NURS 499 Capstone Project Progress Report #1
Introduction/Overview
The focus of capstone project will consist of health promotion efforts in older adults with hypertension (HTN) at Catherine Sheridan Senior Center. Older adults aged 60 years and older are at risk of developing hypertension due to the normal physiological changes that occurs with aging. HTN makes them more susceptible to adverse cardiovascular outcomes heart failure, myocardial infarction and stroke leading to poor quality of life or mortality. “Approximately 60% of the US population has HTN by 60 years of age” (Oliveros et al., 2020). As one of the vulnerable populations in the society, the capstone project aims to promote heart health by providing teaching to the older adult clients of the senior center regarding the current recommendations to manage hypertension. Teaching is reinforced and sustained by making the valuable information accessible to all the clients through integration in facility’s activities, distribution of brochures and placement of posters in rooms where the clients gather.
Goals for project development and implementation within the two-week period:
Identify and validate the need for the project through the input of stakeholders and gathering of data (Harris et al., 2020, p. 5-6)
Determine how the project will change the work environment and workflow of the facility and identify approval or support for the project and readiness for change (p. 6)
Identify possible problems and risk in implementing the project (p. 7)
Progress Goal #1: After the two-week period, a need for a health promotion activity with emphasis on older adults with HTN has been identified as a priority. It has been validated through the input of the site’s program manager based on the prevalence of HTN among their clients. Interaction with 21 clients during blood pressure monitoring activity revealed that most them have HTN. However, more data is needed to meet this goal such as identifying if there are any prior related projects implemented and their effectiveness or sustainability. Gaining insights from other members such as the case manager or transportation coordinator will be valuable in achieving this goal.
Progress Goal #2: After the two-week period, it has been determined that integration of the project in the weekly activities of the clients are feasible and will not significantly alter the work environment and work flow of the facility. The facility has ample space and resources that can be utilized in implementing the project. The program manager is accepting and accommodating to the idea of the project.
Progress Goal #3: Possible challenges identified include changes in the mandates surrounding the opening of senior centers due to COVID-19 that can alter the project plan and language translation strategies needed to disseminate information since Spanish is the dominant language of the clients.
Challenges
Reaching to a consensus on the project has been a struggle as the needs are conflicting by personal interest and about which problem to tackle first. To overcome this conflict, the technique used is to rank order them by engaging others as collective input and support are essential in the success of the project. Prioritizing the need that necessitates rapid response is utilized (p. 6-7). The organization mission, mindset, principles, behavior, culture and infrastructure were also considered (p. 5). Language barrier is a challenge during interaction with clients but assistance of the facility’s travel coordinator has been helpful in the communication process.
Utilization of Coaching/Mentoring
The constructive feedback of the clinical instructor helped in focusing for the feasibility of the project and being sensitive to the diverse cultural backgrounds. The compliments of the clinical instructor on the creative ideas presented to implement the project are motivating and empowering and demonstrates the progress in the project development process. One-to-one interaction with the site manager in identifying development opportunities, reaching a mutually agreed project and expressing support and guidance exemplifies effective coaching (Roussel, Thomas & Harris, 2020, p. 67).
Capstone Project Plan Progress
The project plan is progressing as anticipated. The problem that supports the need for the project has been identified and validated. The strengths, weaknesses, opportunities and threats (SWOT) are assessed. On the other hand, strategies need to be developed to address the identified challenges in implementing the project (p. 6-7). A project budget needs to be established including cost-benefit analysis and return of investment (p. 7). Resources, tools and workforce required to implement the project need to be clearly laid out.
Leadership Lessons Learned
Creative and committed staff are considered as the most important assets and transformational leaders have roles in cultivating these. Transformational leadership does not control constituents through exercise of power rather, empower the members to take action. Transformational leaders consider the values and needs of staff and encourage engagement through shared leadership (Roussel et al., 2020, p. 29). This is consistent with the results of a systematic review regarding the relationship of leadership style and nurses’ job satisfaction which revealed that nurses are more efficient and strive to achieve goals when transformational leadership style is adopted (Specchia et al., 2021).
Outcomes Achieved
Active participation and support from the site manager and other team members in the implementation of the project
Increased awareness on health promotion activity as evidenced by increased participation of clients in blood pressure monitoring activity.
Inclusion of blood pressure monitoring activity in the weekly agenda of the facility.
Clinical Hours
Over the past 2 weeks, a total of 8 clinical hours and 2 hours allotted to research were achieved. Activities carried out include one-to-one interaction with the site manager, assessment of the environment, blood pressure monitoring activity and patient teaching regarding importance of adherence to medication regimen, routine PCP visits and lifestyle modifications including diet, exercise and stress reduction activities.
References
Harris, J., Roussel, L., Dearman, C. and Thomas, P. (2020). Project Planning and Management 3rd Edition. Jones & Bartlett Learning, LLC.
Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical cardiology, 43(2), 99–107. https://doi.org/10.1002/clc.23303
Roussel, L., Thomas P. & Harris, J. (2020). Management and leadership for nurse administrators (8th Edition). Sudbury, Mass: Jones and Bartlett Publishers.
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review. International Journal of Environmental Research and Public Health, 18(4), 1552–. https://doi.org/10.3390/ijerph18041552