1. Purdue University Calumet College of Nursing
Taking the Next Step: Collaborative Partnerships, Faculty Mentors and Students Bring QSEN to Capstone Course in Nursing QSEN National Forum May 25-27, 2016
Ellen Moore, DNP, RN, FNP
Purdue University Calumet College of Nursing
Hammond, IN 46323

2. AIM:
To describe a pre-licensure Capstone course in Nursing that moves away from the traditional preceptor model and integrates QSEN Core Competencies.
To emphasize student-centered learning and the role of Faculty Mentors and Collaborative partnerships.
To demonstrate the “flow” in the curriculum-- Quality and Safety for Professional Nursing Practice through Capstone Course in Nursing.
To engage students in real-world quality improvement and safety initiatives.

3. Overview of Presentation
Rationale for redesigning course
Frameworks that guided redesign
Engaging community partnerships
Team-driven EBP projects
Types of projects
Dissemination of projects
Lessons learned

4. Rationale for Course Redesign
Call for educational transformation
Complexities of nursing practice
Competition for clinical sites
EBP knowledge transfer and implementation science
QSEN integration
Experiential learning
The need for balance! 4

5. Transforming the Capstone Course Frameworks Used
NSEE
Experiential Learning Principles of Good Practice (National Society for Experiential Education, NSEE, 1998)
AACN
The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008)
IOM
QSEN
IOM (2001, 2003, 2010)
QSEN competencies-patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, informatics (2007)
Experiential Learning Principles of Good Practice (National Society for Experiential Education)
Describes the criteria that curriculum should meet to create a successful experiential learning environment
Standards of Practice—Eight Principles
1. Intention
2. Preparedness and Planning
3. Reflection
4. Authenticity
5. Orientation and Training
6. Monitoring and Continuous Improvement
7. Assessment and Evaluation
8. Acknowledgement
The Essentials of Baccalaureate Education for Professional Nursing Practice (American Colleges of Nursing, 2009)
These essentials describe the expected outcomes of BS graduates
Nurse Educators Need to Transform Nursing Education
Be Innovative
Engage Others on the Journey
QSEN Competencies
Evidence-based practice
Teamwork and collaboration
Safety and Quality improvement
Experiential Learning (ExL)
Future of Nursing Education (IOM, 2010)
Nurse as transformational leader
Nurse as change agent
Nurse as future innovator, disseminator, and sustainer of EBP practice changes
The future…
EBP Curriculums
Best Available Evidence for practice
Critical Thinking
Critical Reflection
Collaborative multidisciplinary partnerships
QSEN competency development
IOM and the Future of Nursing

6. Capstone Course in Nursing
Engage in activities that promote the importance of nursing and professional nursing roles in creating change in health care environments.
Design an evidence based practice project that assists individuals, families, groups, or the community meet basic human needs and promote quality of life.
Disseminate knowledge relevant to nursing in a complex health care environment.
Demonstrate accountability to the nursing code of ethics and legal standards of practice.

7. EBP Capstone Project Goals
Communicate and collaborate with healthcare professionals to improve patient outcomes through EBP and QSEN competency development.
Emphasize quality improvement and patient safety.
Disseminate knowledge related to knowledge transfer and implementation science.
Expand competencies of BSN graduates as future EBP champions.

8. How Projects are Selected
Request form sent to healthcare agencies two months prior to start of semester
Agencies identify projects and activities that are currently impacting organization (usually quality improvement and safety initiatives)
First day of class students form teams and choose up to 5 projects from final project list
Course coordinators assign projects (and make every attempt to be fair)!
Includes BSN professional role development
2. Focus and Scope appropriate for BSN student
3. Focus on agency Needs Assessment
4. Outcome driven—patient care, work
environment, staffing needs, practice
issues
5. Incorporates Evidence-Based Practice
6. Presentation to Academic Community via
Capstone Showcase

9. The Course Blueprint over 16 weeks!
Week 1 Course Overview and Project Start-Up
Finalize teams; Prioritize project selection; Assign EBP faculty mentor; Meet with project director
Week 2 Project Analysis
Project management principle review; EBP review; PICO question; Database search mentor/library scientist; RAPID Appraisal; Teamwork and collaboration; Status reports; Guided reflection via journaling
Week 3 Project Design
Engaging in self-directed study; Faculty Mentor and Project Director collaboration; Develop PICO Question

10. The Course Blueprint over 16 Weeks!
Week 4 Project Design
Engaging in self-directed study; Develop Search Strategy; Faculty EBP Mentor meetings
Week 5 Project Design/Intervention Development
Applying best available evidence; peer and
Faculty Mentor feedback; Critical appraisal;
Evidence table; Narrative summary
Week 6 Intervention Development
Poster presentation review; Reflective Journal;
Status Reports; Teamwork/collaboration review;
EBP Plan for Implementation; Plan for
Evaluation

11. THE COURSE BLUEPRINT OVER 16 WEEKS!
Week 7 Intervention Development
Finalize presentations and posters; peer/Mentor/Project Director feedback
Week 8 Summarizing and Integrating QSEN Core Competencies;
Week 9-15—EBP Project continuation meetings with Faculty Mentor/Project Director.
EBP Showcase/Poster Presentation; Post-Project Review; Final reflective journal; EBP Capstone paper (final paper submitted to SafeAssign)

12. Course Activities: EBP Process: Ask, Acquire, Appraise, Apply, Asses
(The 5 A’s)
Self-Directed Learning; Reflective Assignments; Problem-based learning
Peer and Faculty Mentor Meetings; Status Reports
QSEN integration
Student team-led presentations/discussions
Meetings with Project Directors/ Presentations
Professional poster development
Seelio Professional Portfolio
SafeAssign requirement
Completing the final EBP paper—all sections completed
EBP Showcase of posters
EXL agreement

13. Examples of Projects
QI projects related to harms: CAUTI, ClABSI, Falls, VTE,
HAPU, VAP; 30-day readmissions
Enhance handoff communication
Infant Mortality
Increase physician compliance to hand washing; Infection Control
Develop and implement plan for a stroke prevention unit
Policy/protocol for horizontal violence
“Condition H” evidence review/implementation

14. QSEN—Quality and Safety for Professional Nursing Practice Course
Course Objectives:
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.
Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making it achieve quality patient care.
Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.
Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.

15. Assignments and Evaluation
Participation in all in-class activities
Completion of Institute of Healthcare Improvement Open School (IHI) Basic Certification
Team Quality Improvement (QI) written report of project
Team QI PowerPoint presentation
Peer Evaluation of Presentation

16. An Example of a QI Project--HAPU
Our HAPU rates on Unit A have risen significantly over the past 6 months. We have a Wound and Skin Care Nurse (WSCN) who has training in wound care. This nurse does not have a Master’s degree or specialty certification in this area. The Wound and Skin Care Nurse is scheduled to work from Monday through Friday, 8a-5p. The nurse visits every unit and asks about each of our patients. If we identify someone as having a red spot or a potential area of breakdown, we let her know during the rounds.
The WSCN visits patients daily if they are on a computer-generated list of patients at risk for skin breakdown. The list is created when a box is checked in the computerized charting skin assessment area that asks if the patient is on bed rest or is unable to move independently. If a ‘yes’ is checked then the patients name is automatically placed on the list.
The WSCN spends a lot of time on the unit with the biggest problem with HAPU’s, our medical-surgical unit. We sometimes have a problem when a patient needs to be seen by the WSCN but is not on the list. Our current process is to perform the Braden Scale upon initial admission assessment, then once a day, usually during the midnight shifts. The information is entered into the electronic chart (documentation system). We can track the patients’ progress and see what treatments are given to the patient. For the most part, the WSCN does all the treatments unless we are given specific instructions about an individual patient. Because we have a WSCN, the direct care nurses are not familiar with how to care for the patient with skin breakdown unless the WSCN provides specific directions. We need to know what the best practices are for caring for a patient with a HAPU, including nurse driven care versus what the WSCN does for the patient.

17. Hospital Acquired Pressure Ulcers
Group Members
Amma Afriyie-Bonsu
Tiffany Bennett
Ranisha Brown-Simpson
Janea Edwards
Stephanie Norvil
Aisha Daily
Julia Parker

18. Background of Problem
Over the years, hospital acquired pressure ulcers (HAPU) have been a major concern in hospitalized patients.
“More than 2.5 million patients in the United States suffer from pressure ulcers in acute care facilities annually; sixty thousand of those patients die related to the complications of pressure ulcers” (Paul, Hanson, Hasenau & Dunn, 2013, p. 32).
HAPU’s are more prevalent amongst patients with restricted/impaired mobility.
Because patients are often very ill once admitted to an acute care setting, skin assessments and prevention measures are often delayed after admission.
It is stated that “pressure ulcers contribute to extended length of hospital stay, infections, amputations, increased need for specialty consults, increased nursing time, and to the potential for hospital readmission”(Paul et al., 2013, p.32) .

19. Defining Stages of Pressure Ulcers
Definition
According to Swafford et al (2016), pressure ulcers are defined as “any area of skin or been damaged by unrelieved pressure or pressure in combination with friction and shear, typically over a bony prominences in immobilized patients”(p.153).
Hospital Acquired Pressure Ulcers are acquired within 48 to 72 hours post admission.
Defining Stages of Pressure Ulcers
Stage 1
An area that has non-blanchable redness in intact skin
Stage 2
Partial thickness loss of dermis
Stage 3
Full thickness tissue loss that may evolve the subcutaneous tissue only
Stage 4
Full thickness tissue loss that evolves exposure of muscle, bone, or tendons
Unstageable
Full thickness loss where ulcer cannot be staged because of eschar or slough
I.S.K.I.N Bundle I
Identifying patients at risk S
Surface Selection K
Keeping patients turning and moving
Increased moisture and incontinence management N
Nutrition and fluid intake

20. Pico Question
In hospitalized patients with restricted mobility, what is the effectiveness of using the I.S.K.I. N. bundles compared to current practices to reduce the rate of hospital acquired pressure ulcers.

21. Analysis of Current Conditions
According to the case study, HAPU rates on Unit B have risen significantly over the past 6 months.
There is one Wound and Skin Care Nurse (WSCN), servicing the entire facility Monday-Friday from 8a-5p.
The WSCN visits patients based on a computer generated list of patients at risk for skin breakdown.
A problem arises when patients that need to be seen do not populate onto the daily list.
The WSCN provides all the treatments due to the fact that direct care nurses state that they are not familiar with how to care for the patient with skin breakdown unless the WSCN provides specific directions.
Missed Opportunities
Floor nurses don’t know the best available evidence for prevention of skin breakdown.
Patients are only assessed once during the midnight shift.
In order for patients to be seen by the WSCN they must appear on a computer-generated list.

22. Average Hospital-Acquired Pressure Ulcers on Units
Unit A
Unit B
Quarter 1
4.3
.66
Quarter 2 2
3.6
Quarter 3
.33
2.33
Quarter 4

23. Root Cause Analysis

24. Fishbone

25. Action Plan: Target

26. Evaluation and Benchmark
To reduce the occurrence of HAPUs within the facility on all units by 50 % with a targeted timeframe of within six months of implementation and 100% within one year of implementation.
Who
What
When
Reporting
Collaborative approach from all healthcare professionals in the hospital setting such as:
WCSN
Unit Nurses
Patient Care Technicians
Registered Dietitian
Physicians
Unit Managers
Nurse Educator
PT/OT
Work together to assess the patients with HAPUs or at risk for HAPUs.
Implementation of the I.S.K.I.N. bundle (as listed above in the Action Plan)
Communication is essential to implementation of the I.S.K.I.N.
Patients will be educated prior to discharge from the hospital on ways to prevent further skin breakdown
This should begin at admission and ongoing until discharge from the hospital
The I.S.K.I.N. bundle must be performed every shift and as needed as part of the plan of care
During every shift change
To nurses at monthly unit meetings
Posting data on bulletin boards in employee lounges/breakrooms of data and also weekly newsletters
Quarterly meetings with the collaborative healthcare team (as listed under Who) to evaluate the effectiveness of I.S.K.I.N. bundle

27. Best Available Evidence Action Plan
Frequent position changes (at least every two hours)
Avoid friction and shear when repositioning.
When repositioning, use proper technique.
Implement pressure relieving mattresses or surfaces.
Avoid turning patient on an area that is already reddened related to pressure.
For pressure ulcer prevention, do not rub or massage area.
Emollients can be used to hydrate the skin.
Barrier creams to protect skin from increased moisture.
Frequent skin assessments per protocol.
Nutritional risk assessments with interventions.
Additional protein supplements in additional to their regular diet
  Alderden et al (2011) list the following best practices in preventing HAPU’s.

28. References
Alderden, J., Whitney, J. D., Taylor, S. M., & Zaratkiewicz, S. (2011). Risk profile characteristics associated with
outcomes of hospital-acquired pressure ulcers: A retrospective review. Critical Care Nurse, 31 (4), p.
doi: /ccn
Fabbruzzo-Cota, C., Frecea, M., Kozell, K., Pere, K. Thompson, T., Thomas, J. & Wong, A.
(2016). A clinical nurse specialist-led interprofessional quality improvement project
to reduce hospital-acquired pressure ulcers. Clinical Nurse Specialist Journal.
doi: /NUR
Joanna Briggs Institute. (2016). Pressure area care. The Joanna Briggs Institute, 1-6. Retrieved from
3.19.0a/ovidweb.cgi?&S=GJJCFPJOKFDDGOPENCIKMCGCBHLNAA00&Complete+Reference=S.sh.21%7c2%7c1
Spetz, J., Aydin, C., Brown, D. & Donaldson, N. (2013). The value of reducing hospital-acquired
pressure ulcer prevalence. The Journal of Nursing Administration, 43 (4),
doi: /NNA.0b013e a3c
Swafford, K., Culpepper, R., Dunn, C. (2016). Use of a comprehensive program to reduce the incidence of hospital-acquired pressure ulcers in an intensive care unit. American Journal of Critical Care,25 (2), p doi: /ajcc

29. Now TO Capstone Course in Nursing ….EBP Project Example

30. Capstone Project—Phase II
Evidence-Based Implementation of Baby Boxes as a Preventive Measure to Decrease Pregnant Teen Infant Mortality In Lake County, IN.

31. Background
Lake County is ranked in the top 10 counties for having the highest infant mortality rate (IMR) in the state of Indiana with an IMR of 8.5 [per 1,000 infants] between the years of
Within Lake County, the area zip code 46312, East Chicago, has the highest infant mortality with an IMR of 15.1.
Infant mortality is defined as, “the death of an infant before his or her first birthday” (Indiana State Department of Health, 2012).
Top causes of infant mortality include perinatal complications, congenital malformations, Sudden Unexpected Infant Death (SUID).
An unsafe sleep environment is directly related to increased rates of SUID.
The Baby Box provides an independent sleep environment fitted with a firm mattress, lacking pillows, materials, or bedding that could cause suffocation. This evidence-based intervention meets safe sleep standards approved by the American Academy of Pediatrics (AAP).

32. Infant Mortality Rates

34. Objectives
Development of an implementation plan to decrease infant mortality rates within Lake County, IN.
To develop a prenatal program utilizing the Baby Box as an incentive to provide education and promote safe sleep practices.
To collaborate with community clinics and hospitals by engaging stakeholders such as physicians, RN’s, and clinical educators in order to promote continuity of safe sleep education for pregnant mothers.
Create a pre/post survey to determine pregnant mothers confidence levels and knowledge of safe sleep practices before and after education.

36. Databases
CINAHL, Cochrane, JBI, Medline, PubMed
Keywords
“Implementation strategies”, hospital, “implementation framework”, marketing strategy, women, hospitals, infant mortality, “implementation science”, implementation, “infant mortality”, “safe sleep”, “baby box”, “strategies”, “knowledge translation”, “knowledge transfer”, babies, infants, “implementation change”, newborn, marketing, pregnant teens, “intervention strategies”, “low income”, mothers

38. Appraisal Tools Utilized
JBI Critical Appraisal tools, CASP tools, and RAPID tools
JBI Levels of Evidence
Level 2.c -2
Level 2.d- 1
Level 3.b- 1
Level 3.c- 1
Level 4.b- 3
Level 4.d- 3
Level 5.b- 1

39. Implementation Overview
The gap between evidence-based research and implementation into clinical practice is a an unpredictable, slow, and complex process.
Models
The PARIHS model consists of 3 elements including evidence, context, and facilitation.
Barriers
Identifying and preventing potential barriers is essential to implementation success.
Education
Parents mimic behaviors at home practiced by nurses in the hospital.
HCPs should correlate the increased risk of SIDS with unsafe sleep environments during parent education.

40. Implementation Overview
Stakeholders
Participation by all levels of hospital staff improves implementation of innovative evidence-based practices.
Target Population
Self-efficacy is important to access confidence levels and general knowledge on safe sleep.
Most young mothers are in the earlier stages of change and need assistance to move into the action stage.
Marketing
Print, media, brochures and posters placed in locations such as registration desks, bulletin boards, and in front of scales and in examination rooms.

41. Implementation
St. Catherine’s Family Birthing Center showed interest in Baby Box utilization.
Presentations for staff education at local clinics are in the process of being arranged.

42. Implementation
Meeting with project director at 2015 Labor of Love presentation which provided the specific zip codes with the highest IMR to identify our target population.
Provided contacts at Greene County Hospital, St. Catherine’s Family Birthing Center, clinics in East Chicago.
Plans to assist with staff education presentation at specified community health centers.
Teleconferences
Baby Box Company- Jennifer Weber plans to aide with creation of a letter of intent for future grants.
Stork & Co.- Meena Nutbeam, founder of Stork & Co., provided distribution details specific to her company in Milwaukee, WI.
Greene County General Hospital, Linton, IN- Teresa Hutton, OB unit mgr., and Melissa Abbott, quality director, provided information and materials regarding their newly launched Sweet Dreams Baby Bundle incentive program.
Propose implementation plan to Tracy Sharp, L&D unit manager at St. Catherine’s in East Chicago, IN.
Proposed incentive program consists of:
Pre survey completed before the first meeting and post survey completed prior to discharge after delivery.
Receive binder and bag at first visit to add materials after each session.
Outlined education topics adapted for each individual for each trimester visit.
Free materials provided each visit to encourage participation with the Baby Box given at time of delivery in the hospital.

43. Recommendations Marketing strategies to promote incentive program.
Funding sources and grant proposals to purchase and fill Baby Boxes.
Identify a facilitator to head incentive program and conduct individualized teaching.
Distribute pretest survey at first visit and collect data—Revisit QSEN Tools of Quality Improvement.
* Post Survey will be distributed and analyzed in Phase 4.
Continued community outreach to clinics to engage more community leaders.

44. Now to What We Have Learned…

45. Patient Family Suggestions
Lessons Learned: Revisit Writing and EBP Literacy Skills related to PICO Question, Keywords, and Searching—Focus on QSEN Core
Questions
Uncertainty
Controversy
Efficacy
Unplanned Outcomes
Patient Family Suggestions

46. Lesson Learned: The Importance of Weekly Status Reports
Keep informed/engaged with project management and team responsibilities
Watch for conflict…conflict management principles. Emphasize team contract and “rules.”
Barriers and Facilitators for EBP project must be addressed.
No substitute for face-to-face contact with project team members!!!
Keeping everyone on the same page!
PAPER TRAIL ON A REGULAR BASIS!!!

47. Lessons Learned: Communication
Communication among teams and agencies—problem solving and conflict negotiation
Time management and “emergency management” among students and agencies
Student accountability for poster development and professional Showcase
Encourage Seelio updates
Keeping faculty on same page
Each team was very different!

48. Lessons Learned: Course Revisions
Need for flexibility in a real world setting!
Design project proposals sometimes may take a different direction—manage scope!
Attend to EBP barriers and facilitators
Importance of student-centered ownership and active participation throughout EBP project with an emphasis on ExL and QSEN competencies

49. Lessons Learned: Don’t Assume Students Know QSEN Competencies
Reinforce selected competencies: teamwork and collaboration; evidence based practice; patient safety; and quality improvement. Teamwork and collaboration
Emphasis on knowledge, skills and attitudes!

50. Other Lessons Learned Must start projects selection early
Must start project design and implementation early
Must start planning showcase early
Must start celebrating success early

51. Our Resources
Experienced faculty, librarian scientist. good communication , active problem-solving, and “working together”
Experienced project directors
Students positive with EBP capstone project outcomes (once it is done!)
Administrative support and costs associated with poster production and Showcase of EBP projects

52. PROJECTS EIGHT YEARS LATER…
More than 175 projects completed (May, 2016)
25 healthcare organizations partners
Undergraduate Research Grants and Awards
HESI scores in all QSEN areas have consistently measured over 1000 to positively since QSEN course began (2012)
Local and State collaboration and recognition
NLN Accreditation recognition as strength
Students obtaining entry level BSN positions based on Capstone strengths

53. Early Project: CAUTI Prevention

54. Family Presence During Cardiopulmonary Resuscitation

55. Creating Evidence-Based Isolation Signage Jillian Kukla, B. A
Creating Evidence-Based Isolation Signage Jillian Kukla, B.A., David Lukomski, B.A., Kerrie Tollerud, B.A., JulieAnn VanVuren, B.A. Purdue University Calumet School of Nursing
Abstract
Introduction
Conclusion
Standardizing signage and education materials will simultaneously
increase compliance of staff members using personal protective
equipment appropriately and decrease the rate of nosocomial
infections as well as community-acquired infections. The scope of
our project was creating evidence-based isolation signage that is
based on the original product presented by Saint Anthony
Memorial Hospital. Our literature review showed the original
product and other isolation signs available did not follow health
literacy research involving public literacy level, appropriate font
size for older adults, and clear pictures. We worked with the
original product to produce evidence-based signs.
Isolation refers to the separation of people who have a specific infectious illness from those who are healthy, as well as restriction of their movement, to stop the spread of the illness
Today, isolation is a standard procedure used for patients with tuberculosis and certain other infectious diseases (Siegel, Rhinehart, Jackson, & Chiarello, 2007).
Standardizing signage and education materials will simultaneously increase compliance of staff members using personal protective equipment appropriately and decrease the rate of nosocomial infections as well as community-acquired infections.
The scope of our project was creating evidence-based isolation signage that is based on the original product presented by Saint Anthony Memorial Hospital.
The new signage is not ready, at its current status, to be put up into Indiana hospitals.
What we did complete is a product that, if used as the base by which future work is done, will protect patients, staff, and visitors of the hospitals of the state of Indiana.
The signs can assist with lowering infection rates because the instructions are easily understood.
The first recommendation for future work is to have the Spanish on the signs viewed by a professional translator.
Another recommendation is to have the signs evaluated in the community. This process could also be completed for the appropriateness of the Spanish translations.
A final recommendation would be for the CDC to create isolation signs for use nationally.
Review of Literature
Methods
References
The book “Health Literacy in Primary Care: A Clinician’s Guide” became the guide book for the creation of the new signage, providing information for proper implementation of signs and information in the appropriate literacy level (Mayer & Villaire, 2007).
“Promoting Health Care Equity: Is Health Literacy a Missing Link?” has very clear and concise definitions of health literacy and outlines how literacy affects different racial groups and different levels of education (Hasnain-Wynia & Wolf, 2010).
“Health Literacy: The Gap Between Physicians and Patients” presents statistics showing the gap between the education of staff and patients. They thoroughly cover the concepts of the impact, the assessment, and the addressing of health literacy problems and offer suggestions for assisting with patients of lower health literacy and potential sources for further information for physicians with concerns (Safeer & Keenan, 2005).
The Centers for Disease Control and Prevention (CDC) has created and updated isolation guidelines. Isolation precautions come from these CDC guidelines, and these guidelines are used in creating isolation signage (Siegel, Rhinehart, Jackson, & Chiarello, 2007).
North Carolina becoming the “first state to have a ‘voluntary’ unified color scheme for isolation signage” (Hoffman, 2007).
Our research shows that there are plenty of isolations signs other than North Carolina’s. With all of the different signs available, there is a variety of designs used involving different content, colors, pictures, and phrases.
Our literature review showed the original product and other isolation signs available did not follow health literacy research involving public literacy level, appropriate font size for older adults, and clear pictures. We worked with the original product to produce evidence-based signs.
We also needed to incorporate Spanish into the signs in a way that was simple to read and understand.
The original signs had North Carolina isolation sign colors, which were the first color standards used and were incorporated by Washington State for their isolation sign standards, so we continued to use those colors so that the new signs will follow those standards already in place.
List available upon request
Acknowledgements
Faculty Preceptor: Ellen Moore, RN, MHSN, SNP-BC
Project Director: Janene Gumz-Pulaski, RN, BSN, MBA, CIC
Saint Anthony Memorial Hospital
Dr. Peggy S. Gerard, DNSc, RN, Dolores Huffman, PhD, RN
Atom Groom Design
Results
The new sign layout uses appropriate isolation precautions that are stated in a fifth grade literacy level.
The text is 14 point font or larger and is clearly read in black text against a white background.
The silhouettes are also clearly visible as black print on white paper and can work as standalone identifiers as to what actions are necessary. 55

57. Monitoring Outcomes 57

58. Looking Towards the Future…
We thank all of our Capstone students and healthcare partners who were actively involved in preparing for the challenges that lie ahead. We embrace a learning organization culture that supports innovation…and…it has been an exciting ExL experience that will continue to grow!

59. Thank YOU! T