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Nursing is a practice discipline that includes direct and indirect care activities that affect health outcomes. As a master’s nursing student, you are developing new competencies in leadership, and in order to achieve mastery, you must apply those competencies to live-practice experiences and situations. The advanced nursing fieldwork experience is designed to allow you to identify a recently completed organizational change or innovation or one currently in process and use your leadership problem-solving skills to investigate, document, and evaluate the implementation process. During this fieldwork experience, think about how you, as a nurse leader, function as a detective, scientist, and manager of a healing environment.
For this assessment, you will work with a change leader in a healthcare organization to select an organizational change that has occurred within the last six months. If you choose a change currently in progress, it must be far enough into the implementation process in order for you to gather sufficient data for the assessment. The organizational change should have been implemented in order to initiate or support a patient advocacy project, system change, or educational program to increase quality care outcomes. The change leader you choose needs to have been directly involved with the change process.
To select the change you will evaluate, set up a meeting with the change leader. Ask for approximately 30 minutes for the meeting. You need to be respectful of the change leader’s time and other responsibilities. Be well prepared before the meeting so that the time is used efficiently, the conversation is organized and directed, and you have sufficient time to gather the necessary information. During your meeting with the change leader, explain your plan to investigate and evaluate the change process and its impact on the organization.
You should ask at least the following questions during your meeting:
• How was the problem identified?
• What collaborations were needed to solve the problem?
• What was the impact of the solution on the organization and what would the impact have been if the problem had not been resolved?
• What was the plan and what was the thought process that went into constructing the plan to resolve the problem?
• What resources can I seek out to help me gather data?
• How can I participate in or observe implementation team meetings?
Once you and your change leader have discussed the change, you will need to complete the attached “Change Investigation Proposal Form” and submit it to the change leader for approval. The change leader’s signature has to be handwritten. Once the completed proposal is signed by the change leader, it should be either scanned and uploaded in TaskStream or photographed and uploaded in TaskStream as a .jpg, .png, bmp, gif, or any other image file format. In your proposal, you should identify how you will investigate the impletemented organizational change. You will be required to submit a signed approval from the change leader for this assessment.
After your proposal has been approved, you will investigate the selected organizational change using the attached NCQA “QIA Form.” You may utilize the attached “QIA Form Instructions” to help guide you in how to fill out the QIA Form. Your investigation will be used to document how the change was implemented in the organization.
A. Submit your approved proposal using the attached “Change Investigation Proposal Form” that includes the following information:
• a brief description of the organizational change you plan to investigate
• a process for conducting the investigation (e.g., data collection, key stakeholders to talk to), including how you will obtain the information on the “QIA Form”
• approval signature and credentials of the change leader, giving you permission to investigate the change
B. Summarize (suggested length ½ to 1 page) the identified organizational change and the patient population that it affects.
Note: Use the attached “QIA Form” and gather data from the organization that is necessary to populate sections I–V of the form. The form should serve as a guide to complete your assessment and conduct your investigation. Refer to the attached “QIA Instructions Form” for information on how to complete the QIA Form.
C. Submit a completed copy of the attached “QIA Form” in which you record data from your investigation in sections I–IV.
1. Summarize what data you collected for each section (I–IV) of the “QIA Form.”
a. Discuss what data collection measure(s) were used by the organization.
b. Analyze the appropriateness of the data collection measures, including whether the data supported the need for change.
2. Discuss how the data collection measure(s) could have been improved, using master-level nursing and interprofessional standards.
D. Analyze the effectiveness of the change project in the organizational setting by doing the following:
1. Discuss how the change was evaluated for success after implementation.
a. Discuss the effects the implementation has had on the organization and quality care outcomes.
2. Evaluate whether stakeholders involved with implementation were successful in their roles.
3. Discuss how the change project could have been improved to increase quality care outcomes.
E. Summarize your involvement with the organization and/or stakeholders as you conducted your investigation.
F. When you use sources, include all in-text citations and references in APA format.
Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.
Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.
Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section.

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