For this project, I am supposed to pick a problem that affects a unit where I work, and state how this problem affects nursing using 2 articles. I work on a spinal cord injury unit so I decided to talk about DVTs. I have to write a paper that is 4 Pages long and create an electronic poster for the 5th page. please let me know if you have any other questions. 

Article 1:


STOPDVTs: Development and testing of a clinical assessment
tool to guide nursing assessment of postoperative patients for
Deep Vein Thrombosis

Alanna O’Brien BN, MN, Director Clinical Nursing Education1 | Bernice Redley PhD, BN,

Associate Professor Nursing Research2,3 | Beverley Wood PhD, BN, Research

Fellow1,2 | Mari Botti PhD, BN, Chair in Nursing1,2 | Anastasia F Hutchinson PhD, BN,

Associate Professor of Nursing Research1,2

1Centre for Quality and Patient Safety

Research-Epworth HealthCare Partnership,

Deakin University, Geelong, Vic., Australia

2School of Nursing and Midwifery, Deakin

University, Geelong, Vic., Australia

3Centre for Quality and Patient Safety

Research-Monash Health Partnership,

Monash Health, Deakin University, Clayton,

Vic., Australia


Anastasia F. Hutchinson, Anastasia School

of Nursing and Midwifery and Centre for

Quality and Patient Safety Research

Epworth HealthCare partnership, Geelong,

Vic., Australia.

Email: [email protected]

Aims and objectives: To develop and test a clinical tool to guide nurses’ assessment

of postoperative patients for Deep Vein Thrombosis.

Background: Preventing venous thromboembolism in hospitalised patients is an

international patient safety priority. Despite high-level evidence for optimal venous

thromboembolism prophylaxis, implementation is inconsistent and the incidence of

Deep Vein Thrombosis remains high.

Methods: A two-stage sequential multi-method design was used. In stage 1, the

STOPDVTs tool was developed using a review of the literature and focus groups

with local clinical experts. Stage 2 involved pilot testing the tool with 38 surgical

nurses who conducted repeated assessments on a prospective sample of 50 postop-

erative orthopaedic patients.

Results: Stage 1: The focus group members who were members of the nursing lead-

ership team agreed on eight local and systemic signs and symptoms that should be

included in a nursing patient assessment tool for early Deep Vein Thrombosis. Local

symptoms were pain in the limbs, calf swelling and tightness, changes in the affected

limb’s skin temperature. Systemic signs included in the tool were as follows: increased

shortness of breath, increased respiratory and heart rates, and decreased oxygen satu-

ration. Stage 2: The STOPDVTs tool had acceptable face and content validity, the

agreement between the expert nurse and surgical nurses on assessments of individual

signs and symptoms varied between 44%–94%.

CAP Instructions and Rubric

:  The Clinical Application Project (CAP) is an opportunity for the BSN student to identify an issue, topic, or challenge that is relevant to their Role Transition clinical placement. The student will examine the research related to their topic and investigate the literature regarding a potential solution for, or intervention to improve, the issue. The student then creates a final project, intervention, or solution to their identified topic. They will present their work in a professional paper and electronic poster.

Step-by-step directions

1. Identify a problem, issue, concern, or area for improvement relevant to your clinical setting.

2. Educate yourself about the importance of your topic to nursing and your particular clinical placement. Whenever possible, you will want to include facts, statistics etc. relevant to your

3. Critically analyze the literature related to the area of concern.

4. Identify possible solutions to the selected area of concern, based on the evidence in the literature.

5. Review each for its strengths, weaknesses, and feasibility.

6. Select one solution.

7. Engage in the necessary work for this quality improvement project (e.g., develop a new form and identify approvals required for its use). Although students may not have enough time to actually implement their entire project or quality improvement activity, the final work product should clearly outline the plan for implementation, including a timeline. Students will provide evidence of their work by submitting the product of their (e.g., educational program outline, instructional pamphlet, nursing form, pocket resource, new policy, patient or family focused education, etc.)

The student will create an electronic poster which visually represents the clinical application project. The e-poster displays similar components as the paper, but in a very concise and visually pleasing design. Further guidelines and instructions for the e-poster are included in the document entitled “e-Poster Creation”.

The final paper and electronic poster are graded according to the specifics contained in the following grading rubric.

CAP Instructions and Rubric

Grading criteria for PAPER




· Introduces topic and provides overview of the issue (2 pts.)

· Discusses why this issue is pertinent to the particular unit/organization and what led student to choose the topic (2 pts.)

· Identifies unit, manager, etc. support for the project (1 pt.)

· Identifies how the project will specifically benefit the unit/organization (2 pts.)



This sample paper gives students an idea of how to address the content of the CAP. Please be sure to focus on the content and not the formatting. This paper has not been updated to reflect the 7th edition APA rules! See side notes in the margins.

Family-Centered Communication in Day Surgery

Three Quality of Care key drivers for Our Lady of the Resurrection (OLR) Medical Center’s Surgical Services department are measured quarterly. The Surgical Services Department has met or exceeded targets for two of the three key drivers. However, for the past six months, the department has not met the goal for a third key driver: explanations provided about progress following surgery. Meeting the goal for the third key driver is dependent on effective communication processes from staff and surgeons to patients and their families. A communication process exists, but by looking at areas in which the process is broken, relatively easy and effective fixes can be put into place. Comment by Carina Piccinini: Topic introduction, overview of issue, choice of topic.

The charge nurse for preoperative and recovery care has identified difficulty in adhering to the current process due to difficulty in locating family members if they leave the waiting room and due to the volume and acuity of patients that enter the recovery area. The nurse manager has also identified meeting the third key driver as a priority for the institution and supports the project. Comment by Carina Piccinini: Pertinence of issue to the unit and preceptor and unit manager buy-in

Increasing patient satisfaction—and thereby increasing the likelihood of returning to the facility for healthcare needs—can benefit the unit and the organization by increasing revenues. The profession of nursing can also benefit by increasing staff and improving technologies for patient care with additional revenues. Comment by Carina Piccinini: Benefit to the unit/organization

Literature Review of Problem

Much research on factors influencing patient satisfaction in perioperative care has been conducted. A driving factor identified is communication to patients and families during care.

Yellen (2003) surveyed ambulatory surgery patients to determine the influence of the nurse-sensitive variables of age, gender, culture, previous hospital admissions, nurse communication, pain, and satisfaction with pain management on overall patient satisfaction. Results showed that nurse communication was the most significant indicator of patient satisfaction, and satisfaction with pain management was the second most significant indicator. Furthermore, patients who were satisfied with nurse communication also reported satisfaction with pain management.

Fry and Warren (2005) condu

Gestational Diabetes Mellitus: Interventions for Hispanic/Latina Pregnant Women

Luis A. Gutierrez


Resurrection University, NUR 4642: Role Transition


Gestational Diabetes Mellitus (GDM) impacts 2%-10% of all pregnancies in the United States every year (Center for Disease Control and Prevention, 2017).

Per care team, PSMEMC has experienced an influx of Hispanic/Latina pregnant women diagnosed with GDM.

Language barrier is the biggest obstacle with patient education. Staff members reported that Spanish speaking resources for GDM and nutritional education are scarce.

Community background

The racial disparities seen in GDM directly impacts St. Mary’s and Elizabeth Medical Center due to the physical location of the hospital. St. Mary’s and Elizabeth Medical Center is located near the Humboldt Park neighborhood.

Literature Review


Cultural/linguistic barriers. Carolan-Olah et al. (2017) identify that language is one of the barriers understanding the impact that GDM could have on the mother’s health as well as the newborns. In addition, cultural food selection greatly increases the risk for developing GDM for Spanish speaking mothers.

Lack of activity and poor dietary selections. Chasan-Taber (2012) identifies that there is a higher likelihood for gestational diabetes and macrosomia to develop in Latinas who are obese.


Linguistic adaptation. Schellinger et al. (2017) demonstrate that Hispanic/Latina pregnant women participating in a group care model offered in Spanish showed indicators of effective education and implementation regarding GDM and pregnancy.

Cultural background, socioeconomic status and nutrition. Rhoads-Baeza and Reiz (2012) determine that the relevancy of the dietary recommendations provided to women, incorporating cultural factors, contributed and facilitated the success of interventions addressing Hispanic/Latina pregnant women.


An educational group program will be implemented at the St. Mary’s and St. Elizabeth’s OB unit.

The educational group program will provide:

Access professionals in Spanish.

Education and information on reducing their risk for GDM.

Space and support for women to learn healthy diet options that are culturally and linguistically relevant.



Women at risks for GDM will be referred to group by PSMEMC OB Clinic


Group will receive psychoeducation on GDM

Participants will be taught to test and measure glucose levels independently

Utilizing food journals to track meals and generate discussion around their current dietary practices