Running head: ABBREVIATED TITLE (50 CHARACTERS OR LESS) 1

Proposal on a Med Surge IV Course

Author Name (First, Middle Initial, Last)

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Executive Summary

The title “Executive Summary” is at the top of the second page of your curriculum

proposal paper. It is not bolded, underlined, or italicized. While there are no specific APA

formatting requirements for an executive summary, you will need to make sure you use the same

APA formatting required for your paper. For this proposal paper, your executive summary

should be no longer than one page in length.

An executive summary is a synthesis of key points from your proposal paper. It is

finalized after you have completed writing your proposal and is considered a stand-alone

document. After completing each section, enter summary information in your executive

summary so you can refer to it after you have completed your proposal. Your executive summary

should be concise with sufficient detail and clarity to allow the reader to make decisions

regarding your proposal. Oftentimes, the executive summary is the only part of a proposal that is

read.

Arrange the executive summary using the five phases of ADDIE. Summarize each

section with no more than five sentences, including the same details and conclusions as in the

report. An executive summary is similar to an abstract; however, there are distinct differences.

For example, the author’s recommendations are not included in an abstract, while in an executive

summary they should be included. Remember, you want to grab the attention of the readers and

convince them that they should accept your proposal for a curriculum change, innovation, or

improvement.

For additional information on writing executive summaries, please refer to

http://libguides.usc.edu/writingguide/executivesummary
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Proposal on a Med Surge IV Course

Clinical practice is considered as one of the critical components of learning for nursing

students given the vital role in imparting clinical skills. The experience usually gives students the

chance to transfer theoretical knowledge into practice with the aid of registered nurses and other

experienced practitioners. The students get to interact with the real environment, coming into

contact with patients suffering from different conditions and also interacting with different

situations. In the process, they get to develop attitudes that may either be useful or detrimental to

them in their professional career in future. Nevertheless, the experience is a worthwhile activity

that has been made a mandatory obligation in most systems. Apart from developing clinical

skills, nurses are also expected to poses certain transversal competencies that are essential in

accomplishing their roles in healthcare centers. These skills include interpersonal skills,

communication, and leadership attributes, and are also gained through involvement in clinical

practice. I engaged in this practice at an institution of health where I made several observations.

My stay there allowed me an ample time to review the various processes that were undertaken in

the facility as they sought to provide care to their patients. My main focus was to identify an

issue relating to nursing education and had a significant impact in the workplace.

Several issues were identified, with some bearing significant advantages to the facility,

while others were a pain in the back to the center and the healthcare industry in general. The

main issue identified was the struggle that the nurses faced in IV skills. The problem was

particularly rampant in graduate nurses who were just arriving at the center. These individuals,

despite possessing incredible competencies in all the required clinical skills, they lacked

confidence in their IV skills. These nurses had undertaken nursing courses in their respective

schools where they gained theoretical knowledge on IV administration and other related
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activities. However, due to lack of enough practice, they failed to establish these skills; hence,

leading to reduced confidence in themselves. This paper focuses on addressing this issue by

analyzing the challenges posed by this predicament and giving recommendations on how to

alleviate it. The main focus will be on how to come up with a curriculum that will ensure a boost

in confidence in graduate nurses when undertaking IV related activities.

Background

Nursing acts as one of the most critical professions among humans given the vital role

that nurses are tasked with. These individuals are charged with restoring health by performing

operations that ensure a condition affecting a patient is done away with. Given the vitality of

their roles, they are expected to bear the utmost competence in ethics and skills. However, in the

recent past, a significant decline in the number of professional nurses has been noticed in the

healthcare industry due to several factors. The United States has been particularly affected by

this factor as a good number of the population is ageing away. The country falls among the

world’s most hit country by chronic illnesses. The CDC estimates that at least 6 in 10 Americans

are suffering from at least one chronic illness. This statistic implies that the mortality rate of the

population is threatened.

The population in the US is also increasingly getting older and soon enough, most of

them will be required to step aside from their various job positions to allow for the employment

of younger and aggressive individuals. The nursing industry is faced with a similar crisis and is

expected to replace their current working population in some years to come. It is estimated that

close to 69 million individuals currently in the US workforce will have reached retirement age by

2030. These statistics imply an increasing need for more nurses in the field to sustain the

function they are tasked with.

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As the numbers have continued to worsen in terms of shortage of nurses, a corresponding

increase in nurses has made it more imperative to utilize nurses just from school. Graduate

nurses are increasingly getting employed in various health institutions to cover for the deficiency

caused by the shortage in nurses. These nurses have lesser experience but are expected to meet

the same standards kept by the experienced and older professionals. Patients are usually

oblivious of the fact of less experience in these nurses and expect their needs to be satisfied with

the same level of efficiency as always. These nurses end up having a tough time in delivering all

the required objectives.

The increased presence of less experienced nurses in the healthcare industry has led to an

increasing rate of complications related to IV insertion cases. IV-related activities such as

Peripheral Intravascular Catheter (PIVC) insertion constitute the most practiced invasive

procedures in hospitals. It is estimated that 70% of inpatients are subjected to these insertions

during their stay at the hospital. Given the frequency of the activity, it is expected that all

practicing nurses should bear competency in this skill. However, the failure rates and

unscheduled restarts of PIVC are relatively high, with an estimated rate of 33-69%. Several

challenges may be attributed to these high rates of failure including infection, infiltration,

occlusion, phlebitis, pain, and accidental removal. These factors are aggravated by the increased

prevalence of less experienced nurses in the hospitals.

The complications resulting from IV insertions lead to considerable investment in both

human and capital resources to make up for the errors. One major challenge that has resulted

from the involvement of IV insertions is the development of catheter associated urinary tract

infection (CAUTI), which is a medical condition that results when a catheter insertion is made in

the urinary tract and not enough care is provided. The main cause of this challenge has been
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associated with the increased incompetence of the care providers. Nurses are the primary care

providers in hospitals, making them directly responsible for the high rates of CAUTI being

realized. A total of 93,000 CAUTI cases were recorded in the US in 2011 alone, showing the

severity of the condition. The country also incurs a yearly spending of $340-450 million in the

efforts to control the rise in CAUTI cases.

The demanding roles of nurses require high levels of competency in grasping the

necessary skills and possessing the expertise to execute them in real-life scenarios. The

possession of theoretical knowledge on this skill is not a sufficient attribute for a registered nurse

expecting to provide care to patients in hospitals. Numerous other skills are necessary to ensure

effective care is given and all the patients’ needs are satisfied. The process of transforming

theoretical knowledge to practice can only be realized by subjecting nursing students to the

actual clinical environment. Failure to do this, the students will only have a picture of the process

without having a personal experience with the procedure. The exercise usually involves emotions

during interaction with the patient as the practitioners perform their duties. Engaging in such

exercises will aid the student in developing attitudes and values for the task they are engaging in.

the involvement of passion and emotional feelings in the line of work boosts motivation and the

morale to give the best while performing such duties.

Most undergraduate nursing courses lack the capacity to provide practical clinical

experience to their students. The situation has been worsened by the increased rise in online

learning in recent past. Advancements in technology have made this possibility a reality as more

institutions continue to include this in their curriculum. Despite the advantages that have been

showed by inventions like virtual simulation, the provision of the needed clinical experience has

still not been successful. This shortcoming forms the basis of this paper.
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Purpose Statement

This paper is focused on coming up with a solution to a gap identified during a clinical

practice. The main issue identified was the struggle that nurses, mainly graduate nurses, face as

they go about IV related insertions. The problem was realized during my participation in clinical

practice in one healthcare institution. Further research reveals that the problem is a universal

issue that is affecting many nurses in other institutions too. This study seeks to analyze the

situation and come up with a solution to the problem. The suggested solution is to implement a

curriculum that will ensure the students are subjected to more practice. This way, the students

will have a hands-on experience with real-life situations in the clinic environment and help them

develop required skills.

The suggested curriculum is called Med Surge IV course and is simply a short course that

will target graduate nurses. The timeline of the course will lie in the transition period just before

the students get into the workforce. The program will take the approach of an internship schedule

with IV insertion serving as the main topic to be addressed. The short course will last for a

period of six months, in which the students will be heavily engaged in practical exercises of IV

insertions in various hospitals. The nature of the program will force the stakeholders to seek

partnerships from different hospitals to support the program and allow the use of their facilities.

The course will consist of definitions of the various types of IV and their roles in

provision of healthcare. The program will proceed to describe the various situations in which IV

administration is required and the corresponding procedures in performing the operation. Several

assessments and activities will be included to evaluate the competence of the students in relation

to the course objectives. The partner hospitals will be utilized for practicing the learnt theories.

The students will be assigned to other registered nurses in the institutions, who will guide them
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in the different procedures they will be undertaking. The instructor will have an overarching role

of supervising the course of activities and recording the performance of the students on specified

sheets.

The course is mainly meant to enhance the clinical skills of the students by exposing

them to real-life situations from which they will apply their theoretical knowledge on IV

insertions. As such, the program will consist of activities directed in this line. The students will

be subjected to IV insertion procedures on real patients under the supervision of qualified

practitioners with the instructor observing the whole process and assess the performance of the

student. The pass/fail criteria will be based on the performance of the student in both the

practical activities and written assignments. The program will also target the teamwork abilities

of the students as this attribute is an essential one in nursing practice. The students will be

engaged in several teamwork assignments that will be graded and form part of their final score.

The course will be culminated with the issuance of certificates, showing the students’ aggregate

scores from all the assignments and activities.

This paper will highlight the challenges that will be addressed by this new curriculum. It

will also perform a need-gap analysis to show the process of identifying the necessity in the

system that will ensure the desired results are achieved. Other analysis like force-field analysis

and affinity assessment will be conducted to test the feasibility of the suggested course.

Rationale

This proposal is made with the focus of enhancing efficiency and effective practice in the

healthcare centers. The study is focused on encouraging patient safety by enhancing the

competencies of the professionals employed in these areas. Nurses are the primary care providers

in hospitals and spend the most time with patients in these centers. They are usually tasked with
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providing the first attempts of restoring health to patients. As such, they have a significant role in

the outcome of the patient’s condition. This vital role played by nurses makes it paramount to

have the highest competencies in the various skills required for the field. However, this has not

always been the case in the industry as numerous shortcomings have always been rampant in the

field.

The paper is mainly focused on enhancing the IV placement skills in nurses graduating

into the workplace. Observations during clinical practice depicted an increasingly low

confidence and knowledge levels on this very critical skill. This trend is not a friendly situation

in hospitals as it may lead to worse outcomes to individual patients and the healthcare industry at

large. For this reason, the paper is centered on coming up with a curriculum to boost the learning

of these skills in school.

The motivation behind coming up with this program lies in the worsening situations that

have been rampant in the healthcare industry in recent times. Several problems have particularly

occurred that are related to IV insertion skills with the rise in the number of CAUTI cases acting

as the leading reason. CAUTI describes a type of infection that results from the poor

management of catheters inserted in the urinary tract. The condition falls among the most

common infections resulting from ineffectiveness of hospitals. It is estimated that over 7000,000

hospital0acquired infections occur each year with 75,000 of them resulting in fatalities. CAUTI

serves as one of the fatal conditions that leads to death if not handled appropriately.

Your introduction should introduce the reader to your topic and provide the rationale for your

proposal. Present background information on the problem your proposal will address in this

section. Include the theoretical framework that will underlie your project, which can be a

nursing, education, or change theory. The theoretical framework you select must be relevant to
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the topic of your proposal and the process of developing your curriculum change, innovation, or

improvement. The introduction section should end with the purpose of your curriculum proposal.

Literature Review

The first heading in your proposal paper should be your “Literature Review,” which is a

level 1 heading formatted in title case, centered, and bolded. Title case means the first word and

all major words (i.e., nouns, verbs, adjectives, adverbs, and pronouns) are capitalized including

the second part of hyphenated major words (e.g., Evidence-Based, not Evidence-based). All

major words of four letters and more are capitalized.

For your literature review section, present the curriculum gap or problem you identified

within the context of the literature. Summarize and synthesize what is known or not known

(knowledge gaps) about this curriculum issue from the literature and other credible sources. For

additional information on writing a literature review, please visit

http://libguides.usc.edu/writingguide/literaturereview.

You may want to organize your literature by themes or by the quality of the source you

are reviewing. To do this, you may need to create additional levels of headings. Remember to

move headings that fall at the end of a page to the next paper, as they are considered orphan

headings.

After you have searched for relevant articles, select the top ten publications that are most

relevant to your curriculum proposal project. These articles will be used in your “Literature

Review Summary Table.” This table will be too long to include in the body of your manuscript

so place it after your reference list. It should be numbered sequentially following any previous

tables. Use the following criteria to create your table and appraise your ten articles:
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Table 1.
Literature Review Summary Table
First Author Strength of
(Pub Year) Title Purpose Context Findings Relevance Evidence
Last Name Example: Present the Population State the key Summary of Include the
(Year) “Techniques topic, focus, of interest findings that how this level of
for Writing a purpose, or and relate to your article is strength, as
Curriculum question that description proposal. relevant to listed in Unit 4,
Proposal underpins of setting your and present a
Project” your proposal summary of
proposal. strengths and
weaknesses of
the article.

After you have completed your appraisal of the sources used, you will want to synthesize

the results and organize your findings by themes or by the quality of the source you are

reviewing. To do this, you may need to create additional levels of headings.

Level 2 First Subheading Flush Left, Boldface, Title Case

If the paper will have several sections that relate to the level 1 heading above, level 2

headings should be included. These are flush left and bolded with each word of four letters or

more capitalized.

Level 2 Second Subheading

APA requires that you use at least two subheadings under a main heading. One

subheading is not allowed.

Level 3 first heading indented, bold face, and in sentence case. If you have two or

more distinct topics for this subsection and would like to organize your section to highlight key

points, you should create level 3 headings.

Level 3 second heading. As noted above, avoid having only one level 3 heading under a

level 2 subsection. This may disrupt the flow and continuity of ideas presented in your paper. If
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needed, there are level 4 and level 5 subheadings which can be found in your APA Publication

Manual 6th edition. (American Psychological Association, 2010).

Application of the ADDIE Model

This section will include the methods you will use to analyze, design, develop,

implement, and evaluate (ADDIE) your curriculum proposal. The model you will use for

creating your curriculum proposal is the ADDIE model of instructional design. Provide a general

overview of the ADDIE model and describe the phases that will be addressed in your proposal

paper. The phases will become level 2 headings in this section.

Analysis Phase

In the analysis phase of the ADDIE model, the curriculum issue is clarified, the

instructional goals and objectives are established, the learner’s knowledge and skills are

identified, and the learning environment and method of instructional delivery is determined.

This phase will always include some form of need-gap analysis, which consists of the

results of a needs assessment used to create the desired state for a gap analysis. Your need-gap

analysis should be conducted with key stakeholders and academic nurse educators. In this

section, present an overview of the relevancy and qualifications of your stakeholders; however, it

should not include actual names. The need-gap analysis should be a systematic process for

determining and addressing needs or gaps between current curriculum and desired curriculum.

Brainstorming sessions using techniques such as an affinity analysis, also known as the sticky

note method, will help you focus on identifying a need that will fill a curriculum gap. For
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additional information on conducting an affinity analysis, visit http://asq.org/learn-about-

quality/idea-creation-tools/overview/affinity.html.

The results of your affinity analysis should be presented as an affinity diagram and then

the identified need should be incorporated into your curriculum need-gap analysis table. Use

Table 2 below as a template. Your table should not break across pages. It should fit on one page

with text; therefore, if your table spans more than one page move it to the end of your paper,

immediately following your references. In-text, you should refer to it as table X, where X is the

number of the table.

Table 2.

Curriculum Need-Gap Analysis Table

Instructional Current Desired Action Steps to Meet

Objectives Curriculum Curriculum Need-gap the Need-gap

After you have completed your need-gap analysis, you will need to assess organizational

readiness for this change. An effective method for accomplishing this is to complete a force field

analysis that identifies forces for and against your curriculum proposal. Collaborate with your

preceptor and stakeholders to identify factors that could impact the adoption of your proposal.
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Use the following template to complete this readiness assessment and then provide a summary of

your findings regarding the feasibility of implementing this change.

Table 3.

Organizational Readiness for Curriculum Proposal

Forces FOR Curriculum Forces AGAINST

Curriculum Proposal Proposal Curriculum Proposal

   

   

   

   

   

Design Phase

In the design phase of the ADDIE model, you will complete the following elements for a

syllabus for your proposed course. The methods and resources you used to create these elements

will be described in this section, and your syllabus will be attached after tables and figures as

“Appendix A.” In this section, also include information on theories, models, and strategies that

you used to design your course syllabus:

a. Course Description

b. Course Objectives

c. Teaching/Instructional Strategies

d. Learning Materials

e. Course Content Outline

f. Student-Centered Learning Outcomes

g. Course Policies
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h. Grading Policy/Scale

Development Phase

During the development phase, the actual creation of the content and learning materials

based on the design phase, is completed. Review instructions in the assessment for this course

for additional details. The following course materials should be developed and included as

appendices to your paper:

a. Course Unit Overview

b. Lecture Content

c. Learning Resources

d. Learning activities

e. Formative Quiz

f. Summative Test

g. Performance Task

h. Performance Task Evaluation Rubric

Implementation Planning Phase

During the implementation planning phase, you will plan the implementation of your

curriculum proposal change, innovation, or improvement project. It is not the intention of this

proposal to implement this curriculum change at this time; however, planning for an

implementation is a critical piece within the ADDIE process. The following items should be

addressed in this section:

a. Discussion on the learning environment and the method of delivering your course

(e.g., online, classroom, blended, clinical, laboratory, virtual)

b. Resources that will be needed to pilot test and implement the course. Include
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human, financial, and technology resources

c. Stakeholder list that includes the job title and the role that each individual will

have during the implementation process. Do not include actual names

d. Chart with tasks, task owners, and start/completion dates

e. Process that will be used to gather feedback from participants in the pilot phase

f. Procedure for editing/improving the course during the pilot testing phase

g. Faculty training plan (completed prior to course going live)

h. Explanation of how testing will be monitored for errors

i. Description of a backup strategy for use when technical and other problems

prevent students from accessing the course

Evaluation Planning Phase

The last phase of the ADDIE method for instructional design is evaluation. For your

proposal project, you will need to plan for the evaluation of the course by addressing the

following items:

a. Course Performance Metrics: Research course evaluation methods and collaborate

with your academic mentor/preceptor to identify metrics that will be used to

evaluate course performance.

b. Student Evaluations: Create a 10-item end-of-course student survey that students

will use to evaluate the course and instructor. At a minimum, evaluate the

following:

i. Instructor Performance

ii. Learning Materials/Resources

iii. Learning Management System/Technology Usability and Usefulness

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iv. Assessments and Assignments

v. Social Learning/Peer Collaboration

vi. Overall Satisfaction with the Course

a. Formative Evaluation Plan: Present a plan for monitoring course performance that

includes the process, tasks, and the individuals responsible for ensuring the course

is meeting student and instructor expectations.

Conclusion

In your conclusion, bring the reader back to the rationale and purpose of your proposal.

Emphasize how your proposal fills the curriculum need-gap that was identified. Discuss why

implementing this proposal is important and the impact it will have on the broader area of

nursing. This section should focus on the impact and significance of your proposal. Your

conclusion should not present new information, rather it should provide new insight and offer

creative approaches for meeting the need-gap.

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References

The reference list should follow the body of your paper (see the example on the next

page). Each source you cite in your paper must have a corresponding reference listed in the

reference list. A sample reference page is included below with different reference types, such as

books, journal articles, and websites. When using websites, you should italicize the title if the

information is a stand-alone (see National League for Nursing reference on next page). If it is

part of the whole web page or any other electronic data, it should not be italicized (see CDC

reference on next page).

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References

American Psychological Association. (2010). Publication manual of the American

Psychological Association (6th ed.). Washington, DC: American Psychological

Association.

Centers for Disease Control & Prevention. (2017). Epi info 7: Salmonella outbreak tutorial.

Retrieved from https://www.cdc.gov/epiinfo/support/tutorials.html

Raisman, N. A. (2013). The cost of attrition at four-year colleges and universities. Educational

Policy.org Policy Perspectives. Retrieved from

http://www.educationalpolicy.org/pdf/1302_PolicyPerspectives.pdf

Valentine, J. C., Hirschy, A. S., Bremer, C. D., Novillo, W., Castellano, M., & Banister, A.

(2011). Keeping at-risk students in school: A systematic review of college retention

programs. Educational Evaluation and Policy Analysis, 33, 214-234. Doi:

10.3102/0162373711398126

U.S. Department of Health and Human Services, National Institutes of Health, National Heart,

Lung, and Blood Institute. (2003). Managing asthma: A guide for schools (NIH

Publication No. 02-2650). Retrieved from http://www.nhlbi.nih.gov/

health/prof/asthma/asth_sch.pdf

Note: Following your references, you may include tables, figures, and appendices (in this order).

Present key points about these items in the body of your paper and then refer the reader to

the table and figure numbers or the appendices letters. Please refer to your APA

Publication Manual (2010) for examples of proper formatting for these additional
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sources of information.