Capstone PICOT Research Paper: Example and Writing Guide

In this Capstone PICOT Research Paper assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background

2. Problem statement

3. Purpose of the change proposal

4. PICOT

5. Literature search strategy employed

6. Evaluation of the literature

7. Applicable change or nursing theory utilized

8. Proposed implementation plan with outcome measures

9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome

10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Also here example of how needs to be set up

Problem Identification

Problem Impact

Significance to Nursing

Literature Review

Theory

The theory can be either a nursing theory or borrowed theory. An example of a borrowed theory is a change theory or Adult learning theory. It is up to you

Implementation Plan

Proposed solution and rationale – be specific on what you are going to be doing. If doing education, be sure and have objectives and be specific as to the education. May want to put in an appendix

Methods for Approval and Resources – who, what, where and when on how approval for the project will occur

Barriers – all projects have barriers. Capstone PICOT Research Paper Example

Evaluation Plan

Methods: how will you obtain the outcomes listed in the PICOT. Who will gather the data, who will collate the data.

Dissemination Plan

Internal Stakeholders – how will you disseminate the plan to people within the organization. I would highly suggest that you include the bedside nurses

External Stakeholders – how will you provide the results outside of the organization. A lot of students go to large regulatory bodies, which is really not dissemination. How will you disseminate the results to other nurses? A poster presentation at a local conference is always a good idea.

Conclusion

References

Appendices

Appendix A must be the literature evaluation table (this table is completed I will attach in files)

Capstone PICOT Research Paper Example

Capstone PICOT Research Paper

Abstract

COPD is a chronic respiratory disease that is typified by the progressive limitation of the airflow and cannot be fully reversed and the 3 rd leading cause of readmissions in hospitals within the US. The readmission rate among COPD patients is relatively high and it increases morbidity and mortality, and healthcare costs as well. Risk factors to COPD readmission include low health literacy on how to manage the disease and medication devices such as inhalers and lack of information on the possible environmental irritants. The purpose of the proposed change is to educate patients on the correct use of inhalers and oxygen and also educate them about the possible environmental irritants that trigger exacerbations in patients with COPD in order to improve patient self-management skills and health literacy on how to use oxygen and inhalers and avoid environmental triggers after hospital discharge. Databases used during the literature search included PubMed, CINAHL, Wiley library, and Web of science and the Lowa model will be used to implement the change. The project is projected to take about 3-month to ensure full implementation. Potential barriers likely to hinder the implementation of the project include resistance from some of the nursing staff members to support the project due to time limitations and problems with accepting new ideas. Change champions and change agents will be used to educate the staff about the importance of the proposed change and convince them to support and embrace the project.

Capstone PICOT Research Paper

Background

COPD is a chronic respiratory disease that is typified by the progressive limitation of the airflow and cannot be fully reversed. According to Portillo et al., (2018) COPD is the 3 rd leading cause of readmissions in hospitals within the US. Acute exacerbations in COPD are associated with high morbidity and mortality rates which are major public health issues. A majority of patients with COPD and the associated exacerbations experienced a reduced quality of life, depressive symptoms, and some death, one year after hospital discharge (Shah et al., 2016). In the US, hospitalizations for acute exacerbation associated with COPD account for approximately $13.2 billion. The disturbing concern is that 1 in 5 patients with COPD is readmitted within 30 days after hospital discharge. The early and frequent readmissions increase both the morbidity and mortality rate among the patients and also leads to a significant economic burden. Risk factors associated with high readmission rates include low health literacy, long-term oxygen therapy, reduce the quality of life, socioeconomic status, worsening lung function, substance abuse, among other factors (Portillo et al., 2018). Therefore, it is necessary to conduct research regarding the appropriate interventions that can reduce the readmission.

Problem Statement

The readmission rate among COPD patients is relatively high. A high number of patients with COPD are readmitted in 30 days after hospital discharge. The readmission rate increases morbidity and mortality as well, and also significantly increases healthcare costs (Portillo et al., 2018). Risk factors such as low health literacy on how to manage the disease and medication devices such as inhalers, along with lack of information regarding the possible environmental irritants have been associated with preventable exacerbations in COPD. Portillo et al., (2018) explain that about 10% to 55% of readmissions in patients with COPD can be prevented. Furthermore, evidence indicates that the majority of patients with COPD do not know how to use their inhalers and hence they require evidence-based education to correct the misuse of the inhalers. In addition, patients with COPD need to be educated on how to avoid environmental stimuli that cause exacerbations in COPD.

Purpose of the Change Proposal

The purpose of the proposed change is to educate patients regarding the correct use of inhalers and oxygen and also educate them about the possible environmental irritants that trigger exacerbations in patients with COPD. Accordingly, the proposed change will improve patient self-management skills and improve health literacy on how to use oxygen and inhalers and avoid environmental triggers after hospital discharge. This will reduce the likely COPD exacerbations post-discharge and thus reduce the readmission rate for this patient population.

PICOT Question

In COPD patients (P), does patient education on correct inhaler and oxygen use together with the reduction in environmental stimuli (I) compared to no education/reduction of environmental stimuli (C) reduce hospital readmissions (O) over a period of six months (T)

Literature Search Strategy

A detailed and comprehensive literature search was carried out in order to identify suitable studies to be used in this research project. The search was conducted in various databases that are available electronically. The specific databases used during the literature search included PubMed, CINAHL, Wiley library, and Web of science. The comprehensive search was performed to ensure that an adequate number of high-quality research studies were located to answer the PICOT question (Grewal et al, 2016). In addition, a further search was also conducted in the university’s library. The list of references for all research articles retrieved was reviewed thoroughly to see if they met the inclusion criteria and were relevant to the study topic. The search in this study was carried out by breaking the PICOT question into various search terms Capstone PICOT Research Paper Example.

Evaluation of the Literature

The retrieved articles were evaluated according to the set inclusion and exclusion criteria. according to the inclusion criteria, only articles published after 2015 and in the English language were included in the study. In addition, only articles relevant to the study topic were included. The CASP tool was used to evaluate and appraise all studies that met the inclusion criteria. CASP tool ensured that only high-quality literature and robust evidence was included in the research project (Harrison et al., 2017).

The Change Model

The Lowa model will be used to implement the change. The first step involved selecting the topic for the change. The topic for the change was reducing the readmission rate for COPD patients using patient education on correct inhaler and oxygen use and reducing environmental stimuli. The research topic is a priority problem because of the high readmission rate for COPD patients and associated morbidity and mortality. The second step is to form a team whose responsibility will be to develop, implement and evaluate the change (Berwick, 2015). The third step involves a brainstorming session where the relevant evidence to be used is retrieved. The fourth step is to grade the evidence by evaluating and examining the quality of the retrieved evidence. this step ensures that the evidence and retrieved studies are latest and reliable (Pravikoff, et al, 2015). The next step in the Lowa model involves establishing recommendations for practice basing on the decisions from all the members of the team formed. Implementation of the proposed evidence-based practice while involving all the relevant stakeholders, then follows (Nutbeam, 2018). The last step of the Lowa model is to assess and impact of the implemented change. In this case, this step will involve assessing if the readmission rate among the COPD patients reduced after patient education and reduction of the environmental stimuli.

Proposed Implementation Plan with Outcome Measures

The project is projected to take about 3-month to ensure full implementation. The first step will involve sensitizing the relevant stakeholders and training nurses who will take part in educating patients during discharge regarding correct inhaler and oxygen use and reducing environmental stimuli. The resources that will be needed to ensure successful implementation of the project included human resources, as well as training materials and equipment, and the training venue. The trained nurses will then provide patient education to the admitted patients with COPD and their families, and especially during their discharge. The readmission rate before and post-project implementation will then be evaluated. After the project implementation, the pre and post-project implementation data will be entered into an excel spreadsheet to analyze and compare the readmission rate of patients with COPD before and after the implementation of the project.

Potential Barriers to Plan Implementation

The potential barriers likely to hinder the implementation of this research project include resistance from some of the nursing staff members to support the project due to time limitations and problems with accepting new ideas. The main reason behind this barrier is the high workload within the organization and therefore the nursing staff may lack the required time to attend the training sessions and providing comprehensive patient education to patients with COPD.

Barriers to effective implementation of the proposed change include using change champions and change agents within the organization. The change champions and agents will enlighten and emphasize to the staff members about the importance of providing patient education about the proper use of inhaler and oxygen and reduction of environmental stimuli in lowering the readmission rates among the patients with COPD. The change champions and agents will successfully change the attitudes of the staff members who might be resisting the change and thus there will be minimal resistance (Fischer et al., 2016). Another strategy to overcome this barrier is requesting the administration to provide an adequate number of the nursing staff to lower the workload and also ensure that adequate resources are allocated to this project in order to ensure the successful implementation of the project Capstone PICOT Research Paper Example.

References

Berwick DM (2015). Disseminating innovations in health care. JAMA , 289(15), 1969–75.

Fischer F, Lange K, Klose K, Greiner W & Kraemer A. (2016). Barriers and Strategies in Guideline Implementation—A Scoping Review. Healthcare (Basel), 4(3), 36.

Grewal, A., Kataria, H & Ira, D. (2016). A literature search for research planning and identification of research problem, Indian J Anaesth, 60(9), pp.635–639

Harrison, J., Quinn, T., Reid, J., and Shenkin, S. (2017). Using quality assessment tools to critically appraise aging research: a guide for clinicians. Age Ageing , 46(3), pp.359–365

Nutbeam D. (2018). Evaluating health promotion: progress, problems, and solutions. Health Promot Int . 13(1): 27–44

Pravikoff, D. S., Tanner, A. B., & Pierce, S. T. (2015). The readiness of U.S. nurses for evidence-based practice. American Journal of Nursing , 105(9). 40–51.

Portillo, E. C., Wilcox, A., Seckel, E., Margolis, A., Montgomery, J., Balasubramanian, P., … Kakumanu, S. (2018). Reducing COPD Readmission Rates: Using a COPD Care Service During Care Transitions. Federal practitioner: for the health care professionals of the VA, DoD, and PHS , 35 (11), 30–36.

Shah, T., Press, V. G., Huisingh-Scheetz, M., & White, S. R. (2016). COPD Readmissions: Addressing COPD in the Era of Value-based Health Care. Chest , 150 (4), 916–926 Capstone PICOT Research Paper Example . doi:10.1016/j.chest.2016.05.002.