DNP Project Proposal Development

For the DNP project you will evaluate the effect of the intervention implemented in the project. The design of the evaluation is a quasi-experimental design with you either comparing pre-intervention data to post-intervention data or you will have an intervention group and a control group (if ethical).

Project Participants

Considering your participants, how will you select participants for your evaluation? What are the inclusion criteria? What are the exclusion criteria? Approximately how many participants do you anticipate will be involved in your project?

Comparison

Will you compare pre and post intervention data or will you have an intervention group and a comparison group? If you have a comparison group, be sure the intervention is ethical. Withholding participants from an intervention that can be beneficial to them would be unethical.

Summative Evaluation Criteria and Data Collection

What evaluation criteria will you use to determine if your practice change (i.e., intervention) has produced the effect in the outcome that you desired? Summative (sometimes referred to as impact) evaluation is at the end. Remember that you are looking for a change in the selected outcome. What tool are you using to evaluate your outcome? Has the reliability and validity of the tool been established? At what point(s) in time will you collect this data using your evaluation tool and under what conditions?

Formative Evaluation Criteria and Data Collection

What evaluation criteria will you use to ensure that your planned change actually occurred as you planned? Formative (sometimes referred to as process) evaluation is performed throughout the planned change process to determine whether the change has actually been implemented as you intended. Without intermittent formative evaluation, you will not know if the intervention did or did not cause the intended outcome because you will not know whether or not it was actually implemented. Consider how you will know whether the change is being implemented; this may be by audit. At what point(s) in time will you collect this data using your evaluation tool and under what conditions?

Statistician

Who will you be using to assist you with the statistical analysis of your data? It is highly recommended that you consult a statistician. You might consider checking a local college or university to see if they have a statistician to assist you. There are also several statistical consultant available with web services. Finally, you can find a list of statisticians Chamberlain students have used in the past within the “Announcements” of NR702.

Data Analysis

What type of data is produced by your evaluation tools (e.g., nominal, ordinal, or interval)? What statistical tests will you use to determine if your selected intervention produced the outcome that you desired?

Put your answers below and copy and paste this portion into the collaborative thread for week 5

PICOT: In community clinic nursing staff, how does the introduction of standard guidelines within ten weeks affects the accuracy and quality of diagnosing and managing depression in the older population as compared to the staff’s performance before the intervention?

Sample

The main inclusion criteria for the participants are their profession and place of work: the nurses of the VEGA medical center are going to be recruited with the help of handouts and e-mails. No exclusion criteria are planned for the time being; nurses with any level of education and number of years of experience will be recruited. Ten nurses are going to comprise the sample; the size is predominantly defined by the number of nurses available, although this relatively modestly-sized sample will also be expected to produce manageable amounts of data.

Comparison

The project is going to compare pre- and post-intervention data. Predominantly, the quality of depression management will be considered with the help of the National Institute for Health and Care Excellence [NICE] (2016b) quality measures that correspond to the National Institute for Health and Care Excellence [NICE] (2016a) depression management guidelines which are going to be implemented.

Summative Evaluation Criteria and Data Collection

The summative evaluation of the project will be concerned with assessing the quality of depression management as determined with the help of NICE (2016b) quality measures. The National Institute for Health and Care Excellence (n.d.) quality standards are a product of a long development process that involves evidence collection, discussion, validation, and quality examination in collaboration with healthcare organizations and educational institutions.

Thus, it is a valid, high-quality tool. Some of the criteria used by NICE (2016b) include the rates of the employment of various interventions, response to treatment, relapses, and so on. For the summative assessment to be carried out, baseline measurements would be necessary, which are likely to employ the previously collected information that is used by VEGA to monitor its quality. After the intervention, the data on the indicators will be recorded continuously by the nurses, after which it will be collected and audited during the last week of the project.

Formative Evaluation Criteria and Data Collection

The formative evaluation measures will track the process of guideline adoption; the key criteria will include the nurses’ reported understanding of the guidelines and compliance with the guidelines (their usage). The latter will be monitored throughout the process with the help of depression management documentation procedures that will follow NICE (2016a) guidelines on documentation. For the former, nurses will provide feedback on the guidelines, the process of their implementation, and any issues that they might encounter. The mechanisms of feedback solicitation will include weekly meetings; also, a messenger-based chat is likely to be introduced for more urgent matters. Other options will be determined after a discussion with the nurses to suit their needs.

Statistician

The project intends to employ a statistician. The University of Florida Department of Biostatistics (n.d.) maintains the Biostatistical Consulting Lab which offers for-fee services to members and non-members. If any interference makes it impossible to consult the Lab, a Miami service called “Statistics Power” will be employed.

Data Analysis

The assessments are going to produce both qualitative and quantitative data. NICE (2016b) quality indicators mostly present ratio data (percentages); also, the compliance information might be transformed into ratio data to demonstrate the percentage of cases of non-compliance. However, the compliance information and the rest of the collected data are going to be initially presented in the form of qualitative information. Qualitative data cannot be analyzed with the help of statistical methods, and the type of qualitative data that the project will collect is unlikely to benefit from its translation into quantitative data.

For instance, only the qualitative analysis of compliance data can provide the insights that may help in uncovering the issues encountered by the nurses. The project intends to use thematic analysis to work with qualitative data, which is a well-established strategy (Melnyk & Fineout-Overholt, 2015, p. 149; Polit & Beck, 2017, p. 562). However, the primary summative assessment (quality indicators) produces quantitative data, which can and needs to be analyzed statistically. For ratio data, the t-test is a common choice; paired t-test can be employed to work with pre- and post-intervention measurements (Polit & Beck, 2017, p. 415). As a result, this test is planned to be employed.

References

Melnyk, B.M., & Fineout-Overholt, E. (2015). Evidence based practice in nursing & healthcare (3rd ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

National Institute for Health and Care Excellence. (2016a). Depression in adults: Recognition and management. Web.

National Institute for Health and Care Excellence. (2016b). Depression in adults: Quality Standards. Web.

National Institute for Health and Care Excellence. (n.d.). Timeline: Developing quality standards. Web.

Polit, D.F., & Beck, C.T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

University of Florida Department of Biostatistics. (n.d.). Consulting: Biostatistical Consulting Lab. Web.