DNP 801 What changes will you need to make in order to have a feasible topic for your PICOT-D? If it is not feasible, what other topics are you considering

DNP 801 What changes will you need to make in order to have a feasible topic for your PICOT-D? If it is not feasible, what other topics are you considering

DNP 801 What changes will you need to make in order to have a feasible topic for your PICOT-D If it is not feasible, what other topics are you considering

I’ve had several topics for my DPI Project. Over the past eight weeks, my topic/problem has changed multiple times. With feedback from Dr. Etheridge, I think I have a topic that may be workable. Changes incorporated from feedback:

P: End-stage renal disease- Medicare patients Health plan in Oregon that serves Medicare patients

I: Member engagement with a single point of contact for Case Management

C: pending

O: ED hospital utilization, improved self-management

Other options for quality improvement projects include access to healthcare through non-emergent transportation (NEMT).  

My goal is to provide a quality improvement initiative, based on the needs of the health plan. The population will be a vulnerable population and my improvement will be to improve the health inequities of patients with social determinants (SODH) in vulnerable populations.

It’s important to remember to incorporate feedback from our instructors and to remember the focus of the final project. As stated by the American Association of Colleges of Nursing (AACN),:

  • Focus on a change that impacts healthcare outcomes either through direct or indirect care.
  • Have systems (micro-, meso-, or macro-level) or population/aggregate focus.
  • Demonstrate implementation in the appropriate arena or area of practice.
  • Include a plan for sustainability
  • DNP Projects should be designed so that processes and/or outcomes will be evaluated to guide practice and policy. Clinical significance is as important in guiding practice as statistical significance is in evaluating research.
  • Provide a foundation for future practice scholarship

American Association of Colleges of Nursing. Doctor of nursing practice/DNP tool kit. (2022) https://www.aacnnursing.org/DNP/Tool-Kit

Response

Hello Tommie! This is an outstanding and compelling post on your experiences in developing the DPI project. Creating a researchable question is among the challenging tasks a student encounters when initiating a DPI project. However, the utilization of the PICOT process is essential in assisting a student to develop a cautious and thoughtful question that facilitates the search for evidence (Eriksen & Frandsen, 2018). A well-rounded question makes it considerably straightforward to obtain and integrate the suitable terms required to represent the desired data in the query language of the available searching service (Zina, 2021). Once you have formulated a question using the PICO framework, you can consider the type of question you are asking and the kind of research that can provide an appropriate answer. The clinical question should be directly applicable to the clinical issue at hand and expressed in a way that fosters the search for a solution (Vandenbroucke & Pearce, 2018). PICO facilitates the process and is a mnemonic for the critical components of a sophisticated clinical question. It also assists in developing a search strategy through the recognition of the fundamental concepts that should be incorporated in the article to answer the question.

References

Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association: JMLA, 106(4), 420. DOI: 10.5195/jmla.2018.345

Vandenbroucke, J. P., & Pearce, N. (2018). From ideas to studies: how to get ideas and sharpen them into research questions. Clinical epidemiology, 10, 253. DOI: 10.2147/CLEP.S142940

Zina, O. (2021). The essential guide to doing your research project. Sage.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS DNP 801 What changes will you need to make in order to have a feasible topic for your PICOT-D? If it is not feasible, what other topics are you considering:

Before I started my proposed DPI project there are a lot of ideas I have in mind that I can think of to use. I am so happy that the one I chose to do is feasible enough for my PICOT-D project. I was able to discuss my proposed DPI project first with my mentor and seek for her advice if this will be a better project that I should be concentrating and she agreed with me. At first, I wanted to concentrate on mortality rate of sepsis and septic shock and when I first placed it in my PICOT-D Dr. Etheridge suggested that it will be difficult to just concentrate with it and I agree with her feedback.Per Dr. Etheridge feedback it is important that I have correct data and I should include statistics to show. My proposed project is implementing sepsis bundle for early identification for severe sepsis and septic shock. Sepsis is a huge problem in our organization and we don’t have any protocol to follow and guide us when it comes to Sepsis. It is important to identify septic patients in ICU and optimal treatment should be performed immediately. The goal of my proposed project is better outcome and bundle compliance of patients with severe sepsis and septic shock. Early detection and early management in sepsis patients will improve and compliance should be included,

DNP 801 What changes will you need to make in order to have a feasible topic for your PICOT-D If it is not feasible, what other topics are you considering
DNP 801 What changes will you need to make in order to have a feasible topic for your PICOT-D If it is not feasible, what other topics are you considering

If my proposed DPI project is not feasible I would suggest if patient flow from ED to their respective unit will be acceptable. Delays in patient flow and a shortage of bed are common in a hospital. Improving patient flow in any organization is important for patient outcome and patient satisfaction. Crowding can negatively affect patient and staff performance and this leads to problems. Patient flow is a problem in our facility and I am a part of the patient flow committee and I see it everyday. I am very passion in making sure that patient needs to be boarded as soon as bed is available for patient comfort and for staff role as well. To improve patient flow it includes removing unnecessary testings, duplicate orders and identifying what the problem really is, I think that this will be a good project too if I will not be able to do my first proposed project.

References:

Levy, M. M., Rhodes, A., Phillips, G. S., Townsend, S. R., Schorr, C .A. Surviving sepsis campaign: Assocition between performance metrics and outcomes in a 7.5year study. Intensive Care Med. 2014; 40:1623-1633. doe: 10.1007/s00134-014-3496-0.

Rojas-Garcia, A., Turner, S., Pizzo, E., Hudson, E., Thomas, J., Raine, R.; Impact and experience of delayed pdischarge: A mixed studies systematic review; Health Expect, vol. 21, no. 1, pp41-56; 2018.

Response

Hello Beverly! Your reflection on the journey of initiating your proposed DPI project is well-captured and interesting. If your proposed DPI project is not feasible and you decide to suggest a new proposal, there are several factors to consider. First, the proposed topic should cover something you are passionate about for both project enjoyment and also averting the issues of burnout in case the project long time to complete. The proposed topic should also be relevant by striving to accomplish to meet a need or accomplish a goal (Bean & Melzer, 2021). You should perform a situation analysis by assessing possible issues related to the area chosen. The proposed topic should also be researchable. You can seek the help of a supervisor or research experts for guidance on review and how to constrict project focus. Alternatively, you can use a thorough literature review of the suggested topic to provide an in-depth understanding of how to develop or improve appropriate project knowledge and practice (Pawar & Patil, 2021). Finally, the proposed topic should make a positive impact on the nursing practice.

References

Bean, J. C., & Melzer, D. (2021). Engaging ideas: The professor’s guide to integrating writing, critical thinking, and active learning in the classroom. John Wiley & Sons.

Pawar, R., & Patil, S. (2021). Structured Approach to Enhance the Quality of Undergraduate Capstone Project: A Case Study. Journal of Engineering Education Transformations, 34(SP ICTIEE), 607-614. http://ischolar.info/index.php/JEETRIT/article/view/206232

The ESI assignment of patients is so important from the very start. This is where we decide who can wait a few minutes and who needs to be seen now. Current ESI does not consider patient history or recent events. (Ivanov et al., 2021) The AI program I am looking into is smart technology and can utilize all that information quickly to help the nurse make a decision. Unfortunately, even with the best of intentions, patients receive the incorrect ESI and end up with extended waits. The nurses are using their best judgment, and ESI can be confusing at times. Trying to differentiate between level three and level two is all about risk and needs. Even with the handbook, those decisions can be impossible without further information. (Worth et al., 2019)

The project I have chosen includes the implementation of a new program for the EHR at my site. This is a very big undertaking and will require approval from several different committees. However, with the backing of the CNO, I believe this should be obtainable. Although the portion of the program I am geared towards is the ESI in triage, it does have another use from early sepsis identification. Because of this, during my proposals, I am making sure to include this as an important outcome. My worry is that there is a lot riding on this implementation and my project could not move forward if the facility does not want to incorporate it. I do have some ideas on how to utilize tools that will change the way the triage nurse assigns ESI. However, I will need to complete some more research on those tools and see if they are feasible.

The one feedback that I received was about funding for this project. The cost for myself is minimal, however, the cost for the facility will be continuous. This is something I have had to consider and request more information on. Luckily the cost of the program is significantly low, but the patient outcome and benefits are significantly high. My project relies a lot on the approval from the hospital, but I do believe it is the best thing for our patients and can make a huge impact on their outcomes.

References

Ivanov, O., Wolf, L., Brecher, D., Lewis, E., Masek, K., Montgomery, K., Andrieiev, Y., McLaughlin, M., Liu, S., Dunne, R., Klauer, K., & Reilly, C. (2021). Improving ed emergency severity index acuity assignment using machine learning and clinical natural language processing. Journal of Emergency Nursing, 47(2), 265–278.e7. https://doi.org/10.1016/j.jen.2020.11.001

Worth, M., Davis, L. L., Wallace, D. C., Bartlett, R., & Travers, D. (2019). Are emergency departments in the united states following recommendations by the emergency severity index to promote quality triage and reliability? Journal of Emergency Nursing, 45(6), 677–684. https://doi.org/10.1016/j.jen.2019.05.006

Response

Hello Julie! This is a great post on your journey to initiating a DPI project. As you embark on the journey to implement a new program for the EHR at your site, there are various factors that you need to consider. The success of your proposed project relies on how you will effectively formulate the research question depending on the challenges you face in your routine research activities and clinical practice (Joshi et al., 2019). A properly developed research question should be extremely precise and specific to guide the project’s implementation. Some of the strategies for effectively developing a successful project include discussing your research question with a supervisor, informed peers, or mentor from the initiation of the project (Burke & Dempsey, 2021). You should also set and stick to the project timeline since it has a great bearing on the success of the project. Defining completion dates for every phase and intervention of the project is imperative (Pawar & Patil, 2021). Other factors such as budget, resources, clinical trial, sites, and informed consent should also be considered.

References

Burke, J., & Dempsey, M. (2021). Undertaking Capstone Projects in Education: A Practical Guide for Students. Routledge.

Joshi, S., Morkos, B., & Summers, J. D. (2019). Mapping problem and requirements to the final solution: a document analysis of capstone design projects. International Journal of Mechanical Engineering Education, 47(4), 338-370. https://doi.org/10.1177/0306419018780741

Pawar, R., & Patil, S. (2021). Structured Approach to Enhance the Quality of Undergraduate Capstone Project: A Case Study. Journal of Engineering Education Transformations, 34(SP ICTIEE), 607-614. http://ischolar.info/index.php/JEETRIT/article/view/206232