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NR 451RN Capstone Project Milestone 1 | Complete Solution
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Capstone Project Milestone 1:
Practice Issue and Evidence Summary Guidelines


PURPOSE 


Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project.


COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes: 
•    CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO #4)

•    CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO #8)


DUE DATES
Milestone #1 consists of the completion of two worksheets (Practice Issue Worksheet) and (Evidence Summary Worksheet). Submit the completed worksheets to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 3.
POINTS 


Milestone #1 is worth 175 points (75 points for the Practice Issue and 100 points for the Evidence Summary).


PRACTICE ISSUE WORKSHEET DIRECTIONS
1.    Practice Issue Worksheet: 
a.    Read the guidelines including the grading rubrics below.  You will use this worksheet to document the practice issue presented and approved by your instructor in the Week 2 Discussions.  
i.    Your practice issue will be the same for all three Milestone assignments in this course. 
b.    Please type your answers directly into the worksheet.

 

EVIDENCE SUMMARY WORKSHEET DIRECTIONS
2.    Evidence Summary Worksheet: 
a.    Read the guidelines including the grading rubrics below.  You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment. 
b.    Find a systematic review article in the Chamberlain library on your topic. Your Systematic Review Article must be peer-reviewed and include a narrative summary.
i.    Go to the Chamberlain Library, click on RNBSN; NR451 Capstone course. You can find systematic reviews from many databases within the library, or by searching from the library homepage main search bar. 
ii.    To search, combine the phrase 'systematic review' with your topic using the Boolean search operator AND. For example, if you are looking for a systematic review on fall prevention, you would use this Boolean search phrase: systematic review AND fall prevention.  
c.    Type in your practice issue in the search tab; choose a systematic review article with a narrative summary to complete your worksheet.   
d.    Please type your answers directly into the worksheet.

 

GRADING CRITERIA: PRACTICE ISSUE
Category    Points    %    Description
Practice issue statement, scope of practice, practice area    20    27%    Identifies a Practice issue statement that is an independent nursing decision. 
Describes the scope of practice issues.
Example: The number of falls in your facility has been increasing, especially during shift change. What do you believe may be causing this? Are there any new interventions that could be put into place that would lessen or eliminate the falls? This is where you begin your initial search into the problem or practice issue identified. 


Identifies the practice area.
Practice issue identification, rationale for selections    35    46%    Identifies how rationale behind how the practice issue was selected as a practice issue/problem
Documents the practice issue in a logical manner.
Types of evidence to gather, rationale for selections    20    27%    Identifies and documents types of evidence that must be gathered for review of the Practice Issue.
Describes rationale for each type of evidence that is selected.
Total    75 points    100%    

GRADING RUBRIC: PRACTICE ISSUE
Assignment Criteria    A (100%)
Exceptional

Outstanding or highest level of performance    B (88%)
Exceeds

Very good or high level of performance    C (80%)
Meets

Competent or satisfactory level of performance    NI (38%)
Needs Improvement
Poor or failing level of performance    F (0%)
Developing

Unsatisfactory level of performance
Practice issue statement, scope of practice, practice area
20 points    Practice issue is identified. 
Practice issue is an independent nursing decision.
Scope of practice issue is fully described. 
Practice area identified. 
20 points 


Practice Issue is identified but is not clear.
Practice issue is an independent nursing decision. 
Scope of practice issue is described in simple terms. 
Practice area identified


18 points 
Practice Issue is identified but is not clearly related to a nursing practice issue. 
Practice Issue is not an independent nursing decision.
Scope of practice issue is described but is not logical in comparison to Practice Issue described.
Practice area identified. 


16 points 
Practice Issue is unclear.
Practice Issue is not an independent nursing decision.
Scope of practice issue is not described. 
Practice area identified. 


8 points
Practice Issue is not identified; practice issue is not an independent nursing decision; scope of practice issue is not described; practice area is not identified.
0 points


Practice issue identification, rationale for selections
35 points     Documents how the practice issue was identified. 
Rationale for responses is logical and described thoroughly. 
35 points


Documents how the practice issue was identified. 
Rationale for responses is logical and briefly described.
33 points 


Documents how the practice issue was identified. 
Rationale for responses is somewhat logical and vaguely described. 
30 points


Vaguely describes how the practice issue was identified. 
Rationale for responses is somewhat logical and vaguely described. 
15 points


Does not document how the practice issue was identified. 
Rationale is not completed.
This section of the form is blank.
0 points


Types of evidence to gather, rationale for selections
20 points     Identifies and documents what types of evidence is needed for review. 
Thoroughly describes rationale for all checked types of evidence selected. 
20 points


Identifies and documents what types of evidence is needed for review.
Briefly describes rationale for all checked types of evidence selected. 
18 points


Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence. 
16 points


Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence. 
8 points


Does not document types of evidence or rationale. 
0 points


Total Points Possible = 75 points    

GRADING CRITERIA: EVIDENCE SUMMARY
Category    Points    %    Description
Practice Problem     10    10%    States practice problem in own words, with reference to the population, setting, and magnitude and in measurable terms.
Describes practice setting in measureable terms
Example: Consider the example given in the evidence summary above. The setting is the long term care facility where falls have been increasing and a trend has been identified that it seems to occur mainly during shift change. What do you believe may be causing this? What can be done to lessen or eliminate the falls? How does this number of falls relate to other months that have been tracked? 
Source of evidence    20    20%    Identifies a source of evidence that is a nursing topic that is the subject of a systematic review article. 
Identifies search terms.
Provides a complete reference for the systematic review article. 
Objectives of the article/Statement of questions    20    20%    Identifies the objectives of the article.
Identifies questions being addressed by author/s.
Explains relationship to your practice issue.
Interventions/Main findings summary    30    30%    Summarizes, in own words, suggested interventions by the author/s to improve patient outcomes.
Summarizes main findings of the author/s including strength of evidence for each main outcome.
Describes the relevance to the Milestone 2 paper.
Evidence-based solutions and limitations    20    20%    Outlines evidence-based solutions to consider for the capstone project.
Discusses any limitations to the studies included in the systematic review that you believe may impact use of the evidence provided in your project.
Total    100 points    100%    

GRADING RUBRIC: EVIDENCE SUMMARY
Assignment Criteria    A (100%)
Exceptional

Outstanding or highest level of performance    B (88%)
Exceeds

Very good or high level of performance    C (80%)
Meets

Competent or satisfactory level of performance    NI (38%)
Needs Improvement
Poor or failing level of performance    F (0%)
Developing

Unsatisfactory level of performance
Practice Problem
10 points    -Practice problem is in own words, with reference to the population of interest.
-Setting of the problem is identified
-Magnitude of problem is discussed.
-The practice issue is stated in measurable terms. 
Met all objectives as stated above
10 points


-Practice problem is in own words, with reference to the population of interest.
-Setting of the problem is not discussed.
-Magnitude of problem is discussed.
-The practice issue is stated in measurable terms.  
Met 3 out of 4 objectives
9 points


-Practice problem is in own words, with reference to the population of interest.
-Setting of the problem is not discussed.
-Magnitude of problem is not discussed.
-The practice issue is stated in measurable terms. 
Met 2 out of 4 objectives
8 points


-Practice problem is in own words, with reference to the population of interest.
-Setting of the problem is not discussed.
-Magnitude of problem is not discussed.
-The practice issue is stated but not measurable. 
Met only 1 out of 4 objectives
4 points


-Practice problem is not in own words
-There are no references to the population of interest.
-Setting and magnitude of problem is not discussed
-The practice issue is not stated in measurable terms. 
Did not meet any objectives
0 points


Source of evidence 
20 points    -Source of evidence is nursing topic.
-Source is a Systematic Review article. 
-Search terms are identified.
-Complete reference is given for Systematic Review article.
Met all 4 objectives as above
20 points


-Source of evidence is nursing topic.
-Source is a Systematic Review article. 
-Search terms are identified.
-Complete reference is not given for Systematic Review article.
Met 3 out of 4 objectives
18 points


-Source of evidence is nursing topic.
-Source is not a Systematic Review article. 
-Search terms are identified.
-Complete reference is not given for Systematic Review article.
Met only 2 out of 2 objectives
16 points

 
-Source of evidence is not nursing topic.
-Source is a Systematic Review article. 
-Search terms are not identified.
-Complete reference is not given for Systematic Review article.
Met only 1 out of 4 objectives
8 points
-Source of evidence is not nursing topic or Systematic Review article.
-Search terms are not identified. 
-Reference is missing.
No objectives were met.
0 points


Objectives of the article/ Statement of questions
20 points    -Objectives of article are identified.
-Questions being addressed by author/s are thorough. 
-Relationship to your practice issue is explained. 
20 points


-Objectives of article are identified.
-Questions being addressed by author/s are explained but not thorough. 
-Relationship to your practice issue is explained. 
18 points


-Objectives of article are identified.
-Questions being addressed by author/s are not thorough. 
-Relationship to your practice issue is vague. 
16 points


-Objectives of article are identified.
-Questions being addressed by author/s is missing. 
-Relationship to your practice issue is not explained. 
8 points


-Objectives of article are not identified.
-Questions being addressed in article and relationship to own practice is not identified.
0 points


Interventions/ Main findings summary 
30 points    -Thoroughly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.
-Thoroughly summarized main findings of the author/s.
-Included strength of evidence for each main outcome.
30 points


-Briefly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.
-Briefly summarized main findings of the author/s.
-Included strength of evidence for each main outcome.
27 points


-Vaguely summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes.
-Vaguely summarized main findings of the author/s.
-Included strength of evidence for most of main outcomes.
25 points


-Summary of interventions is not in own words.
-Summarized main findings of the author/s is not apparent. 
-Did not include strength of evidence for any of the main outcome.
12 points


-Summary of the interventions the author(s) suggest to improve patient outcomes is missing. 
-Summary of the main findings of the author is missing. 
-The strength of the evidence for outcomes are missing. 
0 points


Evidence-based solutions and limitations 
20 points    -Outline of evidence-based solutions considered for project is documented and clear.
Discussed any limitations to the studies performed.
Documents limitations believed may impact use in project.
20 points


-Outline of evidence-based solutions being considered for project is documented but not clear.
Discussed any limitations to the studies performed.
Documents limitations believed may impact use in project.
18 points


-Outline of evidence-based solutions considered for project is documented but not clear.
Discussed most limitations to the studies performed.
Documents limitations believed may impact use in project.
16 points


-Outline of evidence-based solutions being considered for project is not documented. 
-Discussed most limitations to the studies performed.
Documents limitations believed may impact use in project.
8 points


-Outline of evidence-based solutions, limitations of studies and potential impact to project is missing.
0 points


Total Points Possible = 100 points

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NR 451RN Capstone Project Milestone 1 | Complete Solution
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The nurses in our facility are often required to work for the long working hours with extended shifts thereby risking fatigue that could result in medical mistakes. Extended work shifts of twelve and longer hours have become familiar with hospital nurses. Concerns have been rais...
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