NU840/Project Residency III

Project Faculty Name

Date

Abstract

1

8

Contents Description of the Problem 4 Nature of the Problem 4 Significance of the Problem 4 Available Knowledge from Review of the Literature 5 Concept 1 (depending on your project design you may have more than one) 5 Concept 2 (if needed, see above) 5 Rationale for Selected Framework 5 Name of the Theory or Framework 5 Aim of the Project and This Report 6 Purpose of the Project 6 Purpose of the Report 6 Contexts Considered at Outset 7 Contexts Considered for Implementing the Intervention 7 Concept 2 (if needed, if not delete) 7 Description of the Intervention 7 Overview of the Intervention 7 Project Team (if applicable) 8 Defined Project Evaluation Measures 8 Measure One 8 Measure Two 8 Measure Three 9 Measure Four 9 Measure Five 9 Development of Evaluation Measures 9 Measure Development 9 Analysis of Project Data 9 Project Outcome Relative to Measure One 9 Project Outcome Relative to Measure Two 9 Project Outcome Relative to Measure Three 9 Project Outcome Relative to Measure Four 9 Project Outcome Relative to Measure Five 9 Ethical Considerations 10 Identified Ethical Dimensions 10 Reporting Results 10 Implementation Trajectory 10 Unfolding Measures Analysis and the Intervention 10 Contexts Interacting with the Intervention 11 Associations of the Outcome, Interactions, and Contexts 11 Unintended Consequences Associated with the Intervention 12 Summary of Project Findings 12 Key Findings 12 Strengths of the Project 12 Interpreting Project Results 12 Associating Outcomes with the Intervention 12 Outcomes Correlated with the Literature 13 Project Impact on Stakeholder Groups 13 Differences Between Anticipated and Actual Outcomes 13 Project Trade Offs 13 Observed Limitations 14 Project Design Limiting Factors 14 Approaches Taken to Address Limiting Factors 14 Applying the Intervention in other Settings 14 Project and Process Conclusions 14 Sustainability of the Intervention 14 Potential for Extending the Intervention into other Contexts 15 Implications for Extending 15 Next Step Recommendations 15 Usefulness of the Project 15 Funding and Cost Considerations 16 Funding Sources 16 Funding Impact 16 References 17 Appendix A 18 Appendix B 19

Insert Title of Paper Here

Tips for Introduction: It is always good to start a paper with a grabbing statistic (with citation) regarding the topic to grab the attention of the reader. Then introduce the topic of the paper and why it is important. End the introduction paragraph with a purpose or thesis statement as your last sentence of the paragraph to introduce the main points/sections of your paper. Example: The purpose of this paper is to provide the reader with an overview of an evidence-based practice (or innovation) scholarship project completed as a part of the requirements to be awarded a Doctor of Nursing Practice degree.

Here you are going to discuss the problem you identified that your DNP project was designed to address. Reflect on prior assignments where you described the problem you observed in your practice setting. Include information, data, personal observations/experiences that provide the reader with an appropriate picture of the problem. Include the observation of the problem from your review of the literature and how this compares to or supports your observation of the problem. Review your NU 760, NU 710, and NU 800/810 or NU 801 course assignments. Be sure to revise/refine as needed based on faculty feedback and refinement of your project design.

In this section you will provide the reader with a discussion of how the problem is impacting the practice setting. Include information, data, personal observations/experiences, stakeholder comments that allows the reader to understand why this problem needs an evidence-based or innovative solution.

Review your NU 760, NU 710, and NU 800/810 or NU 801 course assignments. Particularly the synthesis matrix table from NU 760, the first draft literature support from NU 800/NU 801, and the draft prospectus from NU 800/NU 801. Be sure to revise/refine as needed based on faculty feedback and refinement of your project design.

Level 3 Heading (rarely needed – delete if not needed)

If your project encompasses more than one element, moving part, in the design you will need to have literature to support each element. For example, if your project includes implementation of an evidence-based screening tool and you are conducting education with staff who will participate in the implementation – you will need literature references that support the screening tool and literature to support staff education. If your project design includes implementing a new technology that patients will be using and educating patients about the new technology, you will need to have literature that supports the new technology and literature that supports providing patient education.

Level 3 Heading (rarely needed – delete if not needed)

You are not describing a PDSA framework here. That is a process by which you put the project you designed into play in the practice setting. That is different than what is expected in this section of the paper.

This is where you should be reviewing your IRB application Aim Statement and Project Overview section.

Here you will discuss the value of constructing and sharing the outcomes of the project with appropriate stakeholders.

Consider reviewing information from SWOT assignments and change theory assignments from prior course work as that may be of value to you as you construct this section. Also reflect on the assignments you had requiring you to identify potential barriers that could impact implementation and how you plan to address and overcome those through design of the implementation plan. Also, if you faced challenges, anticipated or not, engaging with project stakeholder groups in promoting the implementation of the intervention provide an overview of those challenges here. Ensure you include enough detail so that the reader understands how prepared you were and how hard you worked to move your intervention off the sideline and into the playing field.

Level 3 Heading (rarely needed – delete if not needed)

Level 3 Heading (rarely needed – delete if not needed)

If your project included a team design be sure to provide information about the selection, development, and training of the team members as those activities relate to successfully being able to carry out the intervention.

You project measures are defined in your approved IRB application. You will use a different level 2 heading identifier for each measure. Your project measures are described in your approved IRB application. Develop a paragraph, or a few paragraphs as needed, to fully describe the measures you determined to be appropriate to evaluate the outcome of the project. As you can see I have included headings for up to 5 measures. Most students have 2 to 3 measures outlined in their IRB application. You will simply delete the ‘measure’ headings that are not needed.

In this section you will discuss your thoughts and the reason for developing/selecting the measures you outlined in the section above. From the SQUIRE 2.0 guidelines Explanation and Elaboration page: The choice of measures and type of data used will depend on the particular nature of the initiative undertaken, on data availability, feasibility considerations, and resource constraints. The trustworthiness of the project will benefit from insightful reporting of the choice of measures and the rationale for choosing them.

For each measure identified in the ‘Study of the Intervention Using Defined Evaluative Measures’ section, provide an analysis of the information/data collected relative to that measure. Correlate your findings to the aim and purpose of the project. From the SQUIRE 2.0 guidelines Explanation and Elaboration page: Various types of problems addressed by healthcare improvement efforts may make certain types of solutions more or less effective. Not every problem can be solved with one method –– yet a problem often suggests its own best solution strategy.  Similarly, the analytic strategy described in a report should align with the rationale, project aims, and data constraints. 

Reflect on the discussions and assignments from NU 760 that directed you to consider if any actual or potential ethical principles were represented in your proposed project design. Also reflect on your CITI training that provided a great deal of information about ethics in research. And although the student DNP project is not a research design, examination of the implementation process you developed for your project may have resulted in the need for ethical considerations. For example, all surveys developed as a part of evaluation measures were required to be anonymous. From the SQUIRE 2.0 guidelines Explanation and Elaboration page: Both the original and SQUIRE 2.0 guidelines stipulate that reports of interventions to improve the safety, value or quality of healthcare should explicitly describe how potential ethical concerns were reviewed and addressed in development and implementation of the intervention.  This is an essential step for ensuring the integrity of efforts to improve healthcare and should therefore be explicitly described in published reports. 

Although the final outcome of the project is not known until all the data/information has been collected, the project implementor/observer (you) observes trending changes associated with the intervention processes as they are unfolding. These observations can result in the desire/need to modify the intervention. A discussion of whether or not this phenomenon was observed during the unfolding or your project needs to be discussed here. From the SQUIRE 2.0 guidelines Explanation and Elaboration page: Healthcare improvement work is based on a rationale, or thoughts, as to what intervention will have the desired outcome(s) in a given context.   Over time, as a result of the interaction between interventions and context, these thoughts are re-evaluated, resulting in modifications or changes to the interventions. Although the mechanism by which this occurs should be included in the methods section of a report, the resulting transformation of the intervention over time rightfully belongs under results.   The results section should therefore describe both this evolution and its associated outcomes.

Level 3 Heading (rarely needed – delete if not needed)

Review the information provided here from the guidelines. Consider what, if any, of those contextual elements are observed operationally in your implementation process. Discuss your observations in this section. From the SQUIRE 2.0 guidelines Explanation and Elaboration page: One of the challenges in reporting healthcare improvement initiatives is the effect of context on the success or failure of the intervention(s).  The most commonly reported contextual elements that may interact with interventions are structural variables including organizational/practice type, volume, payer mix, electronic health record use, and geographical location.  Other contextual elements associated with healthcare improvement success include top management leadership, organizational structure, data infrastructure/information technology, healthcare professional involvement in activities, motivation to change and team leadership.  

Now that you have examined the impact of contextual elements on the project, provide a discussion in this section as to how those contextual elements interacted with the intervention process and impacted the project outcomes.

In the preceding sections you provided project outcomes (results) correlated to the defined evaluation measures. You also described the trajectory of the project and the impact of implementation contexts on the observed outcomes. From the SQUIRE 2.0 guidelines Explanation and Elaboration page: relate these main findings back to the nature and significance of the problem and the specific aims previously outlined

Level 3 Heading (rarely needed – delete if not needed)

This is where you will provide your concluding thoughts about the strength of your entire project process. This could include discussing the positive impact the implementation had on the identified problem. This could include discussing the positive impact on the team dynamic, the practice culture, etc.

Level 3 Heading (rarely needed – delete if not needed)

Provide a discussion here about consistency of the outcomes you observed/achieved with your project with what the literature supports about the value of the intervention.