1. Think about a problem in your clinical practice. Are the satisfaction scores in your unit low? Does your unit have a higher than average infection rate? What is a problem you see in your clinical practice? What are some of the possible solutions? Why is it important to evaluate the need for change and not just stick with the “it’s the way we always have done it” mentality?
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2. Evidence based practice dates back to Florence Nightingale, yet it took a long time for nurses to conduct nursing research. Why is it important for nurses to have their own body of knowledge? Give a specific example of how bedside nurses contribute to nursing research?
3. Form a PICO question that you will use for your change project. Include each element of the PICO question. How did you develop this question? Why is it important to your clinical practice?
4. When reviewing a journal article, how do you best determine its credibility and reliability? Why is it important to determine the strength of evidence and how does that affect your implementation of the results into clinical practice?
5. Now that you have identified your capstone project. What is the cost involved to implement your project? Remember that cost isn’t always just money but also time and resources (both tangible and intangible). Will the initial cost pay off in the long run with improved outcomes?
6. Have you ever played the telephone game when you were younger? Communication can take on a life of its own and the content can often be distorted over time. Give an example in your clinical practice where miscommunication was the root cause of an error. How could this communication error have been prevented?
7. Your lesson this week discussed patterns of nursing care delivery. In your opinion, what is the most effective nursing care delivery model and why? What are the advantages and disadvantages of your chosen nursing care delivery model? Give specific clinical examples.
8. Discuss the two articles that you read from the Patient Safety and Quality: An Evidence-based Handbook for Nurses website. Give the title and the URL address for each article. How is the information in each article applicable to your practice?
9. Nurses face many ethical issues on a daily basis. Consider the following scenario:
Your unit has team nursing. As luck would have it, you and your best friend, Jill, are paired as a team this shift. Jill is a new nurse so you feel this is a great opportunity to take her under your wing a bit and show her the ropes. It is a busy shift and you administered Mr. Smith his insulin dose based on the sliding scale before lunch. You chart your medication administration and continuing caring for your patients. An hour later, Jill comes to you terrified because she forgot to chart the insulin she gave Mr. Smith and realized that you also gave the medication. She rushed to take his blood sugar and it was 115. Mr. Smith felt fine and was eating a candy bar his family had snuck in for him. No harm done, in fact he probably needed the extra insulin to compensate for the candy bar he wasn’t supposed to have, Jill explained. Jill begs you not to report this since she is still on probation. She says that she has learned her lesson and since nothing bad happened, why does anyone need to know?
What would you do in this situation? Apply ethical principles to explain the rationale for your decision making process.
10. Explore the website for the Quality and Safety Education for Nurses (QSEN) initiative at http://www.qsen.org. How can these competencies for nurses be implemented into the workplace or professional nursing setting if you are not currently working?
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