DNP Scholarly Project Proposal Development

Vision and Mission

What is the vision statement for your DNP scholarly project? A vision statement is the project’s optimal goal and reason for occurring.

What is the mission statement of your DNP scholarly project? A mission statement is a statement of how the vision will be realized.

Congruence between your Project’s Vision and Mission Statements and those of the Organization

You identified the vision and mission of the institution that is serving as the site of your DNP scholarly project in week 2. Is there congruence between the vision and mission statements that you have written for your project and the vision and mission statements of the institution?

Objectives

What are the short-term and long-term objectives for your DNP scholarly project? If you are not familiar with writing objectives, consider that these are short-term and long-term goals but each objective needs to be specific, it needs to be measureable, it needs to be achievable, it needs to be relevant, and you should include a time-frame. This is referred to as the SMART method of writing an objective. As an example:

At the completion of this 8 week practice change project (timeframe), there will be a 10% reduction in the incidence of hospital acquired pressure ulcers (specific, realistic, and achievable) as evidence by documentation of skin assessment (measurable).

Risks and Unintended Consequences

What are the potential risks or unintended consequences related to your DNP scholarly project?

Change Model

What change model will you use to guide the planned change process? Consider whether this is an individual change or an organizational change and select the model accordingly. The following content maybe helpful when selecting a change model for your project:

Planned Change Models

Lewin’s Theory of Change (1951) provides a starting point for implementing nursing theory and research into clinical practice. In this course, you have identified a specific nursing theory that you believe would provide a scientific underpinning (theoretical foundation) for your eventual DNP project. Now, reflect on the process of change. There are many planned change models available for you to consider for your eventual DNP project.

According to Lewin (1951), there must first occur an unfreezing of the old pattern of doing things. Unfreezing is then replaced with the moving phase of change and followed by refreezing as people adjust to the new ways of doing things.

Rogers expanded on Lewin’s work and proposed the diffusion of innovation model in 1995. This model has five stages in the diffusion process: knowledge, persuasion, decision, implementation, confirmation. In the diffusion of innovation model, there are five adopter categories for any population or social system. These include the innovators, early adopters, early majority, late majority, and laggards.

Kotter developed the 8-step process for leading change model in his 1995 book Leading Change. The eight steps for leading organizational change include: establish a sense of urgency, form a powerful guiding coalition, create a vision, communicate a vision, empower others to act on the vision, plan for and create short-term wins, consolidate improvements and produce still more change, and institutionalize new approaches. Kotter emphasizes that for change to be successful, there needs to be buy-in from 75% of a company’s management, so the first step—creating a sense of urgency—is critical to the success of the change project.

Evidence-based Practice Models for Guiding Change

Schaffer, Sandau, and Diedrick (2012) highlight relevant EBP models for guiding change including the ACE star model of knowledge transformation (Stevens 2004, Kring 2008), the advancing research and clinical practice through close collaboration (ARCC) (Ciliska et al., 2011), Iowa model (Titler et al., 2001), the Johns Hopkins nursing evidence-based practice model (JHNEBP) (Newhouse et al., 2007), the promoting action on research implementation in health services framework (PARIHS) (Rycroft-Malone 2004), and the Stetler (Stetler 2001, Ciliska et al. 2011) model.

Schaffer, M.A., Sandau, K.E. & Diedrick, L. (2012). Evidence-based practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing, 69(5), 1197–1209.

Quality Improvement Models

  • Donabedian Structure, Process, Outcomes Model (1966). This widely recognized conceptual model provides a framework for examining health services and evaluating quality of care. According to the model, information about quality of care can be drawn from three categories: structure, process, and outcomes.
  • Plan-Do-Study-Act Cycle (PDSA) The PDSA cycle is a systematic process for testing a change.

P, Plan: Plan a change or test of how something works.

D, Do: Carry out the plan or test.

S, Study: Observing and learning from the consequences, look at the results. What did you find out?

A, Act: Decide what actions should be taken to improve.

Schedule

What is your schedule for the steps of the planned change process? There are many ways to present the schedule. You can use the table in the Word document APA Template for the Project Proposal in DocSharing. You can use Excel or Visio. You can also search for other web options to develop a Gantt chart such as http://www.smartsheet.com/blog/gantt-chart-excel#.VEB2Dhbzb9k.

Don’t forget to include course requirements such as project proposal (week 6 of NR702), IRB proposal (week 2 of NR705), final paper (week 6 of NR709), and final presentation (week 7 of NR709).

Resources

What resources, including human resources and support, financial support, data resources, and materials, will you need for your DNP scholarly project?

Budget

What is your budget for your DNP scholarly project, including expenses and revenue (if applicable)? Your budget must be balanced so you need to identify revenue to offset all expenses. Nothing is free so even if dietary provides free coffee, it comes from the dietary budget so the actual cost of the coffee needs to be on the expense side and the dietary cost center must be included on the revenue side.

Put your answers below and copy and paste this portion into the collaborative thread for week 4

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?

Vision and Mission

The vision of the project is the achievement of the optimal quality of the management of depression in the older patients of the VEGA medical center.

The mission is to improve the quality of depression management of the VEGA center by promoting evidence-based practices with the help of standardized guidelines provided by the National Institute for Health and Care Excellence [NICE] (2016a).

Congruence between your Project’s Vision and Mission Statements and those of the Organization

The project is in line with VEGA’s vision and mission. VEGA aspires to improve the health of the community, and its mission is high-quality and affordable care. The promotion of evidence-based practice is likely to improve the quality of depression management and, therefore, the health of the community, and the employment of care standards can have a positive impact on the costs of care (Petrosyan et al., 2017).

Objectives

Two long-term objectives are proposed to prove the adoption of the guidelines and measure their effects.

  1. At the completion of the project (week ten, timeframe), all the adopted quality indicators suggested by National Institute for Health and Care Excellence [NICE] (2016b) will experience at least a twenty-percent improvement (specific, realistic, achievable) as evidenced by the depression case management documentation (measurable).
  2. At the completion of the project (week ten, timeframe), all the participants will report being able to apply the new guidelines as evidenced by the documentation of the final discussion with them (specific, realistic, achievable, and measurable).

The first objective can be supplemented by the following long-term objective.

At the completion of the project (week ten, timeframe), the must-do quality indicators suggested by NICE (2016b) will achieve 100% (specific, realistic, achievable) as evidenced by the depression case management documentation (measurable).

The must-do aspects include, for instance, proper assessment procedures, the revision of treatment for resistant cases, and so on.

Short-term objectives are the following ones.

  1. During the first week of the project (timeframe), 100% of the nurses will review and understand the new guidelines as evidenced by their reports during the discussion of the first week (specific, realistic, achievable, and measurable).
  2. At the beginning of the second week of the project (timeframe), 100% of the nurses will be using the new standards (specific, realistic, achievable) as evidenced by their use of depression case management documentation (measurable).
  3. By the fifth week of the project (timeframe), at least 50% of the nurses’ reported concerns and difficulties will be addressed (specific, realistic, achievable) as evidenced by the discussion documentation (measurable).

Additional goals may be introduced by the principal investigator in collaboration with the nurses.

Risks and Unintended Consequences

The project aims to improve the quality of care, but it is acknowledged that this outcome may be not achieved. Thus, the unintended consequence of the project is the lack of improvement. Moreover, the change is a complex process, which might cause short-term confusion and decrease in the quality of care. Also, the change might put additional pressure on nurses, which may also affect their productivity in a negative way and, possibly, discourage them from employing the new methods. All the stress-related risks and unintended consequences are going to be mitigated with the help of active communication.

Change Model

The project will employ the change model by Rogers, which can be successfully merged with the previously selected Iowa model (Hanrahan et al., 2015). The five stages of the approach are focused on the engagement of individual stakeholders, which is an important basis for organizational change: technically, the latter depends on the former (Pashaeypoor, Ashktorab, Rassouli, & Alavi-Majd, 2016).

Moreover, the theory also discusses the innovation properties, the determination and management of which can help the stakeholders in the process of adoption (Hanrahan et al., 2015). For instance, determining that a change is viewed as too complex should prompt additional educational efforts, which can change this perception. Overall, the theory promotes sustainable change, and its emphasis on the individual adoption processes will help to address nurses’ concerns and difficulties.

Schedule

Appendix A presents the proposed schedule of the project. The “feedback” element refers to the feedback on the project; the feedback from nurses on the intervention is a part of formative assessment. The specific implementation activities are highlighted in italics; the implementation of intervention will include all the elements proposed by the change model.

Resources

Human resource (time and effort) is crucial for the project. The participants are not going to be motivated by money; rather, they will be provided with a chance for improving their practice as an incentive. However, the statistician will be hired: the University of Florida Department of Biostatistics (n.d.) presents its fee rates, which can be used to calculate the expected payment. Other than the statistician’s assistance, no services are expected to be used.

The evidence review requires the access to research articles and books, which is obtained by the principal investigator. The implementation process is going to need some supplies, equipment, and space. NICE (2016a) provides change enabling tools, including flowcharts and guides. These materials are freely available, but some of them may need to be printed for convenient use, and this aspect of future expenses appears in the “supplies” field of the budget. Also, the project will be employing the equipment and software that is already available at the center (for instance, computers). No financial support is offered by VEGA, but it will accommodate the training and discussion and provide nurses with time off for the sessions if needed. The summary of resulting expenses is presented below.

Budget

EXPENSES REVENUE
Direct Billing 1500
Salary and benefits 0 Grants 0
Supplies 600 Institutional budget support 0
Services
Statistician 300
Indirect
Overhead 600
Total Expenses 1500 Total Revenue 1500
Net Balance

References

Hanrahan, K., Wagner, M., Matthews, G., Stewart, S., Dawson, C., Greiner, J.,… Williamson, A. (2015). Sacred cow gone to pasture: A systematic evaluation and integration of evidence-based practice. Worldviews on Evidence-Based Nursing, 12(1), 3-11. Web.

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.

Pashaeypoor, S., Ashktorab, T., Rassouli, M., & Alavi-Majd, H. (2016). Predicting the adoption of evidence-based practice using Rogers’ diffusion of innovation model. Contemporary nurse, 52(1), 85-94. Web.

Petrosyan, Y., Sahakyan, Y., Barnsley, J., Kuluski, K., Liu, B., & Wodchis, W. (2017). Quality indicators for care of depression in primary care settings: A systematic review. Systematic Reviews, 6(1), 1-14. Web.

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

Appendix A

Schedule

Schedule