Professional Capstone and Practicum Discussion

Professional Capstone and Practicum Discussion

Professional Capstone and Practicum

Question One

Based on the evaluation plan, the independent variables include patient demographics. In contrast, the dependent variables are the number of Covid-19 cases before and after the education program, the associated change in mortality rates, and the change in Covid-19 knowledge compared to baseline information. The dependent variables rely on the project intervention outcomes (Kaur, 2020). The evaluation team will collect data relating to change in Covid-19 knowledge to determine the children’s ability to comprehend the learned content. The data will examine whether the project achieved its short-term goal Professional Capstone and Practicum Discussion

Additionally, the team will collect data relating to the incidence of Covid-19 and the associated mortality rates in the pediatric population to establish the long-term impacts of the intervention. Collection of demographic data helps to assess the children’s ability to comprehend content in the educational materials. It also enables the implementation team to tailor each session to match the needs of each demographic group (Suresh, 2018). Lastly, demographic data determines whether the study sample represents the larger population in the region.

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Question Two

The effective implementation of evidence-based interventions requires careful comprehension and interpretation of research findings. It is, therefore, important to understand the difference between clinical and statistical significance. Clinical significance refers to the practical importance of an intervention outcome or impact. It is a subjective decision made by experts concerning the practical significance or relevance of an intervention or treatment (Sharma, 2021). A clinically significant result occurs when researchers and other experts state that the research finding is medically efficient and can be applied in the provision of care to patients.

Conversely, statistically significant research findings show that the association (difference or relationship) between variables was not mainly due to chance or normal variation. The parameter indicates the likelihood that a research finding is true and that it did not occur by normal variation or chance (Polit, 2017). I can employ clinical significance to support positive outcomes in my project by ensuring that the revaluation outcomes are statistically significant. I would demonstrate that the change in Covid-19 awareness among the children results from the education program and not by chance. I will then consult with nurse practitioners and physicians to examine the findings and determine whether they are sufficient to be used in primary care.

References

Kaur, S., P. (2020). Variables in research. https://sites.usp.br/rnp/wp-content/uploads/sites/830/2020/10/complemento-aula-1.pdf

Polit, D. F. (2017). Clinical significance in nursing research: A discussion and descriptive analysis. International Journal of Nursing Studies, 73, 17-23. https://doi.org/10.1016/j.ijnurstu.2017.05.002 Professional Capstone and Practicum Discussion

Sharma, H. (2021). Statistical significance or clinical significance? A researcher’s dilemma for appropriate interpretation of research results. Saudi Journal of Anaesthesia, 15(4), 431. https://doi.org/10.4103%2Fsja.sja_158_21

Suresh, S. (2018). Nursing research and statistics. Elsevier Health Sciences.

Summary of the Evaluation Plan

The evaluation assesses the effectiveness of the project in achieving its objectives and can identify any potential lessons learned for application in future change projects (Melnyk & Fineout-Overholt, 2019). The purpose of this paper is to provide an overview of the evaluation plan for a change project that is included the description of data collection, the people responsible for collecting data, and how data will be communicated to the project team.

Data Collection and Tool to be Used

The evaluation plan devised for this project focuses on gathering data on the demographics of the pediatric population and information on Covid-19 cases. Data collection will facilitate evaluating how effective educational interventions have been in increasing knowledge about Covid-19 and its prevention. Besides, the evaluation will determine how educational programs helped prevent Covid-19 cases among the pediatric population. The tool that will be used to collect this data is a questionnaire. The questionnaire used to collect data from the participants will be then compiled and analyzed using statistical tools such as IBM SPSS version 28.0.1.1. The results of this evaluation will help me and the project team target specific aspects in the pediatric population, which could harbor Covid-19 prevention. This evaluation will help improve the planning and execution of future prevention interventions targeting the pediatric population.

Responsible People for Data Collection

Identifying who will be responsible for collecting data is a significant step in conducting a change project on COVID-19 education and prevention among pediatric patients/school-going children in an acute pediatric unit. In this project, I will recruit three pediatric nurses and one pediatrician assistant who are most familiar with COVID-19 and its effects on pediatric patients. The four members chosen will be responsible for collecting the data and will form the education and prevention team.

Communication of Data to the Team

Regarding the communication of evaluation data, the project manager will hold a meeting with the care team to discuss the data and what changes should be made based on the findings. Another way to communicate the data is by writing a report detailing the findings and recommendations. The report would be shared with the care team to review and make any necessary changes to practice.

References

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. https://b-ok.africa/dl/5010066/6e27c8

Benchmark-Capstone Project Change Proposal

Jennifer Parduhn

Grand Canyon University

NRS 493, Professional Capstone and Practicum

Ellie Milo

July 4, 2022

Background

COVID -19, or Coronavirus disease -2019, is a respiratory virus first identified in 2019 and causes severe respiratory illness in humans (Wang et al., 2021). Since then, it has spread rapidly worldwide, causing many cases and deaths. So far, COVID -19 has affected people from all walks of life, from young children to the elderly. COVID -19 is a serious infection and can lead to serious complications, including kidney failure and even death. The disease spreads quickly through close contact with respiratory secretions, such as saliva or mucus. Individuals most at risk of getting infected with COVID -19 include those with a weakened immune system, such as the elderly, children, pregnant or breastfeeding, or those with severe respiratory conditions.

As the world grapples with the ongoing COVID -19 pandemic, scientists have been working tirelessly to learn more about the virus and its potential treatments. Since the outbreak began, research teams have published several studies that provide valuable insights into the virus and its response. Studies have looked at COVID -19 virus transmissions and found that the virus is spreading rapidly through close contact and that healthcare workers are particularly vulnerable to infection (Gray et al., 2020). Also, studies have looked at the efficacy of different treatments for COVID -19 and found that some patients responded well to antiviral drugs while others did not. Overall, these studies provide valuable insights into the virus and its response and have helped healthcare professionals understand how the virus spreads, potential treatments, and how well they work (Caini et al., 2022). This knowledge is essential as we continue to fight COVID -19 and protect patients’ safety and improve the response to the disease.

The outbreak of COVID -19 has been a devastating event for the world. The virus has killed hundreds of millions of people and has caused widespread panic and economic turmoil. So far, the virus has been associated with a high mortality rate and significant morbidity. The clinical implications of COVID -19 are significant in both the short and long term. In the short term, COVID -19 is likely to cause a high mortality rate. Most patients who contract the virus die from the respiratory distress associated with the disease. In the long term, COVID -19 may cause significant morbidity and disability Professional Capstone and Practicum Discussion .

Clinical Problem Statement

COVID-1 poses a significant threat to the health and social life of many school-going children, their parents, and their families. In our hospital, confirmed cases of pediatric patients presenting at the acute care department are increasing, and the statistics are unacceptable. The clinical problem perturbing our healthcare facilities is the increasing incidences of pediatric or school-aged children admitted for COVID-19 treatment. Most children with confirmed infections present with severe symptoms, demonstrating how the virulent SARS-CoV-2 virus is deteriorating children’s health.

Pediatric and school-aged children are a special age cohort that is highly vulnerable and susceptible to the Covid-19 due to their lack of understanding about the preventive measure. School-aged children are also at higher risk of contracting the virus due to incautious close contact with peers during play or learning activities. Suffice to say that the Coronavirus can be spread by droplets, cough, sneezing, or saliva (Cascella et al., 2022). Besides, the pediatric patients may have weak, underdeveloped immunity and interact intensively with other people or family members, exposing them to Covid-19.

Although studies revealed that preventive measures implemented within the communities have helped abate the overall transmission burden of the disease, there are practice gaps, which cause increased incidences among children. Hagabimana et al. (2021) highlight that governments and organizations have rolled out successful interventions such as public health education, vaccination, and personal protective measures. The mentioned interventions have contributed significantly to containing the COVID-19 infection. However, interventions, especially public health education, are packaged for adult populations leaving school-age children and pediatrics with little or no information. This change project seeks to close the knowledge and practice gaps by focusing on school-age children’s health education. Considering how vulnerable children are and how children are victims of the disease due to lack of information, an effective health education program should target the improvement of knowledge and skills in preventing the disease.

Purpose of the Change Proposal

This change project aims to increase knowledge about COVID-19 prevention among pediatric patients or school-age children since they are vulnerable members of society exposed to the disease. Therefore, the change will increase their ability to prevent COVID-19 among pediatric/school-going children and help them be active members in potential preventive consequences of the disease in their health and social life. By doing so, the change project will impact the provision of the patient in the changing healthcare system. The project will introduce new nurses’ roles in the acute pediatric unit. Nurses will intensify patient health education during the project, including detailed descriptions of COVID-19.

The change project will also involve nurses in providing care as educators, counselors, caregivers, health promoters, and advocates. Such nurses’ role will be essential because some patients included in this project will be school-age children with confirmed COVID-19. Nurses will assess the children for potential emotional and mental consequences of the disease and counsel them appropriately. Consequently, this change project will help alleviate the burden of COVID-19 among children and prevent them from potential consequences caused by the disease.

Nurses will use new learning materials to facilitate learning. Children will interact with the written content on pamphlets, images on videos, and audio messages to promote their awareness and develop deep connections with the topic. In current practice, there are several programs for adults and teenagers to learn about preventing the COVID-19. However, not much has been done for pediatric or school-age children. By implementing this project, pediatric and school-age children will receive health education to learn key health practices for preventing the transmission or contracting of the disease.

PICOT Question

This change project seeks to implement health education among pediatric patients and their parents/caregivers and raise knowledge of the risks, presentation, dangers, and prevention of Covid-19 as the most effective solution in reducing the burden of COVID-19 among school-aged children and their families. Due to their close contact with their peers or relatives and a lack of health awareness, school-aged children can easily contract COVID-19 (Zar et al., 2020). Therefore, the intervention will help them learn the details of the disease and pandemic to become active members in preventing its transmission.

Population – School-aged pediatric population

Intervention – Health education

Comparison – No health education

Outcome – Alleviating the burden of Covid-19 among school-aged children and the general population.

Time – 3 Months

Therefore, the PICOT question is “Among school-aged pediatric population (P), will the provision of health education (I) compared to no health education (C) alleviate the burden of Covid-19 among school-aged children and in the general population (O) in 3 months (T)?”

Literature Search Strategy Employed

To access relevant studies addressing the implementation of health education to alleviate the burden of Covid-19 among pediatric or school-aged children, the nurse conducted the literature search in the Cochrane Library, CINAHL, PubMed, and EBSCOhost online databases. The keywords used in the literature search were school-aged children, pediatric population, health education, alleviating the burden of COVID-19, and the general population. Following the initial search, the nurse combined searches to identify studies relevant to the PICOT question. Study reports chosen for the literature evaluation were written in English and published within the last five years. Consequently, eight studies were selected for evaluation.

Evaluation of the Literature

Since the disease outbreak in 2019, different researchers and organizations have conducted quantitative and qualitative studies to investigate different aspects of the disease. The literature search identified studies that supported the EBP Capstone project by providing the most recent and pertinent details concerning COVID-19 prevention strategies for children. To commence with, the minimization of contact among children effectively breaks the chain of transmission among them. Andrejko et al. (2022) evaluated the social contact patterns among school-age children and investigated the effects of closures on social contact pattern among the pediatric population and their families. The study found at least one family member infected with COVID-19 among 16% of the respondents. The need for the closure of schools to reduce contact was implicated Professional Capstone and Practicum Discussion .

Most school-age children and adolescents remain susceptible to COVID-19. However, preventive measures such as vaccination within this age cohort remain low. Baxter et al. (2021) assess the incidence rates of the disease among children and its impact on them. In their study on protecting children from COVID-19, Baxter et al. (2021) included school-age children and adolescents and assessed their risk of contracting the disease. The study found that children were at significant risk of contracting the illness and required approved vaccines for the age cohort and other effective preventive measures such as appropriate face mask use. A similar study by Xue and Shen (2021) revealed higher rates of COVID-19 transmission among children and subsequent hospitalization and mortality than in adults. The studies recommended the need for clinical trials to approve vaccines for the pediatric population.

The transmission of SARS-Cov-2 among the children called for the implementation of measures to abate the trend and the overall burden of the disease. A meta-analysis of observational studies by Caini et al. (2022) found that schools had a positivity rate of 0.31%. Students and staff reported the highest rates. Follow-up studies by some of the peer-reviewed publications used in the meta-analysis showed increased prevalence among the students. This study and others, which revealed the increasing incidence of morbidity among children, recommended the closure of schools and the implementation of more preventative measures.

Applicable Change or Nursing Theory Utilized

The theory employed in this capstone change proposal is Kurt Levin’s change theory which proposed three stages useful in implementing change within an organization. According to Levin’s theory, change may be affected through comprehending the forces driving it, employing a systematic method to facilitate change, aiding staff members as they adjust to the change, and supporting the persons involved (Hussain et al. 2018). Kurt Lewin proposed that the change process comprises three steps: unfreezing or pre-change, changing/movement or change, and refreezing or post-change.

Pre-change step refers to when people in the organization or group are unaware of the change or forces causing change. At this stage, the project manager plans to increase awareness about the change among the nurses, other care providers in the acute pediatric unit, managers, and leaders in the hospital. At this stage, the project manager will seek support from all nurses to ensure easy implementation and minimal resistance to change. The changing or movement stage is when individuals in the organization become aware of the forces but are unclear about how to react. At this stage, the change is affected to ensure that people conform to new practices.

The post-change stage refers to the period after the changes have occurred. According to Lewin’s theory, the pre-change period should concentrate on understanding the causes driving change and educating personnel about those forces. Lewin’s theory recommends concentrating on assisting the implementation of change throughout the change stages by giving team members the tools and resources they need to adjust to the new environment (Hussain et al., 2018). Lewin’s theory recommends concentrating on maintaining the changes that have been accomplished during the post-change phase. Lewin’s theory is predicated on the notion that change is possible.

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Proposed Implementation Plan with Outcome Measures

Implementing the proposed change will involve several steps ranging from assessment of the targeted population, implementation of educational programs, and data collection on the impact of interventions. The project will involve a needs assessment among the pediatric population regarding the prevention of COVID-19 and identify the knowledge gaps to be addressed by the intervention. The assessment of the target population will also identify the school-aged children at risk for contracting the virus, as evidenced by the number of children who tested positive for the virus. Nurses would undergo continuous professional development about COVID-19 among the pediatric population and be equipped with appropriate knowledge and skills for utilization during the project. Specifically, nurses will be educators, counselors, and caregivers of the target population; hence will use the knowledge and skills gained to enhance the project’s success.

The plan for implementing the nursing practice intervention will also involve delivering health education messages to school-age children and their parents or caregivers during the education sessions. Nurses will use a guideline to help to deliver health messages. Educational sessions will include distributing educational resources to the target pedantic populations and their parents and issuing pamphlets and printed articles. The project team will consider the age and literacy level of the child to ensure effective communication and a full understanding of the content in the resources. Also, patient education will include technology such as videos and audio to help deliver relevant messages regarding different aspects of COVID-19 and its prevention.

The outcome measures will involve a change of knowledge about COVID-19 and its prevention among the pediatric population. Implementing the evidence-based interventions is expected to help reduce the virus transmission among school-age children. Therefore, the subsequent morbidity and mortality rates after the project implementation will include outcome measures to help determine the effect of the intervention. After the educational sessions and project, the evaluation of children will help determine the change in knowledge and skills compared to baseline information. Overall, the outcomes measures will help determine changes among the target population and the ultimate effect of the project.

Discussion of How Evidence-Based Practice Was Used in Creating the Intervention Plan

The EBP proposed in this project is an educational program for the pediatric population of school-aged children care in our healthcare facility and neighboring community. The overall goals of implementing the intervention will be to increase knowledge and skills for COVID-19 prevention and reduce the incidence rates of the disease. The intervention is evidence-based as studies recommended implementing educational programs as effective in improving the awareness and overall ability to protect self and others from the disease (Gray et al., 2020). The intervention strategy considers the roles of nurses, hospital leadership, parents, and caregivers to improve the outcomes of prevention efforts. Before implementing the educational programs and assessments on the target population, nurses will undergo professional development training to familiarize themselves with each project aspect.

The intervention plan will involve using guidelines to ensure that health education sessions deliver all appropriate messages for preventing transmission and disease development among pediatric patients. Besides audio and videos to help children learn about COVID-19, nurses will access guidelines to help them cover or address each aspect of prevention. The guidelines to be used have been drawn from the UNICEF recommendation on cleaning and supply to protect children in school and at home. The guideline highlights the need to communicate to the pediatric patients, caregivers, or parents using various print and electronic channels of communication

Nurses will deliver heath education of messages ranging from safety measures, hand and personal hygiene, respiratory etiquette, face masks, and social distance. Specifically, the guideline recommends teaching the role of school-age children in ensuring health and safety of self and others, hand washing with soap and running water, and contact with other people’s secretions such as saliva on shared cups, among others. The guideline will be a significant tool in promoting the acquisition of appropriate skills such as respiratory etiquette and hand washing. Nurses will demonstrate the practices and play videos on the appropriate performance of the practices.

The guideline considers the significance of adults such as parents, caregivers, teachers, and nurses who may supervise and help children adhere to the preventive measures. Therefore, nurses will emphasize the need for caregivers and parents to assist children in propagating the practices to ensure continued or sustained prevention. Each educational session will be tailored to the child’s age and ability to comprehend the content within learning materials. The project manager will monitor the implementation of interventions and completion of tasks to ensure they occurred within the estimated timeframes. Nurses and project managers will regularly meet each Thursday to review the progress and seek solutions for any arising challenges. The project team will share the EBP interventions with other care providers attending to the children to ensure continued support for the implementation process.

Plan for Evaluating the Proposed Nursing Intervention

The educational program evaluation on COVID-19 prevention will involve the administration of topic question reviews for children to determine their ability to recall or comprehend learned content. The project team will evaluate school-age children’s knowledge and skills as the immediate outcomes of the project implementation. A follow-up study would be necessary to evaluate the effects of health education among school-age children on the incidence of COVID-19. Therefore, the impact of the intervention on the incidence rates of the disease will be determined by reports of confirmed COVID-19 cases of school-age children brought for medical attention. During the study, suspected cases of children presenting with COVID-19 symptoms at the pediatric facility will require COVID-19 PCR tests to confirm or rule out.

Identification of Potential Barriers to Plan Implementation

According to Melnyk & Fineout-Overholt, (2019), the common barriers in an EBP change project include lack of EBP knowledge, an organizational culture steeped in tradition, negative attitudes towards EBP, lack of trust that EBP results in improved outcomes, resistance to change, lack of time, unavailability of resources and lack of support among others. The potential barriers to this project are resistance from some nurses and other healthcare professionals, misconceptions about the efficacy of EBP, mistrust about the intervention’s ability to improve practice, and lack of knowledge about EBP.

Discussion of How These Could Be Overcome

To overcome the barrier of misconception about evidence-based practice, the project manager will clarify these conceptions and impart the fundamentals of EBP, which are essential for developing evidence-based treatment. For instance, the search and critical appraisal of evaluating study reports is a laborious and time-consuming procedure. The project manager will clarify the use of databases such as The Cochrane Library and PubMed, which provide easy access to studies describing an aspect of COVID-19 and its prevention.

For care providers with mistrust of the importance of EBP, the project manager will use real-world examples where heath education on COVID-19 prevention outperformed care rooted in traditional practices. For instance, the project manager will use articles highlighting the efficacy of health education in improving the prevention of COVID-19 among children and other members of society (Gray et al., 2020). The change project will begin with assessing knowledge and skills of COVID-19 prevention among nurses to assess the status of EBP in the organization. The assessment will allow the project team to introduce the project to nurses and the care team. Another advantage of starting the EBP project with surveys is to enhance awareness about the new practice and ignite a change to proposed intervention among care providers Professional Capstone and Practicum Discussion .

Appendix Section

Educational Guidelines for Health Education Sessions

References

Andrejko, K. L., Head, J. R., Lewnard, J. A., & Remais, J. V. (2022). Longitudinal social contacts among school-aged children during the COVID-19 pandemic: the Bay Area Contacts among Kids (BACK) study. BMC infectious diseases, 22(1), 1-14. https://doi.org/10.1186/s12879-022-07218-4

Baxter, N., Crabb, B., Cole, K., Davidson, A., Pulver, L. J., Flanagan, J., & Veness, B. (2021). Protecting children from COVID-19 and making schools and childcare safer. https://ozsage.org/wp-content/uploads/2021/10/Children-and-schools1.pdf

Caini, S., Martinoli, C., La Vecchia, C., Raimondi, S., Bellerba, F., D’Ecclesiis, O., … & Gandini, S. (2022). SARS-CoV-2 Circulation in the School Setting: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 19(9), 5384. https://doi.org/10.3390/ijerph19095384

Gray, D. J., Kurscheid, J., Mationg, M. L., Williams, G. M., Gordon, C., Kelly, M., … & McManus, D. P. (2020). Health-education to prevent COVID-19 in schoolchildren: a call to action. Infectious diseases of poverty, 9(1), 1-3. https://doi.org/10.1186/s40249-020-00695-2

Hagabimana, A., Omolo, J., El-Khatib, Z., Rwagasore, E., Benemariya, N., Nsekuye, O., Kabeja, A., Balisanga, H., Umutoni, A., Musafili, A., & Ndagijimana, A. (2021). Baseline knowledge and attitudes on COVID-19 among hotels’ staff: A cross-sectional study in Kigali, Rwanda. PloS one, 16(12), e0261744. https://doi.org/10.1371/journal.pone.0261744

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127.

UNICEF (2020). Supplemental Content A: Cleaning and Supply Recommendations. Guidance for Covid-19 Prevention and Control in Schools. https://www.unicef.org/lac/media/12456/file

Wang, L., Sola, I., Enjuanes, L., & Zuñiga, S. (2021). MOV10 Helicase Interacts with Coronavirus Nucleocapsid Protein and Has Antiviral Activity. mBio, 12(5), e0131621. https://doi.org/10.1128/mBio.01316-21

Xue, F. X., & Shen, K. L. (2021). COVID-19 in children and the importance of COVID-19 vaccination. World Journal of Pediatrics, 17(5), 462-466. https://doi.org/10.1007/s12519-021-00466-5

Zar, H. J., Dawa, J., Fischer, G. B., & Castro-Rodriguez, J. A. (2020). Challenges of COVID-19 in children in low- and middle-income countries. Pediatric respiratory reviews, 35, 70–74. https://doi.org/10.1016/j.prrv.2020.06.016 Professional Capstone and Practicum Discussion