Capstone Project, Risk and Challenges

Implementation, Challenges and Resolution

The implementation of the narcotic waste process project has encountered several notable challenges during its initial phases. One of the factors is the hesitation of the administration to provide funding, although the relatively modest implementation cost of $1,600 for the basic factors such as training materials, spending time for training of staff, documentation forms and conducting weekly audits is hardly an impediment: Capstone Project, Risk and Challenges.

This issue was tactically approached by putting forth a cost-benefit analysis to indicate that a monthly reduction in expenditure by about $3,000 was achievable through reduced time spent investigating narcotic discrepancies and reduced risks of incurring regulatory fines. Securing the necessary support for the project’s financial requirements was made easier by the fact that the investment returned positive cash flows within the first month.

The project also faces significant challenges in coordinating training schedules between day and night-shift nurses. Heagney (2022) points out that scheduling conflicts of this sort can make a substantial difference to the timing of project interfaces and the dynamics of the teams involved. In order to get around this problem, training was recorded on video and made available to all shifts, thus promoting consistent learning opportunities while maintaining operational efficiency.

Potential Risks and Challenges

The project has certain critical risks that may influence its success negatively. One clear area of concern pertains to staff discontent with additional documentation provision, considering the present workload during high census periods. Such discontent may be dire in terms of the set target of achieving 90% compliance with two-nurse verification procedures.

There is also a risk associated with the additional workload related to the new supporting documents. As Hussein et al. (2021) indicated, efforts aimed at ensuring quality might fail to reach their goals since they also contribute to increasing the load on the already burdened staff. Such an added load can trigger staff turnover and make it difficult to maintain the schedule of training, as well as the implementation period.

Other challenges regard the integration of the electronic medication administration record (eMAR) system and standardization of the process for documenting wastage for various shifts. These further lead to a shortage in the number of trained pharmacy personnel to assist in the training process and the probable delays in approval from concerned regulatory agencies.

Triple Constraints Triangle Analysis

The identified risks and challenges are in line with Heagney’s triple constraints model, which provides a view of the project limitations alongside their interconnectedness. The time constraints predominantly come up due to interference in training schedules and difficulties in maintaining proper documentation during high censuses. In addition, the SLA requirements of 24 hours for waste verification also put some time pressure on the project.

Cost constraints include both costs associated with the initial implementation as well as costs that are incurred after the training with respect to compensating time. These financial constraints should, however, be weighed against the anticipated gains associated with increased operational efficiency and compliance with required standards. Scope constraints, on the other hand, are the most controversial aspects of this project because of the extensive cross-training of the staff and the many levels of regulatory requirements from the DEA, Joint Commission, and State Board of Nursing.

Contingency Plan and Strategies

A comprehensive contingency plan has been developed to effectively address these challenges. To begin with, hybrid training options that mix recorded sessions and in-person training have been incorporated as part of the training and documentation strategy, which makes it more flexible while ensuring education quality remains intact. In addition, mobile-friendly documentation tools are going to be used to improve the verification process efficiency, while peer mentorship will offer ongoing support to employees.

Moreover, resource management strategies concentrate on creating backup staffing plans for high census periods and establishing a rotating schedule for pharmacy staff support. In their work, Preuss et al. (2023) argue that proper controlled substance management entails sustained supervision as well as supportive systems. The financial mitigation plan involves spreading implementation costs over several budget periods and documenting early successes in order to retain administrative backing.

Strategic Plan Modifications

A series of modifications based on the risk assessment should be proposed. Extending the training period by the duration called for in the hybrid method of training and providing more buffer time between implementation phases will help with unexpected hurdles. Regular review points must, therefore, be in place where procedures may be amended upon staff review and feedback.

Process changes include adding preliminary testing of documentation procedures and the establishment of clear escalation procedures related to compliance issues. The objective of these changes is to provide a much stronger, more flexible implementation process while maintaining focus on core project objectives.

The success of such changes largely depends on keeping the lines of communication open with all parties involved and flexibility in approach, while firm in regulatory requirements. Ongoing evaluation of these strategic changes will ensure they are fully meeting the identified risks yet supporting the project’s overall objectives.

References

Heagney, J. (2022). Fundamentals of project management (6th ed.). AMACOM.

Hussein, M., Pavlova, M., Ghalwash, M., & Groot, W. (2021). The impact of hospital accreditation on the quality of healthcare: A systematic literature review. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-07097-6

Preuss, C. V., Kalava, A., & King, K. C. (2023, April 29). Prescription of controlled substances: benefits and risks. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK537318/

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Getting Started

Throughout the NUR-495 course, you will actively engage in strategically planning for and managing a planned change project within the scope of your current professional role.  For this field-based project, you will identify a specific problem or need to serve as the foundation for a faculty-guided capstone experience.  Project-related experiences are integrated throughout the course, and will involve application of strategic planning and management processes.

As you consider the activities necessary to implement your capstone project, you will find many similarities between the “planning and implementation” phases of the nursing process to the “work schedule” used to guide the capstone project.  In both cases, these steps serve as an action plan to direct specific activities and tasks that will facilitate achieving a specific outcome.  In the case of your capstone project, the work schedule you developed in Workshop Three serves as a dynamic plan to communicate the activities and tasks that are necessary to perform to successfully achieve your project outcome.

In this discussion, you will assess specific risks that may threaten your capstone project.  You will identify challenges related to getting the necessary time, human resources, funding, and material supplies necessary for success of the capstone project. You will develop specific strategies to intervene, should those risks become reality.  Finally, you will explore the impact of those risks and challenges on your overarching plan.

Upon successful completion of the course material, you will be able to:

• Synthesize a contingency plan to address risks and challenges that impact the capstone project.
• Implement the activities of your strategic plan necessary to complete the capstone project.

Resources

• Textbook: Fundamentals of Project Management

Background Information

As discussed in Workshop One, the planned change process is rather iterative in nature, with dynamics that are organic rather than static.  For this reason, we tend to think of a planned change project as a work in continual process.  With each workshop, you will polish and fine-tune aspects of your plan as part of the learning process.

Each facet of the planned change process will be unpacked, examined, and critically applied to your capstone project.  As you advance in the course, each workshop will bring an opportunity to carefully reflect upon and streamline your work.  When the capstone course ends, your final project documentation will accurately articulate the planned change process that you have created and managed.

In the previous workshops, you carefully considered a variety of factors that affect the change process, established a problem statement, planned for evaluation, and detailed a work schedule to guide the capstone project.  This week, you will identify potential risks and challenges to its progress, and develop a contingency plan to manage those issues.

Please note: Eight hours of workshop time is allocated to your efforts in this assignment.  Though your work in planning for potential risks and challenges does not directly pertain to your major deliverable (the 7.3 Capstone Project Presentation), it is crucial to the overall success of your planned change initiative.

Instructions

1. Review the rubric to make sure you understand the criteria for earning your grade.
2. In the Leading and Managing in Nursing textbook, read chapter 23.
3. In the Fundamentals of Project Management textbook, read chapters 6, 10, and 11.
4. Revisit the capstone work you completed in the previous workshops, as well as any faculty feedback that you received.
5. In Chapter 11 of the Fundamentals of Project Management textbook, three sources of change are depicted in the “triple constraints triangle.”  These sources of change can become potential risks to the capstone project.  Chapter 6 of the Fundamentals of Project Management (Heagney, 2016) textbook discusses strategies to manage risks and establish contingency plans.  Based on these readings, navigate to the threaded discussion and respond to the following:
   1. Identify any challenges with implementing the capstone project you have experienced; discuss how they were addressed or resolved.
   2. Discuss potential risks and challenges that may threaten your capstone project.
   3. Explain how real or potential risks and challenges fit into the “triple constraints triangle”?
   4. Describe a contingency plan including specific strategies to manage the real or potential risks and challenges to your project.
   5. Based on your assessment of risks and challenges, what, if any, changes are needed to your strategic plan or timeline?
6. Cite and reference a minimum of one source for your initial posting.
7. Your initial post is due by the end of the fourth day of the workshop.
8. Read and respond to at least two of your classmates’ postings by the end of the workshop.  You are encouraged to respond to follow-up instructor questions directed to you.
9. Your response to classmates should also:
   1. Be well developed by providing substantive feedback with evidence of critical thinking.
   2. Your observations should add greater depth to the discussion by introducing new ideas.
   3. Provide clarification to classmates’ questions and provide insight into the discussion.
   4. Be posted on two different days during the workshop.