Benchmark – Capstone Project Proposal

Benchmark – Capstone Project Proposal

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Obesity amid Adolescent in the United States.

It’s finally here. The week you all have been waiting for. Your Capstone Project is due!!

The following is a reiteration of the instructions. Make sure you have covered all points.

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

  1. Background
  2. Problem statement
  3. Purpose of the change proposal
  4. PICOT
  5. Literature search strategy employed
  6. Evaluation of the literature
  7. Applicable change or nursing theory utilized
  8. Proposed implementation plan with outcome measures
  9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
  10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.



Nursing Department Staffing and Communication Issues Completed Sample Paper





Nursing Department Staffing and Communication Issues

The effectiveness of any team of employees is based on their ability to engage in responsibilities within a particular organization. Consequently, the employer bears the responsibility of ensuring that the working environment is suitable enough for appropriate performance, contrary to which the employees may not be in a position to perform as is necessary. The issues experienced at Skylar Healthcare Center include an understaffed team of nurses, and difficulties in accessing necessary information for decision-making purposes. Consequently, the nurse practitioners are often left to make decisions pertaining to their activities in relation to the health process, which often elicits review from the management at the hospital.

Context of the Issue

Clearly, the issues experienced within the organization are primarily related to appropriate management of the human resource team. It reflects the existence of challenges in the human resource management department as a converse situation would include appropriate handling of the nurses within the facility (Birken et al., 2015). In this case, the department has limited knowledge or has not been active enough in taking the necessary action to improve the welfare of the nurse practitioners, which has left the levels of fatigue relatively high (Smith-Miller, Shaw-Kokot, Curro. & Jones, 2014). According to research, such exhaustion of employees has been known to create challenges in their performance effectiveness (Lee, Yen, Fetzer, & Chien, 2015). At the current rate of patient to nurse ratio, the chances of the services reducing in quality significantly are relatively high.

Impact of the Problem

Poor communication within a healthcare facility may not be as adverse on its own, but the situation changes when the issue is compounded by other organizational adversities. In any case, the existence of an organizational culture helps the employees make suitable decisions even in the absence of support the management (Smyth & McCabe, 2017). However, with the management and organizational structure at Skylar not being keen enough to appropriately induct the employees into the organization, and the consequent lack of an organizational culture, most decisions made by the subordinate staff are often placed under review (De Bono, Heling, & Borg, 2014). Ultimately, such reduces the motivation among the nurses, which has resulted to a high rate of punctuality issues in coming to work.

Significance of the Problem to Nursing

Staffing has often been an issue of discussion in most research studies (Shield, Wetle, Teno, Miller, & Welch, 2005). However, it would be important to note that the issue often transcends the management department in most healthcare organizations, to include issues related to funding. Ultimately, although the human resource management could be the problem at Skylar, it would be important not to overlook the role played by the management in advancing the issues related to care delivery (Ginter, Duncan, & Swayne, 2018). As long as challenges exist in the management of the personnel within various department, the quality of service is bound to be relatively low.

The solution to issues experienced at Skylar lies within the complete overhaul of the management at the hospital. Notably, managers within the health sector undergo significant training to guarantee that they are capable of providing the necessary services within various organizations (Eriksen et al., 2005). However, the current case indicates a situation in which the management has limited concern for the employees, irrespective of the integral role played in determining the quality of service provided. The issues currently experienced may not be solved through training programs, as they stem from basic ignorance of the needs of employees and appropriate organization to achieve desired change.


Birken, S. A., Lee, S. Y. D., Weiner, B. J., Chin, M. H., Chiu, M., & Schaefer, C. T. (2015). From strategy to action: How top managers’ support increases middle managers’ commitment to innovation implementation in healthcare organizations. Health Care Management Review40(2), 159.

De Bono, S., Heling, G., & Borg, M. A. (2014). Organizational culture and its implications for infection prevention and control in healthcare institutions. Journal of Hospital Infection86(1), 1-6.

Eriksen, H. R., Ihlebaek, C., Mikkelsen, A., Grønningsæter, H., Sandal, G. M., & Ursin, H. (2002). Improving subjective health at the worksite: a randomized controlled trial of stress management training, physical exercise and an integrated health programme. Occupational Medicine52(7), 383-391.

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons.

Lee, H. F., Yen, M., Fetzer, S., & Chien, T. W. (2015). Predictors of burnout among nurses in Taiwan. Community mental health journal51(6), 733-737.

Shield, R. R., Wetle, T., Teno, J., Miller, S. C., & Welch, L. (2005). Physicians “Missing in Action”: Family Perspectives on Physician and Staffing Problems in End‐of‐Life Care in the Nursing Home. Journal of the American Geriatrics Society53(10), 1651-1657.

Smith-Miller, C. A., Shaw-Kokot, J., Curro, B., & Jones, C. B. (2014). An integrative review: fatigue among nurses in acute care settings. Journal of Nursing Administration44(9), 487-494.

Smyth, O., & McCabe, C. (2017). Think and think again! Clinical decision-making by advanced nurse practitioners in the Emergency Department. International Emergency Nursing31, 72-74.




Hospital Length of Stay Completed Sample




Hospital Length of Stay

The hospital environment should be efficient enough in providing the appropriate environment for patient recovery from different health issues to all patients. However, Toh, Lim, Yap, & Tang (2017) conducted a research in different hospital environments, determining that the median age for patients with a prolonged length of stay at the health facilities was 85 years. The study puts the geriatric patients as the population most likely to the experienced length of stay within the facilities, prompting a change in the practices of caregivers, towards an improvement in the attendance to the geriatric population within such environments.

Picot Question

P-Geriatric patients are the population most vulnerable to lengthy stays within hospital settings. I-nutritional status and comorbidity of diseases, C-proper care by healthcare professionals including individualized attention. O-a significant reduction in the length of stay in hospitals. An analysis of research conducted on geriatric hospital stay would be highly consequential in the development of an ideal solution to the extended stay of patients in healthcare facilities. Such creates the basis of evidence-based practice within healthcare facilities, whose adaptation would not only help patients recover and return to their families fast enough, but it would also aid the healthcare facilities, and the government at large, to save a significant amount of resources.

Toh et al. (2017) posit that a possible improvement in discharge planning would be an effective way to improve the length of stay among the geriatric patients. In essence, the greater the effectiveness in the healthcare facility’s management of discharge information, the easier it would be to discharge the patients fast enough. Such an intervention practice guarantees a significant reduction in the time taken to clear the patient for discharge, essentially reducing the time spent in the hospital.

Additionally, an improvement and oversight of patient nutritional aspects would be consequential to addressing the issue. Developing a program that would actively involve the patient and the caregiver in the maintenance of the former’s nutritional factors at an optimal level would guarantee ease in fighting the disease-causing pathogens, irrespective of the challenges faced (Cereda et al., 2015). Ultimately, such would require significant input from the hospital as an agency as the patients may not necessarily have the necessary knowledge to provide all the information necessary. Therefore, the inclusion of additional practitioners to deal with the geriatric patients in addition to the nurse practitioners would be highly consequential to the recovery process.

Ultimately, the research herein intends to achieve positive change in nursing practice, one which focuses on geriatric patients as a cohort in need of additional attention based on the distinct nature of the issues affecting their stay in hospitals. According to research, factors such as constant observation levels influence the length of stay among the geriatric patients unlike among patients of other ages (Ismail, 2012). As long as the general practice in healthcare takes note of such differences, and effectively outs to practice different measures intended to provide health care to the patients, it would be possible to efficiently address the elderly’s length of stay in hospitals. Evidence based practice is primarily focused on using research findings as the basis of intervention son various issues highlighted as being detrimental to a particular industry, and based on the findings from the research herein, it will be possible to develop appropriate intervention measures to the issue in question.




Cereda, E., Klersy, C., Pedrolli, C., Cameletti, B., Bonardi, C., Quarleri, L., … & Caccialanza, R. (2015). The Geriatric Nutritional Risk Index predicts hospital length of stay and in-hospital weight loss in elderly patients. Clinical Nutrition34(1), 74-78.

Ismail, Z., Arenovich, T., Grieve, C., Willett, P., Sajeev, G., Mamo, D. C., … & Mulsant, B. H. (2012). Predicting hospital length of stay for geriatric patients with mood disorders. The Canadian Journal of Psychiatry57(10), 627-634.

Toh, H. J., Lim, Z. Y., Yap, P., & Tang, T. (2017). Factors associated with prolonged length of stay in older patients. Singapore medical journal58(3), 134-138.



Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences):


Criteria Article 1 Article 2 Article 3 Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article



Barreca M, Renzi C, Tankel J, Shalhoub J, Sengupta N.

Cooley, M.

Dogan K, Kraaij L, Aarts EO, Koehestanie P, Hammink E, van Laarhoven CJ, Aufenacker TJ, Janssen IM, Berends FJ.

Johnston MJ, Davis RE, Arora S, King D, Reissis Y, Darzi A.

Article Title and Year Published


2016 2017 2015 2015

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study


Nurse involvement; in postoperative treatments as primary care providers are more feasible as compared to when nurses are involved as secondary care providers. The critical role of nurses in postoperative gastric bypass Nurse involvement in both perioperative and postoperative operations reduces hospitalization time and complication rates. Nurses being a primary participant in both postoperative and perioperative are important because it offers an opportunity for patients to effectively solicit care.

Design (Type of Quantitative, or Type of Qualitative)


Quantitative descriptive design Qualitative case study Quantitative descriptive design Quantitative



University teaching hospital, United Kingdom

Bariatric Patient


75 consecutive morbid obese patients Three London hospitals

Methods: Intervention/Instruments





Meta-Analysis study conducted by Barreca et al (2016) where sample population of 278 members was examined before and after undergoing a bariatric surgery. a systematic study conducted by Cooley (2017) to examine the critical role of nurses in postoperative gastric bypass. randomized controlled study where two groups of 75 consecutive morbidly obese patients were subjected to LRYGB a cross-sectional study conducted by Johnston et al (2015) where a total of 155 surgical patients from three hospitals were subjected to similar questionnaires to examine their willingness to call for help from nurses as compared to doctors.

Key Findings


Nurses’ involvement in both perioperative and postoperative gastric bypass reduces readmission rates. Postoperative care is also important because it assists in early detection and prevention. The reduced hospitalization originates from the fact that nurse involvement in a multidisciplinary team in postoperative nursing care help in rendering effective care to patients.

The involvement of nurses makes it easier for patients to access care.




Nurses should be involved in the postoperative treatments as primary care providers in which case their involvement will boost the recovery days of the patients as well as the satisfaction indexes.


Involvement of nurses in the nurse gastric bypass after follow-ups is essential in avoiding acute pain in patients Nurse involvement in both perioperative and postoperative operations reduces hospitalization time and complication rates.

The nurses help is imperative to patients and as such it is imperative that nurses are involved in a bid to

nurse’s makes it easier for patients to access care.


Explanation of How the Article Supports EBP/Capstone Project


The article is relative to the Capstone project as it is relative to the obese people who are being surgically treated for weight loss. This relates directly to the PICOT statement under assessment The article is important as it examines the critical role of nurses in postoperative gastric bypass, elements that are essential in studying of the obese people who are being surgically treated for weight loss The article supports the EBP/Capstone Project in that the data is relative to the PICOT statement established on obese patients The article is relative to the capstone projects as it projects the impact of surgeries on patients owing to the fact that the project is surgery for obese patients.



Criteria Article 5 Article 6 Article 7 Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article



Mihir M. Shah

Ben W. Hunter

John F. Sweeney

Edward Lin

Sebastian D. Perez

Cheryl Parker

Steven Scott DavisJr.


van der Beek, E. S., Monpellier, V. M., Eland, I., Tromp, E., & van Ramshorst, B.

Julie A. Campbell


Douglas Ezzy


Amanda Neil


Martin Hensher


Alison Venn


Melanie J. Sharman

Andrew J. Palmer

Ratcliffe, Denise; Doyle, Jacqueline; Sogg, Stephanie; Rassool, Sara.

Article Title and Year Published


2017 2015 2018 2016

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study


Surgical times (STs) and total operation times (ORT) are reduced when nurses are involved in the postoperative and perioperative operation Nutritional deficiencies originate from poor management of patients conditions after undergoing gastric bypass



The importance of psychological support pre and post bariatric surgery doesn’t ameliorate or negatively affect weight loss and could thus could be unnecessary.

Design (Type of Quantitative, or Type of Qualitative)


Quantitative correlational Qualitative Ethnographic studies Qualitative Phenomenology Qualitative case study



One hundred seventy-nine consecutive LRYGB cases 427 gastric bypass patients Focus group data bariatric rehabilitation services (BRS)

Methods: Intervention/Instruments


Tests Observation Focus groups observational



The article offers a randomized controlled study conducted by Shah et al (2017) where sample population of 179 consecutive LRYGB cases was analyzed, it was concluded that surgical times (STs) and total operation times (ORT) are reduced when nurses are involved in the postoperative and perioperative operation. A study Meta-analysis study conducted by Van der Beek et al (2015) where a group of 427 gastric bypass patients was subjected to same conditions

impacts of bariatric surgery on health economic for obese patients  and effects of  improved practice in health economics


Importance of the psychological support offered pre and post bariatric surgery

Key Findings


Appropriate and accurate nursing care and interventions help in reducing the hospital stay.


Nutritional deficiencies originate from poor management of patients conditions after undergoing gastric bypass Emotional capital and financial distress were recognized BRS intervention was not relative to  greater weight loss 12 months after surgery was done on a obese patient.



It is imperative to integrate accurate nursing care and interventions in a bid to help in reducing the hospital stay.


It is important to consider the preoperative and postoperative assessments in treating patients while taking account of the nutritional deficiencies of patients undergoing gastric bypass surgery. It may be imperative to integrate a mixed‐method technique in the assessment of the economic aspect that bariatric surgery poses. Psychological support should be removed from the  NICE guidelines

Explanation of How the Article Supports EBP/Capstone


The article is relative to the capstone project as it emphasized on the need for nursing care after surgery in such a manner that the obese patients are catered to. The article is important for the capstone project as it reflects the effects of surgery on obese patients The article projects the impact of economic bariatric surgery on obese patients The article is relative to the capstone project as it projects the impact of Psychological support on bariatric surgery


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