Name
Western Governors University
D226 BSNU Capstone
Prof. Name
Date
As a committed wound care nurse, my primary goal is to deliver high-quality, evidence-based care that promotes healing and improves patients’ overall well-being and quality of life. I focus on integrating clinical expertise with a patient-centered approach, aiming to develop standardized care protocols. These protocols are designed to reduce variations in treatment and ensure consistent, effective care for all patients. My future ambition is to take on leadership roles that foster collaborative environments, encourage ongoing professional development, and ultimately lead to enhanced patient outcomes and satisfaction.
How will reflecting on the professional mission statement guide your nursing career?
Reflecting on my professional mission provides guidance for my nursing career by emphasizing the importance of evidence-based practice, patient-centered care, and leadership growth. Staying informed with the latest research enables me to apply effective treatments, especially in complex wound care, which improves healing rates and reduces complications. For example, using wound dressings supported by clinical research can prevent infections and speed recovery. Respecting patients’ cultural values builds trust and improves satisfaction, essential for holistic care. As I move into leadership, promoting teamwork and innovation will empower me to implement advanced protocols, ensuring high-quality care delivery by the healthcare team. This mission aligns with my core values and influences both clinical and managerial decisions.
Two academic assignments that best showcase my growth as a learner and healthcare professional are the D226 Task 1 paper and the D221 Performance Assessment. These projects enhanced my research skills and deepened my understanding of evidence-based practice (EBP), which is vital for improving clinical care. They highlight my ability to conduct focused literature searches and use scholarly databases effectively to find credible EBP sources. Additionally, they demonstrate my analytical problem-solving skills through comprehensive assessments and the design of practical, evidence-supported solutions that consider both challenges and benefits.
My portfolio reflects key professional strengths such as leadership, communication, critical thinking, and teamwork. The table below summarizes how selected works demonstrate these competencies:
| Paper Name | Course/Task | Demonstrated Strengths | Description |
|---|---|---|---|
| D226 Task 1 Paper | D226 | Research skills, Problem-solving | Analyzed unit challenges and proposed evidence-based interventions. |
| D221 Performance Assessment | D221 | Leadership, Communication, Detail orientation | Assessed barriers and benefits of change; developed implementation strategies. |
These works illustrate my capability to identify clinical issues, synthesize evidence, and create inclusive solutions involving stakeholders.
Balancing chronic health conditions and learning disabilities with the demanding BSN curriculum was a significant challenge. Symptoms like fatigue, malaise, and migraines often interfered with meeting deadlines. Additionally, medications used to manage my health sometimes exacerbated cognitive difficulties. Lack of formal documentation for my learning disabilities complicated access to academic accommodations, requiring me to devise personal strategies to support my learning and complete assignments successfully.
I overcame these difficulties through a strong support system and self-advocacy. Finding a low-stress outpatient nursing role aligned with my studies helped reduce stress and manage health symptoms. Emotional support from my spouse was crucial in mitigating mental strain. Collaborating with my physician helped optimize medication to reduce cognitive side effects. Coworkers assisted in identifying distraction-free environments for testing, and my program coordinator guided me through accommodation processes, collectively enabling my academic success.
The BSN program significantly enhanced my role as an outpatient wound care case manager and inspired my interest in preceptorship. It strengthened my commitment to patient and staff education and improved my critical evaluation of clinical practices. Collaborating with nurse managers and directors led to tailored initiatives addressing specific patient needs. This experience fostered a holistic approach to care, emphasizing coordinated referrals and innovative strategies to address community health determinants.
Ethically competent practice means developing a professional identity grounded in accountability, collaboration, and ethical behavior that aligns with nursing standards and core values.
The Culturally Competent course reinforced my commitment to delivering respectful, culturally sensitive care. It increased my awareness of personal biases and encouraged proactive strategies to prevent these biases from affecting patient care. This competence enables me to advocate for diverse populations and support colleagues in improving their cultural sensitivity. Incorporating patients’ cultural beliefs into care plans promotes a holistic and respectful healthcare environment.
This assessment refined my skills in critically evaluating and applying research to support clinical practice changes. I learned to distinguish between evidence types, assess their relevance, and utilize data to advocate effectively within healthcare settings. Recognizing the integration of professional values, clinical expertise, and research is crucial for implementing ethical and context-appropriate evidence-based practice.
EBP is vital in nursing as it merges current research, clinical expertise, and patient values to improve care quality. It facilitates informed decision-making, enhances patient safety, and reduces variability in practice. Implementing standardized protocols and continuous quality improvement through EBP leads to higher patient satisfaction and better health outcomes.
Extended handoff periods increase patient fall risks and sentinel events due to overlooked patient needs and poor communication.
Ineffective handoff communication costs healthcare organizations approximately $1.7 billion annually, largely due to sentinel events.
| Component | Description |
|---|---|
| P | Patients in inpatient care units |
| I | Implementation of standardized handoff tool |
| C | Nurses not using standardized handoff tool |
| O | Reduced costs, fewer medication errors, improved safety |
Does the use of a standardized nursing handoff communication tool in inpatient units improve patient safety compared to not using such a tool?
A systematic review examined 20 studies on electronic health record (EHR)-supported handoff tools, motivated by the high costs and patient harm from communication failures during nurse handoffs.
Six databases were searched for peer-reviewed articles (2009-2019) on EHR handoff tools. Twenty articles met inclusion criteria and were assessed using the Melnyk and Fineout-Overholt evidence hierarchy.
This review provides Level III evidence, indicating moderate strength.
Studies were organized by author, date, location, design, sample, setting, and outcomes for comprehensive analysis.
No ethical approval was needed since the review used publicly available data without involving human subjects.
The review was rated high quality, adhering to the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model for transparency and thoroughness.
Communication errors in handoffs significantly contribute to patient harm and costs. EHR-supported tools reduce these errors effectively. Success depends on involving end-users in design, using concise and standardized formats, allowing customization, and ensuring mobile access.
The findings confirm that standardized electronic handoff tools improve communication and patient safety, supporting the practice change question.
Information loss and disorganized handoffs cause medication errors and treatment delays, threatening patient safety.
This quality improvement project is Level V evidence and was rated high quality for clear objectives, audits, and outcomes.
Standardized handoff protocols reduced medication errors and improved safety in adult surgical wards.
Structured handover tools are essential, with nurse leaders playing a critical role in sustaining improvements.
| Aspect | Details |
|---|---|
| Practice Change | Implement standardized handoff communication tools during shift changes |
| Design Participation | Involve end-users for usability, flexibility, and mobile access |
| Example Tools | SBAR (Situation, Background, Assessment, Recommendation) |
| Key Stakeholders | Nurse managers, charge nurses, educators, IT department |
| Barriers | Resistance from nurses used to traditional methods |
| Strategies | Weekly audits, education sessions, incentives |
| Outcome Indicators | Audit data on tool usage and reduction in errors and incidents |
Integrating informatics with clinical practice is essential for safe, high-quality care that meets professional standards. The course enhanced my ability to apply concepts in practice, revealing gaps in system integration at my workplace. I advocate for linking documentation systems and implementing patient portals to streamline care, boost patient engagement, and improve care continuity.
Creating a safe, cost-effective care environment involves applying evidence-based safety principles. Developing a practice improvement plan highlighted fall risks and patient acuity issues on my unit. The Falls TIPS program has been effective in reducing falls through tailored interventions promoting teamwork and continuous monitoring.
| SBAR Component | Content |
|---|---|
| Situation | Mercy Hospital faces frequent falls, especially among elderly confused patients, often before staff arrival. |
| Background | Three falls in three months; reliance on alarms; staffing shortages; average fall cost $62,521; safety grade B. |
| Assessment | Falls extend hospital stays, increase injuries, workload, and costs, negatively affecting safety metrics. |
| Recommendation | Implement Falls TIPS program, proven to reduce falls by 25%, saving $14,600 per 1,000 patients; overcome barriers via education. |
The Falls TIPS program encourages shared decision-making among patients, families, and care teams to create individualized prevention plans with visual cues, improving adherence. Outcome measures include monitoring fall rates annually to assess effectiveness. Current team nursing emphasizes patient-centered care but suffers from inconsistent staffing, necessitating improved scheduling and communication for success.
Leadership focuses on prioritizing goals to optimize person-centered care and population health. Reflecting on leadership clarified differences between leadership and management and identified my strengths and areas for growth. Setting SMART goals for patient activities such as brisk walking and range-of-motion exercises provides clear, achievable targets aligned with patient needs, encouraging adherence and motivation.
| Goal Number | Goal Description | Specifics |
|---|---|---|
| 1 | Walk briskly 10-20 minutes twice daily for 2 weeks | Specific pace, frequency, duration; measurable improvements |
| 2 | Perform shoulder and back exercises 3 sets of 10 reps daily for 2 weeks | Targets range of motion and soreness relief; time-bound |
Innovation in healthcare is the ability to creatively and adaptively respond to the complexities of evolving care environments. This involves applying systems-based, value-driven approaches to provide care across the patient continuum with ethical and evidence-based solutions.
Courses such as Scholarship in Nursing Practice, BSNU Capstone, Healthcare Systems and Policy, Population Health Management, Ethics, and Cultural Competence have strengthened my skills in assessing community health needs, fostering empathy, and applying ethical, culturally sensitive, and evidence-based care plans. These courses emphasize tailoring care to individuals and integrating technology for improved outcomes.
Data is fundamental for informed decision-making and supports organizational and systemic improvements by:
Identifying trends and gaps
Measuring intervention effectiveness
Optimizing resource allocation
Advocating policy changes
Using data strategically enhances care quality and patient satisfaction.
| Feature | Description |
|---|---|
| Facility | UNC Rex Health Care, Raleigh, NC |
| Type | Short-term acute care with specialized services |
| Control | Governmental nonprofit funded by insurance, taxes, and reimbursements |
| Patient Care Accessibility | Offers care regardless of insurance status; charity care provided |
| Medicare Rating | 5/5 stars in safety, readmissions, patient experience, mortality, timeliness (2024) |
| Ethics | Emphasizes autonomy, justice, non-discrimination, respect, dignity, informed consent |
Nurses play a key role in managing resources efficiently by minimizing waste and providing comprehensive discharge education to prevent costly readmissions, contributing to cost savings and improved patient outcomes.
Improving nurse-to-patient and doctor-to-patient ratios could enhance communication and care quality. Encouraging interdisciplinary team huddles would also foster better coordination and outcomes.
| Aspect | UNC Rex Health Care | Duke Raleigh Hospital |
|---|---|---|
| Control | Governmental nonprofit | Voluntary nonprofit funded by donations |
| Community Service Flexibility | Higher due to funding sources | More limited due to donation reliance |
| Value-Based Care Alignment | Strong; better mortality and safety scores | Strong in patient communication and equity |
| Patient Satisfaction | High in safety and timeliness | High in communication and education |
Poor air quality worsens health risks for older adults with chronic conditions such as diabetes and obesity (EPA, 2024). Respiratory illnesses like asthma and COPD are exacerbated, increasing hospitalizations and healthcare costs. Fixed incomes and Medicare limitations often restrict seniors’ ability to manage these conditions effectively.
| Statistic | General Population | Older Adults (65+) |
|---|---|---|
| Poverty Rate | 9.1% | 17.3% |
| Median Household Income | $37,223 | $29,740 |
Many seniors spend over half their income on housing, leading to insufficient funds for food, healthcare, and essentials, contributing to food insecurity and worsening health.
Chronic diseases, especially heart disease driven by unmanaged hypertension and diabetes (CDC, 2024)
Mental health crisis, underdiagnosed due to stigma
Prescription drug misuse and polypharmacy complicating care
Barriers to care access, including transportation and medication coverage limits
Available Resources:
Charity care reducing hospital readmissions
SNAP program supporting food security (Carlson & Llobrera, 2022)
Needed Resources:
Meals on Wheels for home-delivered nutrition and social support (Bean, 2021)
Expanded charity care for medication and emergency needs
Implementing universal enrollment of seniors in nutritional aid programs (including vitamins and meal replacements) combined with biannual food insecurity screening in primary care can reduce episodic food insufficiency (Applied Economic Perspectives & Policy, 2022). Early nutritional intervention prevents complications and reduces emergency visits, enhancing quality of life.
A portal must be intuitive for patients of all ages and abilities, as well as staff. Ease of use promotes engagement and efficiency. Training before rollout minimizes frustration and encourages adoption.
Features such as automated reminders for dressing changes, appointments, and medication adherence support patient compliance. Billing functions allow patients to view statements and manage payments easily.
The portal must comply with HIPAA, employing data encryption, secure login protocols, and ongoing security monitoring to protect sensitive health information and maintain trust.
A pilot phase tests usability and integration with a small patient group. Feedback guides iterative improvements, ensuring a smooth full implementation.
| Working Style | Description | Personal Reflection |
|---|---|---|
| Explore | Creative, independent, big-picture thinker | Enjoys creative freedom and multitasking |
| Excite | Motivating, positive energy but requires effort | Needs to manage energy post-shift |
| Examine | Detail-oriented, seeks structure | Relies on others for realistic perspectives |
| Execute | Task-focused, driven to complete work | Enjoys leadership and delegation; restless until completion |
Balancing creativity with detail focus helps in delivering holistic care. Challenges include overworking and self-comparison, which affect mental health. Setting realistic goals and respecting limits are strategies for improvement.
My communication style is a blend of accuracy and authenticity. I actively listen to support others emotionally while maintaining honesty and clarity. For instance, I offered empathetic support to a coworker coping with trauma while learning to withhold judgment and seek multiple perspectives in personal relationships.
This course enhanced my mindfulness and communication skills. Meditation, though challenging, helped me remain present. I now prioritize meaningful conversations and teach conflict reduction techniques within my family. Continuing to develop emotional awareness and leveraging my strengths in delegation and project completion will support my growth.
Afonso, J., et al. (2021). The effects of stretching and strength training on range of motion: A systematic review. Journal of Physical Therapy Science, 33(4), 291-298. https://doi.org/10.1589/jpts.33.291
Applied Economic Perspectives & Policy. (2022). Addressing food insecurity among seniors. Applied Economic Perspectives & Policy.
Bai, X., et al. (2021). Cardiovascular benefits of brisk walking: A meta-analysis. Journal of Cardiopulmonary Rehabilitation and Prevention, 41(1), 1-7. https://doi.org/10.1097/HCR.0000000000000503
Bean, M. (2021). Nutrition and social support for older adults: The impact of Meals on Wheels. Journal of Aging & Social Policy.
Carlson, S., & Llobrera, J. (2022). The role of SNAP in supporting seniors’ health. Public Health Nutrition.
Centers for Disease Control and Prevention (CDC). (2024). Heart disease statistics in Oklahoma. https://www.cdc.gov
Dykes, P. C., et al. (2023). Economic burden of patient falls in hospitals. Healthcare Economics Review, 12(2), 145-159. https://doi.org/10.1186/s13561-023-00456-9
Environmental Protection Agency (EPA). (2024). Climate change and the health of older adults. https://www.epa.gov
Joint Commission. (2024). National Patient Safety Goals. https://www.jointcommission.org/standards/national-patient-safety-goals/
Wong, X., Tung, Y. J., Peck, S. Y., & Goh, M. L. (2019). Clinical nursing handovers for continuity of safe patient care in adult surgical wards:
A best practice implementation project. JBI Database of Systematic Reviews & Implementation Reports, 17(5), 1003–1015. https://doi.org/10.11124/JBISRIR-2017-004024
