2.2

Impacting Factors Tool

Stakeholder Identification and Engagement Strategies to Secure Support	Stakeholders: · Patients/ Resident · Nurses · Psychiatric  physicians · Dietitian · Social workers · Unit manager Engagement strategies to secure support would be to: · Collaborate with the nursing staff and explain the plan clearly on how to improve depression on newly admitted seniors at Lydia healthcare. · Educate the stakeholders on early assessment for depression, and the use of exercises and diet to eradicate depression on mental ill seniors. This strategy will be cost-effective to implement because it will eliminate high rates of suicide as well as increase the census rate. I believe these strategies will be effective in getting everyone involved in the plan.
SWOT Analysis	Strengths · The primary strength is the passion and commitment of the team. · Good communication channels between family, patients and the staff. · The team is composed of experts in the field of mental health, psychology, dietitian, and social work.	Weaknesses · A lack of awareness of the issue among key stakeholders, including mental ill seniors, their families, and the staff who support them (Vafaeinasab et al., 2022). · A lack of resources to effectively engage all stakeholders in the issue. · Lack of nurses and other staff to take care of mentally ill residents.
	Opportunities · The opportunity to raise awareness about the problem of depression in seniors with mental health issues. · The opportunity to engage all stakeholders in the issue and secure their support for taking action to improve mental health and psychological well-being for seniors. (Chen & Xu 2020). · Improve seniors overall wellness. · Decrease the number of seniors with depression. · Improve nurse and patient interaction.	Threats · Poor implementation may result from uncertainty about the cost and services offered when engaging a personal trainer. · The efficient execution of this plan may be hampered by newly admitted seniors switching from their personal doctor and their medical diagnostic. · If a recommendation calls for the use of a public or outdoor exercise facility, the availability and rules of that facility will determine how well the plan is carried out.
Financial Implications of the Capstone Project	• Patient financial impact: There is no patient financial impact.   The facility’s expenses will include the cost of bringing on a personal trainer who comes in 2 times a week for 3 weeks. This will be an estimated cost of about $180. • Potential income: The facility will avoid needless medical expenses associated with misdiagnosed or incorrectly diagnosed depression. • The prospective revenue will exceed the project’s possible cost.
External Influencing Factors	There are a number of external factors that could influence the success of the project. Some of the external factors that could influence the project include: External Stakeholder Engagement · Patients, family members, mental health specialists, and general health workers (Tyndal et al., 2018). · Engagement with the stakeholders should be done during the first stage of the planning. State/Federal Regulations · The set legislation will influence the outcome of the project · Examples include Food and Drug Administration regulations Accreditation · The presence of accreditation bodies such as the Joint Accreditation committee will influence the outcome of the policies · Examples include National Patient Safety Goals.
Outcome statement for the capstone project	A special assessment of seniors with mental illness who are also exhibiting depressive symptoms will be done by 10% of the workforce. Conduct and observe seniors as they work out for 30 minutes, three times a week, doing things like stretching and stair climbing. Assure the elderly have an adequate diet. At the end of each shift, all shifts will record and submit their report. After eight weeks, the entire report will be assessed to determine whether we succeeded in lowering senior residents with mental illnesses’ rates of depression to 5%. The number of individuals who have demonstrated improvement in engaging in the facility’s socially organized events will be used to measure this.   No modifications were needed for this outcome
Evaluation plan for the capstone outcome	The evaluation process will involve assembling all of the shift reports. This objective will be achieved if all of the report’s findings lower the incidence of depression below 5%.   No modifications were needed for this outcome

3.4

Capstone Project Work Schedule

Activities	Target Date
Choose a topic for a planned change by outlining a problem in detail, coming up with ways to address the issue in order to bring about the desired change, formulating a problem statement, and setting a desired outcome utilizing a SMART objective.	9/3 /22
Identify the stakeholders who will be engaged in the change, as well as any necessary physical resources, time resources, and financial resources, to determine whether the change is feasible.	9/5/22
To examine the intended change and present evidence-based research to support the need for a change, meet with the project facilitator.	9/12/22
Analyze the most recent weekly admission records of elderly patients who have mental illnesses and exhibit depressive symptoms.	9/15/22
To introduce planned change and provide evidence-based information to justify the need, meet with internal stakeholders (nurses, nursing assistants, dietitians, social workers, personal trainers, unit managers, and mental physicians). At this time, I was also able to gather input on the intended result and respond to queries and worries.	9/19/22
Examine the current obstacles to tool implementation, such as staffing, financial and facility issues.	9/21/22
Determining on inclusion and exclusion standards for patients who will follow a nutrition and exercise plan. To locate the finest solutions for the elderly who are mobile and immobile, I will rely on the personal trainer’s advice. Every senior will receive a recommended diet from the dietitian.	9/22/22
To analyze our progress and make sure we are following the expected plan, I will have a second meeting with the project facilitator.	9/26/22
To discuss the need for educational meetings to mobilize seniors with depression and staff members to ensure suitable practices are used for safety, I will met with the unit manager, trainer, and dietician.	9/27/22
Second meeting to discuss roles of each staff member during project implementation with internal stakeholders (nurses, nursing assistants, dietitians, social workers, personal trainers, unit managers, and psychiatric physicians).	9/29/22
I will be turning my blueprint into an action plan over the course of the next four weeks, including an exercise routine and food recommendations for seniors with depression. It will progress as the resident is able and include several phases. Upon admission, the resident will be evaluated to determine the best phase for them. Exercise and dietary progress will be made during the resident’s stay as determined by the inclusion/exclusion criteria. A daily 30-minute x 3 days walk, yoga aerobics, and stretching exercises will comprise the first phase. The second phase includes dancing, swimming, and climbing. The third stage will involve senior outdoor activities, movie outings, and bowling. Following each workout session, residents will consume the proper amount of calories and nutrients for their bodies through a balanced meal. During the implementation of this plan, the nurses, trainers, and nutritionists will be the senior residents with depression’s strongest supporters. The seniors with depression will have their actions observed and recorded.	9/30/22-10/28/22
After the strategy is in place, I will visit the unit three times each week to examine any obstacles or worries the team may have at this time.	10/29/22
Examine the team’s records from the 30 days of the strategic plan’s implementation for depression reduction (nurses, nursing assistants, dietitians, social workers, personal trainers, unit managers, and psychiatric physicians) to see if the outcome was met.	10/31/22

4.3

Discussion: Capstone Project: Risks and Challenges Web Page

Identify Any Challenges with Implementing the Capstone Project You Have Experienced

            One of the challenges I experienced with implementing our capstone project was Scope creep. This is when the scope of the project expands beyond the original content. I addressed this challenge by having weekly meetings with my team to discuss the project’s progress and ensure everyone was on track(Heagney, 2016). Another challenge I faced was a lack of resources. I addressed this by being creative with my resources and reaching out to my stakeholders for help.

Discuss Potential Risks and Challenges That May Threaten Your Capstone Project.

Three primary sources of change could potentially impact my capstone project: schedule, cost, and scope. The schedule for my project is very tight, and any delay could cause significant problems. I need to ensure that all my team members are aware of the schedule and working diligently to meet deadlines(Heagney, 2016). The cost of my project is another potential risk. I need to make sure that I can get the necessary funding in place in order to complete the project. The scope of my project is also a potential risk. I need to ensure that I do not try to take on too much and am realistic about what I can achieve.

Explain How Real or Potential Risks and Challenges Fit into the “Triple Constraints Triangle”?

            Risks and challenges can fit into the “triple constraints triangle” in several ways. First, they can impact the schedule of the project. For example, if a team member gets sick and cannot work, this could delay the project. Second, risks and challenges can impact the project’s cost(Heagney, 2016). For example, if a key piece of equipment fails and needs to be replaced, this could increase the project’s cost. Finally, risks and challenges can impact the scope of the project. For example, if a risk materializes and causes significant damage, this could reduce the project’s scope.

Describe A Contingency Plan Including Specific Strategies to Manage the Real or Potential Risks and Challenges to Your Project.

            A contingency plan is a plan that is put in place to deal with potential problems that may arise during a project. One strategy is to have a backup plan for key team members in case they cannot work(Heagney, 2016). Another strategy is to have a contingency fund that can be used to cover unexpected costs. Finally, it is important to be flexible and willing to adjust the project scope if necessary.

Based On Your Assessment of Risks and Challenges, what, If Any, Changes Are Needed to Your Strategic Plan or Timeline?

            Based on my assessment of risks and challenges, I may need to change my strategic plan or timeline. I may need to add some additional buffer time into the schedule to account for potential delays(Heagney, 2016). I may also need to increase the size of my contingency fund to cover unexpected costs. Finally, I may need to be flexible and be willing to adjust the project scope if necessary.

 

5.3

    
Capstone Project: Financial Impact and Sustainability

   What is the current financial impact of your capstone project on the organization and the patient?  Explain current costs involved with project implementation, and how those expenses are being funded.  (Be sure to include the cost of both human and material resources, as well as savings realized through the initiative.

The project’s progress is tracked using an estimate, and without a plan, there is no control. (Heagney 2016). Reducing the depression rate among newly admitted senior residents to 5 % will have some financial impact on the organization. Implementing the project will increase the organization’s budget for the year. The income lost by the facility in the area of decreased census rate, increase in hospitalization and suicidal rate, will be more than the change in change project cost. Before starting the project, it is crucial to let the residents know of the cost to them;  this will enable the residents to make informed choices and increase the likelihood of compliance with the project. Luckily there will be no financial cost to be incurred by the residents to implement this project. Rather all the residents will have to contribute their time and willingness to participate. The project is being implemented by 10% of the workforce which includes nurses, social worker, dietitian, personal trainer, unit manager, and psychiatric physician that are required to work extra 30 minutes three times a week. This is estimated to cost the facility an additional $3000.00 in payroll over eight week period. The estimated cost of weekly staff meetings, educating, and training staff to document the result of the project plus the cost of procuring additional exercise equipment is $2000.00. When compared to the income from one depressed resident that was paying $3000.00 a month ($3000.00×2 months = $6000.00) per resident, you will find out my plan has a positive financial impact of $1000.00 on the budget of the facility. But if the plan achieved its goal of reducing depression to two people out of 10 residents, the positive financial impact will then be 8 x$6000.00= $48000.00 income -$5000.cost= $43000.00 profit for the current year.

. What is the future financial impact of your capstone project on the organization and the patient? Explain projected costs necessary to sustain the change project, and how those expenses will be funded. (Be sure to include the cost of both human and material resources, as well as savings projected for the future.)  

My capstone project will have a major positive financial influence on the facility’s and the resident’s future financial standing. This is due to the estimated $5000.00 cost of both materials and human resources that will be required to maintain the change project. While my proposal, which aims to prevent 8 out of 10 residents from developing depression, will earn $6000.00 for each resident prevented ($48000 for 8 residents). Therefore, even if one resident is kept out of depression, the financial prognosis for the future appears to be quite advantageous. The resident incurs no financial expense because all that is required of them is their time and willingness to participate in the change project.

Identify and explain any modifications to the capstone project that are necessary because of financial considerations.

The facility won’t put in an indoor pool for the senior resident due to financial constraints. The seniors will instead be given a membership card to a local private gym so they can go indoor swimming as a modification to the change project. The employees who will be watching over the elderly residents will travel with them on a facility bus.

 

Describe the project-related activities you want to sustain after your NUR-495 coursework is Complete, and explain how sustaining these elements of the project will benefit the organization. Include specific resources, stakeholders, and collaboration necessary to sustain your change Initiative.

 The project-related activities I would like to sustain after the NUR-495 coursework is completed would be to encourage the Facility to continue to carry out the three phases of exercise that my plan recommended. Sustaining these project elements will benefit the facility because the exercise will improve the overall well-being of the resident health and decrease depression and suicidal rates. This recommendation will then routinely be carried out by 10% of the workforce which include nurses, dietitian, trainer, social worker, unit manager, and psychiatric physician.  

6.3

Capstone Project: Evaluation

My strategic plan is to reduce the rate of newly admitted seniors with mental illness who exhibit symptoms of depression from 100% (10) to 5% (2) by October 28th, 2022. This plan will involve three thirty-minute phases of exercise 3x a week and diet to achieve the goal. The exercise and diet will be monitored and recorded by nurses, social workers, personal trainers, psychiatric physicians, dietitians, and unit managers.

The evaluation approach entails comparing and assessing the behavioral occurrences of seniors with depressive symptoms from previous years before the exercise and dietary plan was put into place, as well as data collected eight weeks after the process started. The nurses, social workers, personal trainers, psychiatrists physicians, dietitians, and unit managers. Will keep an eye on and record every workout and dietary change to make sure the elderly residents involved are adhering to the new method. It will be decided whether the depression rate decreased to 95% after examining their data. The examination will be placed on October 31st, 2022.

            The evaluation records kept during admission and the assessment records kept at the conclusion of the plan will be used to gather the data. If the documentation demonstrates a significant decrease in the depressive symptoms of eight out of ten seniors with mental illness displayed at the conclusion of the implementation, the strategy has been successful. Analysis of the information gathered from the social participation record will be another tool (SPR). The documentation of the stages of exercise and nutrition regimen was done in SPR. If the SPR at the end of the plan’s implementation shows a 95% increase in social involvement from the SPR at the start, the objective has also been met.

 The information is credible because the three phases of exercise are done 3x a week with dieting. The assessment log is recorded by the nurses, social workers, and psychiatric physician during the initial admission of the resident. The SPR is documented at the start of every exercise by the nurses and personal trainer. The unit manager checks all the recordings of every other team member to ensure it was filled out correctly. The only limitation in the evaluation plan is if the staff that went out with the seniors to the local swimming pool forgot to fill out the SPR. The information can be found and easily entered into the chart by using the records of the local swimming pool census sheet. At this time, I have only had one staff forget to fill in their SPR charting. I think the project has continued to run smoothly from that point and does not need further modification or clarification.