my capstone ideas -would appreciate feedback please

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So this is it..the last leg for me!!!! I'm trying to get my preceptorship all finished (even though I don't want it to end but I need time for capstone and NCLEX prep!!!)

Anyway these are my capstone ideas. Can anyone give feedback please as to which you think is the best one, or why some would be bad or good?

These are for the emergency department and/or pediatric emergency department population.

1. Foley catheter in every heart failure pt who comes in, to more accurately monitor I&O's. This would be hard to implement, but it was one of the preceptor's ideas.

2. Incentive spirometers protocol...I haven't seen 1 in the ED but they're all over the floors..and with all the flu cases coming in, I was surprised.

3. Septic shock early warning signs protocol

4. Sterile technique checks for blood draws. But this is hard because I don't know how to gather data to show sterile technique hasn't been properly used. And you know especially with pediatrics, even the best nurses are ripping the gloved finger off to feel the vein.

5. Rounding in the ED...so one nurse will round hourly to check Foley's, central lines, and the patient's priority

6. Suicide risk screening tool (because we are getting a lot of young crisis patients) and I think the suicide risk screening could include more than just asking if they have thoughts to harm self, such as if they are bullied, home enviro, etc

7. In person SBAR/IPASS transfer of pt to floor, not over the phone

THANK YOU

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Specializes in Rehab, Ortho-Spine, Med-Surg, & Psych.

Hello! Here are my comments:

1. Foley catheter in every heart failure pt who comes in, to more accurately monitor I&O's. This would be hard to implement, but it was one of the preceptor's ideas.

Comment: CHF does not cause urinary retention, thus a foley catheter is not going solve CHF. Furthermore, foley catheters pose a high risk of UTI, which if deemed as a nosocomial infection... the hospital would be responsible for its costs.

2. Incentive spirometers protocol...I haven't seen 1 in the ED but they're all over the floors..and with all the flu cases coming in, I was surprised.

Comment: Incentive spirometers are used for patients that will spend a lot of time in bed to keep them well oxygenated, maintain normal temperature, and prevent pneumonia. The Emergency Department is not the right unit to implement this as patients spend relatively little time in them. So I am NOT surprised the ED does not have them.

3. Septic shock early warning signs protocol.

Comment: In my hospital, we conduct a Sepsis screen every start of shift. If the hospital of your choice does not do it, then it would be a good protocol for them to implement it. Look into it.

4. Sterile technique checks for blood draws. But this is hard because I don't know how to gather data to show sterile technique hasn't been properly used. And you know especially with pediatrics, even the best nurses are ripping the gloved finger off to feel the vein.

Comment: All caregivers are supposed to follow safety procedures/techniques when drawing blood. If they don't, they should be fired! Not a revolutionary topic for a capstone project.

5. Rounding in the ED...so one nurse will round hourly to check Foley's, central lines, and the patient's priority.

Comment: Patients in the ED are transient... priority has already been assessed in triage; indwelling catheters and central lines are reserved for patients who are admitted and followed up by the secondary unit. Not a strong topic for a capstone project for the ED.

6. Suicide risk screening tool (because we are getting a lot of young crisis patients) and I think the suicide risk screening could include more than just asking if they have thoughts to harm self, such as if they are bullied, home enviro, etc.

Comment: Suicide risk assessment is usually assessed at triage; however, if you think there is something else (of value) that can be added to the ED screening... it might make a good capstone topic.

7. In person SBAR/IPASS transfer of pt to floor, not over the phone

Comment: An "in-person" SBAR report from the ED nurse at the accepting unit is beyond than an unreasonable proposal... the idea will be D.O.A. Transportation techs (non-licensed personnel) usually takes them to their unit destination after the ED nurse calls the receiving nurse for report. You will not be successful arguing for an in-person SBAR.

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I found a website with 100 Capstone topic ideas... well worth it to explore: Full text of "List of 1 Best Capstone Project Ideas"

Best wishes !!

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Thank you so much! I'm trying to make my capstone idea specific to issues I see on the eds, but most what I see are too big or out of my scope for me to address. I'll check out that list and see what I can come up with, but your comments make a lot of sense, very helpful glad I asked before I went ahead!

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Specializes in School Nurse.

One thing to examine might be ways to monitor "parked" patients. It wasn't uncommon back when I was in the ER (and that was a long time ago) for patients, no longer emergent, to be parked awaiting admission elsewhere (or perhaps discharge) for extended periods without any monitoring.

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