Insight for Capstone NEEDED!!

[Deidra36]

Hi all!

Purdue U. (of northwest indiana) has changed their capstone on us and taken away our 90 hrs. clinical preceptorship and replaced it w/an experiencial learning project composed of 3 team members (students) with a faculty preceptor. What is happening is hospitals are presenting us with issues that they want researched and policy change for. We are to pick a project and each contribute 90 hrs. of time towards and develop policy change for that hospital and present it at the end of the semester (4 yr. RN program ending Dec. this yr) at a convention center with an audience of all the participating hospital managers/coordinators. My problem is the project we got "stuck" with--that and of course the fact that we will be lacking 90 clinical hrs. everyone before us was entitled to!!!

Project: To develop a strategy and policy for a brief (diaper) free facility for incontinent adults.

I (and my team members) would appreciate ANY ideas, insight, information, any of you could provide us. 270 hrs. of work towards this project seems excessive and over kill. But we can hit it at any angle.

PLEASE HELP!

Deidra, PUNS (purdue university nursing student)

[Riseupandnurse]

I really feel for you. I can't understand why this is better than 90 hours of preceptorship. I also don't see how doing away with all the briefs could work. Is there no way out of this?

[HM2VikingRN, RN]

Well behavioral strategies are one angle.

-Scheduled toileting

-prompting

Increasing staff (like that will happen.)

It is probably a "dignity" issue for patients on paper but more likely it is for cost savings.

[llg, PhD, RN]

As you may already know, you have been asked to complete an "evidence-based practice practice project."

1. Do some reading on "evidence-based practice" (EBP) to get good feel on the process if you haven't done so already.

2. Find out if the particular hospital you are working for has a particular model that they follow for evidence-based practice projects. While the major models of EBP are all very similar, it will help you and your grade to follow the particular one the hospital and/or your schools uses.

3. Generally, once you have your topic/question clarified -- then you will need to do a comprehensive literature search. That means formally evaulating all the significant literature on the topic -- not just retrieving a few articals. Most EBP models have formal systems for evaluating the strength of the available evidence. That's where a lot of your 270 hours will come in. Retrieving and formally evaluating the evidence.

4. From there, depending on your EBP model, you will develop a guideline to be implemented.

5. You will also need to develop a way to gather data before the guideline is implemented to compare to additional data you gather after the guideline is implemented.

6. The final step is to share your pre- and post- guideline data along with the details of your project so that the rest of the nursing world has your findings to include in any future studies/projects related to the same topic.

That is how REAL clinical practice changes are supposed to happen. 270 hours is really a very small amount of time to do all that and your school may not require that you complete all of the steps. In "real life," when hospital staff members are trying to make an improvement in their practice procedures in the midst of getting other work done throughout the day ... it can take many months (or even more than a year) to complete a major project.

If done correctly, such a project can improve patient care tremendously -- and can teach the people involved the proper way to make clinical decisions. But I can certainly understand your disappointment at not getting the extra "hands on care" time in your program.

Good luck.