NUR443 Evidence-based Nursing Research And Practice

Introduction

The Doctor of Nursing Practice (DNP) provides the climax of the nursing doctoral studies and the chance for a DNP student to put research evidence and acquired knowledge into practice (Joel, 2017). In addition to having the chance to make a contribution to the evidence-based practice, the DNP provides a good ground on which DNP student prepares themselves for future nursing scholarships. However, all these can only be achieved with a rigorous and well crafted DNP project. A well written DNP project must meet certain components for a successful implementation of evidence into practice. Usually, these components are provided in the DNP project handbook. The paper provides a critique of an existing DNP project that was done by a student in the graduate school.

Evaluation of the Body

The successful approval of the project proposal paves way for the final project report to be developed by the DNP student (Joel, 2017). According to the DNP project handbook, at a minimum the DNP project report should consist of the title page, signature page, the executive summary, the table of contents, the body as organized by chapters, references and the appendices. The existing DNP project that was done in the graduate school has been organized into some of these sections, though with some discrepancies.

The ideal executive summary should provide project outcomes in the organization that the project was implemented. According to (Moran, Burson & Conrad, 2016) the executive summary should be 1-2 pages providing information regarding the current status and why change is needed, findings, implementation process, evaluation metrics, project outcomes and implications. A scrutiny of the existing DNP project reveals the presence of an executive summary, which provides an overview of the project. However, the DNP project’s executive summary is three (3) pages, making it long. This is inconsistent with the basic requirement of an ideal executive summary as outlined in Moran, Burson & Conrad and as stated in the DNP Project (Capstone) Handbook.

In chapter two (2) of the report, the DNP project provides a statement of the problem. In this section, the author describes the challenges in the healthcare while highlighting the need for improvement in healthcare outcomes without increasing healthcare costs. The author notes that the healthcare needs of the population continue to evolve and increase, which needs an alignment of these needs with the healthcare resources. However, the author fails to provide literature review in this section of the chapter, but proceeds to provide the same in the third chapter, which is contrary to the requirements provided in the DNP project handbook. Also, though the section is long, the author proceeds to provide the purpose for which the project was designed and the project phases without provision of clear theoretical framework.

According to (Grant & Osanloo, 2014), the theoretical framework is an important component of a research study. Moreover, Moran, Burson & Conrad, (2016) adds that besides stimulating research, the theoretical framework provides a foundation from which knowledge is constructed. It acts as a structure and support for the rationale behind the study, the problem statement, significance, purpose and research questions. However, the author omitted the theoretical framework and the background of the problem, though the introduction at the beginning of chapter two (2) serves as a good background of the problem under study. Instead, the author provided the significance of the problem before embarking on the third chapter of the project.

The second chapter of a DNP project is the project description, which entails information regarding the project design, purpose and objectives. However, the author begins this section by providing the literature review. According to (Taylor, Kermode & Roberts, 2007; Bonnel & Smith, 2013) the synthesis of the literature is critical in provision of critical analysis and a summary of literature that already exists in the clinical area of interest. In the report, the literature review section is succinct and connects well with the latest evidence in nursing, while also providing a good synthesis of information. The author employed books and journals that were within the 5-year publication period.  However, the author does not provide any information regarding the project design (which is later provided in chapter three (3) of the project report) nor is any information regarding the purpose of the project and objectives provided in this section of the paper.

The third chapter of the project offers the project design, which is supposed to be part of chapter two (2) of the DNP project report, instead of providing information about project evaluation, which is a component of chapter 3 of the NDP project report. However, in the project evaluation section, the author provides project evaluation plan with three objectives. The first objective was to obtain the baseline information regarding telehealth guidelines. The second objective regards the evaluation of the existing telehealth guidelines and the final objective was the development of a tele mental health clinical practice guideline.

The DNP project report handbook demands that an evaluation plan be outlined together with objectives and strategies for their evaluation (see DNP project report handbook). On reading through the first, second and third objectives, it was noted that the author of the DNP project stated the objectives well. However, there were no clear or specific methods in which those objectives were evaluated. In addition, there are no evidence-based measures or instruments that were applied to each objective. Though the author failed in these regards, the DNP project, however, provided methods of analysis for each of the stated project objective. The author pointed that the data collected from the survey findings were analyzed using descriptive statistics to provide qualitative findings.

In regards to the results and outcomes, DNP project report presented these in the fourth chapter as outlined in the project handbook. White (2015) asserts that the DNP report results and outcomes must be written against each of the project objective. Although the author provides outcomes written against each project objective, this was the case for only objective one. Given that the project had three objectives, it was expected that the outcomes be outlined against each of the project objectives. However, only the extent to which the first objective was achieved was provided. Despite this, the author provided key facilitators for the objectives, while also identifying the barriers to the achievement of project objectives. This is consistent with the fact that the application of scientific knowledge in clinical nursing practice cannot be realized fully owing to barriers (Duphily, 2016).

The DNP project handbook demands that the DNP project report provide a recommendation and implication section. According to (Adams & McCarthy, 2007) the recommendations are often specific and provide what the paper recommends for the specific change process. In the DNP project report, the author provides a number of recommendations which are not easy to determine. The report provides recommendations in form of descriptive text, which do not provide a specific linkage with the project site. For example, in the first paragraph of the project, the author simply recommends that appropriate training is essential for quality telehealth engagement. In addition, to the poorly written recommendations, these recommendations have not been linked to the study site.

In addition, the report fails to align the recommendations within the framework of the organization strategic plan, while failing to provide the people to be involved in the future phases of the project. The recommendations also failed to provide the possibility of application of the project in other practice settings. Also, there are no evidence of data collected in the survey process. However, ongoing evaluations have been provided in the report.  

Conclusion

The DNP project report is a critical component in advanced nursing practice, which allows nurses to put evidence into practice. In addition, it prepares nurses for future scholarship positions. In the existing DNP report, it can be concluded that the paper does not follow the DNP project handbook report format. The sections are interchanged between chapters with long paragraphs. Though the report adopted an extensive research and good literature review, there was no evaluation plan for the second and third objectives. The research paper fails to meet the important components and requirements of those components in some of the chapters.

References

Adams, S., & McCarthy, A. (2007). Evidence-Based Practice Guidelines and School Nursing. The Journal of School Nursing, 23(3), 128-136.

Bonnel, W., & Smith, K. (2013). Proposal Writing for Nursing Capstones and Clinical Projects. New York: Springer Publishing Company.

Duphily, N. (2016). Linking Evidence to Practice: A Clinical Practice Guideline Project. Nursingplus Open, 2, 26-34.

Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating A Theoretical Framework In Dissertation Research: Creating The Blueprint For Your “House”. Administrative Issues Journal Education Practice And Research.

Joel, L. (2017). Advanced Practice Nursing: Essentials for Role Development (4th ed.). Philadelphia: F.A. Davis.

Moran, K., Burson, R., & Conrad, D. (2016). The Doctor of Nursing Practice Scholarly Project: A Framework for Success (2nd ed.). Burlington: Jones & Bartlett Publishers.

Romsa, Beth J. Exploration of Tele Mental Health Program Integration with Application into Psychiatry Services at Ivinson Memorial Hospital Behavioral Health Unit. Unpublished Doctor of Nursing Practice capstone project, University of Northern Colorado, 2017.

Taylor, B., Kermode, S., & Roberts, K. (2007). Research in Nursing and Health Care: Evidence for Practice. Melbourne, Vic.: Thomson.

White, K. (2015). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nurse (3rd ed.). Burlington: Jones & Bartlett Publishers.