DNP Project: Implementation
DNP Project: Implementation
PICOT Question:
In adult oncology patients at an infusion Center at Queens Hospital Center, does the implementation of a music therapy program compared to current practice impact pain scores during chemotherapy over 8-10 weeks?
The discussion for this week is focused on project implementation. Review the steps in your change process and your implementation schedule, identify milestones, and discuss how you will ensure the achievement of these milestones. How has your implementation plan changed, if at all? Why were these changes necessary? Have you started implementation?
The DNP project is a summative evaluation of many essentials learned throughout the curriculum. The projects focus on changes that can bring positive health outcomes. It includes implementing evidence-based practice, evaluating outcomes, and making a sustainability plan. Often the DNP students encounter many barriers to implementing evidence-based practices secondary to lack of site support. Many studies were done to improve project implementation. An enhanced model for DNP projects was tested in six DNP projects and found to improve the completion of assignments, defense, and graduation (VanderKooi et al., 2018).
Developing a clear timeline with all the tasks listed with special attention to time and costs and making a project schedule is critical for the success of any project (Baum and Swig, 2017). The final scholarly project indicates if the graduate acquired all the essential skills needed to be a leader in clinical practice (Roush & Tesoro,2018). The proposed project will be implemented over eight to ten weeks, and the detailed activities during pre-planning, implementation, data analysis, and dissemination are included in the Gantt chart
Week-1
A meeting will be held with critical stakeholders on week one to brief the project thoroughly. The DNP student will offer an educational session for registered nurses at the infusion center on the effectiveness of music intervention as an adjunct treatment for cancer pain and demonstrate the implementation process. Participants will be selected from the infusion center schedule based on inclusion and exclusion criteria. Selected participants will be contacted in person if possible or via telephone and asked about their willingness to participate in the project. Those willing to participate will receive a brief education about the music intervention, media player (MP3 player), visual analog scale, and be allowed to select their preferred music from a list of choices. Additionally, the participant will be informed that the proposed music intervention will be given during their next chemotherapy session. Participants will be recruited until week eight to satisfy the proposed sample size.
Week two through nine:
The implementation phase will begin on week two and continue through week nine. Participants will receive a single session of music intervention during chemotherapy. Informed consent will be obtained, and all questions and concerns will be answered for the participants. Therapeutic music will be provided to the participants, and pain scores will be assessed before and after the intervention using a visual analog scale for pain. Instructions will be given to ensure an accurate assessment of pain level. Pain scores will be documented in the electronic medical record. All the collected data will be stored in a locked file cabinet and a password-protected computer at the practicum site. The DNP student will be physically available during the project implementation to ensure compliance. Further, a compliance checklist will be utilized to document the correct implementation process. A retrospective chart review also will be done to ascertain the implementation process. The DNP student will perform formative evaluation from week two through nine by directly observing the implementation process and frequent huddling with the project team members. The preceptor will be updated about the project’s progress every day, and the course instructor will be contacted weekly or as needed. The DNP student will conduct a biweekly conference with stakeholders to update the progress. Daily staff meetings will be conducted with the health care team of the infusion center and oncology department administration. During the meeting, staff can provide feedback regarding the project, and the DNP student will update the project’s progress.
Post-implementation phase
The DNP student will thank all the participants and the health care team for their participation and support. All collected data will be analyzed with the help of a statistician. A retrospective chart review will be conducted to ascertain project implementation compliance. Project presentation before the Chamberlain faculty and sharing the results with practicum site stakeholders.
Major milestones identified in my project are a) educating the staff and b) recruiting the participants, c) implementation, d) data management, e) data analysis, f) project presentation, and sharing the results with the stakeholders at the practicum site. The project manager will use a compliance checklist and a retrospective chart review to ensure project compliance. The Gaant chart also provides an organized schedule for the smooth implementation process. There are no changes in the project implementation plan. Implementation will begin on the first week of NR 707.
Please provide your instructor and student colleagues with an update on the implementation phase of your DNP Project. Share any successes, challenges, or barriers you experienced this week.
The project implementation, planning, and preparation are progressing well. The DNP student is not foreseeing any barriers to the planned implementation of the project.
References
Baum, N., & Swig, B. (2017). Project management for healthcare practices: costs and timing. The Journal of Medical Practice Management, 32(4), 271–275. (Links to an external site.)https://www.proquest.com/docview/1930760068?parentSessionId=GgAgfndYvaWOJq5AAkHSCbrELfT7tKDlVF%2BSxK1VBuM%3D&pq-origsite=primo&accountid=147674 (Links to an external site.)
Roush, K & Tesoro, M. (2018). An examination of the rigor and value of final scholarly projects completed by DNP nursing students. Journal of Professional Nursing, 34(6), 437–443. https://doi.org/10.1016/j.profnurs.2018.03.003
VanderKooi, M., Conrad, D. M., & Spoelstra, S. L. (2018). An Enhanced Actualized DNP Model to Improve DNP Project Placements, Rigor, and Completion. Nursing Education Perspectives, 39(5), 299–301. https://doi.org/10.1097/01.NEP.0000000000000384
DNP Project 2
Complete the following outline. This outline should be brief bullet point answers. You will utilize this outline to complete all sections of the DNP Project proposal in DNP Project II.
| Section II |
Description of the intervention(s) in sufficient detail that others could reproduce it. Specifics of teams involved in the work. Review your project objectives for this section. What tools do you need to accomplish your project objectives? . |
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| SQUIRE Criteria | Please outline project plan details | |
| Interventions |
Interventions Describe planned interventions in sufficient detail that it could be reproduced. (Use the timeline and write a few sentences to briefly describe your approach to your QI project. The full timeline does not need to be included in the paper but your general plan for intervention should be. (Note, data collection and analysis will be done during section 3)
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Week 1
· Gather data regarding readmission rates for DM patients readmitted with 30 days of discharge from acute setting. Data will be collected 4 weeks prior to implementation
· Administer pretest
· Staff training- Will have 3 days of training broken down into 2 one-hour sections a day to accommodate staff schedule.
· Provider knowledge Evaluation using a posttest with a passing grade of 80% · -Group Remediation will be competed for staff members with less than 80%
Week 2- Week 4
· Implementation of the protocol/Go live
· Be present to support staff. Observe compliance answer questions that might arise during implementation
· Start a retrospective audit of discharged patients to see if participants are compliant with protocol.
· Audit will be done by checking if provider assessment and documentation tool was used and in Patient’s chart
Week 5
· Project success will be measured by comparing readmission rates for DM patients 4 week prior and 4 weeks post project implementation.
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Tools |
Describe each tool that will be necessary for achieving your objectives and carrying out interventions of the QI project. Include the following information: · Who will develop the tool (will you use an existing/established tool or develop your own)? · 2) How will the tool be validated (was it validated by a previous study, or will you seek expert consultation through stakeholders and the project team)? · 3) If using an established tool, do you need to seek permission to use the tool? From who? Note that every project will have different tools. Examples are provided below. · Protocol/Policy · Pre-Post Education Test/Questionnaires · Educational Presentation/handouts · Published Tools (Obtain Permission) · Chart Audit Tool
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· Provider assessment and documentation template a guide for provider documentation and gauge for compliance with Transition of Care. Tool will be Self-developed and validated by expert consultation through stakeholders and the project team will be sought for validation.
Transition of care protocol PowerPoint presentation and theoretical framework graphics for staff training
· Tool will be Self-developed and validated by expert consultation through stakeholders and the project team will be sought for validation.
A pre-post education test questionnaire will also be utilized to gauge providers attitudes and knowledge of the TOC protocol. Tool will be Self-developed and validated by expert consultation through stakeholders and the project team will be sought for validation. .
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| Appendices |
All tools need to be completed and placed in the appendices by the final due date for this section. Appendices should be listed in the order they appear in your paper. Use this section to plan out the order that you will list your appendices in your paper. Additional appendices that should be included: · Permission to complete project at the site · IRB materials where applicable from the project site · IRB determination form for TUN · Graphic of any models/theories/frameworks being used in the project (where appropriate)
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· Letter from project site (No affliation needed)
· Theoretical Framework graphic
· Transition of care protocol · PowerPoint presentation
· A pre-post education test
· Provider assessment and documentation template
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| Section III |
Approach chosen for assessing the impact of the intervention (s) Approach used to establish whether observed outcomes were due to the intervention (s) |
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| SQUIRE Criteria | Please outline project plan details | |
| Study of Interventions/ Data Collection |
Procedure for collecting data and plans for maintaining confidentiality during this process. Common data collection approaches to consider: · Chart review done using specific ICD codes at pre-implementation and then 5 weeks post implementation to evaluate outcomes and/or compliance. · Participant surveys before and after implementation or pre-implementation and then 5 weeks post implementation. |
· EHR data on 4 weeks prior to readmissions will be at baseline and 1-week post-implementation to facilitate statistical analysis. · Data will be collected using readmission report and stored on an excel spreadsheet. All member identifiers will be removed
· The results will show the project’s impact on DM patients.
· Pre and post-test will be completed by participating providers to determine improvements in knowledge, attitudes, and compliance with TOCs
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| Ethics/ Human Subjects Protection |
Explain how you will conduct ethical and confidential implementation. · Discuss IRB process- note TUN doesn’t require IRB for QI projects- in week 10, you will submit an IRB determination form to demonstrate you have a QI project. · Does your project site require IRB or QI Committee oversight? If so, define IRB process for the site. · Benefits/Risks for participants · Compensation for participants · Recruitment methods (how will you get people to your training?) |
· EHR data on 30-day readmissions will not contain patient identifiers like their names, Medicaid ID, address to ensure confidentiality.
· Data analyses will be conducted using a password-protected computer that only the DNP student can access.
· Data will not be disclosed to the public or third parties
· Project site does not require IRB or QI committee oversight
· The questionnaire will not collect provider and facility-specific information like their names and staff number. · Participants will be informed that no compensation will be offered for participating in the project before the study commences
· Participation will be voluntary and free.
· Nurses in the case management and care coordination department will benefit from the quality improvement DNP project as it would enhance their skills on TOC and educate them on how to achieve better care outcomes for DM patients Risks Loss of privacy and confidentiality. However, all mitigation strategies will be utilized. · There will be no compensation for participants
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| Measures/Plan for Analysis |
· Appropriate statistical analysis tests chosen and decision justified. · Discussion of assumptions to be addressed and specific process for analysis included · Will you hire a statistician at the site to complete your analysis? · (Note, in week 3 you will complete a statistics worksheet and submit to a TUN statistician and they will approve or redirect your plan for statistical analysis) |
· SPSS statistics software. Will help to run data in a simpler manner as compared to entering the data. Fisher’s exact test. It is more accurate when dealing with a small sample size as compared to other tests such as the chi-square test and the G-test of independence. · Assumptions: Add assumptions of the Fischer’s test
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Project Implementation Timeline
Please complete the timeline below by the assigned due date. The purpose of this assignment is to determine a timeline of activities necessary to perform during the implementation phase. This schedule will keep both you and your project team on track and will assist in weekly communication. Please copy and paste some of the introductory the information from your project proposal for consistency. You will utilize this timeline during the implementation of your project in DNP Project III. You may also utilize this form for providing updates during DNP Project III.
| Introduction | |
| Project Site |
Organization |
| Project Mentor |
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| Project Purpose |
Reduce readmission rates for patients diagnosed with diabetes to reduce health care costs for that population.
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| Project Question |
how does the use of a TOC protocol (I) compared to? the current practice without TOC protocol (C) reduce the readmission rates for patients. diagnosed with DM (O) within 4-5 weeks (T)?
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| Project Timeline | |
| The purpose of this timeline is to keep you and the project team on track during the implementation phase which will occur in DNP Project III. Intervention or project timeline should be clearly described. Time to carry out implementation, collect data, and evaluate the project should be clearly delineated. Please plan out the activities you will be performing each week during the implementation phase. Please set actual concrete dates for any training, interventions, data collection, and/or data analysis. | |
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Week 1 Dates: (please obtain from course announcements. Week 1 should correlate with the first week of DNP Project III unless special permission is granted to implement early.)
· Nov. 3–9
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· Data collection · Debriefing the clinical staff, Interpretation of findings · · Administer Pretest
· Training / and Presentation · Provider knowledge Evaluation using a posttest with a passing grade of 80% -Group Remediation will be competed for staff members with less than 80%
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Week 2 (Nov. 10–16) |
· Implementation of the protocol/Go live
· Be present to support staff. Observe compliance answer questions that might arise during implementation
· Start a retrospective audit of discharged patients to see if participants are compliant with protocol.
Audit will be done by checking if provider assessment and documentation tool was used and in Patient’s chart
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Week 3 (Nov. 17–23) |
· Implementation of the protocol/Go live
· Be present to support staff. Observe compliance answer questions that might arise during implementation
· Start a retrospective audit of discharged patients to see if participants are compliant with protocol.
Audit will be done by checking if provider assessment and documentation tool was used and in Patient’s chart
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Week 4 (Nov. 24–30) |
· Implementation of the protocol/Go live
· Be present to support staff. Observe compliance answer questions that might arise during implementation
· Start a retrospective audit of discharged patients to see if participants are compliant with protocol.
Audit will be done by checking if provider assessment and documentation tool was used and in Patient’s chart
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Week 5 (Dec. 1–7) |
· Evaluation of project/Analysis/ Dissemination of findings
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| Weekly Summary | |
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Clearly and succinctly summarizes project status and discussion includes any updates to the project timeline.
DO NOT COMPLETE THIS NOW- SAVE THIS FOR DNP PROJECT III |
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| Week 1 |
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| Week 2 |
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| Week 3 |
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| Week 4 |
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| Week 5 |
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ADDITIONAL INSTRUCTIONS FOR THE CLASS
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- Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
- Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
- APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
- Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
- LopesWrite Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score. DNP Project: Implementation
- Late Policy
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. DNP Project: Implementation
- Communication
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. DNP Project: Implementation
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