NURS 4220: Leadership Competencies in Nursing and Healthcare

Week 5 Capstone Paper Part II – Quality Improvement Project Plan

Course and Assessment

Course code/title: NURS 4220 – Leadership Competencies in Nursing and Healthcare (BSN capstone/practicum core)
Program level: BSN completion QI project format)
Assessment label: Week 5 Assignment – Capstone Paper Part II: EBP QI Plan and Resources (Capstone Project Milestone 2)
Assessment type: Individual written quality improvement project proposal
Length requirement: 3–4 page paper (approximately 1,000–1,400 words), excluding title page, references, and appendices
Weighting: 25–30% of course grade
Submission format: APA 7th edition paper with clearly labeled QI plan sections; LMS submission

Assignment Overview

The NURS 4220 capstone sequence builds toward a comprehensive quality improvement project. Part II focuses specifically on evidence-based interventions and the resources required for implementation. Students propose a realistic quality improvement initiative that addresses a clinical or organizational problem identified in Part I. The assignment emphasizes leadership competencies including systems thinking, interprofessional collaboration, ethical decision-making, and change management within complex healthcare environments.

Learning Outcomes

Upon successful completion of this assignment, students will be able to:

Develop an evidence-based quality improvement plan using recognized improvement models such as PDSA, DMAIC, or Lean.
Identify and justify human, financial, technological, and material resources required for implementation.
Demonstrate leadership competencies in planning organizational change that improves patient safety or quality outcomes.
Articulate measurable outcomes and describe evaluation strategies aligned with quality improvement standards.

Project Context

The Week 5 paper builds directly on the practice problem identified in Weeks 2–3. Examples include:

Reducing hospital-acquired pressure injuries
Improving medication reconciliation accuracy
Enhancing hand hygiene compliance
Reducing patient falls on a medical-surgical unit

If a specific issue was not previously assigned, students may select a realistic unit-level issue from their practicum site.

Example Practice Problem

A medical-surgical unit reports a high rate of patient falls, currently 12 falls per 1,000 patient days, exceeding national safety benchmarks.

Task Instructions

Write a 3–4 page APA-formatted paper using the required headings below. Support all sections with current scholarly evidence from leadership and quality improvement literature.

Evidence-Based Practice Quality Improvement Plan Explanation (2–3 Paragraphs)

Clearly describe the proposed QI intervention or interventions, grounded in 3–5 recent scholarly studies or professional guidelines.
Identify the selected QI framework, such as the Plan–Do–Study–Act cycle, and outline implementation steps, timeline, and involved stakeholders.
Discuss anticipated barriers, such as staff resistance, workflow disruption, or resource limitations, and present mitigation strategies that demonstrate leadership foresight.

Project Resources (1–2 Paragraphs)

Identify and justify the resources necessary for implementation, including:

Human resources: Registered nurses, nurse aides, nurse educators, unit champions, interdisciplinary team members.
Material resources: Educational materials, signage, checklists, technology supports.
Financial resources: Budget allocations, staff education time, shift differentials.
Informational resources: Electronic health record tools, audit systems, reporting dashboards.

Explain why each resource is essential and provide estimated cost considerations or availability factors where appropriate.

Expected Outcomes and Evaluation (1 Paragraph)

Define two to three SMART outcomes. For example, a 30 percent reduction in falls within three months.
Describe data collection methods such as incident reports, EHR audits, rounding logs, or compliance checklists.
Explain the evaluation plan using tools such as run charts, trend analysis, or comparative benchmarks.

Personal Leadership Reflection (Short Paragraph)

Reflect on how the project demonstrates two to three leadership competencies addressed in the course, such as collaboration, advocacy, systems thinking, or change management. Provide a concise example of how you would lead stakeholders through implementation.

Formatting and Academic Integrity

Length: 3–4 pages of main content.
References: 5–7 scholarly sources published between 2018 and 2026.
APA 7th edition formatting required.
Appendices: Optional QI flowchart or implementation timeline.
Originality: The project must be site-specific or realistically applicable, with accurate citation of all sources.

Analytic Scoring Rubric – Capstone Paper Part II

Evaluation criteria include problem relevance, strength of evidence, feasibility of the plan, justification of resources, clarity of outcomes, leadership insight, and scholarly writing quality.

QI Plan Explanation (40 Points)

Exemplary (36–40): Strong evidence base, clearly articulated QI model, detailed timeline and stakeholder engagement, insightful barrier analysis.
Proficient (32–35): Solid plan supported by appropriate evidence with minor gaps.
Developing (28–31): Feasible plan but limited evidence or vague implementation steps.
Needs Improvement (27 or below): Unrealistic or unsupported plan.

Project Resources (25 Points)

Exemplary (23–25): Comprehensive, categorized, and realistic resources with strong justification and cost awareness.
Proficient (20–22): Adequate resource identification with rationale.
Developing (17–19): Incomplete or vaguely described resources.
Needs Improvement (16 or below): Minimal or unrealistic planning.

Outcomes and Evaluation (15 Points)

Exemplary (14–15): Clearly defined SMART outcomes with robust evaluation methods.
Proficient (12–13): Measurable outcomes with basic evaluation strategy.
Developing (10–11): Measurable outcomes but weak evaluation plan.
Needs Improvement (9 or below): Outcomes unclear or absent.

Leadership Reflection (10 Points)

Exemplary (9–10): Insightful and specific linkage to course competencies.
Proficient (8): Relevant but general reflection.
Developing (7): Limited insight.
Needs Improvement (6 or below): Superficial or missing.

Scholarly Writing and APA (10 Points)

Exemplary (9–10): Clear, polished academic writing with accurate APA formatting.
Proficient (8): Minor APA or clarity issues.
Developing (7): Noticeable writing or formatting errors.
Needs Improvement (6 or below): Major academic writing flaws.

Sample Discussion Guide

Effective quality improvement initiatives in nursing leadership require structured implementation models, interdisciplinary collaboration, and rigorous outcome evaluation to ensure sustainability within complex healthcare systems. The Plan–Do–Study–Act framework provides a systematic method for testing changes on a small scale before wider adoption, thereby reducing organizational risk and increasing stakeholder engagement. Empirical evidence demonstrates that purposeful rounding and structured safety interventions significantly reduce fall rates when compliance is consistently monitored and reinforced through leadership accountability mechanisms (Todd, Cash and Gonzalez, 2022). Integrating evidence-based strategies with leadership competencies such as communication, change management, and systems thinking strengthens both patient safety outcomes and team cohesion across clinical settings.

Scholarly References

Institute for Healthcare Improvement, 2023. How-to guide: Prevent harm from high-alert medications. Available at: http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventHarmHighAlertMedications.aspx (Accessed 19 February 2026).

Todd, B., Cash, K. and Gonzalez, J., 2022. Purposeful rounding in acute care: A best evidence synthesis. Worldviews on Evidence-Based Nursing, 19(1), pp.51–59. https://doi.org/10.1111/wvn.12545

Patmon, B.E., Gee, E.M., Johnson, D., Loughman, J.A., Maxwell, C.A., Prastein, L., Ruppert, E., Simones, J., Snyder, B. and Staggers, K., 2021. Quality improvement project to reduce patient falls in a central New York hospital. Journal of Nursing Care Quality, 36(4), pp.323–329. https://doi.org/10.1097/NCQ.0000000000000545

von Lengerke, T., Lutze, B., Krauth, C., von Kiel, K., Stahmeyer, J.T. and Raspe, H., 2019. Promoting patient safety and preventing hospital-acquired infections through hourly rounding: A quality improvement project. Health Services Research, 54(S2), pp.1240–1248. https://doi.org/10.1111/1475-6773.13219

White, K.M., Dudley-Brown, S. and Terhaar, M.F., 2021. Translation of evidence into nursing and health care. 3rd ed. New York: Springer Publishing Company.

Melnyk, B.M. and Fineout-Overholt, E., 2019. Evidence-based practice in nursing and healthcare: A guide to best practice. 4th ed. Philadelphia: Wolters Kluwer.