Proposal and Problem Statement

Present and discuss a topic that you are interested in researching for this course. 

Explain why this topic interests you. 

Provide a brief background of the topic and speculate on arguments you could pose or problems you could solve. 

Additionally, draft a potential problem statement. 

Pose ideas and solicit feedback from your peers on your ideas.

Capstone Project Topic Selection and Approval 

In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.

Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

1. The problem, issue, suggestion, initiative, or educational need that will be the focus of the project
2. The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
3. A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
4. Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
5. Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
6. A proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

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

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

week 1 discussion 

 Research is used in my facility. The type of research used in my facility is mainly is clinical trials. This is different from other nursing roles in that the nurses like myself focus on taking care of patients using the knowledge and skills that we have gained through college and on the job training, etc. And we use evidence-based practice to administer care for the best proven outcomes. On the other hand, “A clinical trial is a controlled research study that evaluates the safety and benefits of new medications or medical devices” (Mangel, 2017).

         My hospital’s healthcare system has a research institute which is the centralized research facility serving all the five hospitals in the Wellstar health System. The institute offers progressive top of the line therapies to patients and contributes to the advancement of medical science. It is beneficial to patients, physicians, the community and society as a whole. The institute supports doctors and others who conduct the research, as well as patients who receive new drugs, devices and procedures through clinical trials. According to Mangel (2017), “Some drugs and therapies being studied have not yet been approved by the U.S. Food and Drug Administration. But they have been approved for human trial and are believed to be better, more effective or result in fewer side effects than existing treatments.” All research performed at WellStar is approved by an Institutional Review Board for oversight of all trials. 

        Research is an important component of clinical practice because it provides a foundation for clinical decision-making. It gives nursing care has a scientific base, and helps to save cost for interventions.  Evidence based practice proves that there is professional accountability for the work that we take on, and the knowledge gained from research can be put to practice for better health outcomes

  

Case Study

Heart Failure

Patient Profile

M.G. is a 77 year old woman who saw her health care provider for dyspnea. She is now being admitted to the hospital for acute heart failure. She was diagnosed once before with heart failure 6 years ago. She is currently taking the following medications:

Furosemide 40mg po daily

Potassium chloride 20meq po daily

Enalapril 10mg po BID

Subjective data

Was taking furosemide at home but ran out two days ago and has not been able to refill her prescription

Complains of difficulty breathing; had to “sleep in the chair” last night

Has some swelling in her feet that is worse than usual

Objective Data

Physical examination

· Temp 98.4 F, pulse 92 irreg., resp. 24 labored, blood pressure 144/86, oxygen saturation 89% on Room air

· Ht. 5’5”, wt. 170 lbs.

· Alert and oriented to person, place, and time

· Fine crackles bilateral lower lobes

· Shortness of breath with minimal exertion

· S1 and S2 without murmur or extra heart sounds

· Capillary refill sluggish in lower extremities, normal in upper extremities

· 2+ pitting edema bilateral lower extremities

Interprofessional Care

Admission orders include: 

· Oxygen 2L/ nasal cannula

· Furosemide 40mg intravenous BID

· Enalapril 10mg po BID

· ECG now

· Vital signs with SPO2 q 4 hrs

· 2 gm sodium diet

· Strict I&O

· Daily weight

Answer the following questions thoroughly and cite resources appropriately in APA format.

Describe a plan for implementing these orders. 

Based on M.G.’s clinical manifestations, what type of heart failure do you suspect? Support your answer

What assessment data will you use to determine the effectiveness of the provider’s orders?

What is the rationale for the oxygen, IV furosemide, and enalapril?

What are the priority nursing diagnoses for this patient? (list at least 3)

What other orders might you anticipate for this patient?

Think about plans for discharge, what are your primary concerns for this patient?

Any other information you need or would like about this patient?