NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal

NRS 493 Week of October 19-25

I am so excited to be so close to the end of my BSN journey, it is an accomplishment for my personal and professional growth as a nurse. As a nurse, I never thought I would have advanced this quickly in my career. This journey has been challenging but tolerable why working as a full-time nurse. This program has allowed me to look at situations differently now than I did before. I met this week several times with my mentor, whom I look up to as a nurse, so I am so happy to be working with her in my place of work. My pre-conference form was signed by my mentor with no concerns about the requirements. I first went over my Individual Success Plan for the next 10 weeks throughout this course.

NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal

After she reviewed the plan, she signed it for me to turn in. We had a good conversation in person about the few ideas that I had for my Capstone topic. She advised me on those topics and helped me to narrow it down to 3 topics for my change project. I want to focus on nurse-driven protocols, as I think it’s important as nurses to push for the best care possible and to help the nursing profession provide the highest level of care in the safest way possible for the patient.

New practice approaches are new solutions that are used to improve the care or the skill of health care. After speaking with my mentor, I understand not all facilities do the same intervention for different issues in health care. I want to push nursing protocols and bundles for the improvement of catheter associated urinary tract infections within this facility. In my facility, we use a nurse-driven protocol, and it has improved the way Foley catheters are used and maintained.

However, there are other new practice approaches that I have seen in research that would also implement a good nurse-driven protocol or bundle that would be great to try even on my unit or throughout the facility. The first discussion questions this week was super helpful in that we were able to as a class share and collaborate about different research databases to use for this class. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal. I look forward to seeing what next week’s objectives bring to the table and to continue working on this change project topic.

Week of October 26- November 1 (NRS 493 Benchmark – Professional Capstone and Practicum Reflective Journal )

Week 2 has been a success. My mentor and I discussed how Health care delivery and clinical systems involve different features of quality and safety within health services. This includes health advancement, disease anticipation and promotion, diagnosis of diseases, treatment options for different illnesses, management of diseases, and credible need for diverse rehab supports. Each healthcare delivery differs depending on where the patient is in their life. After looking at this and speaking with my preceptor we decided that looking at and speaking with different areas of my organization would ensure proper health care delivery for indwelling urinary catheters. This includes speaking to the physicians, manager, floor nurses, infection disease nurses (which is my mentor), nursing assistance, and so many more as healthcare is a team approach.

Each member including the patient should be encompassed in the patient’s care must be up to date with the latest evidence-based practice to provide safe patient care and outcomes. The topic I chose for my change proposal project is a nurse-driven protocol to reduce catheter-associated urinary tract infections within an acute care setting. This issue is a big problem across my hospital as I am sure it is in other facilities as well. My unit being nephrology and a big medical-surgical unit in my facility we see a lot of catheters placed, left in place, and or chronic Foleys with no real reason for it being chronic.

Our unit makes it a big goal to get urology on board if Foleys are left in for over 2 days. Indwelling Foley catheters many times are necessary to give patients relief and treatment within an acute care setting. Depending on the treatment for the patient whether they are having a surgical procedure, intubated, sacral wounds, or having retention issues it is always imperative to assess the situation to decide when to take the Foley out. Unfortunately, Foley catheters can put patients at risk for catheter-associated urinary tract infections (CAUTI). I completed my capstone summary and capstone project topic selection and approval with research that I found to support my nurse-driven protocol to reduce catheter-associated urinary tract infections.

Week of November 2-8

My preceptor and I focused this week on two different topics. We conversed about the different ethical considerations in health care and the practices of culturally sensitive care. There are four main principles of ethics in healthcare these are autonomy, beneficence, justice, and nonmaleficence. After talking with my preceptor, I am about to understand that each patient has their right to make their own decisions strictly based on his/her personal beliefs and values. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal. With this understanding, I also came to acknowledge that sometimes cultural and spiritual beliefs come into play when the patient is making their own decisions about their health care and treatment plan. Many times, patients also use their culture to make their decisions as well.

An example I remember learning about in nursing school was that Jehovah’s witness cultural beliefs that blood transfusion and blood product are bad in the aspects that it is dirty and that their own body will provide the blood they need. As nurses, we are to respect our patient’s beliefs and decisions on their care, whether we agree with them. The patient’s ethical considerations must be recognized by the nurses, doctors, and other healthcare team professionals. This can affect the patient’s outcome and give them the comfort they need as well. This week has been very busy with research on my change topic project. I came up with my PICOT question this week and I worked on my three objectives and rationales for my topic. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal

Week of November 9-15

My preceptor and I deliberated the importance of ensuring the integrity of human dignity in the care of all patients. We reviewed the importance of patients as human beings and how they are made in the image of God. Each person merits the respect and dignity they deserve when they are receiving care from health care professionals. As a nurse, we are not to judge others by to push aside our judgment and care for others. We were created equal in God’s image by God himself, and we should show respect for others as just that. No matter what each person’s situation is as nurses, showing a patient you care for them by ensuring them their integrity and dignity and stand up for that will change that person’s vision on you as a person and as a nurse as well.

Many elderly individuals lose their integrity and dignity when they lose the ability to do for themselves. We are caregivers should give that back to them as much as we can. Nurse have control of many things that are simple to do but huge to the patient. This week I completed my literature evaluation table with 8 research articles that went in-depth to provide support for my change project topic, nursing-driven protocols that reduce the incidence of catheter-associated urinary tract infections. I also completed 3 capstone change project outcomes with rationales to support each, that I reviewed with my preceptor.

NRS 493 Benchmark – Professional Capstone and Practicum Reflective Journal Week of November 16-22

I discussed with my preceptor the population health concerns that are here in our community. Hypertension and diabetes are some of the major health concerns we see around our area. These issues lead to other health concerns that we see so much such as stroke, heart failure, and kidney failure. The population I chose for my project is individuals who possibly need urinary catheter placement and/or those who have catheters and need them removed. These individuals have to meet the criteria for the catheter to be placed, and they would need to have a reason for the catheter to stay in. This population usually have issues with delayed catheter removal and even catheter-associated urinary tract infections.

Monitoring this population more closely with a nurse-driven protocol will help to reduce this population’s health concerns with urinary catheters. During this week I evaluated and discussed the organization and community’s key stakeholders within my discussion questions. I also evaluated the culture of the organization for potential challenges and barriers when integrating the new change project. I wrote a strategic plan defining how the nursing practice intervention would be implemented among the interprofessional team for adequate success and participation. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal

Week of November 23-29

My preceptor and I chatted about the role of technology in improving health care outcomes this week. As we spoke, we concluded that technology has greatly influenced the health care system and provides guidance toward positive outcomes. One example of this technology in health care is the Electronic Medical Records (EMR). It has changed the health care field traumatically by taking all paper filing and paper charting methods to a more easily assessable health record. This information can be accessed by all members of the health care team that are treating that patient. This allows for fast response in the patient’s care.

It will guide the nurses on the need for catheter placement or removal. Using technology in health care helps guides nurses and catch medical errors before they happen this saves lives and improving health care. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal. This week I completed my Literature review paper that included the comparison of research questions, comparison of sample populations, and comparison of the limitations of the study. I also evaluated resources that would be needed in the implementation process of my change project proposal. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal

Week November 30-December 6

After meeting with my preceptor this week, we spoke about the next topic which was the health policies. At my facility of work and I’m sure at other’s place of work, it has many policies set in place to ensure the best possible care be provided to the patient. Health policies are set in place to guarantee every patient is spoken to, explained, and consents to all procedures, risks, and possible effects with proper communication.

Many policies within a health care facility are financial insurance policies, procedure policies, HIPPA policies, emergency policies CODE BLUE, communication policies, honesty policy, and many more. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal. These policies were not created only to protect our healthcare workers, but it also protects each patient and their rights. This week I developed and reviewed a plan to evaluate the effectiveness of the intervention and develop communication plans for the spreading of information related to my project outcomes. Week of December 7-13. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal

This week I met with my preceptor, and we spoke about how nurses no matter the level of care needs strong leadership skills and need to be a strong economic model to supply adequate care for the patient but also to train, lead, and guide other fellow nurses as well. Nurses can be effective leaders by showing strong skills in teamwork, interdisciplinary collaboration, and advocation. To be an effective leader knowing the organization and its policies and procedures will allow that nurse leader to provide adequate guidance for fellow nurses.

As a nurse leader, it’s important to evaluate new nurse practices and help implement these new evidence-based practices into practice. Nurses can use their leadership skills to enhance the health care field and improve nursing overall. Met with my preceptor about the goals that were set for this week and the capstone project proposal paper and the objectives that were touched on. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal

NRS 493 Benchmark – Professional Capstone and Practicum Reflective Journal Week December 14-20

In the medical hospital that I am following my preceptor, the community’s health knowledge level is low. Most individuals do not use or know about the resources that are there for them. That being said many patients are at higher risk for having health disparities such as untreated obesity, substance abuse, smoking, hypertension, diabetes, and heart disease. During this week my preceptor helps me identify the community resources that I can use as a nurse to provide for my patients or when I am out in the community. This will help direct these individuals to a better life or way of life. This week I met with my preceptor on the goals and objectives for this week.

I put together a creative professional presentation for my capstone project change proposal on the nurse-driven protocol to reduce catheter-associated urinary tract infections. NRS 493 Benchmark Professional Capstone and Practicum Reflective Journal. This was reviewed by my preceptor and was submitted for review by my instructor for the course. I will be presenting this presentation to the staff of my organization to implement my nurse-driven protocol into action. On my unit, I have already reviewed this project idea with my manager, and we have started to put it into action to see the participation and reaction from the staff and to get feedback on this proposal.