NURS FPX 6026 Assessment 3 Population Health Policy Advocacy
Phillip October 3, 2023 No Comments

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Student Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Problem Statement (PICOT)

The NCLEX, an acronym for the National Council Licensure Examination, is developed for nursing graduates in the United States and Canada to successfully pass the computerized test to receive a license for practicing in clinical areas as Practical Nurses (PN) or Registered Nurses (RN). The NCLEX-PN/RN is a test to measure the essential competencies of newly graduated nurses to provide safe and effective care in patient care areas. For this purpose, organizations continuously strive to improve their learning strategies and processes. This assessment investigates the details of a problem statement using the PICOT approach: “Does a blended learning approach to LPN education, compared to a traditional in-person program, lead to improved NCLEX pass rates over 12 months.” 

Need Assessment 

Improving the passing rates of the NCLEX exam among LPN students is the pivotal need that this project revolves around. Specifically, the project is investigating if a blended learning approach (a combination of both online and classroom learning modalities) will be valuable compared to traditional classroom learning to improve the performance of concerned students in passing their licensure exams. There are several reasons behind the importance of clearing NCLEX for nursing students. These include ensuring patient safety and expanding the healthcare workforce. Licensed practice nurses (LPNs) play a crucial role in healthcare by providing direct care to the patients at the frontline and maintaining patient safety (Vaismoradi et al., 2020). Their competency is indicated through the NCLEX passing rates. Furthermore, high NCLEX passing rates will eventually expand the frontline workforce, addressing nursing shortages nationwide. Thus, there is a pressing need to improve NCLEX pass rates using different educational modalities. 

Assumptions of Analysis

This need assessment analysis is based on the assumption that NCLEX is vital for nurses in clinical areas_ it ensures that nurses are competent with their knowledge of nursing practices, it helps to maintain patient safety and improve the quality of care, it indicates that educational programs are effective and further resources should be invested to introduce other educational modalities to enhance further the licensure exam passing rates. 

Population and Setting 

Through this capstone project, I will target LPN students presently enrolled in nursing education programs. The goal is to apply the intervention (blended learning) to observe the passing rates of NCLEX for 12 months. Career growth and development is one reason that signifies the need to improve the licensure exam passing rates within my project population. Since LPN students are future healthcare providers, completing and passing licensure exams is necessary. If proven to be an effective learning approach, blended learning will help the targeted population become qualified and licensed to provide care, which is essential for their career growth and development. 

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Simultaneously, the targeted setting in this capstone project is Chippewa Valley Technical College (CVTC), where a one-year Practical Nursing (LPN) diploma program is established. This program helps students learn basic nursing skills to help and support other healthcare providers (physicians, nurses, and nurse practitioners) in healthcare settings. The delivery method of this program is face-to-face; thus, a blended learning approach is planned to be introduced in the college through this capstone project. Since LPN programs are developed to prepare students to work in patient care areas, increasing licensure exam passing rates is imperative. Addressing the need through our proposed intervention is significant to identify the quality of the education, consequently preparing nurses for providing safe and effective care. Moreover, high NCLEX passing rates are essential for the organization to seek accreditation and retain a positive reputation. 

Quality Improvement Method

The quality improvement method used in our project is the PDSA (plan-do-study-act) cycle, also called Deming’s cycle. It is a four-stage, repetitive QI method focusing on continuous progress in quality improvement projects (Chen et al., 2021). In our project’s “planning” phase, we will select a batch of nursing students who will act as an interventional group. Further, we will identify the need to address NCLEX exam rates by analyzing test pass rates in the past three years and a short and long-term goal is decided. For instance, the goal of our project is to improve NCLEX passing rates by 20% within the first six months and by 50% at the end of the year.

In the “doing” stage, the planned intervention (blended learning approach) is implemented. After implementation, pre- and post-intervention passing rates will be assessed in the “studying” phase, along with gathering feedback from faculty and students on our intervention. In the last stage (acting phase), the continuous improvement process will begin by analyzing the results. The approach will be scaled up on positive results, and further improvements will be made on receiving negative results. 

Potential Challenges 

Limited access to technology and digital literacy are significant challenges that students may encounter, eventually hindering their learning process. Another challenge is time consumption, explicitly affecting the faculty. A study claims that creating blended learning modules and courses is more time-consuming than face-to-face interaction (Alvarez Jr, 2020). Moreover, technical problems like poor connectivity and lack of resources may disrupt the effectiveness of learning and development. To address these challenges, it is imperative to ensure adequate resources, student and faculty training, improvising technological infrastructure in the organization, and allocating incentives for faculty on their extra efforts. 

Intervention Overview

Several educational interventions can be applied to improve the NCLEX passing rates. However, our project focuses on using a blended learning approach to address the identified need among LPN students at CVT College. I would use problem-based learning (PBL), webinar courses, virtual discussion forums, and quiz completion applications in my project. Since blended learning provides flexible learning times and develops skills for independent study (Shang & Liu, 2018), it is the best fit for LPN students due to their diverse schedules and responsibilities.

Moreover, it is an appropriate intervention for CVT College as the faculty and administration are always welcoming to improving the quality of their education. However, certain aspects that require attention are the availability of technological resources and learners’ ability to utilize these blended methods of education effectively. These aspects can act as the weaknesses of blended learning; therefore, assessing students’ readiness to change and tailoring the program according to their preferences is imperative. Additionally, a budget must be allocated for adequate technological resources within the campus that students can utilize for learning purposes. 

Comparison of Approaches 

Alternative approaches to education that can directly or indirectly impact the need of the project (improving NCLEX passing rates) are inter-professional education and simulation-based learning. 

Inter-professional Education (IPE)

When learning together, students from various healthcare backgrounds, such as nursing, medicine, and pharmacy, can foster a collaborative environment and improve healthcare practices in clinical areas (Zechariah et al., 2019). This approach will encourage LPN students to perform inter-professional care by exposing them to diverse perspectives and skills. While IPE would not directly target the NCLEX passing rates, it will motivate the students to perform well in their licensure exams. Nevertheless, conducting IPE can be resource-intensive and may become inappropriate for organizations with limited resources, such as our project setting. Additionally, analyzing the effects of IPE on NCLEX pass rates is a complicated process. Thus, there is a need to address these weaknesses before applying the alternative approach. 

Simulation-based Learning 

Simulation-based teaching involves the deployment of realistic scenarios where  LPN students are exposed to a simulated clinical environment where they work alongside other healthcare professionals, fostering collaboration and inter-professional care. It is an appropriate approach for CVT College as some study programs have incorporated simulation learning. Thus, the organization has simulation labs equipped with the necessary technologies. Literature supports simulation-based education to improve NCLEX pass rates as this approach improves critical thinking ability, consequently enhancing students’ clinical judgment (Boev, 2023), directly contributing to their readiness for the NCLEX and their ability to provide safe and effective patient care.

However, simulation-based learning is cost-ineffective, and several technical problems may hinder the smooth learning process. While both approaches are supported by literature, they are different from blended learning, as the primary target of our intervention is to improve NCLEX pass rates. Comparatively, these learning modalities focus on enhancing teamwork and inter-professional collaboration, which will not directly but subsidiarily impact passing rates. Thus, assessing the project setting, infrastructure, and stakeholders’ readiness to adapt to the changes is imperative before implementing the interventions. 

Initial Outcome Draft 

The outcome that I want to achieve through this project is to increase the percentage of NCLEX passing rates among LPN students within 12 months. Enhancing students’ learning, education process, and readiness to pass NCLEX is directly interlinked with our outcome and intervention’s goal. Also by increasing the number of students passing their licensure exam, the project aims to determine the effectiveness of blended learning in improving LPN students’ academic performance, confidence, and knowledge. The criteria to evaluate the achievement of outcomes is based on the seamless transition of LPN students into their roles as practical nurses. Consequently, the results of the NCLEX passing rates, the quality of safe and efficient patient care, and patient satisfaction levels will be evaluated. 

Time Estimate 

The estimated time for intervention development would range from 3 to 6 months. This time is needed to design the course, develop an application, and prepare resources for PBLs. Thus, it is realistic for the faculty and the organization. However, particular challenges may hinder the smooth processes. They may extend the timeline by securing necessary funds and resources, coordinating with the faculty to schedule their extra responsibilities, and aligning with the educational regulatory requirements.

On the other hand, an estimated time frame for implementation can vary between 6 months to a year. This includes the rollout of the blended learning modalities, training for faculty, and overcoming students’ limited access and knowledge about technological mediums. During the implementation phase, a one-year record of NCLEX passing rates will be analyzed to find an answer to our PICOT question. However, the implementation challenges can become uncertainties, including resistance to change among faculty or staff, inadequate resources, and unforeseen situations. These may exceed the timeline and would require urgent addressing. 

Literature Review 

Various studies in the literature advocate the need for improving NCLEX passing rates in nursing education. As stated in the literature, the recent decline in the NCLEX passing rates of about 7% for first-timers (Hanson-Zalot et al., 2019) encourages organizations to improve their education system to increase the number of students passing NCLEX. Another report by the National Council of State Boards of Nursing (NCSBN) reveals that the average passing rate in 2022 for all candidates who appeared for NCLEX-PN is 67%, with a slight increase of only 3% in 2023 (NCSBN, 2022; NCSBN, 2023). This minimal average rate has alerted the faculty and students to address the need for LPN students to pass NCLEX urgently.

Educational institutions are striving to modify the teaching and learning modes, which is why the blended learning approach has been proposed in our PICOT project for LPN students in CVT College. A study identifies that poor study skills, personal matters, prioritizing studies, and unexpected job demands are some factors that impact NCLEX passing rates (Cosper et al., 2023). A blended learning approach can effectively address some of these factors by providing flexible learning times. It also develops skills for independent study, improving their understanding and knowledge according to their pace (Shang & Liu, 2018).

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Another study explains that since nursing education is full of complexities, utilizing a blended learning approach through PBL and online media resources has effectively improved student outcomes and interaction with the learning management systems (Sáiz-Manzanares et al., 2020). Thus, our PICOT project is supported by credible evidence. The relevance, credibility, and trustworthiness of these pieces of evidence can be assessed using CRAAP criteria – currency, relevance, authority, accuracy, and purpose. The CRAAP criteria are developed for researchers to find authentic resources that fall under the current date of publication (within five years), relevant to the topic of the research, adequately authorized by reliable authors and journals/websites, claims are accurately supported, and the purpose of the study revolves around the purpose of the research (Fielding, 2019). 

Health Policy, Healthcare Technologies, and Other Communications

The Title VIII Nursing Workforce Development Act is the policy relevant to our identified need to improve NCLEX passing rates among LPN students. This act is developed to provide adequate funding to organizations providing high-quality nursing education to expand the nursing workforce (American Association of Colleges of Nursing, 2023). Moreover, this act is relevant to our identified need as one of the reasons to improve NCLEX passing rates is to bring qualified nurses to clinical areas for safe patient care. These funding resources can impact our intervention (blended learning) to address the identified need as various blended learning methods can be introduced for LPN students, consequently affecting their NCLEX passing rates. 

Simultaneously, Virtual Reality (VR) and Telehealth platforms will impact the blended learning approach as VR devices can be used as a blended learning method to make students practice real-life scenarios and achieve immersive learning experiences (Lange et al., 2020).  Furthermore, telehealth platforms could be used in blended learning programs through virtual consultations with expert support from senior clinical nurses. This will help students to learn from specialists and get the support they need to succeed in their licensure exams.

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Additionally, these technological mediums can be used for simulation, which can incorporate student practice skills (Lister et al., 2018). These technological mediums will also address the personal factors impeding LPN students from performing well in their NCLEX. Such factors described prior are poor study skills, diverse responsibilities, prioritization issues, and geographical barriers. 

Other communications from NCSBN and the American Association of Colleges of Nursing (AACN) can be utilized for effectively addressing the need using the resources these bodies publish. The resources and accreditation standards can also be integrated into blended learning programs to improve the efficacy of education. Therefore, enhancing licensure exam passing rates and generating a competent workforce for clinical areas. However, the analysis misses the information about students’ preferences in terms of learning and how cost-effective the program will be for them. 

Conclusion 

This assessment concludes our PICOT question, where the identified need is to improve NCLEX passing rates among the targeted population of Licensed Practical Nursing students in the targeted setting of Chippewa Valley Technical College. The proposed intervention is a blended learning approach compared to traditional in-person teaching. This intervention will include online courses, applications for quizzes, online discussion forums, and in-person problem-based learning. The outcome is to increase the number of students passing NCLEX in one year.

Several literature evidence present the importance of the identified need and support the blended learning approach as an effective method in nursing education. Furthermore, the health policy of VIII Nursing Workforce Development Act supports blended learning and NCLEX passing rates through monetary resources. Other technological mediums and standard guidelines can be fused into our interventional plan to accomplish desired outcomes. Overall, the PICOT research aims to improve NCLEX passing rates, subsequently evolving a competent workforce for augmenting quality of care and patient safety. 

References

Alvarez Jr, A. V. (2020). Learning from the problems and challenges in blended learning: Basis for faculty development and program enhancement. Asian Journal of Distance Education15(2), 112–132. https://files.eric.ed.gov/fulltext/EJ1285361.pdf 

American Association of Colleges of Nursing. (2023, March). TITLE VIII NURSING WORKFORCE DEVELOPMENT PROGRAMS. https://www.aacnnursing.org/Portals/42/Policy/PDF/Title-VIII-Fact-Sheet.pdf 

Boev, C. (2023). Next generation NCLEX: Why simulation matters. Journal of Nursing Education62(5), 285–289. https://doi.org/10.3928/01484834-20230306-04

Chen, Y., VanderLaan, P. A., & Heher, Y. K. (2021). Using the model for improvement and plan‐do‐study‐act to effect smart change and advance quality. Cancer Cytopathology129(1), 9–14. https://doi.org/10.1002/cncy.22319 

Cosper, S. M., Callan, R. S., & Anderson, L. S. (2023). Investigating student and faculty perspectives related to predictors of NCLEX-RN success: A mixed methods approach. Teaching and Learning in Nursing18(3), 360–365. https://doi.org/10.1016/j.teln.2023.02.002 

Fielding, J. A. (2019). Rethinking CRAAP: Getting students thinking like fact-checkers in evaluating web sources. College & Amp; Research Libraries News80(11), 620. https://doi.org/10.5860/crln.80.11.620

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Hanson-Zalot, M., Gerolamo, A., & Ward, J. (2019). The voices of graduates: Informing faculty practices to establish best practices for readying NCLEX-RN applicants. Open Journal of Nursing9(2), 125–136. https://doi.org/10.4236/ojn.2019.9201 

Lange, A.-K., Koch, J., Beck, A., Neugebauer, T., Watzema, F., Wrona, K. J., & Dockweiler, C. (2020). Learning with virtual reality in nursing education: Qualitative interview study among nursing students using the unified theory of acceptance and use of technology model. JMIR Nursing3(1), e20249. https://doi.org/10.2196/20249 

Lister, M., Vaughn, J., Brennan-Cook, J., Molloy, M., Kuszajewski, M., & Shaw, R. J. (2018). Telehealth and telenursing using simulation for pre-licensure USA students. Nurse Education in Practice29, 59–63. https://doi.org/10.1016/j.nepr.2017.10.031 

NCSBN. (2023). The pathway to practice – National Council of State Boards of Nursing. https://www.ncsbn.org/public-files/NCLEX_Stats_2023-Q2-PassRates.pdf 

NCSBN. (2022). The pathway to practice – National Council of State Boards of Nursing. https://www.ncsbn.org/public-files/NCLEX_Stats_2022-Q3-PassRates.pdf 

Sáiz-Manzanares, M. C., Escolar-Llamazares, M.-C., & Arnaiz González, Á. (2020). Effectiveness of blended learning in nursing education. International Journal of Environmental Research and Public Health17(5), 1589. https://doi.org/10.3390/ijerph17051589 

Shang, F., & Liu, C-Y. (2018). Blended learning in medical physiology improves nursing students’ study efficiency. Advances in Physiology Education42(4), 711–717. https://doi.org/10.1152/advan.00021.2018 

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health17(6), 2028. https://doi.org/10.3390/ijerph17062028 

Zechariah, S., Ansa, B. E., Johnson, S. W., Gates, A. M., & Leo, G. D. (2019). Interprofessional education and collaboration in healthcare: An exploratory study of the perspectives of medical students in the United States. Healthcare7(4), 117. https://doi.org/10.3390/healthcare7040117