilingual healthcare settings, language barriers can delay care, cause misunderstandings, and compromise patient safety. By using tablet-based applications that provide immediate, accurate translations, nurses can conduct assessments, deliver education, and ensure patient comprehension without waiting for an interpreter. This technology not only enhances efficiency but also fosters trust between the nurse and patient, which is essential for achieving positive health outcomes. Combined with resources like CDC WONDER, such innovations contribute to a more inclusive, patient-centered care model. References Centers for Disease Control and Prevention. (2020). CDC WONDER. Retrieved February 16, 2021, from https://wonder.cdc.gov/WelcomeT.html Chamberlain College of Nursing. (2020). NR451 RN capstone: Week 7 lesson. Downers Grove, IL: Online Publication. NR 451 Week 7 Discussion Paterson, C., Bacon, R., Dwyer, R., Morrison, K. S., Toohey, K., O’Dea, A., Slade, J., Mortazavi, R., Roberts, C., Pranavan, G., Cooney, C., Nahon, I., & Hayes, S. C. (2020). The role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer team: Implications for practice. Seminars in Oncology Nursing, 36(6), 15109. https://doi.org/10.1016/j.soncn.2020.15109

Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date Week 6 Assignment: EBP Change Process Form ACE Star Model of Knowledge Transformation Star Point 1: Discovery (Identify topic and practice issue) Identify the topic and the nursing practice issue related to this topic. The selected topic focuses on reducing nursing errors within healthcare institutions through the establishment of a robust safety culture. In hospital environments, clinical errors occur frequently, placing patients at significant risk of harm, disability, or even death. These errors can involve medication administration, patient monitoring, infection prevention, and procedural accuracy. Promoting a safety-oriented culture in nursing practice is a crucial strategy for minimizing these incidents and improving patient outcomes. Briefly describe your rationale for your topic selection. Include the scope of the issue/problem. Hospital errors represent a global health challenge. According to the World Health Organization, millions of patients are adversely affected annually by preventable errors. The causes are multifaceted—ranging from fatigue and distraction to insufficient communication and lack of adherence to protocols. Nurses, as the largest group of healthcare providers with direct patient contact, are uniquely positioned to design and implement strategies that reduce such risks. Creating and sustaining a safety culture can significantly reduce preventable harm and improve the overall quality of healthcare delivery. Star Point 2: Summary (Evidence to support need for a change) Describe the practice problem in your own words and formulate your PICOT question. The core practice issue is the persistent occurrence of clinical errors in healthcare facilities. These may include omissions in patient care, delayed interventions, infection control lapses, patient falls, and medication misadministration. Despite the known dangers, the implementation of systematic safety culture initiatives remains insufficient. Strengthening this culture is vital for enhancing patient safety and preventing adverse outcomes. PICOT Question:In acute care hospital settings (P), how does the implementation of a structured patient safety culture program (I) compared to standard practice without such a program (C) influence the frequency of nursing errors (O) over a period of six months (T)? List the systematic review chosen from the Cochrane Database of Systematic Reviews from the Chamberlain library. APA Reference:Ammouri, A. A., Tailakh, A. K., Muliira, J. K., Geethakrishnan, R., & Al Kindi, S. N. (2015). Patient safety culture among nurses. International Nursing Review, 62(1), 102–110. https://doi.org/10.1111/inr.12159 List and briefly describe other sources used for data and information. Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence. The systematic review emphasizes that patient safety is a cornerstone of quality healthcare delivery. Nurses play a pivotal role in promoting a culture of safety due to their continuous involvement in direct patient care. Key predictors of a strong safety culture include open communication about errors, consistent feedback loops, managerial commitment, clear expectations, and interprofessional teamwork. The evidence presented in the review is robust, supported by both qualitative and quantitative studies across diverse healthcare settings. Outline one or two evidence-based solutions you will consider for the trial project. Two key interventions will be prioritized: Star Point 3: Translation (Action Plan) Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning. Existing best-practice guidelines, such as the World Health Organization’s Patient Safety Curriculum Guide and The Joint Commission’s National Patient Safety Goals, recommend structured safety training, error-reporting mechanisms, and continuous skills enhancement. These protocols provide a solid foundation for intervention planning. NR 451 Week 6 Assignment: EBP Change Process form List your stakeholders (by title and not names) and describe their roles and responsibilities in the change process. Stakeholder Title Role and Responsibility Staff Nurses Implement safety measures, report incidents, complete safety checklists. Nursing Leadership Oversee implementation, allocate resources, monitor progress. Hospital Management Approve policies, provide funding, ensure organizational alignment. Pharmacists Reduce medication errors through verification and dispensing protocols. Patients Engage in care process, report safety concerns, provide feedback. What specifically is the nursing role in the change process? Nurses are central to executing the change process. Their responsibilities include promptly reporting errors or near misses, using shared governance channels to address unsafe conditions, and rigorously applying standardized checklists to ensure comprehensive care delivery. List your stakeholders by position titles. Why are the members chosen important to your project? What type of cost analysis will be needed prior to a trial? Who needs to be involved with this? A cost–benefit analysis will be conducted, focusing on training expenses, materials production (checklists, posters, flashcards), and digital resources (training videos). Involvement will include hospital administrators, finance officers, and nurse leaders to ensure budget feasibility. Star Point 4: Implementation Describe the process for gaining permission to plan and begin a trial. Permission will be formally requested by nurse leaders through a written proposal to hospital management. The proposal will outline the identified problem, its patient safety implications, and the evidence-based interventions proposed, along with anticipated benefits. Describe the plan for educating the staff about the change process trial. Staff will undergo structured training sessions highlighting the importance of safety culture and practical strategies to prevent errors. Interactive workshops, case studies, and role-playing scenarios will be incorporated to ensure deep understanding and engagement. Outline the implementation timeline for the change process. Date Activity 01.02.2018 – 14.02.2018 Staff training on safety culture and error prevention. 15.02.2018 – 28.02.2018 Preparation of educational and promotional materials. 01.03.2018 – 30.03.2018 Safety awareness campaign launch. 01.04.2018 – 31.04.2018 Evaluation of skill application and knowledge retention. List the measurable outcomes based on the PICOT. How will these be measured? PICOT Element Measurement Indicator P – Number of Medication Errors Incident reports before and after intervention I – Promotion of Patient Safety Safety audit compliance rates C – Use of Checklists Percentage of checklist completion per shift O – Mortality Rate Monthly mortality statistics T – 6 Months Comparative analysis at baseline and at 6 months What forms, if any, might be used for recording purposes during the pilot change process? Incident report forms, electronic medication error logs, and checklist compliance sheets will be used to track progress and outcomes.

Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date Academic Integrity Statement By submitting this assignment, I affirm, on my honor, that the work presented here is my own original effort, except where proper quotations and citations have been provided. I have not received unauthorized assistance in completing this assignment. ICARE in Nursing I currently serve in a remote capacity for a healthcare organization that offers in-home urgent care services to patients. Our approach relies heavily on an interdisciplinary care model, involving various professionals such as nurse care managers, social workers, behavioral health care managers, nurse practitioners, and licensed practical nurses. Each team is responsible for the management of approximately 400 patients. To coordinate effectively, we hold a virtual morning huddle each day via Microsoft Teams to address patient concerns and share updates. However, due to the large patient load, these huddles are often too brief to cover all cases comprehensively. Furthermore, the absence of social workers and behavioral health team members from these meetings can limit the holistic exchange of information. Extending the duration of the huddles and ensuring full interdisciplinary participation could improve care coordination and outcomes. Compassion Compassion forms a cornerstone of nursing practice, enhancing the therapeutic relationship between nurses and patients, and contributing to improved health outcomes (American Nurses Association [ANA], 2021). It becomes easier for nurses to express compassion when supported by their interdisciplinary colleagues. Compassionate care involves showing respect, empathy, and genuine concern for the patient’s well-being, as well as engaging in active listening to make patients feel heard and respected. In my telephonic nursing role, active listening plays an especially critical role. My team consistently applies this practice, both with patients and with each other, reducing miscommunication and strengthening our professional relationships. This, in turn, fosters better collaboration, which directly impacts patient outcomes positively. Advocacy Nurses hold the dual responsibility of advocating for their patients, their profession, and the public (Caves, 2022). Patient advocacy involves ensuring that individuals receive the necessary care and intervening when their needs are not met. Additionally, nurses are in a position to advocate for safe workplace conditions. When unsafe practices or workplace violence occur, taking a stand becomes essential to protect both patients and staff. Interdisciplinary teams play a pivotal role in identifying, addressing, and revising unsafe practices or policies. Collaborative advocacy strengthens safety protocols, thereby safeguarding patient outcomes. Resilience Resilience, the capacity to adapt effectively during periods of adversity, is essential in the demanding and high-pressure nursing environment (Henshall et al., 2020). Nurses frequently encounter emotionally taxing situations, high workloads, and staffing shortages—factors that can lead to burnout. The COVID-19 pandemic highlighted the importance of resilience-building interventions. These initiatives help restore emotional balance and reduce stress. My current organization actively supports such interventions. For example, all team members were granted a paid “compassion day” to use for personal well-being activities. Such initiatives enable healthcare providers to maintain their mental and emotional health, ultimately allowing them to deliver higher-quality care. Evidence-Based Practice Evidence-based practice (EBP) underpins effective nursing interventions, ensuring that care strategies are supported by research and clinical evidence. In my current role, we apply EBP to reduce the rate of hospital readmissions within 30 days post-discharge. Research has shown that conducting a transitional care visit within three days of discharge significantly lowers readmission rates. As a result, our organization revised its policy from seven days to three days for post-discharge visits. This change required adjustments from both nurse practitioners, who conduct the visits, and nurses, who schedule them. The success of this initiative relies heavily on precise coordination between team members. By adhering to EBP, we are able to improve patient health outcomes while reducing unnecessary hospitalizations. NR 451 Week 5 Assignment iCARE Paper Table: ICARE Model in Practice ICARE Component Definition Application in Current Role Impact on Patient Outcomes Compassion Showing empathy, respect, and understanding to patients. Active listening via telephonic care; mutual respect within the team. Improved communication, reduced misinterpretations, better trust. Advocacy Acting to ensure patients and staff have safe, effective care. Reporting unsafe practices; ensuring patient needs are met. Enhanced patient safety and care quality. Resilience Ability to adapt and recover during challenging times. Company-provided “compassion day” for self-care. Reduced burnout, improved provider well-being. Evidence-Based Practice Using current research to guide care decisions. Reduced readmission rates by conducting visits within three days. Fewer hospitalizations, better recovery outcomes. Summary The ICARE framework—encompassing compassion, advocacy, resilience, and evidence-based practice—serves as a foundation for high-quality, patient-centered care. In my current role, this model fosters effective interdisciplinary collaboration, enhances patient satisfaction, and improves clinical outcomes. While our organization applies this model well, continuous evaluation and adjustment are necessary to address evolving healthcare challenges. References American Nurses Association. (2021). Nursing (4th ed.). https://ambassadored.vitalsource.com/books/9780999308882 Caves, L. (2022). What is advocacy. Ohio Nurses Review, 97(4), 22. https://doi.org/10.1016/j.profnurs.2022.04.006 NR 451 Week 5 Assignment iCARE Paper Henshall, C., Davey, Z., & Jackson, D. (2020). Nursing resilience interventions—A way forward in challenging healthcare territories. Journal of Clinical Nursing, 29(19–20), 3597–3599. https://doi.org/10.1111/jocn.15276

Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date Week 4 Discussion:  After looking at the National Culturally and Linguistically Appropriate Services Standards (CLAS) at the Think Cultural Health website, it is clear that the purpose of the stated standards is to “advance health equity, improve quality, and help eliminate health care disparities” within healthcare organizations. The National CLAS Standards, as outlined on the Think Cultural Health platform, provide a comprehensive framework designed to enhance equity, quality, and inclusivity in healthcare. These standards focus on ensuring that all individuals—regardless of cultural background, language, or literacy level—have equitable access to safe and respectful healthcare services. The ultimate aim is to bridge health disparities by fostering an environment where cultural and linguistic needs are not only recognized but are also actively addressed in care delivery. For these standards to yield tangible results, healthcare professionals and organizations must deliberately integrate them into their daily practices. In my professional experience, my colleagues and I consistently work toward incorporating these guidelines into patient care. One core method we use is actively recognizing and respecting the cultural differences among our patients. For example, when providing treatment, we are attentive to traditions, beliefs, and practices that may influence health decisions. This cultural sensitivity may include modifying care routines, avoiding culturally prohibited actions, or adapting communication styles to align with patient preferences. This approach aligns with the Principal Standard of the CLAS guidelines, which emphasizes delivering “effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs” (Think Cultural Health, 2019). By practicing cultural humility and tailoring interventions to each patient’s unique context, we ensure that care is not only clinically appropriate but also culturally congruent. The nursing action to improve cultural competence One actionable step I plan to adopt to further strengthen cultural competence in my practice is actively promoting the recruitment and retention of a culturally and linguistically diverse workforce. According to CLAS Standard 3, healthcare organizations should “recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area” (Think Cultural Health, 2019). A diverse healthcare team enhances patient trust, improves communication, and increases the likelihood of delivering culturally appropriate interventions. In practical terms, this can involve collaborating with human resources to design targeted recruitment strategies, participating in mentorship programs to support underrepresented groups in nursing, and advocating for leadership diversity within the institution. The relationship between workforce diversity and patient outcomes is well-documented. For instance, Barksdale et al. (2016) highlight that increasing representation from various cultural backgrounds can significantly reduce misunderstandings, promote inclusivity, and help address specific community health disparities. NR 451 Week 4 Discussion: Advocacy and Cultural Competence Table 1 Summary of CLAS Standards Application in Nursing Practice CLAS Standard Number Standard Description Application in Practice Expected Impact Principal Standard Provide effective, equitable, understandable, and respectful quality care responsive to cultural and linguistic needs Tailoring care to patient cultural beliefs, adapting communication, respecting traditions Improved patient satisfaction, better adherence to treatment, reduced health disparities Standard 3 Recruit, promote, and support a culturally and linguistically diverse workforce Encouraging diverse hiring, mentorship, and leadership representation Workforce that reflects community diversity, increased trust, culturally competent care delivery Other Relevant Standards Offer language assistance services, provide training on cultural competency, collect demographic data Use of interpreters, cultural competency training sessions, data-driven program planning Enhanced communication, better patient-provider relationships, evidence-based approaches to reducing disparities Conclusion Integrating CLAS standards into nursing practice is not simply about following regulations—it is about fostering a healthcare culture rooted in respect, understanding, and inclusivity. By valuing diversity in both patient care and the workforce, nurses can play a pivotal role in addressing healthcare inequities and building trust with communities. Encouraging a culturally diverse workforce not only aligns with national guidelines but also strengthens the profession’s ability to deliver compassionate and effective care across diverse populations. References Barksdale, C., Rodick, W., Hopson, R., Kenyon, J., Green, K., & Jacobs, C. (2016). Literature review of the National CLAS Standards: Policy and practical implications in reducing health disparities. Journal of Racial and Ethnic Health Disparities, 4(4), 632–647. https://doi.org/10.1007/s40615-016-0273-0 NR 451 Week 4 Discussion: Advocacy and Cultural Competence Think Cultural Health. (2019). The National Culturally and Linguistically Appropriate Services Standards (CLAS). U.S. Department of Health & Human Services. https://thinkculturalhealth.hhs.gov/clas/standard

Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date Summary of the Bill The proposed legislation aims to amend the Public Health Service Act by strengthening protections for the confidentiality of health records, specifically for patients receiving treatment for substance use disorders (SUDs). This bipartisan bill, sponsored by Representatives Markwayne Mullin (R-OK) and Earl Blumenauer (D-OR), was introduced to the 116th Congress on April 3, 2019. The bill intends to ensure that healthcare providers have access to complete patient medical histories, including records related to substance use, when delivering care. This access is crucial in avoiding harmful prescribing decisions—for example, preventing the administration of opioids to patients with a documented history of opioid abuse. By integrating SUD records with the broader medical record, the bill aims to promote informed clinical decision-making and reduce the risks associated with uninformed treatment choices. Key Feature Details Bill Type Bipartisan amendment to the Public Health Service Act Sponsors Markwayne Mullin (R-OK) and Earl Blumenauer (D-OR) Date Introduced April 3, 2019 Purpose Protect confidentiality of SUD health records while ensuring access for appropriate treatment decisions Impact on Nursing Practice Standards if Passed If enacted, the bill would directly influence nursing practice by embedding the responsibility to safeguard SUD patient records as part of standard care protocols. Nurses would be required to handle these records with heightened confidentiality, ensuring compliance with federal privacy requirements. Written patient consent would be necessary before sharing SUD medical information for treatment, billing, or other healthcare purposes. While this could be seen as adding procedural complexity, it would also reinforce the ethical commitment to protect patient privacy. The bill includes provisions for criminal and civil penalties for violations of the confidentiality rules, particularly where disclosures occur outside the structure of the Health Insurance Portability and Accountability Act (HIPAA). Importantly, the legislation prohibits using SUD information in criminal or civil proceedings, thereby preventing discrimination from employers, landlords, or other entities. However, the increased restrictions could also have drawbacks. Patients may remain hesitant to seek treatment for fear that their health records will not be fully protected. Additionally, healthcare professionals might face challenges in making comprehensive treatment decisions if SUD records are more difficult to access than other medical information. Impact on Nursing Practice Standards if Not Passed If the bill does not become law, current access protocols for SUD records would remain unchanged, allowing healthcare providers—including nurses—to retrieve this information without requiring additional patient consent. This might support faster, more integrated clinical decision-making but could leave patients feeling less secure about the privacy of their medical information. From a nursing perspective, the absence of enhanced confidentiality protections might discourage some patients from pursuing treatment, fearing that their records could be used against them. On the other hand, streamlined access to medical history, including SUD records, would continue to benefit nurses when formulating care plans. NR 451 Week 3 Healthcare Policy Scenario Potential Impact Bill Passed Greater patient privacy, stricter access controls, more administrative steps for nurses Bill Not Passed Easier access for providers, but potentially less patient trust and reduced treatment-seeking behavior Impact on My Nursing Practice Standards As a nursing professional, the bill presents both advantages and concerns. On one hand, it strengthens the legal and ethical framework for managing sensitive patient information, ensuring that I maintain strict confidentiality in handling SUD records. This formalizes a process-oriented approach and eliminates any possibility of treating such information casually. On the other hand, the bill’s requirement for explicit consent could limit timely access to crucial records, potentially affecting patient safety. Nurses play a primary role in preventing medication-related harm, particularly in patients with substance use histories. Therefore, a balance must be struck between protecting patient privacy and enabling healthcare providers to fulfill their duty of care effectively. Communicating My Concerns Regarding the Bill To address these issues, it is essential for the bill to include clear guidelines that help patients understand the importance of granting consent for access to their medical records. Education campaigns could emphasize that such consent directly supports safe and effective nursing care. Furthermore, the legislation should allow for the secure sharing of SUD information among healthcare professionals involved in a patient’s treatment, ensuring continuity of care without compromising confidentiality. The Bill’s Impact on My Community If passed, the bill could foster greater trust between substance use patients and healthcare providers, leading to increased treatment-seeking behavior. This would improve the overall health outcomes of the community, potentially reducing the prevalence of untreated SUDs. Improved provider-patient relationships, built on transparency and privacy assurance, may also enhance public perception of the healthcare system. By ensuring accurate data collection on SUD prevalence, the bill would also allow public health officials to design targeted interventions and allocate resources more effectively. Ultimately, these changes could contribute to both individual well-being and broader community health improvements. References H.R. 2062: Overdose prevention and Patient Safety Act. (n.d.). GovTrack.us. https://www.govtrack.us/congress/bills/116/hr2062/text NR 451 Week 3 Healthcare Policy Wollschlaeger, B. (2018). Opioid overdose education, prevention, and management (DRAFT). Oxford Medicine Online. https://doi.org/10.1093/med/9780190265366.003.0013

Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date Week 2: The Clinical Question The initiation of the capstone change project begins with identifying a relevant and impactful practice issue that warrants improvement. This practice issue must be directly linked to a systematic review chosen from the List of Approved Systematic Reviews for the capstone project. The link to this list is provided in the Week 3 Capstone Project: Milestone 1 guidelines. Selecting the most suitable systematic review requires alignment with professional interests, current practice environment, and the potential for meaningful clinical application. Once the review is selected, the next step is to formulate a significant clinical question that will serve as the foundation for the capstone change project. This question should be precise, researchable, and directly relevant to nursing practice. Choose a systematic review from the list of approved reviews based on your interests or your practice situation. The first step in this process involves carefully reviewing the list of approved systematic reviews and selecting one that aligns with my current clinical role and interests. My selection criteria included the prevalence of the issue in my patient population, the potential for measurable improvement, and its applicability to nursing-led interventions. Formulate a significant clinical question related to the topic of the systematic review that will be the basis for your capstone change project. A significant clinical question should be framed using the PICO(T) model (Patient/Population, Intervention, Comparison, Outcome, and Time). This ensures that the question is specific, measurable, and evidence-based. Below are two possible clinical questions considered for this project. Relate how you developed the question. The clinical questions were developed after observing recurring gaps in postoperative care and reviewing systematic reviews addressing infection control and postoperative recovery optimization. Input from multidisciplinary teams, including nursing staff and surgeons, further refined the focus areas. Describe the importance of this question to your clinical practice previously, currently, or in the future. This question is critically important because surgical site infections (SSIs) and delayed postoperative recovery remain significant challenges in surgical care. Addressing these issues has implications for patient safety, hospital costs, and quality metrics. In my previous practice, I observed that inconsistent adherence to postoperative protocols directly affected patient outcomes. Currently, I aim to implement evidence-based strategies that reduce infection rates and enhance recovery. In the future, integrating such protocols can standardize care and improve long-term outcomes for surgical patients. Describe what a research-practice gap is. A research-practice gap refers to the difference between what is supported by current evidence and what is implemented in clinical practice (Titler, 2018). In other words, it is the delay or failure to integrate best evidence into patient care. This gap may result from barriers such as lack of awareness, insufficient resources, or resistance to change. Closing the gap ensures that patients receive care based on the most recent and effective interventions. Clinical Question Option 1 Question: Use of antimicrobial dressings and topical antibiotics vs. the traditional sterile gauze dressings on surgical sites cause decrease SSI’s. PICO(T) Component Details P (Patient/Population) Adult patients undergoing surgery I (Intervention) Use of topical antibiotics, including antimicrobial dressings C (Comparison) Traditional sterile gauze dressings O (Outcome) Reduction in surgical site infections (SSIs) T (Time Frame) 30 days postoperatively This question addresses the ongoing challenge of SSIs, which contribute to extended hospital stays, increased healthcare costs, and patient morbidity. Literature suggests that antimicrobial dressings may offer superior protection compared to standard gauze, but adoption in practice varies (Leaper et al., 2020). Clinical Question Option 2 Question: In patients with bowel surgery, how does early frequent ambulation and nourishment compare to conventional recovery methods of rest and bowel rest, affect the return of bowel function and length of hospitalization in the first 72 hours postoperatively? NR 451 Week 2 Discussion PICO(T) Component Details P (Patient/Population) Adult patients undergoing colorectal surgery I (Intervention) Early and frequent ambulation combined with early nutrition C (Comparison) Reduced ambulation and bowel rest O (Outcome) Return of bowel function and reduced length of hospital stay T (Time Frame) 72 hours postoperatively This question focuses on enhanced recovery protocols (ERAS), which emphasize early mobilization and nutrition to improve surgical outcomes. Research indicates these interventions can significantly reduce complications and hospitalization time (Ljungqvist et al., 2017). However, cultural beliefs and patient reluctance can limit implementation, making nursing advocacy crucial. May I deviate from the chosen systematic review from the list and choose a different topic? While adherence to the approved list of systematic reviews is generally expected for the capstone project, there may be situations where an alternate, equally evidence-based topic is warranted. Any deviation should be discussed with the course instructor to ensure alignment with project requirements. References Leaper, D., Assadian, O., & Edmiston, C. E. (2020). Approach to chronic wound infections. British Journal of Dermatology, 182(5), 959–969. https://doi.org/10.1111/bjd.18621 NR 451 Week 2 Discussion Ljungqvist, O., Scott, M., & Fearon, K. C. H. (2017). Enhanced Recovery After Surgery: A review. JAMA Surgery, 152(3), 292–298. https://doi.org/10.1001/jamasurg.2016.4952 Titler, M. G. (2018). Translation science and context. In Patient safety and healthcare improvement at a glance (pp. 60–65). Wiley-Blackwell. https://doi.org/10.1002/9781119368704.ch13

Student Name Chamberlain University NR-451: RN Capstone Course Prof. Name Date Week 1: Types of Nursing Models and Frameworks of EBP What are some of the models and frameworks of EBP currently in use? The development of nursing models began gaining momentum in the late 1950s and 1960s, when nursing theorists and researchers started formalizing conceptual structures to guide nursing practice (American Nurses Association [ANA], 2015, p. 17). These models are essential for directing practice changes, ensuring they are tailored for various clinical environments and patient care scenarios (Chamberlain College of Nursing, 2018). Stevens (2013) identifies forty-seven prominent evidence-based practice (EBP) models in the literature, giving clinicians multiple approaches for integrating research into care. Two widely recognized models are: NR-451: RN Capstone Course Model Description Key Features ACE Star Model of Knowledge Transformation Interdisciplinary framework for translating research into practice and enhancing quality outcomes (Schaffer, Sandau, & Diedrick, 2013). Five-point star representing stages: (1) knowledge discovery, (2) evidence summary, (3) translation into practice recommendations, (4) integration into practice, and (5) evaluation of outcomes. Johns Hopkins Nursing Evidence-Based Practice Model Designed to facilitate the application of research into practice through a team-based process (Dearholt & Dang, 2012). Three-step process: (1) developing a practice question, (2) gathering and evaluating evidence, and (3) translating findings into practice changes. Other models, such as the Iowa Model of Evidence-Based Practice to Promote Quality Care, emphasize identifying triggers for change, assessing priority, and implementing evidence-driven interventions (Titler et al., 2001). How does the strength of the evidence determine translation into practice? The reliability and rigor of evidence directly influence its adoption in clinical settings. High-quality evidence—such as that from systematic reviews, meta-analyses, and randomized controlled trials—provides the strongest basis for achieving optimal patient outcomes (Stevens, 2013). By synthesizing large bodies of research, these reviews enable practitioners to make informed decisions grounded in consistent and reproducible findings. According to the ANA (2015), the EBP process offers a structured pathway for clinicians, educators, and researchers to generate patient-centered, clinically relevant, and testable questions. These questions lead to well-developed guidelines that improve patient safety and care quality. Without credible, up-to-date research, care decisions risk being based on outdated traditions rather than proven effectiveness. Considering the rapid evolution of medical science and patient needs, nursing practice must remain responsive to emerging evidence. Why is it important to integrate both evidence-based practice and patient and family preferences? Patient-centered care is one of the foundational competencies for baccalaureate-prepared nurses. While EBP offers a scientifically validated framework for clinical decisions, patient and family preferences ensure care remains personalized and respectful of individual values, cultural contexts, and spiritual beliefs. Integrating these perspectives supports shared decision-making, strengthens trust, and increases adherence to treatment plans (Smirnoff, 2013). For example, cultural beliefs may influence a patient’s willingness to undergo certain procedures, while religious convictions might affect acceptance of specific medications. Awareness of these factors allows nurses to adapt evidence-based interventions in a way that honors patient autonomy without compromising safety. What is the nurse’s responsibility when EBP and patient and family practice do not match? When discrepancies arise between EBP recommendations and patient or family preferences, nurses play a vital role as educators, advocates, and facilitators of informed choice. This includes: Smirnoff (2013) recommends engaging in open dialogue about the pros and cons of each option, relating them to the patient’s values, and promoting shared decision-making. Ultimately, while EBP forms the foundation of safe, effective care, the final plan must respect the patient’s informed choice. References American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author. Chamberlain College of Nursing. (2018). NR439 Capstone course, lesson week 1. Downers Grove, IL: DeVry Education Group. Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International. Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing, 69(5), 1197–1209. https://doi.org/10.1111/j.1365-2648.2012.06122.x NR-451: RN Capstone Course Smirnoff, L. (2013). Incorporating patient and family preferences into evidence-based medicine. BMC Medical Informatics and Decision Making, 13(Suppl 3), S6. https://doi.org/10.1186/1472-6947-13-S3-S6 Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2), Manuscript 4. https://doi.org/10.3912/OJIN.Vol18No02Man04 Titler, M. G., Kleiber, C., Steelman, V., Rakel, B., Budreau, G., Everett, L. Q., Buckwalter, K. C., Tripp-Reimer, T., & Goode, C. J. (2001). The Iowa Model of Evidence-Based Practice to Promote Quality Care. Critical Care Nursing Clinics of North America, 13(4), 497–509.