NRSE 4600: MODULE 5: ASSESSMENT 6: WRITTEN ASSIGNMENT

Experiential Learning Project Research: Module 5

Assignment Objectives:
• Extend academic experience into areas of nursing practice interest, working with new ideas, issues, organizations, and individuals.
• Demonstrate the ability to think and act critically and creatively about nursing practice issues.
• Develop analytical and ethical leadership skills necessary to address and help solve these issues.
• Utilize evidence-based research and demonstrate proficiency in written and communication skills.

Assignment Instructions:
This week you are going to respond to the last questions that will help you complete your project, discuss EBP and further research, and identify stakeholders and resources. Lastly, you will give an overall update of your project.

Last week you answered the following questions:
1. What are the scope, duration, and history of the problem?
2. What data is available to describe the problem?
3. What are the implications of the problem?
4. How does/will your selected organization support your topic?

This week you should be able to answer the following questions:
1. What are the gaps in the existing data?
2. What types of additional research might be useful?
3. Who are your stakeholders?
4. What are you needed resources?

In the template below you will answer the last several questions above. Your answers should be based on supporting evidence. You may need to review the information from your EBP course. Be attentive to the instructions and remember you are professional nurses; writing and thought processes should be indicative of scholarly writing.

This week’s assignment is the first of five assignments to complete your Clinical Practice Project (CPP). Each weekly assignment will build upon the last one. It is very important that you follow the directions carefully and review your teachers document/grading rubric for comments so that you can improve each week.

To complete this assignment type in the boxes below, the boxes will expand as you type. Be sure to save your document frequently. Points will be deducted for incomplete work, spelling/grammar errors, lack of thought and use of abbreviations. All content must be in your own words, not directly quoted; however, you must provide supportive details by using in text citations (Journal Article references at the end of the form-please see your rubric for an explanation of refereed Journals). This assignment is worth 30 points…be sure your work reflects 30 points. Save as a PDF and submit in Bb.
Change the FONT to red to highlight your revisions from the module four template.

Student Name Date:

Project Topic: Give a description of your topic. Include at least one paragraph and provide a citation and reference (no direct quotes).
QSEN Competency: (example, Patient-centered Care)
Project Topic: Risk Factors and Prevalence of Tracheostomy-Associated Infections in Home-Based Care
This project examines the causes and frequency of infections associated with tracheostomies in patients receiving home care. It will involve developing a prevention guide tailored for caregivers and patients. The QSEN competency that best aligns with this issue is Safety, as preventing infections directly protects patients from harm (QSEN Institute, 2012). The project will also reinforce evidence-based safety protocols and promote safe care transitions from hospital to home.
Safety
QSEN Definition: Define your QSEN Competency in your own words (paraphrase) using the 2012 graduate competencies AACN link: 2012 graduate competencies (example: for competency Patient-Centered Care the definition on the web site is Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs—take this information then write your definition in your own words (paraphrasing, remember to cite the QSEN site).
Safety, as defined by the AACN (2012), refers to the ability of nurses to minimize the risk of harm to patients and providers by designing and implementing effective system and individual performance strategies. In this project, safety involves ensuring that patients with tracheostomies receiving care at home are protected from preventable infections through evidence-based education and caregiver empowerment (American Association of Colleges of Nursing Education Consortium [AACN], 2012).
List two Knowledge/Skills/Attitudes (KSAs)- use two each (Knowledge/skills/attitudes using the 2012 graduate competencies AACN link: 2012 graduate competencies which are listed under your chosen competency that you think will help you to meet your selected competency. Then write your KSAS in your own words (paraphrasing/editing related to your specific project—remember to cite the QSEN).
Knowledge Skills Attitudes
1. Examine human factors and other basic safety design principles as well as commonly used safety tools in care processes (AACN, 2012). – This project will apply safety tools and design principles by creating a tracheostomy care guide that accounts for common human errors and simplifies proper technique for caregivers in home environments (AACN, 2012).
2. Value the nurse’s role in preventing errors (AACN, 2012). – The nurse plays a pivotal role in identifying and preventing infection risks in tracheostomy care. This project highlights that role through caregiver education, observation, and real-time correction of practices during home visits (AACN, 2012). 1. Examine human factors and other basic safety design principles as well as commonly used safety tools in care processes (AACN, 2012). – This project will apply safety tools and design principles by creating a tracheostomy care guide that accounts for common human errors and simplifies proper technique for caregivers in home environments (AACN, 2012).
Value the nurse’s role in preventing errors (AACN, 2012). – The nurse plays a pivotal role in identifying and preventing infection risks in tracheostomy care. This project highlights that role through caregiver education, observation, and real-time correction of practices during home visits (AACN, 2012). 1. Examine human factors and other basic safety design principles as well as commonly used safety tools in care processes (AACN, 2012). – This project will apply safety tools and design principles by creating a tracheostomy care guide that accounts for common human errors and simplifies proper technique for caregivers in home environments (AACN, 2012).
Value the nurse’s role in preventing errors (AACN, 2012). – The nurse plays a pivotal role in identifying and preventing infection risks in tracheostomy care. This project highlights that role through caregiver education, observation, and real-time correction of practices during home visits (AACN, 2012).
Understanding safety principles enables nurses to identify common sources of error or infection, especially in complex care scenarios like tracheostomy maintenance. For this project, knowledge about best practices in home-based tracheostomy care helps guide the development of accurate, effective caregiver instructions (AACN, 2012). Utilizing assessment and safety improvement tools is crucial in evaluating caregiver techniques and reinforcing proper practices. Teaching caregivers how to identify early signs of infection and intervening effectively ensures they provide safe and responsive care at home (AACN, 2012). A commitment to safety and quality care includes recognizing the nurse’s role in preventing complications. Valuing attention to detail and caregiver support helps foster a home environment that prioritizes the patient’s well-being and minimizes hospital readmissions (AACN, 2012).
Discuss Health Care Organization (this is not the facility/organization where you are implementing your project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence-based literature in relation to your topic) that will help support your project. Discussion should include the mission/values of the organization (in your own words). Provide citations and references (no direct quotes).
The American Association of Critical-Care Nurses (AACN) supports evidence-based practices in tracheostomy care. Its mission is to advance nursing practice for high-acuity patients through education, research, and advocacy. The AACN’s values emphasize integrity, innovation, and excellence, which align with the goals of this project. Their clinical resources and practice alerts on airway management will inform the development of educational tools to enhance safety in home care (AACN, 2023).
Global Objective: the purpose of a global objective is to provide a vision for your overall project-what are you developing and implementing-what is your expected impact on patient outcome? It should be broadly stated-in one sentence. (Do Not Use Any Abbreviations)
Upon completing this project, I will have developed and implemented a tracheostomy care educational tool to reduce infection risk, presented it to caregivers, and utilized it with ten patients receiving home-based tracheostomy care.
Project Objectives: Now your global objective should be broken down into more focused steps. Be sure your Project Objectives support your Global Objective! How will you achieve your global objective? Be specific. Write 4 Project Objectives…objectives should start with an action verb! (Do Not Use Any Abbreviations) For example; Research on…Develop a tool/guide/protocol/policy/process to…Develop and present education to staff on new tool…Implement new tool on ___number (the number should be adequate to meet your minimum of 1-2 log hours in direct patient contact) of patients to improve (how will your project impact patient outcomes)…

Project Objectives
1. Research current literature on tracheostomy-associated infection prevention and caregiver education.
2. Develop an infection prevention guide tailored for tracheostomy care at home.
3. Educate caregivers on safe tracheostomy care practices using the developed guide.
4. Implement the guide with six patients and their caregivers to reduce infection risk during home care.
Possible Steps to Assist Me in Completing My Project: List at least 4 steps in your project
(Do Not Use Any Abbreviations) Week I hope to accomplish by:
Provide hopeful completion date
1. Meet with the preceptor to discuss project goals and feasibility in the home care setting.
2. Review literature and guidelines from the American Association of Colleges of Nursing (AACN) and Centers for Disease Control and Prevention (CDC) on tracheostomy care.
3. Design a clear, user-friendly tracheostomy infection prevention guide.
4. Schedule caregiver training sessions and implement the guide with selected patients. Complete by 7/23/25

Complete by 7/31/25

Complete by 8/5/25
Complete by 8/12/25
Direct patient engagement: Describe in a one or two sentences how you will provide direct patient engagement (contact) in your clinical practice project and describe how this will impact patient outcomes. (keep in mind you are not required to actually measure your outcomes, but you will need to describe your potential/projected improved patient outcomes) Be specific.
I will engage directly with six patients who have tracheostomies and are receiving home-based care, along with their primary caregivers. During scheduled home visits, I will introduce and implement an educational guide designed to prevent tracheostomy-associated infections. The guide will include step-by-step instructions for hygiene, suctioning techniques, and signs of infection, ensuring it is understandable and practical for non-clinical caregivers. I will provide individualized instruction, answer questions, and observe care practices to reinforce proper technique and ensure adequate care. This direct patient engagement is expected to improve caregiver’s confidence, reduce infection rates, and enhance patient safety. By equipping caregivers with clear, Evidence-based tools, the project aims to strengthen infection prevention efforts and ultimately improve patient outcomes in the home care environment.
What is the history/background of the problem? What is the scope of this problem—>how big of an issue is this problem–what is the duration—>how long has this been a problem, explain these with the data from your facility, community, state, and/or national data. Write 3-4 paragraphs related to your selected problem. Provide supportive details using in text citations. Give supportive data from facility, community, state, or national data to explain why you feel this is an issue and to explain the history, scope, and duration of this issue.
Your paragraphs should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). (Supportive data requires
paraphrased citations from your research, not direct quotes)
Tracheostomy-associated infections (TAIs) have long been recognized as a significant cause of morbidity and healthcare burden in both acute and chronic care settings. As more patients are discharged from hospitals with tracheostomies, the responsibility of maintaining safe airway care has shifted to home caregivers, many of whom lack adequate training. Studies have shown that improper hygiene, suctioning, or equipment handling in home environments can contribute to a high incidence of infections, sometimes resulting in emergency room visits or readmissions (Morrison et al., 2024).
The scope of this problem is growing as the prevalence of long-term tracheostomy care increases, especially among pediatric and geriatric populations requiring ventilator support or airway protection. National studies indicate infection rates in tracheostomy patients range from 25% to 35%, with higher rates in home-care settings due to limited monitoring and education (Almansour et al., 2024). According to Selekwa et al. (2023), the absence of standardized home-care protocols contributes significantly to variability in outcomes and safety concerns.
This problem has persisted for decades, but with the rise in home-based healthcare services, it has become more pressing. The COVID-19 pandemic accelerated early discharges and care transitions, thereby intensifying the challenge of preparing caregivers for complex procedures, such as tracheostomy care (Tovichien et al., 2023). Despite various training interventions, long-standing gaps remain in infection prevention education tailored to the home setting, particularly in low-resource environments.
At the state level, data from Delaware’s home health agencies suggest increased reports of tracheostomy-related complications over the past five years, many linked to inadequate caregiver education. Nationally, readmission rates due to preventable airway infections strain health systems and increase healthcare costs. This persistent, system-wide issue reinforces the urgent need for comprehensive, evidence-based, and accessible caregiver education programs (Nyanzi et al., 2023).
Who does your problem affect? Write 1-2 paragraphs discussing individuals, communities, etc. that are affected by this problem. Remember to include all parties that are affected. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
This problem primarily affects patients with tracheostomies who receive care in a home setting. These individuals—often older adults, children with congenital conditions, or those with chronic respiratory diseases—are vulnerable to infection due to direct access of the tracheostomy tube to the lower airway. Complications such as pneumonia, sepsis, or tracheitis can be life-threatening if early signs are not recognized or if care is not performed correctly (Swain, 2025).
Caregivers, particularly family members or aides without formal medical training, are also profoundly affected. They bear the responsibility of managing the patient’s airway, yet they may lack sufficient education, confidence, or resources (Almansour et al., 2024). This results in stress, caregiver burden, and an increased risk of providing suboptimal care. Healthcare providers, including nurses and home health agencies, are impacted by the downstream consequences such as increased follow-up calls, emergency interventions, or preventable readmissions (Tovichien et al., 2023).
Your selected organization: (remember this is not the facility/organization where you are implementing your
project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence-based literature in relation to your topic) How does this organization support your topic? Some things to consider when researching…Have they advocated? Do they support financially? Are they involved in research to support your topic? Do they use it as part of accreditation requirements? Write 1-2 paragraphs. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references.)
The American Association of Critical-Care Nurses (AACN) actively supports the safe management of tracheostomy patients through the development of clinical guidelines, continuing education, and quality improvement initiatives. The AACN has released practice alerts and research-based recommendations aimed at preventing respiratory complications, emphasizing the early recognition of infection and proper suctioning techniques (AACN, 2023). These resources are instrumental in shaping the infection prevention guide for caregivers used in this project.
Moreover, the AACN advocates safer care transitions from hospital to home, a critical point of vulnerability for tracheostomy patients. They fund research into airway safety and include tracheostomy management as part of professional development modules for nurses. Their educational materials are evidence-based and align with QSEN’s emphasis on safety, supporting this project’s mission to reduce infections and promote best practices in home care settings (AACN, 2023).
What are the implications of the problem? What will happen or not happen if the problem is not resolved? Write 1-2 paragraphs discussing the implications with supporting details (information from your selected organization and/or health care facility would be important here). Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
If tracheostomy-associated infections in home-based care are not addressed, patients may experience preventable complications, including emergency room visits and hospital readmissions. These outcomes can lead to prolonged recovery, increased mortality risk, and greater healthcare costs (Swain, 2025). Infections can escalate rapidly due to the invasive nature of tracheostomy tubes, especially when caregivers fail to recognize warning signs or maintain hygienic practices.
Furthermore, the absence of standardized caregiver education perpetuates a cycle of poor outcomes. Without intervention, caregiver anxiety and burnout may worsen, and health systems will continue to absorb the costs of repeated interventions (Almansour et al., 2024). Implementing a structured educational guide not only mitigates these risks but fosters a culture of safety and empowerment in the home care environment. As supported by the AACN (2023), investing in caregiver training contributes to broader patient safety and reduces strain on healthcare resources.
Plan of Action: Plan of Action: In the space below outline your plan of Action. Remember your plan of action should assist you in meeting your global and project objectives; therefore, they must be linked. Your plan of action can include your action steps from week one or they may have changed. In either case, list your action steps (that you have already completed and planned steps) and provide a one paragraph (per action step) explanation supporting this action. You should have a minimum of four action steps (no more than five), this means you should have a minimum of four paragraphs and no more than five. Your actions steps should have supportive details (references). Your paragraphs should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
Step 1: Conduct a literature review on best practices in tracheostomy infection prevention.
The foundation of this project is evidence-based practice. A comprehensive review of current guidelines from the CDC, AACN, and peer-reviewed journals helped identify critical risk factors for infections in home settings. This research phase included assessing caregiver barriers, common complications, and successful intervention models (Morris et al., 2025; Selekwa et al., 2023). Findings guided the content and design of the prevention guide.
Step 2: Develop an easy-to-understand educational guide for caregivers.
Using the literature findings, a clear, visual infection prevention guide was developed. It includes handwashing protocols, suctioning procedures, equipment maintenance, and warning signs of infection. The guide is tailored for non-clinical users with illustrations and color-coded steps to enhance understanding and retention. Studies support that visual tools can significantly improve adherence in home-based care (Tovichien et al., 2023).
Step 3: Provide caregiver training through home visits.
Ten patients and their caregivers will be engaged through scheduled home visits, during which the guide will be introduced. Personalized demonstrations will be conducted, allowing caregivers to practice skills under the guidance of an expert. This step ensures hands-on learning and addresses individual concerns. Direct training has been shown to improve caregiver competence and reduce complications (Almansour et al., 2024).
Step 4: Reinforce safe care practices and monitor implementation.
Follow-up visits and calls will be conducted to reinforce the training. Caregivers will be encouraged to ask questions and report concerns. Observational checklists will be used to assess adherence to hygiene and care practices. Continuous support fosters caregiver confidence and establishes a feedback loop to refine the intervention as needed (Hong et al., 2024).

Proposed Solution: Write 2-3 sentences describing your proposed solution to your problem. Remember that your solution should be linked to your global and project objectives. Your proposed solutions should have supportive details (references), professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
The proposed solution is to develop and implement an illustrated tracheostomy infection prevention guide specifically designed for home caregivers. By combining evidence-based recommendations with hands-on training, the project aims to reduce infection risks, improve caregiver confidence, and enhance overall patient safety in home settings (AACN, 2023; Morrison et al., 2024).

What are the gaps in the existing data? In research articles on your topic, look for limitations/research not found on some area related to your topic or future directions/suggestions (usually discussed at the end of the article)—this will guide you in finding what are the gaps in the current research. Write 1-2 paragraphs related to your selected problem. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). You may need to look back at your Evidence-based Nursing Textbook for some help.

What types of additional research might be useful? What gaps in research did you find in the last question—is future research needed in these areas? Write1-2 paragraphs discussing additional research that describes individuals, communities, other issues etc. that are affected by your topic. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). Be sure the research relates to your problem.

Identify Stakeholders: Write 1-2 paragraphs identifying the key stakeholders to your problem with supporting examples. Individuals or groups that are directly or indirectly influenced by the problem or solution are the stakeholders. In some cases, the stakeholders are obvious; however, in some cases stakeholders can be developed. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

List needed resources: A successful change agent will identify all available resources. Resources include money, time, connections, and those resources which help you to meet your objectives. You may list your resources but explain why the resource is needed and how these resources will help support your change.

Project Update: Write 2-3 paragraphs discussing your project progress. Include in your discussion how your QSEN competency and KSAs are supporting your project and if your global and project objectives are close to being met. You do not need citations or references; however, this should be professionally written.

Work with Mentor this week: In 2-3 paragraphs discuss activities with your Mentor (Preceptor) for this project so far. Include positive and negative thoughts, what was helpful and what information or activity would have been helpful. No citations or references are needed; it should still be professionally written.

Week Five Practice Log: Begin typing documentation on your Clinical Log and the below practice log, provide here a brief explanation of time you have completed this week – you will need to document on your clinical log in addition to this template, this update does NOT take the place of completing your required log submitted in M7.
NOTE: This item does not receive points but must be completed for review.

— Do not include: Orientation off the Unit, Observation, writing or researching papers/assignments, Lunch or Break time.

— Do include: A total over the course includes a Minimum of 3 hours with preceptor, Maximum of 6 hours on research of topic, a minimum of 1-2 hours in direct patient contact and the remainder- 10-11 hours in implementation of your project, Total of 21 true hours.
Type Date Time
(ex: 1:00pm-2:00pm) Total Time Spent
(ex: 1 hour) Description
(describe specifically what you did in one or two sentences)

Preceptor
(a minimum of 3 hours is required for the course)
11:00am-12:00pm 1 hour

Research on topic
(a maximum of 6 hours is allowed for the course)
4:00pm-6:00pm 2 hours
Patient
Engagement/Direct Patient Contact Time
(a minimum of 1-2 hours)
Specify number of patients and how you impacted the patient outcomes, i.e. describe your actual/projected improved patient outcomes –improved patient quality/safety-how, prevention of, reduced-what)

7:15am-8:15am

11:30am-12:30pm 1 hour

1 hour

Implementation
(the remainder should be spent in implementation, 10-11 hours)

10:30am-1:00pm

4:00pm-6:30pm

3:00pm-5:00pm
2.5 hours

2.5hours

2.00 hours
Total Time spent this week (by the end of the course you should spend at least 21 true hours) Total for this week =

References (double-space and use correct 7th ed. APA format)
This should include references from Weeks 3 and 4

Almansour, N. A., AlHedyan, Y. A., Alshathri, N. N., Alsubaie, R. S., Alsuliman, S. Y., Omair, A. A., Alanazi, A. K., & Alserayaa, A. S. (2024). Efficacy of home healthcare on the management of tracheostomy patients. Saudi medical journal, 45(7), 724–730. https://doi.org/10.15537/smj.2024.45.7.20240294
American Association of Colleges of Nursing Education Consortium. (2012). Graduate-level QSEN competencies: Knowledge, skills and attitudes. https://qsen.org/competencies/graduate-ksas
American Association of Critical-Care Nurses. (2023). AACN practice resources. https://www.aacn.org/clinical-resources
Hong S, Wu X, Feng H, et al. (2024). Risk factors for patients with tracheal stenosis: a systematic review and meta-analysis. Journal of International Medical Research;52(9). doi:10.1177/03000605241275884
Morris, L. L., Brenner, M. J., Williams, R. L., & Pandian, V. (2025). Preventing and Managing Tracheostomy-Related Emergencies in the Radiology Suite: Best Practices for Safety and Preparedness. Journal of Radiology Nursing. https://doi.org/10.1016/j.jradnu.2025.03.004
Morrison, J. M., Kono, N., Rush, M., Hahn, A., Forster, C. S., & Cogen, J. D. (2024). Factors associated with tracheostomy-associated infection treatment: A multicenter observational study. Pediatric Pulmonology. https://doi.org/10.1002/ppul.27117
Nyanzi, D. J., Atwine, D., Kamoga, R., Birungi, C., Nansubuga, C. A., Nyaiteera, V., & Nakku, D. (2023). Tracheostomy-related indications, early complications and their predictors among patients in low resource settings: a prospective cohort study in the pre-COVID-19 era. BMC surgery, 23(1), 59. https://doi.org/10.1186/s12893-023-01960-5
Selekwa, M., Maina, I., Yeh, T., Nkya, A., Ncogoza, I., Nuss, R. C., … & Xu, M. J. (2023). Tracheostomy care quality improvement in low-and middle-income countries: A scoping review. PLOS Global Public Health, 3(11), e0002294. https://doi.org/10.1371/journal.pgph.0002294
Swain, S. K. (2025, January–April). Complications of tracheostomy: A scoping review. Airway, 8(1), 1–8. https://doi.org/10.4103/arwy.arwy_32_24
Tovichien, P., Khaowsibsam, N., Choursamran, B., & others. (2023). Impact of respiratory care training and family support using telemedicine on tracheostomized children admitted with respiratory infection after discharge. BMC Pediatrics, 23, 627. https://doi.org/10.1186/s12887-023-04455-7

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