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This is the assignment for the capstone project. The instructions are listed below, previous assignments and grading RUBRIC are attached. Let me know if you have any questions. I also included a Capstone PPT example from a former student that took this course.

7.3 Assignment: Capstone Project Presentation

Getting Started

Throughout the NUR-495 course, you have actively engaged in strategically planning for and managing a planned change project within the scope of your current professional role.  For this field-based project, you identified a specific problem or need to serve as the foundation for a faculty-guided capstone experience.  Project-related experiences were integrated throughout the course, involving application of strategic planning and management processes.

Throughout the capstone project, similarities between the nursing and strategic planning processes have emerged — in both methods, you identify a problem and develop an action plan to facilitate achieving a specific outcome.  In addition to defining the problem, constructing a plan for intervention, and evaluating the outcomes of the capstone project, you have also examined multiple, complex factors impacting the strategic planning process.

This week, you will develop a visual presentation to convey the essence of your planned change.  This assignment integrates each step in the journey and provides an update regarding the sustainability of your capstone work.  As you know, the strategic planning process is ongoing; for some students, the project may still be well underway, which is completely normal and to be expected.  Although projects may be at different stages in the change journey, this assignment provides an opportunity to condense and succinctly communicate the capstone work through a presentation format.

Upon successful completion of the course material, you will be able to:

Construct a professional presentation, integrating key elements of the planned change process, to communicate the capstone project.

Background Information

Throughout the previous workshops, each facet of the planned change process has been unpacked, examined, and critically applied to your capstone project.  As a nurse leader, whether serving at the bedside or in administration, education, or another context, identifying key concepts and communicating them in a succinct and clear manner is an essential skill.  Toward that end, in Workshop Seven you will integrate all elements of the capstone project as you create a visual presentation to communicate your work.

As you craft your assignment, remember that the characteristics of an effective and professional visual presentation differ from those of a written paper.  When developing a presentation, the challenge lies in pulling out (or distilling) the key elements and developing a creative means to communicate the essence of your work.  Resist including lengthy narrative passages and extraneous details.  Focus on succinct, clear, bulleted phrases to communicate the essence of your work.  Instead of giving extensive lists of activities, for example, deliver a clean, succinct list of critical milestones.

You want your presentation to have a professional appearance; you may use motion, images, photos, clip art, or graphics, but

only

when they truly

augment

your message.  Motion, images, photos, clip art, and graphics are not required, and should not be used in a manner that draws attention away from the content of your presentation.

To summarize, this assignment will challenge you to synthesize, distill, integrate, and creatively communicate key elements from each phase of your planned change process.  As you move forward, consider innovative ways to condense and concisely deliver information and facts.  Finally, remember to incorporate the characteristics of professional, effective visual presentations as you construct this culminating assignment in your baccalaureate nursing coursework.

Instructions

Review the rubric to make sure you understand the criteria for earning your grade.

Prepare a PowerPoint presentation (20-slide maximum, not counting title slide and reference slide) that integrates each aspect of the capstone project.  Your presentation should include:

Statement of the problem or need addressed by the capstone project

Background of the problem or need (data supporting the problem within the organization; literature substantiating the problem/initiative)

Environmental context impacting the capstone project (SWOT, stakeholders, influencing factors, financial considerations)

Capstone project outcome statement

Activities with timeline for completion

1
Significance of Interprofessional Team Collaboration in a Planned Change Initiative
Name:
Instructor:
Institution:
Course:
Date:
2
Significance of Interprofessional Team Collaboration in a Planned Change Initiative
The person I interviewed was our Community Health Worker, (Initials: S.E.) and he is
new to the team but, this proposed project change for our elderly population suffering from
uncontrolled hypertension can also open doors for him as our CHW to see which of our patients
would benefit from home health assistance to have a nurse come by to assist them with
medication adherence. This is one of the areas where we find could be a threat to the actual
program if participants don’t adhere to the medication regimen.
1. Based on your stakeholder interview, apply and discuss one of the four competency
domains essential to interactions with this stakeholder?
Poor interprofessional collaboration (IPC) can adversely affect health services and patient
care delivery (Ghebrehiwet, 2020). Interprofessional communication is essential to interact with
the stakeholder from the four competency domains. Through clear and effective communication,
the stakeholder will know about the change and participate, thus helping to achieve the desired
goal. Interprofessional communication is the critical competency for effective collaboration as it
empowers the team members and promotes comprehensive patient care through clear and
efficient interaction thus ensuring patient-centered care is achieved. (Homeyer et al., 2018).
Communication is vital because it’s how planning and follow-through occur. Effective
communication is where mutual respect of each team member occurs. Through professional
communication, each team member can relay their professional opinions to get the patients to
their healthiest. Effective communication between team members (stakeholders) allows the
change to occur. How a person communicates professionally to other team members can cause a
breakdown or improve the team.
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2. Discuss how the outcome of the planned change process will be impacted by
interprofessional collaboration/communication.
The interprofessional collaboration will support a team approach to promoting (a
change), maintaining health, and preventing and treating diseases (Core Competencies, 2016).
Interventions that address IPC problems can improve professional practice and healthcare
outcomes in various ways (Ghebrehiwet, 2020). Effective interprofessional
collaboration/communication can positively impact the change outcome. Good interprofessional
collaboration/communication is the cornerstone for implementing a change process.
Interprofessional collaboration involves multiple professional disciplines that trust and respect
the contributions of one another in their area of expertise, and experience, and work
collaboratively to achieve the desired outcome. Interprofessional collaborative practice helps
develop mutual trust and respect, thus having a positive impact on the plan change.
4
References
Ghebrehiwet, T. (2020). INTERPROFESSIONAL COLLABORATION FOR PERSONCENTERED CARE. International Journal of Person Centered Medicine, 8(4), 47.
Homeyer, S., Hoffmann, W., Hingst, P., Oppermann, R. F., & Dreier-Wolfgramm, A. (2018).
Effects of interprofessional education for medical and nursing students: enablers, barriers,
and expectations for optimizing future interprofessional collaboration–a qualitative study.
BMC nursing, 17(1), 1-10.
Interprofessional Education Collaborative. (2016). Core competencies for interprofessional
collaborative practice: 2016 update. Washington, DC: Interprofessional Education
Collaborative
Capstone Project
Tonia Rodriguez
NUR 495: Baccalaureate Capstone: Synthesis/Evaluation
Sheila Leis
July 25, 2020
Statement of Need
Patients with chronic pain in the United States face a crisis because of substantial
issues with obtaining adequate paint management. According to the Morbidity and
Mortality Weekly Report approximately 50 million adults in the United States suffer
from chronic pain (Dahlhamer, et al., 2018). An estimated 20% of patients who
present to physician offices with pain symptoms or diagnoses receive an opioid
prescription (Donovan, et al., 2017). The implementation of a multidisciplinary
approach for chronic pain management is necessary in this physiatry clinic due to the
large amount of chronic pain patients in order to provide safe and high quality care to
pain management patients. This capstone examined various ways to improve pain
management in the physiatry clinic. These include the following treatment modalities
that were utilized in an effort to better control pain in chronic pain patients. .
Background of Problem
• The most common ailment that people seek treatment for is Chronic pain.
• An estimated 20% of patients who present to physician offices with pain symptoms or diagnoses receive an
opioid prescription (Donovan, et al., 2017). .
• 40% of patients that seek treatment for chronic pain fail to achieve adequate pain relief with opiate medications
alone.
• Chronic pain is defined as pain that lasts beyond normal healing times, typically a few months, according to the
IASP (2018).
• Hospitals or medical professionals unwillingness to treat pain aggressively
Background of Problem (cont.)
• Hospitals or medical professional do not always take the patient’s pain seriously.
• Over use of opioid therapy for pain relief.
• Underuse of complementary therapies to treat chronic pain.
• The implementation of a multidisciplinary approach for chronic pain management is necessary in this physiatry clinic
due to the large amount of chronic pain patients in order to provide safe and high quality care to pain management patients.
Key Environmental Factors
Stakeholders
• Nursing Staff
• Patients
• Physiatrist
• Administrative Staff
• Medical assistants
• Patients and their families
• Providers of the complementary therapy
Financial Implications
• Manpower expenses approximately $ 37,250. Each patient will need to be seen for a 30
minute appointment one time each week, there are 50 patients being used for this trial and we will
be visiting with them once a week for 6 weeks. That is the approximate cost for paying the Physiatrist,
two nurses, two medical assistants and two front desk/administrative staff.
My previous estimate was using 100-125 patients which would cost $95,040 for 6 weeks. But the time restraints will not allow
for that number of patients.
• Cost to each patient in 6 weeks (rise in clinic income) $ 300.00, if the patient is paying $50.00 on average for
each office visit. That is a $ 15,000 rise in clinic income over 6 weeks.
* Educational booklets have been donated so that comes at no cost .
External Factors
• Insurance coverage for complementary therapies.
• Patient transportation/access to complementary therapy.
• Consistency of therapy modality provided.
SWOT Analysis
Strengths
Weaknesses
• Support of project from physician and clinic supervisors
• Strong communication between staff members.
• Strong reputation of the clinic in the organization.
• Time constraints of appointment
• Possible patient resistance to reducing
pain medication.
• Patient compliance with prescribed
change.
Opportunities
• Decreased pain ratings.
• Decrease in narcotic use to control pain.
• Increased patient satisfaction.
• Positive reputation in the community.
Threats
• Failure of patients to meet the
expected goals.
• Patient does not follow the narcotic
reduction plan.
• Patient transportation/access to
complementary therapy location.
Outcome Statement
• To reduce the use of narcotic medication for chronic pain issues in the
physiatry clinic by 5% by July 20, 2020, after the implementation of adding
complementary therapies to their treatment plan.
Activities
•
Gather staff (nurse, physiatrist, medical assistants, and
front desk staff) involved in the capstone project for first
meeting in regards to the start-up of the capstone study.
Meet with the supervisor of the clinic to outline the project
and summarize results of staff meetings.
•
Outline a budget plan for the capstone project. Present the
outline to the clinic supervisor for approval. Obtain
approval from clinic supervisor implement the change
proposed by the capstone project in the facility. Obtain
informed consent from participants involved in the project.
•
Pass out 1st chronic pain self-assessment. This survey will
consist of questions that determine the participant’s
perception of their current chronic pain issues including a
numeral from the numbers pain scale. This questionnaire
will also include their assessment of the effectiveness of
their current pain treatment regimen (also completed at last
visit) The 1st count of narcotic medications will take place
(count takes place at each visit). A comprehensive history
and physical exam that includes a functional assessment
will be completed by the physiatrist (also completed at last
visit). Pain contract will be initiated.
Timeline (Projected)
• Completed June 2020
• (June 05-09)
• June 2020 (June 12)
• June 2020 (June 16-18)
• June 2020(June 19-23)
•
Nurse will assess and document participants ADLs, mood changes, anxiety
symptoms and perform suicide risk screening (this population has a suicide rate
higher than the rate of the general population.). Assess participant’s readiness to
learn. Education booklet will be given to participants and explained. Questions
answered at this time. Front desk staff will schedule follow up appointments.
Medical assistants will provide schedule of follow up appointments and
scheduled appointments for complimentary therapies. Collect questionnaires
and evaluate them and Implement project period. Present information to the
stakeholders, disseminate information regarding the capstone project including
any changes that need to be made, remind them we are a team and that each one
is important and has a part to play. Receive their feedback and discuss.
Review all orders from physiatrist and complimentary therapy providers.
Medical assistant monitor patients compliance with the plan and document any
discrepancies. Front desk staff to make call reminders to patients regarding apt
at the clinic as well as reminders of complimentary therapy appts.
Weekly patient appts, attempt at reducing narcotic medications by the doctor,
weekly discussion between patient and nurses regarding their progress and
documentation of necessary components.
Meeting with physiatrist and other involved staff by end of week to obtain
feedback and provide information going forward.
Collection of last visit questionnaires and assessments
Evaluation of results (interpretation and analysis)
* June 2020
(June 19-23)
*June 23 2020
June 25 2020
onwards
June 25 2020
onwards
June 25 2020
onwards
July 1st 2020 onward
July20, 2020
July 30, 2020
Dissemination of results through university preferred modality (PowerPoint
presentation)
Evaluation
• Results will not be completely final until August 14, 2020. Progress was slowed down by health systems COVID
Protocol in our clinic. We have been forced to reduce the amount of patients allowed in the clinic at a time.
Current results are as follows:

23 patients felt their pain was properly controlled with the addition of complementary therapies (45%).

37 patients were completely compliant with and understood their plan of care (75%).
 25 patients reported pain relief with the addition of natural anti-inflammatory supplements (50%).
 4 patients replaced their opiate medications with complementary therapies (8%).
Evaluations were made using :
 Evaluation of the pain scale from first and last week pf project.
 Chronic Pain Assessment Questionnaire will be compared to the one from week one.
 Evaluation of survey questionnaire regarding effectiveness of complementary on their chronic pain.
 Use of narcotic medication after its addition.
 In addition to this the amount of narcotic medication tablets will be counted at each visit.
Value of Project
• Identifies room for improvement:
• Patients overall pain control.
• Communicating plan of care and monitoring patient compliance with
• Plan of care according to the project.
• Identifies strengths within the department:
• Willingness of staff to come together as a team to meet a goal that is in the patients
best interest.
Open honest communication and collaboration amongst staff.
Sustainability
The project could remain sustainable by
• Continuing to use pain contracts and assessing patients for willingness to participate in
multidisciplinary approach for management of their chronic pain from their first appt.
Using pain assessments at each visit.
• Slowly titrating opiate medications and using complimentary therapies from the beginning.
•
References
Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., Debar, L., . . . Helmick, C. (2018). Prevalence of Chronic Pain and
High-Impact Chronic Pain Among Adults — United States, 2016. MMWR. Morbidity and Mortality Weekly Report, 67(36),
1001-1006. doi:10.15585/mmwr.mm6736a2
Donovan, E., Ranney, M. L., Patry, E. J., Mckenzie, M., Baird, J., & Green, T. C. (2017). Beliefs
About a Complementary and Alternative Therapy–Based Chronic Pain Management Program for a
Medicaid Population. Pain Medicine, 18(9), 1805-1816. doi:10.1093/pm/pnx051
ASP International Association for the Study of Pain. (2018). Classification of Chronic Pain, Second Edition (Revised).
Retrieved July 25, 2020, from https://www.iasp-
pain.org/PublicationsNews/Content.aspx?ItemNumber=1673&navItemNumber=677
Kavadar, G., Demir, S. E., Aytekin, E., & Akbal, Y. (2019). Use of traditional and
complementary medicine for musculoskeletal diseases. Turkish Journal Of Medical Sciences,
49(3), 809-814. doi:10.3906/sag-1509-71
1
Discussion: Capstone Project: Risks and Challenges
Name:
Instructor:
Institution:
Course:
Date:
2
1. Identify any challenges with implementing the capstone project you have
experienced; discuss how they were addressed or resolved.
From week one, our workflow was perfect until the medical assistants started feeling like
they are overloaded with other tasks being added on to their daily duties and they did not seem to
be not motivated. To resolve the conflict, the practice manager offered a bonus of $250 if we
reach 25% of our goal, $500 if we reach 50% of our goal, $750 if we reach 75% of our goal, and
$1000 if we reach 100% of our goal. Another challenge is meeting the time frame for our
project, by 5th July, we are supposed to have recruited all 155 participants but so far as by June
27th, we are at 90 patients only. To limit the chances of not reaching the goal of having 155
participants in the program by the week of July 5th, the practice manager is working on an
overtime schedule, where we will get to work extra hours enrolling our patients.
2. Discuss potential risks and challenges that may threaten your capstone project.
First, time does not seem to be in our favor and if we do not get the targeted 155 patients
By 5th July to participate in our program, will affect the time frame of all following activities in
our schedule. Second, the clinical staff may feel overloaded with the overtime strategy and be
unable to meet the daily demands of contacting patients with phone reminders for BP checks.
Another threat is that eating healthy requires a lot of work. People may default back to old
eating habits because of the convenience unhealthy foods provide. Consequently, the lack of
patient readiness for the proposed program and lack of transportation for some patients seems
like a potential threat. Finally, poor patient attendance for education classes and follow-up
appointments may cause inconveniences in the future.
3. Explain how real or potential risks and challenges fit into the “triple constraints
triangle”?
3
In project management, the three elements (and their variations) are defined under the
triple constraint theory as follows: Time, money, and scope (Heagney, 2016). If we are unable to
enroll 155 patients for the program by 5th July, we will already be behind time. While on the
other hand, if our practice manager is offering financial motivation for our medical assistance, as
well as compensating for the overtime, these expenses are already affecting our forecasted
budget for the program. Finally, the scope of our project is to recruit hypertension patients under
a healthy diet, but eating and sticking to healthy foodstuffs is already a challenge because of the
convenience brought by unhealthy foods.
4. Describe a contingency plan including specific strategies to manage the real or
potential risks and challenges to your project.
The biggest risk we are facing in meeting the target patients in the provided timeframe.
To address it, the medical assistants will work overtime to recruit more patients in a day unlike
before. Second, to ease the work overload the medical assistants will have to handle, the
registered nurses will help them during the enrollment exercise and other short-term personnel.
The registered nurses will also educate and create awareness among the patients regarding what
to expect during the exercise. The physicians will be in charge of ensuring all patients are on
healthy diets and reminders regarding appointments via phone are made to all other participants
at home.
5. Based on your assessment of risks and challenges, what, if any, changes are needed
to your strategic plan or timeline?
The chances of the risks and challenges both real and potentially affecting our timeline
and strategic plan are high. In case it happens, we are unable to meet the 155 patients by 5th July,
the management may either settle on working with the already enrolled patients so we affect the
4
strategic plan and not the timeline of activities, or extend the enrolled period which will impact
the timeline of events thus the whole project schedule. After settling on either of them, the
timeline or strategic plan will undergo the six steps involved in the change plan before it starts to
function.
5
References
Heagney, J. (2016). Fundamentals of project management.
1
Capstone Project Discussion
Name:
Instructor:
Institution:
Course:
Date:
2
What is the current financial impact of your capstone project on the organization and the
patient? Explain current costs involved with project implementation, and how those
expenses are being funded. (Be sure to include the cost of both human and material
resources, as well as savings realized through the initiative.)
The capstone project significantly impacted the health care system since it helped save money
that may have been spent on hypertension care. Due to the numerous stakeholders’ contributions
to the accomplishment of the capstone project, the organization has also lowered the expenses
for giving educational training and administering the medication. Because home health pressure
monitors will help monitor an individual’s pressure, people won’t have to pay as much for
medical care (Carter et al., 2018). Patients will also make informed decisions based on the cost
knowledge, thus increasing their adherence to the project (Yoder-Wise, 2019). The project now
costs $80,000, which is paid for by several stakeholders, including doctors, business people,
local government funding, and other fundraisers. Marketing Department ($125 to $150/Hr.) in
overtime, Pressure monitors ($14.40 per unit), Web hosting ($249/month), and Educational
Material/Brochures for patients ($37.17 per 50 books) = $1486.80. Other expenses will include
$74.34 for 50-1731 – Understanding and Controlling Your High Blood Pressure and $100.04 for
50-1736A – Shaking Your Salt Habit educational brochures. The company reserves a specific
sum for capital expenditures each year (Yoder-Wise, 2019). The facility sets aside $5,000.00
each year for capital expenses. Capital investments will cover a portion of the project’s costs. The
organization will use all the intern students, bringing the project cost to roughly $1500.00.
What is the future financial impact of your capstone project on the organization and the
patient? Explain projected costs necessary to sustain the change project and how those
3
expenses will be funded. (Be sure to include the cost of both human and material resources
and savings projected for the future.)
The capstone project will have a positive long-term effect on the organization by
lowering the price of medical care. Patients will gain from the scheme since they will avoid
visiting hospitals for medication and spend less money on healthcare. The estimated cost to
maintain the change is $80,000, which will be paid for by different stakeholders. A patient is
expected to cost $1,000, and material resources will cost $1,000. The company will hire students
for internships to assist in documenting the outcome, bringing down the cost of hiring from
$20,000 to roughly $100,000. Due to the project’s lack of deadlines, it will eventually reach its
maximum possible rate (Heagney, 2016). The anticipated future savings amount is $20,000.
Future expenses for the patient won’t be incurred. In the event of hypertension caused by an
unhealthy diet, the patient will save time, money, and physical discomfort.
Identify and explain any modifications to the capstone project necessary because of
financial considerations.
Because the funding from the stakeholders fell short of the goal, one of the necessary
alterations is a smaller area to be covered. To allow the home care professionals to see a lot of
patients, the duration will also be altered dependent on the available funding. Additionally, the
establishment won’t organize all Web hosting because of budgetary restrictions. To solve the
issue due to fiscal concerns, some project alterations include providing staff with educational
guidelines brochures that will be used and shared with the patient regularly during all shifts. To
cut costs, the facility will conduct project documentation by interning students.
Describe the project-related activities you want to sustain after your NUR-495 coursework
is complete, and explain how supporting these project elements will benefit the
4
organization. Include specific resources, stakeholders, and collaboration necessary to
maintain your change initiative.
I encourage employees to carry their Hypertension Education brochure for their usage
and share it with patients regularly throughout all shifts as project-related tasks after the NUR495 coursework is finished. The organization will gain from maintaining these project
components since installing an educational web hosting on hypertension will not be necessary,
saving money. Distributing educational brochures is less expensive than hosting academic web
training. The workforce and the hypertension education brochure will be some of the resources.
The practice Manager, outreach Executives, receptionists, physicians, N/LPN/Medical
Assistants, and patients and family members will all be stakeholders. Collaboration from all
stakeholders is required to maintain this change.
5
References
Carter, E. J., Moise, N., Alcántara, C., Sullivan, A. M., & Kronish, I. M. (2018). Patient barriers
and facilitators to ambulatory and home blood pressure monitoring: a qualitative study.
American journal of hypertension, 31(8), 919-927.
Heagney, J. (2016). Fundamentals of project management (5th edition). New York, NY:
American Management Association.
Yoder-Wise, P. S. (Ed.). (2019). Leading and managing in nursing (7th ed.). St. Louis, MO:
Elsevier Mosby.
Strategic Planning Tool
Instructions: Revisit your strategic plan under development in Discussion 1.2. Use this tool to
document your updated strategic plan to guide the planned change capstone process. Be sure to
cite and reference your sources according to APA format, using the last page for your reference
list.
Name: Hope Chung____________________________________________________________
Statement of Need or
Statement of Problem
to Be Addressed
Background of the
Problem
(minimum of three
scholarly sources
current within the last
five years)
Estimates issued by the World Health Organization indicate that in
the United States alone, over 85 million people are suffering from
hypertension. In the low and middle-income countries in the world,
urbanization has steadily caused an upsurge in the number of
diagnosed cases of hypertension due to changes in lifestyle habits.
Globally, increased blood pressure has been found to cause over 7
million deaths, a figure which accounts for over 12% of the total
world deaths. Overall, both men and women develop high blood
pressure, although the prevalence rates are higher for men than for
women. Therefore, hypertension is a public health concern that has
been found to cause the development of cardiovascular disease and
stroke (Khdour, Hallak, Shaeen, Jarab & Shahed 2013).
Here at Oak Street Health, we serve the underserved communities
where 74% of our patient population suffers from a modifiable
health concern of hypertension. The purpose of this capstone project
is to demonstrate how crucial it is to incorporate lifestyle
modifications alongside medical treatments in the management of
high blood pressure so that our patients can regain optimal health
and wellness.
Oak Street Health is a community based medical center that
caters to the needs of the elderly population in the surrounding
communities. Approximately 74% of our patients suffer from
hypertension and have not had adequate follow up care or education
regarding their disease and remain in an uncontrolled status. The
condition is disproportionate among men. About one in four men are
diagnosed with hypertension. Statistics show that one in every three
adults in the United States has hypertension (Kirkland et al., 2018).
Despite the US
heavy investment in healthcare, hypertension remains among
chronic diseases that are still undertreated. One of the main
challenges resulting in reduced healthcare quality and delivery is an
investment in treatment instead of primary preventive measures.
Hypertension has become a significant health problem because
of its high prevalence and the numerous health risks it poses to
patients, such as cardiac disease, chronic kidney problems, and
cerebrovascular problems. A 2018 publication by the Centers for
Disease Control and Prevention (CDC) considers hypertension as a
primary or contributing cause of mortality in about 494,873
Americans (CDC, 2020). A more recent CDC publication in 2020
estimated that about 108 million adults in the United States (45% of
the adult population) are affected by hypertension (CDC, 2020).
High blood pressure (hypertension) is relevant to the patients
because it can quietly or more appropriately, asymptomatically
endanger health for a long period before its detected. People all over
the world are wary of hypertension because unchecked increase high
blood pressure can bring about a poor-quality life, disability, a
deadly cardiac arrest, stroke, and death. Medication treatment and
adoption of healthy lifestyle are important in controlling high blood
pressure to prevent or reduce the risk of life-threatening
consequences. The impact of Hypertension affects care quality
patient safety and poses a financial burden to both the patient and the
health care system for close to half of the adult population in the
United States, as reported by Del Pinto & Ferri (2019).
Desired outcome of
the capstone
project
74% of our patient
population suffer
from hypertension.
The desired outcome
is to have patients
participate in our
Hypertension
Program that will
provide them with
resources and
education to
decrease their blood
pressures to goal
levels of 130/80 to
140/90 for 10% of or
patient population
within eight weeks.
Related activities to
facilitate the stated
outcome
Form a
multidisciplinary team
to include the team
leader (RN),
physicians, medical
assistants, and the
patients.
Timeline for
implementation of
stated activities
Week 1
June 7, 2022
Assess current views
on the implementation
of the hypertension
program, engage
patients and clinical
staff in the process to
enroll in the
Hypertension
Program.
Week 2
June 14, 2022
Recognize challenges
Week 3
Evaluation plan
(corresponding to
the stated outcome)
To measure the
effectiveness of what
is being implemented,
patients will monitor
their blood pressures
daily at home and
keep a blood pressure
log and meet weekly
with the staff RN for
blood pressure checks
as well as provide any
education and
coaching to reach
desired patient set
goals. By enrolling
155 patients into the
Hypertension
Program and
decreasing their blood
and discuss the aim of
the implementation of
the program.
June 21, 2022
Enrolled patients
continue daily blood
pressure monitoring
and weekly nurse
visits.
The team leader will
ask the physicians and
clinical staff what is
going well and what is
not and make
necessary
improvements.
Obtain data of
enrolled patients with
improvement in
lowering blood
pressures
Monitor the nurse’s
commitment to the
process and
Week 4
June 28, 2022
Week 5
July 5, 2022
Week 6
July 12, 2022
Weeks 3-8: beginning
June 21, 2022
The team leader will
Weeks 5 and 7
ask the physicians and July 5, 2022
clinical staff what is
July 19, 2022
going well and what is
not and make
necessary
improvements.
pressures to Goal
ranges of 130/80 to
140/90, our patient
population with
hypertension will
successfully decrease
by our goal of 10%.
References
CDC. Facts About Hypertension. (2020). Facts About Hypertension in the United States.
Retrieved from https://www.cdc.gov/bloodpressure/facts.htm
Del Pinto, R., & Ferri, C. (2019). Hypertension management at older age: an update. High Blood
Pressure & Cardiovascular Prevention, 26(1), 27-36.
Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N., …
& Moran, W. P. (2018). Trends in healthcare expenditures among US adults with
hypertension: National Estimates, 2003–2014. Journal of the American Heart
Association, 7(11), e008731.
CAPSTONE PROJECT – WORK SCHEDULE TOOL
Instructions: Use this tool to create a work schedule for your capstone project. In the appropriate column,
indicate the specific task or activity, as well as the target date for implementation of that activity or task. If an
activity requires a span of time, such as implementation over a particular week, simply include the range of
dates in the target date column. You may add additional rows as needed.
Delete the red explanatory wording and use this form.
Name:
Hope J. Chung_____________________________________________________
List all activities necessary for your project. Include
activities to address research, development, approval,
education, implementation, and evaluation. Be as
detailed as possible.
Capstone Project Work Schedule
Activities
Gather staff (Physicians, medical assistants, and front office staff) involved in the
capstone project for the first meeting in regard to the start-up of the capstone study.
Discuss with team the number of patients in clinic with uncontrolled hypertension with
data collected by RN over the past month.
Outline a budget plan for the capstone project. Present the outline to the clinic manager
for approval.
Obtain approval from clinic manager and implement the change proposed by the
capstone project in the facility.
Meet with team to assess current views on the implementation of the hypertension
program, engage patients, and clinical staff in the process of enrollment in the
Hypertension Program. Patients will start to enroll to participate in the program and
sign consent forms.
Enrolled patients are coming in for nurse visits for baseline labs, EKG, and blood
pressure checks and will have a focused discussion outlining the program guidelines
and be provided with resources to help lower their blood pressures such as diet
modification, exercise routines, daily blood pressure monitoring log and blood pressure
machine for home use.
.
Recognize challenges and discuss the aim of the implementation of the program
Program participants continue to monitor the blood pressures daily at home and are
returning for their weekly follow up with the RN to assess blood pressure in the office,
discuss patient goals and answer questions or concerns patient/family may have.
Target Date
June 2022
(May 16-20)
June 2022
(May 23-30)
June 2022
(May 30- June 3)
Week 1
(June 6-10)
Week 2
(June 13-17)
Week 3
(June 20-24)
Week 4
(June 27-30)
Activities
Present information to the stakeholders regarding my capstone project including any
changes that need to be made, remind them we are a team and that each one is
important and our commitment to the patients will determine a successful outcome.
Receive feedback from stakeholders. Continue weekly nurse/program participant visits.
Address any concerns from program participants/family. Compare baseline
measurements and current blood pressure readings to assess for improvement). Meet
with provider to see if medication adjustments are necessary for individual participants.
Continue weekly nurse/program participant visits.
Continue weekly nurse/program participant visits. Collect final week of participant
assessments. Evaluate results of program participants.
Present final results/program outcome to stakeholders.
Present final results to Prof Leis via university preferred modality
Target Date
Week 5
(July 6-10)
Week 6
(July 11-15)
Weeks 2 through 7
(June 13th – July
28th)
July 30, 2022
© 2013
____________________________________________________________
SCHOOL OF NURSING
Impacting Factors Tool
Instructions: Use this tool to document your assessment of the factors impacting the capstone
project. Be sure to cite and reference necessary sources according to APA format, using the last
page for your reference list.
Name: __Hope J. Chung____________________________________________
Stakeholder
Identification and
Engagement
Strategies to
Secure Support
Stakeholders:
• Practice Manager
• Outreach Executives
• Receptionists
• Physicians
• RN/LPN/Medical Assistants
• Patients and family members
Engagement strategies to secure support:
• Communication of the plan in a clear, concise, consistent and
ongoing manner. Manage expectations by sharing outcomes
often
• Involve providers to endorse the concept of the interventions
with patients, identify needed interventions needed to
engage patients, and provide valuable input
• Collaboration in achieving a shared sense of opportunity
SWOT Analysis
Strengths
•
•
•
•
Strong support from
practice manager and
physicians.
Increasing access to blood
pressure monitors.
Increase access to healthy
food.
Positive change in the
overall health of
individuals living in Stone
Mountain.
Weaknesses
•
•
•
•
Time consuming for
clinical staff and
possible overtime
accumulation.
Some staff see the
program as an extra
duty to an already busy
caseload.
High turnover rate
amongst clinical staff.
Staff unable to meet
daily demands of
contacting patients with
phone reminders for BP
checks.
Opportunities
•
•
•
•
Eating healthy can become
a trend like glutton free
diets, forcing companies to
adopt.
Improves
doctor/nurse/patient
interactions.
Opportunity for
patient/family to discuss
plan of care.
Improve patient
satisfaction.
Threats
•
•
•
•
Financial
Implications of the
Capstone Project
External
Influencing
Factors
Eating healthy requires
a lot of work. People
may default back to old
eating habits because of
the convenience
unhealthy foods
provide.
Lack of patient
readiness for the
proposed program.
Lack of transportation
for some patients.
Poor patient attendance
for education classes
and follow up
appointments.
Direct Budget Proposal
• Marketing Department ($125 to $150/Hr.) in overtime
• Pressure monitors ($14.40 per unit) if not covered by
insurance
• Web hosting ($249/month)
• Web Developer
– $7,000 to $11,000
– $59/Hr. to make updates to the website
• Educational Material/Brochures for patients ($37.17 per 50
books) = $1486.80
Stress, psychological and emotional conditions
Strong emotions (both negative and positive) trigger the activation
of the sympathoadrenal axis, a long chain from the brain to the
adrenal glands, which leads to the release of hormones into the
bloodstream, such as adrenaline. Adrenaline makes the heartbeat
faster and leads to vasoconstriction. In such situations, blood
pressure rises. This is one of the reasons why people with
cardiovascular disease are advised to avoid strong emotional
experiences. Chronic stress is an important factor in the
development of hypertension. In urban conditions, it is provoked by
increased noise, an abundance of artificial light and the syndrome of
professional burnout. Studies show that men in general cope worse
with these factors than women. Only 5 years of work associated with
negative emotions is enough for the development of hypertension
(Samadian, et.al, 2016). Women are also confirmed to be influenced
by an unfavorable environment, however, for the development of
hypertension, the duration and strength of environmental factors
must be greater than in the case of men.
Other external factors
In addition to the factors described above, the World Health
Organization (WHO) note the following most common reasons for
an increase in blood pressure levels:
•
•
•
•
Outcome
statement for the
capstone project
Evaluation plan
for the capstone
outcome
unbalanced nutrition, excessive consumption of table salt
and caffeine (Ozemek, et.al, 2018)
poor environmental conditions, high levels of lead, cadmium,
mercury (Brook, et.al, 2011)
use of certain drugs, which side effects can increase blood
pressure
smoking (Ozemek, et. al, 2018).
74% of our patient population at Oak Street Health suffer from
hypertension. The desired outcome is to have 155 patients
participate in our Hypertension Program that will provide them with
resources and education to decrease their blood pressures to goal
levels of 130/80 to 140/90 for 10% of or patient population within
eight weeks.
No modifications to be made
By enrolling 155 patients into the Hypertension Program and
decreasing their blood pressures to Goal ranges of 130/80 to
140/90, our patient population with hypertension will successfully
decrease by 10%. Our initial evaluation of program participants will
include baseline labwork, EKG, and blood pressure measurement.
Thereafter, patients will have weekly blood pressure checks to
evaluate their progress.
Modifications were made
References
Brook, R. D., Weder, A. B., & Rajagopalan, S. (2011). “Environmental hypertensionology”
Effects of environmental factors on blood pressure in clinical practice and research.
Journal of clinical hypertension (Greenwich, Conn.). 3(11), 836-842.
https://doi.org/10.1111/j.1751-7176.2011.00543.x
Cleveland Clinic (2016). Disease and Conditions. Retrieved June 16, 2022, from
https://my.clevelandclinic.org/health/diseases_conditions/hic_Hypertension_High
Blood_Pressure
Nirajan Panthee Passionate engineer who loves talking about Machine learning and ways to
Improve Software development practices. CEO and Director of Software Engineering
of Wolfmatrix. (2022, June 10). Web developer salary [2022 updated]. Wolfmatrix.
Retrieved June 17, 2022, from https://wolfmatrix.com/application-development/webdeveloper-salary
Ozemek, C., Laddu, D.R., Arena, R., & Lavie, C.J. (2018). The role of diet for prevention and
Management of hypertension. Current opinion in cardiology, 33(4), 338-393.
https://doi.org/10/1097/HCO.0000000000000532
Samadian, F., Dalili, N., & Jamalian, A. (2016). Lifestyle Modifications to Prevent and Control
Hypertension. Iranian journal of kidney diseases.
World Health Report 2016. Reducing risks, promoting healthy life. World Health Organization;
Geneva: 2016.
1
Discussion post 6.3
Name:
Instructor:
Institution:
Course:
Date:
2
1. Briefly state your SMART, patient-focused project outcome, your corresponding
plan for evaluation, and date for evaluation.
Specific- To demonstrate how crucial it is to incorporate lifestyle modifications alongside
medical treatments in the management of high blood pressure so that our patients can regain
optimal health and wellness.
Measurable- The data of the participant patients will be analyzed after eight weeks and compared
with the previous data to check the impact of the hypertension program.
Attainable- The attainable objectives of the project are to decrease the participant patients’ blood
pressures to goal levels of 130/80 to 140/90 for 10% of our patient population with hypertension
will successfully decrease by 10% within eight weeks.
Relevant-the project is relevant because it focuses on educating hypertension patients on
nonclinical home remedies for decreasing their blood pressure.
Time- The project will be completed within 8 weeks, and an evaluation will be conducted to
determine
2. What type of data or information must you gather to determine the degree to which
your SMART, patient-focused capstone project outcome has been achieved?
The information necessary to determine project outcome achievement is the information
needed will include baseline lab work, EKG, and blood pressure measurement expressed as two
figures and measured in millimeters of mercury (mmHg): Systolic pressure and diastolic
pressure. The patients’ blood pressure will be measured twice a day, ideally in the morning and
the evening starting from the first day of admission. The information obtained will be used to
work out average blood pressure and monitor the patients’ blood pressure. The data will be
collected over eight weeks.
3
3. What data collection method will you use to gather the information you need to
determine whether the project achieves your desired outcome?
The data will be gathered using the tracking and monitoring technique. The time, date,
and nurse who performs the blood pressure measurement will be tracked by Cerner through
information from nurses’ charting and papers in the patients’ files. Thereafter, patients will have
weekly blood pressure checks to evaluate their progress.
4. How can you ensure your evaluation results are credible to stakeholders and others
in your organization?
To measure the effectiveness of what is being implemented, patients will regularly check
their blood pressure at home, keep a blood pressure diary, and meet with the staff RN for blood
pressure checks. The RN will also give any necessary information and coaching to help patients
accomplish their desired goals. The workers and I have developed a level of confidence, and they
are aware of my monitoring because I am in charge of any projects that call for monitoring and
data collecting. If necessary, the data can also be checked for consistency of accuracy in the
patient’s chart.
5. What limitations can you identify about your evaluation plan?
The limitation I have seen is that some staff see the program as an extra duty to an
already busy baseload. Thus, the staff are unable to meet the daily demands of contacting
patients with phone reminders for BP checks. This will hinder the project from attaining its
objectives effectively (Heagney, 2016). Secondly, eating healthy requires a lot of work. People
may default back to old eating habits because of the convenience unhealthy foods provide
(Roberto, 2020). Consequently, lack of transportation for some patients will hinder the patients’
attendance for education classes and follow-up appointments.
4
6. Are there any aspects of your SMART, patient-focused capstone outcome statement
or corresponding evaluation plan that need further clarification, modification, or
streamlining? If so, please share along with your plan to improve alignment between
these two aspects of your strategic plan.
No modifications are to be made. Overweight and hypertension affect 74% of Oak Street
Health’s patients. The goal is to enroll 155 individuals in our hypertension program, which will
give them the tools and knowledge they need to lower their blood pressure to target ranges of
130/80 to 140/90 for 10% of our patient group within eight weeks. Thereafter, patients will have
weekly blood pressure checks to evaluate their progress. However, on clarifications, some
patients will need further supervision and aid as they might not be able to measure their blood
pressure at home. To solve that, their caregivers will attend training on the same.
5
References
Heagney, J. (2016). Fundamentals of project management.
Roberto, C. A. (2020). How psychological insights can inform food policies to address unhealthy
eating habits. American Psychologist, 75(2), 265.

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