NURS 499 Capstone Project Progress Report #2
Introduction/Overview
Goals for project development and implementation within the two-week period:
Identify any previous implementation of project related to prevention and management of hypertension in older adults including its effectiveness and sustainability (Harris et al., 2020, p. 5-6)
Gather data on the prevalence of hypertension among the members of the senior center and the community using facility records, interviews and public records (p. 143)
Formulate strategies to address possible risks or problems identified in implementing the project (p.7)
Progress Goal #1: According to Ms. Ortiz (Program Manager) and Ms. Rojas (Case Manager), there we no previous or current projects or initiatives in terms of prevention and management of hypertension in older adults. This is an excellent opportunity to introduce such project to establish change within the organization.
Progress Goal #2: This is supported by the data from Community Health Profiles 2018 of Jackson Heights. 24% of the population in this area are ages 45-64 and 12% are more than 65 years old. According to the report, 29% of adults in the community have hypertension.
Progress Goal #3: In the event that the senior center closes due to COVID-19, project will be implemented virtually through social media or communication platforms such as Zoom and Facebook or through phone call to accommodate clients who are unable to use such platforms. To address language interpretation or translation, Ms. Ospino (Transport Coordinator) will provide assistance in Spanish. For all other languages, the facility implements Language Access Plan which provides language assistance telephonic services through LanguageLine Solutions at no cost.
Challenges
Time limitations and fear of interrupting work of the facility personnel to assist with data gathering were found to be challenging. They are constantly assisting clients on their various needs which are the priorities. The first week was busy for them as they are handing green market vouchers/coupon to clients which they mentioned happens only once a year.
Utilization of Coaching/Mentoring
Coaching/Mentoring was demonstrated during discussion on the possible ways to implement project such as handing of brochures/pamphlets, putting up information corners with posters in areas of gathering such as the activities room and TV room and integration of information on their weekly BINGO game. Also, this created an opportunity to educate them regarding current recommendations of hypertension management. Listening and real-time feedback demonstrated partnership and maximized the potential of all stakeholders to achieve and sustain change (Roussel, Thomas & Harris, 2020, p. 67).
Capstone Project Plan Progress
Within the two-week period, the project plan is progressing as expected. Needs assessment remains ongoing as it is “a project in itself” (p.138). It is a crucial element of project planning and requires thoughtful and informed completion. It has to observe IOM’s six specific aims and observable metrics: safety, effectiveness, efficiency, timely, patient-centered and equitable (p. 139).
Leadership Lessons Learned
Leadership lessons reinforced within this two-week period is that a leader’s commitment can translate into fulfillment. Dedication to make a change and take action reflects on the way a leader presents him/herself with compassion and empathy. This serves as a driving force to all stakeholders to participate and sustain the improvement project.
Outcomes Achieved
Clinical Hours
Over the past 2 weeks, a total of 10 clinical hours and 4 hours allotted to research were achieved. Activities carried out include team discussion, ongoing needs assessment, 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
Communication and Change Plan
Change Theory
Understanding that a change is needed is the emphasis of Lewin’s Change Framework. Actions to initiate change and its success involve active participation of key stakeholders and integrating to the organization’s norms, culture, practices and policies. It is a three-step model. Stage 1 is known as Unfreezing involving readiness to change emphasizing status quo is ineffective and can be improved. Stage 2 is known as Moving or the process of initiating change facilitated by research, learning, group dynamics and support. Refreezing is the final stage wherein establishing the change requires personnel or the system integration (Batras, Duff & Smith, 2016).
II. 3 Major Barriers to Implementing Change
Robust data needed to validate the need for capstone project to facilitate understanding and readiness for change of the staff
Resistance to change
Sustainability of change
III. Strategies to Implement Change
Transparency
Communication
Active Participation of the Staff
Positive reinforcement and recognition of efforts
IV. Activities to Implement the Capstone Project
Stage 1: Refreezing- Open discussion about the need to implement a project to manage hypertension among the members of the senior center
Stage 2: Moving- Encouraging active involvement of the staff in decision-making and planning through feedback, reflection and support. Leveraging on their skills and strengths of the organization.
Stage 3: Unfreezing- Integrating change seamlessly in their routine guided by the organization’s mission and values
V. Communication and Approval
Planning and implementation of change is mainly communicated and approval lies with the program manager Mariana Ortiz. Case manager Carmen Rojas and Transport Coordinator Janeth will also be informed.
References
Batras, D., Duff, C. and Smith, B. (2016). Organizational change theory: implications for health promotion practice. Health Promotion International, Volume 31, Issue 1, March 2016, Pages 231–241, https://doi.org/10.1093/heapro/dau098
Harris, J., Roussel, L., Dearman, C. and Thomas, P. (2020). Project Planning and Management 3rd Edition. Jones & Bartlett Learning, LLC.
Hinterland K, Naidoo M, King L, Lewin V, Myerson G, Noumbissi B, Woodward M, Gould LH, Gwynn RC, Barbot O, Bassett MT. Community Health Profiles 2018, Queens Community District 3: Jackson Heights; 2018; 45(59):1-20.
Roussel, L., Thomas P. & Harris, J. (2020). Management and leadership for nurse administrators (8th Edition). Sudbury, Mass: Jones and Bartlett Publishers.