In collaboration with the approved clinical preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The selected problem should encourage the student to engage in interprofessional collaborative practice.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

Topic: Improving Medication Reconciliation Accuracy at Admission and Discharge

Medication errors often occur during care transitions. This project could introduce a nurse-led medication reconciliation checklist or electronic workflow enhancement. Measurable outcomes may include medication discrepancies, readmission rates related to medication errors, and patient understanding of discharge medications.

This project is only a proposal and will not be implemented in a practice setting.

Write a 750-word description of your proposed capstone project topic. Include the following:

1. Describe the problem or issue that will be the focus of the change proposal. Explain with which category (leadership or community) the selected topic would best align.

2. Discuss the setting or context in which the problem or issue can be observed and describe the population affected by this problem or issue.

3. Discuss the implications this clinical practice problem or issue has on nursing practice.

4. Based on your needs assessment in Topic 1, describe why this is a priority for the community/clinical site or affected clinical population.

5. Briefly describe the organizational structure (mission, vision, values, leadership structure, etc.) of the practicum site. What internal and external processes will impact care coordination for the selected population or community?

6. How effective has the organization been in addressing the identified problem or issue?

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Struggling with where to start this assignment? Follow this guide to tackle your assignment easily!

Step-by-Step Tutor Guide to Writing Your 750-Word Capstone Project Topic Description

This assignment is designed to assess your ability to identify a real clinical problem, analyze it through an evidence-based lens, and align it with organizational and community priorities. Below is a structured approach to help you meet each requirement clearly and efficiently.

Step 1: Describe the Problem and Category Alignment (≈150 words)

What to Do

Begin by clearly defining the clinical problem:

Medication reconciliation errors during admission and discharge
Emphasize care transitions as high-risk periods

Category Alignment

This topic aligns best with:

Leadership (nurse-led initiatives, workflow improvement, interprofessional coordination)
It can also be framed as quality improvement, which is often embedded within leadership initiatives

Tutor tip: Explicitly name the category and justify it—don’t assume the reader will infer it.

Step 2: Discuss the Setting and Population (≈120–150 words)

Setting

Describe the clinical environment where this issue occurs, such as:

Acute care hospital
Medical-surgical units
Transitional care or discharge planning units

Population Affected

Identify who is most impacted:

Older adults
Patients with multiple chronic conditions
Patients on polypharmacy regimens
Individuals with low health literacy

Explain why this population is vulnerable during transitions of care.

Step 3: Implications for Nursing Practice (≈120 words)

Focus on how this issue affects nurses:

Increased risk of adverse drug events
Ethical responsibility for patient safety
Time burden and workflow inefficiencies
Accountability in patient education and discharge planning

Tutor reminder: Connect the problem to professional nursing roles, not just patient outcomes.

Step 4: Priority Based on Needs Assessment (≈120 words)

Using insights from Topic 1 (needs assessment):

Explain why medication reconciliation is a priority
Link to:
- Readmission penalties
- Patient safety metrics
- Accreditation and quality benchmarks

Clearly state how improving accuracy supports:

Better outcomes
Reduced costs
Improved patient understanding and self-management

Step 5: Describe the Organizational Structure (≈120–150 words)

Include a concise overview of the practicum site:

Mission, vision, and values (e.g., safety, quality, patient-centered care)
Leadership structure (shared governance, nursing leadership roles)

Internal Processes

Interdisciplinary rounds
EHR workflows
Nursing handoffs

External Processes

Regulatory requirements
Reimbursement policies
Community partnerships

Explain how these processes impact care coordination for medication reconciliation.

Step 6: Effectiveness of Current Organizational Efforts (≈100 words)

Critically evaluate:

Existing medication reconciliation processes
Gaps or inconsistencies
Limitations in staff training or technology

Acknowledge what is working and what is not—this sets the stage for your proposed change.

Tutor tip: This is not criticism; it’s a rationale for improvement.

Step 7: Integrate Evidence (Throughout the Paper)

You must cite at least three peer-reviewed sources:

Published within the past 5 years
Relevant to nursing practice and patient safety

Use evidence to support:

The significance of the problem
The effectiveness of nurse-led reconciliation
Outcomes such as reduced errors and readmissions

Suggested Scholarly Resources

You may use the following peer-reviewed and authoritative sources:

Agency for Healthcare Research and Quality (Medication Reconciliation):
https://www.ahrq.gov/patient-safety/settings/hospital/medication-reconciliation.html
Institute for Healthcare Improvement – Medication Safety:
https://www.ihi.org/Topics/MedicationSafety
Mueller et al. (2019). Hospital-based medication reconciliation practices:
https://pubmed.ncbi.nlm.nih.gov/
World Health Organization – Medication Without Harm Initiative:
https://www.who.int/initiatives/medication-without-harm

Capstone Change Proposal on Medication Reconciliation