In modern healthcare, ensuring patient safety is one of the most critical priorities. Despite advances in medicine and technology, preventable errors such as medication mistakes, patient falls, and hospital-acquired infections remain pressing concerns. To address these challenges, nurses must learn how to analyze safety issues at their root and design effective strategies for improvement.
Capella University’s NURS FPX 4010 course in the RN-to-BSN program begins with Assessment 1: Root-Cause Analysis (RCA) and Safety Improvement Plan. This assessment equips nursing students with the skills to systematically examine a healthcare problem, identify its underlying causes, and propose evidence-based interventions.
This article provides an in-depth guide to completing NURS FPX 4010 Assessment 1, including its purpose, structure, step-by-step process, and strategies for success.
Purpose of Assessment 1
The primary objective of Assessment 1 is to help nursing students:
Conduct a root-cause analysis of a patient safety issue
Apply systems thinking to uncover contributing factors
Develop a safety improvement plan supported by scholarly research
Align recommendations with ethical, cultural, and organizational considerations
Build a foundation for future assessments in the course
This assessment simulates real-world nursing leadership roles, where professionals must not only provide care but also advocate for patient safety and quality improvement.
Understanding Root-Cause Analysis (RCA)
Root-Cause Analysis (RCA) is a structured approach used in healthcare to identify the fundamental causes of errors or adverse events. Instead of focusing on individual blame, RCA emphasizes systems and processes.
Common RCA Tools
Fishbone (Ishikawa) Diagram – Categorizes causes into people, processes, equipment, environment, and policies.
The 5 Whys – A questioning technique that digs deeper into why an error occurred.
Flowcharts – Visualize steps in a process to identify gaps or risks.
For example, if a patient received the wrong medication, an RCA might reveal that:
Pharmacy labeling was unclear
Nurses were understaffed
Double-check policies weren’t followed
Electronic medical records lacked safeguards
By analyzing these causes, a systemic improvement plan can be designed.
Structure of NURS FPX 4010 Assessment 1
Capella typically requires students to organize their paper into clear sections:
Introduction – State the purpose of the assessment and identify the safety issue.
Description of the Problem – Explain the event or risk (e.g., medication errors, falls).
Root-Cause Analysis – Analyze contributing factors using RCA methods.
Safety Improvement Plan – Propose interventions aligned with best practices.
Evidence-Based Support – Use 3–5 scholarly sources to justify your plan.
Ethical and Cultural Considerations – Discuss how your plan respects patient rights, diversity, and equity.
Conclusion – Summarize findings and emphasize the importance of the intervention.
References – APA 7 citations for all sources.
Step-by-Step Guide to Completing Assessment 1
Step 1: Choose a Safety Issue
Select a patient safety problem relevant to your workplace or common in healthcare:
Medication Errors – Wrong drug, dose, or route
Patient Falls – Leading to injuries and longer hospital stays
Hospital-Acquired Infections (HAIs) – Catheter-related UTIs, MRSA, ventilator-associated pneumonia
Communication Breakdowns – Poor handoffs, lack of standardized reporting
Step 2: Conduct a Root-Cause Analysis
Use a structured framework (Fishbone Diagram or 5 Whys) to explore the underlying causes. Example:
Problem: High rate of patient falls in a medical-surgical unit
Why 1? Patients attempt to walk without assistance → understaffed unit
Why 2? Bed alarms not consistently used → lack of training
Why 3? Fall risk assessments incomplete → documentation gaps
Why 4? Staff rushed due to workload → inadequate nurse-patient ratio
Why 5? Organizational policy doesn’t enforce hourly rounding
This RCA reveals both human and systemic factors contributing to the problem.
Step 3: Develop a Safety Improvement Plan
Based on your RCA, propose evidence-based interventions.
Example Interventions for Fall Prevention:
Implement hourly rounding protocols
Use bed alarms and non-slip socks for high-risk patients
Conduct mandatory fall risk assessments at admission and shift change
Provide staff training on fall prevention strategies
Engage patients and families in safety education
Ensure your plan is measurable using SMART goals:
Reduce fall rate by 20% within 6 months through hourly rounding and staff education.
Step 4: Support with Evidence-Based Research
Back your plan with peer-reviewed sources from the last 5 years. Examples:
Studies showing hourly rounding reduces falls (Meade et al., 2020)
Guidelines from The Joint Commission or Agency for Healthcare Research and Quality (AHRQ)
Research on team collaboration and safety culture improvements
Step 5: Address Ethical and Cultural Considerations
Every intervention should align with nursing ethics and cultural competence.
Autonomy: Respect patients’ choices (e.g., informed refusal of bed alarms)
Equity: Ensure all patients receive equal safety measures regardless of background
Cultural Sensitivity: Adapt communication and education to patients’ cultural needs
Beneficence & Nonmaleficence: Prioritize actions that promote safety and prevent harm
Step 6: Write a Strong Conclusion
Summarize your RCA findings and emphasize how the safety improvement plan will reduce risks, enhance patient care, and foster a culture of safety.
Example: Assessment 1 in Practice
Case: High Medication Error Rates in a Hospital Unit
Problem: 15% increase in reported medication errors in one quarter
RCA Findings:
Staff fatigue due to overtime
Lack of barcode scanning compliance
Poor communication during shift changes
Confusing medication labeling
Improvement Plan:
Enforce barcode scanning policy
Implement fatigue-reduction scheduling
Train staff on SBAR (Situation-Background-Assessment-Recommendation) communication
Collaborate with pharmacy to improve labeling clarity
Evidence: Peer-reviewed studies show barcode scanning reduces errors by 50% (Anderson et al., 2021).
Ethical Considerations: Protect patients from harm while ensuring fair workload distribution among staff.
Tips for Success in Assessment 1
✅ Select a realistic and manageable safety issue
✅ Use 3–5 scholarly sources (PubMed, CINAHL, Cochrane Library)
✅ Apply a structured RCA method instead of vague analysis
✅ Use SMART goals for your improvement plan
✅ Address ethical and cultural dimensions clearly
✅ Follow APA 7 guidelines for citations and formatting
Common Mistakes to Avoid
❌ Choosing a topic too broad (e.g., “all medical errors”)
❌ Writing without using RCA frameworks
❌ Failing to connect interventions to evidence
❌ Ignoring ethical or cultural aspects
❌ Overlooking APA formatting requirements
Why Assessment 1 Matters
NURS FPX 4010 Assessment 1 is more than just an academic paper. It teaches critical nursing skills:
Analytical Thinking: Looking beyond symptoms to identify systemic causes
Leadership: Proposing actionable safety improvements
Collaboration: Engaging stakeholders in quality initiatives
Advocacy: Promoting ethical, patient-centered care
By mastering RCA and improvement planning, nursing students prepare to become change agents in healthcare organizations—professionals capable of reducing risks, enhancing patient outcomes, and shaping a culture of safety.
Conclusion
NURS FPX 4010 Assessment 1 sets the stage for the rest of the course by developing essential nursing competencies in patient safety, quality improvement, and ethical practice. Through root-cause analysis and safety planning, students learn to investigate healthcare issues systematically and propose evidence-based, culturally competent solutions.
This assessment mirrors real-world nursing challenges where professionals must go beyond bedside care to identify systemic problems, lead improvements, and ensure safe, equitable patient outcomes.
By completing this assessment successfully, students not only meet academic requirements but also gain lifelong skills that are invaluable in clinical practice and nursing leadership.