Nursing students undertaking a quality improvement (QI) capstone project will go through several key steps as they design and implement their project. The overall goal is for students to apply QI concepts and methods to address an identified issue within a healthcare organization and work to enhance patient care and outcomes.

The first major step is for the student to select an appropriate clinical site where they will conduct their project. This is usually a healthcare facility where they have done clinical rotations, allowing them to have connections and insight into opportunities for improvement. The site preceptor, often a nurse manager or director, will act as a mentor and approve the selected project topic.

With approval from the clinical site secured, the student then needs to conduct an initial assessment to identify the specific focus area for their QI project. This involves gathering background information on the issue through various means such as reviewing pertinent studies, collecting organizational data, interviewing staff, and directly observing operations. Through this assessment, the student aims to gain a comprehensive understanding of the existing problem, its causes and impacts.

Once the focus area is identified, the student develops a PICOT (Population, Intervention, Comparison, Outcome, Time) question to help guide their project. This clearly defines the specific patient population, describes the proposed intervention, compares it to current practices, outlines the expected outcomes, and establishes a timeline. Development of the PICOT question is an important step to ensure the project scope remains focused and measurable.

With the PICOT question finalized, the student then performs an extensive literature review. They search multiple databases and sources to find the most current evidence and best practices related to their project topic. This research helps the student determine the most appropriate evidence-based intervention strategies to implement and how similar initiatives were planned and evaluated.

After completing the assessment and literature review phases, the student develops a project proposal. This formal document outlines the identified problem and need for the project. It presents background research, discusses the PICOT question, describes the planned intervention methods, identifies measures and tools for data collection/analysis, covers the projected timeline, and addresses potential barriers and ethical considerations. Stakeholder buy-in is important, so the proposal is reviewed by faculty and site preceptor for approval before moving forward.

With all preliminary work approved, the student implements their planned intervention over 8-12 weeks. This often entails facilitating staff training, developing new protocols or tools, providing patient education, conducting small testing of changes (PDSA cycles), monitoring compliance and collecting outcome data through tools such as chart audits or surveys. Throughout implementation, the student works closely with their site preceptor and communicates regularly with their faculty advisor.

As the project timeline nears completion, the student shifts focus to evaluation. They analyze all data collected during the implementation phase using appropriate statistical methods. Comparisons are made between baseline measures assessed during initial problem identification and current outcomes after intervention to determine the overall impact. Documentation also includes details around facilitators and barriers encountered, lessons learned, and sustainability planning.

The final step is disseminating the project results through a scholarly written report and oral presentation. For the paper, all aspects of the project from start to finish are thoroughly described including assessment, literature review, development, implementation, evaluation and conclusions. Presentations allow the student to verbally share their experience, findings and recommendations with faculty, site administrators, and other students. Feedback incorporated helps strengthen professional development.

The comprehensive quality improvement capstone provides nursing students the opportunity to apply evidence-based practice change management skills within a real-world clinical setting. By following this systematic process, students work to resolve an identified patient care issue through planning, implementing, and evaluating an evidence-based intervention project. The experience aims to foster leadership and improvement competencies integral for advancing the nursing profession.