Nursing Capstone Project Assignment

Nursing Capstone Project Assignment

Work paper needed based on the below.

Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to the nursing shortage in perioperative services including OR nurse address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it for just the nursing shortage in general.  How did you narrow your focus? (Example, and discuss that I follow focused though analysis and research with the team and human resources  to pertain to the problem as the nursing shortage was too broad and the real focus was supporting recruitment, retention, and evidence based practice for perioperative services which was lacking) What led to your current perspective and direction?  Fill this in with research of evidence based practice, working with my mentor, meeting with leaders and staff and physicians in essence stakeholders to drill down for the real problem of shortage of perioperative/OR nurses in recruitment and retention and how to solve it and derive at a project to submit and execute to be competitive in the market as well as implement evidence based practice Nursing Capstone Project Assignment.


The capacity of medical facilities to retain their qualified personnel, particularly nurses, has become an issue that is increasingly difficult for a range of reasons. These reasons range from patient load and high acuity to long working hours and low pay. The result is that the affected facilities have experienced care deterioration occasioned by nursing turnover. The concern in the issue comes from the fact that care quality, turnover, and retention are significant organization drivers. Each of these drivers has associated costs from the economic perspective and has financial implications for the facility. The costs of these drivers include losing knowledge in the facility, loss of talent, expenditure in training new personnel, and direct cost to hire new nurses (Ellis, 2016). In this respect, although nurse turnover can be justified by workload, acuity, working hours and pay issues, it has care quality implications for any medical facility.

The implication is that nurse turnover and retention is a source of concern since it causes a shortage of nurses in medical facilities. The shortage is only expected to worsen if the situation is not arrested and realistic effective strategies implemented to retain qualified nursing staff in the facility as there is already a limited population of qualified nursing professionals from which to choose. This situation increases the risk that patients face when seeking care since it is likely to be substandard and costly as facilities seek to recoup the funds they spend in new staff orientation and training. In fact, the typical cost that a facility incurs for a single nurse turnover is upwards of $55,000. Other than the direct costs, there are many hidden costs that are not easily apparent. These hidden costs include money spent on advertising the vacant positions. Another cost is the wages the facility pays out on temporary staff to cover the work requirements before new personnel begin work, as well as overtime pay and lost revenue when services are withdrawn and departments are closed off (Marquis & Huston, 2017) Nursing Capstone Project Assignment.

Yet another negative consequence of the turnover is the loss of organizational knowledge. Even as nurses leave the facility, they take with them the established organization morals, cultures, norms and knowledge. This implication is that part of the facility’s identity is eroded even as the nurses leave with the history with the possibility of compromising facility initiatives to improve processes and quality. Besides that, the facilities that report high nurse turnover figures could also experience lower fiscal profitability (Fulton, Lyon & Goudreau, 2014). The issue is further complicated by the fact that nursing education programs are not very common, and health stakeholders are not keen to invest in nurses training or even put new personnel through a lengthy orientation process. This situation coupled with progressively arduous workloads for facility nurses has created a retention and recruitment crisis (Ellis, 2016).

A review of the problem reveals that it has two origins. The first origin is staff shortage while the second origin is staff turnover. The staff shortage directly influences retention while contributing to increased turnover figures. The staff shortage intensifies and aggravates related costs and turnover figures. This correlation has a direct link to issues with lateral violence, inter-professional and inter-personal relationships, work environment, poor leadership, difficulties with scheduling, and increasing patient workloads. Consequently, a high turnover rate disrupts the facility’s capacity and capability to offer high quality and safe care. This is particularly conspicuous in facilities that report high nurse-patient ratios (Black, 2016). Nursing personnel also struggle with the adjustment to medical advances that include new technologies and information within a dynamic medical environment. The issue is confounded by the lack of consistent and reliable nursing education. The combination of these problems causes acclimatization difficulties for new nursing staff thus highlighting the need for preceptor education (Marquis & Huston, 2017).

To summarize, the demand for qualified nursing personnel in medical facilities exceeds the surplus, and nursing turnover figures average about 15% annually. Evaluating strategies to address turnover, while attracting and retaining nursing personnel in a complicated medical environment is a requirement to reduce the turnover rates. In fact, the outcomes show that a practice change is necessary to influence and facilitate staff retention, care quality, and patient safety. This need is explained that facilities with high turnover rates will also report comparatively longer length of stay for patients, reduced patient satisfaction levels, reduced care quality, and higher risk-adjusted mortality rates. This is a substantial issue, particularly when looking at the facility’s fiscal longevity since the drivers are linked to reimbursement scale. Also, provision of nursing care is already a challenge with staff shortages complicating the issue (Marquis & Huston, 2017).

The nursing profession is acknowledged to include some elements of risk, especially bullying and horizontal violence. In fact, risk is a major contributor to nurse turnover thus influencing patient safety and care quality. These risks are expensive since they result in poor quality care that attracts reduced reimbursements causing nursing staff to leave their position. The situation is partially caused by the reimbursement scales being dependent on indicators of care quality. Equally important is the stressful and exigent nature of staff assimilation into the new role, without proper guidance and support. Preceptor training could alleviate some of the risks by improving nurses’ capacity to address them, thus improving retention figures. The training does this by facilitating the staff assimilation process while improving satisfaction levels to justify the training costs (Black, 2016).

Once nursing students and new personnel go through preceptor training, the facility can be assured of better retention since the training intention is to retaining personnel familiar with the facility. The training strengthens the nurses’ abilities while educating them through offering essential professionals skills and tools to successfully complete and perform nursing tasks in the facility. Personnel who have been through the training program will typically be skilled and dedicated to improve retention figures (Ellis, 2016) Nursing Capstone Project Assignment.


Based on the presented analysis and awareness, preceptor training has been proposed as a nurse retention strategy. This means that newly hired nursing staff should participate in a preceptor training program to enculturate them into their professional role in the facility as new personnel. The training creates a collegial and professional relationship between new hires and experienced personnel in the facility. That is because the preceptor facilitates the amalgamation and assimilation of the new hires into their professional role while focusing on their clinical skills, inter-professional relationships, and professional growth. Establishing the training program for instructions supports and assists the preceptors in their role while maximizing strengths that could affect the satisfaction levels of new hires and retention (Ellis, 2016). As a result, nurse retention for new hires can be improved through preceptor training that intentionally seeks to improve satisfaction levels.


Black, B. (2016). Professional nursing-e-book: concepts & challenges. New York, NY: Elsevier Health Sciences.

Ellis, P. (2016). Evidence-based practice in nursing (3rd ed.). London: Learning Matter/SAGE Publications Ltd.

Fulton, J., Lyon, B. & Goudreau, K. (2014). Foundations of clinical nurse specialist practice, (2nd ed.). New York, NY: Springer Publishing Company, LLC.

Marquis, B. & Huston, C. (2017). Leadership roles and management functions in nursing: theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins Nursing Capstone Project Assignment.





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