HS499 Unit 9 Capstone Project Draft Example

Built to Be Read Before It Is Finished: A Unit 9 Capstone Project Draft on Night Lift Use at a 120-Bed Nursing Home

[Student Name]

Purdue University Global

HS499: Bachelor's Capstone in Health Science

Unit 9 Capstone Project Draft

[Instructor Name]

[Date]

Brookmere Care Center, its residents, staff, costs and every figure are composite; the sources cited are real.

Draft Status

Version 0.9, prepared for instructor review. Open items: (1) the laundry service's quote for scheduled sling washing, expected next week; (2) the director of nursing's confirmation that lifts may be parked on halls under the fire code; (3) whether the night resource role can be filled from existing staff on all four halls. Each is marked where it appears in the text.

Summary

At Brookmere Care Center, 41 residents have mechanical full-body transfer written into their plans, yet most of their evening and night transfers happen by hand. Across the last twenty-four months, thirty-one of the forty-four handling injuries among nursing assistants occurred on those shifts. A needs assessment found the largest gaps were access, with lifts locked away after 9 p.m. and six minutes to fetch, and slings, with 22 slings for 41 residents and many in the laundry. The draft recommends a one-hall pilot of evening lift staging, a sling for every lift resident, a written rule on mechanical transfers and a trained night resource person, at a first-year cost of about 4,300 dollars plus a laundry charge still to be confirmed.

Chapter 1: Problem and Scope

The capstone studies manual transfers of lift-dependent residents during the later two shifts at one 120-bed nursing home. It excludes sit-to-stand transfers, falls prevention and staffing levels. The problem matters because manual full-body transfers exceed the weight considered safe to lift by hand in almost any technique (Waters, 2007).

Chapter 2: Evidence

The synthesis found four things. Programs combining equipment, a policy limiting manual lifting and training reduce caregiver injuries (Collins et al., 2004; Teeple et al., 2017). Hand transfers of fully dependent residents load caregivers beyond accepted limits. Owning lifts protects nobody unless staff actually reach for them (Lee et al., 2013). And evidence on resident outcomes is uncertain. No study reported results for night shifts in small facilities, the gap this capstone addresses.

Chapter 3: Local Assessment

Five data sources were used: the injury log, a three-night inventory, timed walks, care plan review and an anonymous staff survey with a 62 percent return. The two-week tally showed lift use for full-body transfers at 86 percent on days, 41 percent on evenings and 22 percent on nights. The survey and the inventory disagreed about sling availability; the physical count is preferred over the survey's impressions. Gaps were ranked by how directly each explains manual transfers at night and whether it can be closed in a pilot.

Chapter 4: Recommendation

The recommendation is a twelve-week pilot on one long-stay hall: park a full-body lift on the hall from 3:00 p.m.; give each lift resident on the hall a correctly sized sling stored in the room; adopt a written rule that these residents are transferred mechanically; and name one already-scheduled assistant per later shift as the trained go-to person. A larger plan with new lifts and a night lift team was considered and rejected because it did not address access and exceeded night staffing.

The recommendation spends least on equipment and most on putting existing equipment where night staff can reach it.

Chapter 5: Implementation

Week 1: train evening and night staff on the hall in the staging rule and sling storage. Weeks 1 to 12: run the pilot, with the night resource person checking lift placement at shift start. Week 6: midpoint review with the quality committee. The director of nursing owns the pilot; the environmental services manager owns sling laundering.

Chapter 6: Evaluation

Success will be judged mainly by the proportion of full-body transfers after 3 p.m. done with a lift, from lift usage counters checked against a sample of a transfer log. A balancing measure tracks call light response times, which could lengthen if staff take more time per transfer. Injuries are tracked but are too few for a twelve-week comparison. Reporting follows improvement guidelines (Ogrinc et al., 2016).

Chapter 7: Limitations

The capstone studies one facility; the tally relied on charge nurse observation; and the pilot covers one hall. Reviewer question flagged here: is a single hall enough to persuade the committee to expand?

Chapter 8: Reflection on the Process

The capstone changed direction twice. The first change came in Unit 1, when an interest in burnout shrank to full-body transfers in the evening and overnight because the injury log pointed there. The second came in the seminar, when a large recommendation built around new lifts and a night team shrank to a staging rule and slings once classmates priced it against seven night staff. Both changes made the project smaller and, I think, more useful. A reader of this draft should be able to see that the recommendation is not what I expected to propose at the start, and that the evidence, not my first instinct, decided it.

Chapter 8b: Budget Detail

The pilot's direct cost is eleven slings for Hall B at about 95 dollars each, roughly 1,045 dollars, plus a laundry charge confirmed after this draft at 160 dollars for twelve weeks. A full rollout across four halls would add slings for the remaining 30 lift residents and spare slings for each size, about 3,250 dollars, bringing first-year cost to about 4,300 dollars. No new equipment or positions are included. Against this, a single lost-time injury at Brookmere last year cost an average of about 9,000 dollars in workers' compensation and overtime.

Chapter 9: What the Committee Would Need to Decide

The quality committee would need to decide three things: whether to charter the pilot, which hall to use, and who owns it. The draft proposes Hall B, which has the most lift residents, and the director of nursing as owner. It also proposes that the committee agree in advance what result at week thirteen would justify extending the change to all halls: lift use on evening and night shifts above 70 percent, no increase in call light response times, and no lift damage attributable to parking.

Reconciliation Note

Figures were reconciled across chapters. The resident count is 41 throughout; the injury count over two years is 44, of which 31 were on evening or night shifts, and the earlier twelve-month figure of 23, with 17 on those shifts, appears only in the problem statement where its period is stated.

References

Collins, J. W., Wolf, L., Bell, J., & Evanoff, B. (2004). An evaluation of a "best practices" musculoskeletal injury prevention program in nursing homes. Injury Prevention, 10(4), 206-211. https://doi.org/10.1136/ip.2004.005595

Lee, S.-J., Faucett, J., Gillen, M., & Krause, N. (2013). Musculoskeletal pain among critical-care nurses by availability and use of patient lifting equipment: An analysis of cross-sectional survey data. International Journal of Nursing Studies, 50(12), 1648-1657. https://doi.org/10.1016/j.ijnurstu.2013.03.010

Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2016). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. BMJ Quality & Safety, 25(12), 986-992. https://doi.org/10.1136/bmjqs-2015-004411

Teeple, E., Collins, J. E., Shrestha, S., Dennerlein, J. T., Losina, E., & Katz, J. N. (2017). Outcomes of safe patient handling and mobilization programs: A meta-analysis. Work, 58(2), 173-184. https://doi.org/10.3233/WOR-172608

Waters, T. R. (2007). When is it safe to manually lift a patient? American Journal of Nursing, 107(8), 53-58. https://doi.org/10.1097/01.NAJ.0000282296.18688.b1