| Course | NU 476 Nursing Capstone |
|---|---|
| Unit | Unit 1 |
| Paper type | Capstone topic proposal |
| Length | About 810 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NU 476 Unit 1
Capstone Proposal: Twice-Daily Oral Care for Non-Ventilated Patients on One Medical Unit
Student Name
Department of Nursing, Herzing University
NU 476: Nursing Capstone
Instructor Name
January 21, 2026
Capstone Proposal: Twice-Daily Oral Care for Non-Ventilated Patients on One Medical Unit
The Change Proposed
I propose to implement a standardized oral care routine, brushing the teeth morning and evening with a soft brush and fluoride paste, plus denture care where needed, for adult patients who are not on a ventilator on 4 East, the 30-bed medical unit where I have been on staff for four years. The question, framed for an evidence-based project (Melnyk & Fineout-Overholt, 2023), is whether a standardized routine increases the proportion of patient-days with documented oral care twice daily. The project will run for eight weeks of the term, from week 4 through week 11, after approvals in weeks 1 to 3. It is framed as a small test of change of the kind quality improvement methods recommend (Langley et al., 2009), and it does not attempt to reduce pneumonia rates within the term, which would be too rare an outcome to measure in eight weeks on one unit, and it does not change practice on any other unit.
Why This Problem, Here
Pneumonia acquired in hospital by patients not on ventilators is common and serious, and poor oral hygiene allows bacteria in dental plaque to be aspirated into the lungs. In one hospital, a program of basic oral care for non-ventilated patients was followed by a marked reduction in non-ventilator hospital-acquired pneumonia (Quinn et al., 2014). The problem exists on 4 East. Over the past year, the unit's infection preventionist recorded six cases of non-ventilator hospital-acquired pneumonia, more than any other medical unit. A spot check I conducted with my manager's permission on two days in December, reviewing documentation for all 28 patients on the unit each day, found oral care documented twice in 24 hours for 9 of 56 patient-days, or 16%. Toothbrushes were present at the bedside for 21 of the 28 patients. Several nurses and nursing assistants said that oral care is "what we skip when it's busy."
Feasibility
The project is feasible within the term for four reasons. It uses supplies the hospital already stocks: toothbrushes, toothpaste, and denture cups, which cost little. It requires no change to the electronic record, since an oral care field already exists in the flowsheet. It fits within the scope of nursing assistants, who provide most personal care, with nurses checking and documenting. And my manager has agreed to support it and to allow a 10-minute education session at each shift huddle in week 3.
Risks to the Project
Three risks could stop the project before it reaches its measure. Staffing is the first: if the unit is short of nursing assistants during the implementation weeks, oral care will again be the task that is skipped, and the result will reflect staffing rather than the routine. I will record daily staffing alongside the measure so that the two can be read together. Supplies are the second: toothbrush kits must be stocked in every room, and the unit's supply par levels are set by materials management, not the unit; I have asked for the par level to be raised for the eight weeks. The third is my own schedule: I work three 12-hour shifts a week, and the data collection plan uses two fixed review days so that it does not depend on which shifts I work.
Who Must Agree
The nurse manager has agreed in principle. The unit's practice council must approve a change to the daily care routine at its February meeting. The infection preventionist has agreed to share pneumonia data. The capstone preceptor, a clinical nurse specialist, has agreed to supervise. No institutional review board approval is expected, because this is a quality improvement project using unit data; the hospital's quality office will confirm that determination.
What I Will Measure and Report
Primary measure: percentage of patient-days with oral care documented twice, from a daily review of all patients on the unit two days a week during the baseline period and the implementation period. Process measures: toothbrushes and toothpaste present at the bedside; staff completing the education session. The pneumonia rate will be reported for context only, with the explicit statement that eight weeks on one unit cannot show an effect on such a rare outcome.
Why a Smaller Project Is the Stronger Choice
An earlier version of this proposal aimed to reduce hospital-acquired pneumonia across the hospital's three medical units. My preceptor pointed out that approvals for three units alone would take most of the term, and that pneumonia is too rare to measure reliably in eight weeks. Narrowing the project to one unit and to a behavior that can be measured weekly means I will be able to implement the change, measure it, and hand it over, rather than end the term with a plan. If the project succeeds on 4 East, the results and materials can support spreading it later.
References
Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing and healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Quinn, B., Baker, D. L., Cohen, S., Stewart, J. L., Lima, C. A., & Parise, C. (2014). Basic nursing care to prevent nonventilator hospital-acquired pneumonia. Journal of Nursing Scholarship, 46(1), 11-19. https://doi.org/10.1111/jnu.12050
Reading the NU 476 Unit 1 instructions
Unit 1 asks you to propose a capstone project for your practice setting. Expect to describe the change, explain why the problem matters at your site, show the project is feasible within the term, name risks, identify who must agree and say what you will measure. Many versions ask how small a capstone should be and what to do about weeks with no clinical time. Check whether your section requires a problem from your own site. A project you can complete and measure in one term is stronger than an ambitious one that stalls. Use a process measure you can collect yourself. Name approvals early, since waiting for a council can consume half the term. Cite evidence for the change, not only for the problem.
Inside the NU 476 Unit 1 example
The proposal opens with the change in one paragraph, specific enough to picture. The problem section uses local observation and published evidence on non-ventilator pneumonia. The feasibility section lists four reasons, such as existing supplies and a supportive manager. The risks section names three threats and what would be done about each. The approvals section separates who has agreed from who still must. The measure section defines the primary measure and how it will be collected daily. The final section is the proposal's distinctive move: it explains why the project was narrowed from reducing pneumonia, which a term cannot show, to improving the care routine, which it can. Each claim is cited to the evidence base.
Where the points sit in the NU 476 Unit 1 rubric
Herzing's rubric for the capstone proposal usually covers the description of the change, significance at the site, evidence, feasibility, risks and approvals, measurement and writing. Feasibility carries a large share, because graders know an infeasible project will fail later units. Significance points reward local data and published evidence. Evidence criteria look for support for the intervention itself. Risk and approval points go to named obstacles and decision makers. Measurement earns credit for a defined process measure the student can collect. The scope argument often earns credit within feasibility. Quinn's study of oral care and non-ventilator pneumonia and the Model for Improvement text by Langley and colleagues belong in the APA 7 references.
NU 476 Unit 1 help before you submit
Capstone proposals in Unit 1 often slip by choosing an outcome, such as reducing pneumonia, that cannot change measurably in one term. Another frequent problem is skipping approvals, which delays the start. Students often cite evidence for the problem but not for the intervention. Feasibility is asserted without reasons. Risks are not named. The measure is vague, such as better oral care. Weeks without clinical time are not planned around. Finally, explain why your scope is right, because graders reward a proposal that shows the student thought about what can actually be done and measured before the term ends.
Get a NU 476 Unit 1 example written to your instructions
Send the Unit 1 instructions and the rubric from your NU 476 classroom, plus your site and the problem you want to work on. We write a custom example scoped to the term with feasibility actually examined, returned in 24 to 48 hours. The first custom sample is free.
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NU 476 Unit 1 questions, answered
How small should a capstone be?
Smaller than feels impressive. One change on one unit with one measure can be planned, implemented and evaluated inside a term; anything broader consumes the whole period in preparation. Faculty see far more capstones fail from ambition than from modesty, and a small project completed well scores above a large one that never started.
Does the problem have to come from my own site?
It should, because that is what makes it a capstone rather than a paper. Something you have seen, with a local figure however rough, gives you access, stakeholders who care and data you can reach. A problem drawn from the literature leaves you negotiating for a setting that has no particular reason to help.
What do I do about weeks with no clinical time?
Plan around them from the start. Academic terms contain breaks, examination periods and weeks where you are not on site, and a project timeline that assumes continuous access will slip. Map the calendar first, mark the weeks you can actually be there, and fit implementation into those rather than discovering the gap in week seven.
Where can I find a free NU 476 Unit 1 sample paper?
The full NU 476 Unit 1 oral care capstone proposal is free on this page, from the change and feasibility to approvals and the measure. A proposal for your own capstone topic can be written on request.
How small should a nursing capstone project be?
Small enough to complete and measure in one term, usually a process change on one unit. This sample narrows from reducing pneumonia unitwide to twice-daily oral care documented on one medical unit, which can be measured within weeks.