Overview
Assignment 1: Background/Significance, Purpose and PICOT
Content
This is the first assignment where you are starting to write your project paper. Here are some hints towards a successful background, significance, purpose and PICO question.
Background and Significance
This is the beginning of the paper when the author (you) have to sell the problem to the reader (faculty). A nice strategy is to begin with some statistics that demonstrate the seriousness of the problem. This grabs the reader's attention right from the start. Then go into some definitions of clinical terms.
Describe the clinical nature of the problem, Including physiology and pathophysiology. Remember, you are clinical experts and here is where that can be displayed.
Purpose
Address current practice and what is the gap between current practice and best evidence. Be concise in your purpose statement. Imagine riding in the elevator and you are asked to explain your project.
PICO
What is the population, intervention, comparison, and outcome? Who is your population of focus? What is the intervention? The comparison is best evidence to current practice, for example. What is the outcome?
GENERAL CLASS INSTRUCTIONS
Your proposal must be written using APA format. The template has been prepared with basic APA formatting. Please pay particular attention to headers, spacing, in-text citation format, and reference list citations. Refer to you APA Manual (7th edition) and/or the Purdue OWL (Online Writing Lab) resource for details. Owl tutorial
ASSIGNMENT 1 INSTRUCTIONS
Using the DNP Paper TemplateDownload DNP Paper Template , write a brief introduction to your proposed project. See the template for more information and description of the specific components. Include the following:
- Create a Title and complete the Title Page (add running head in the document header)
- Write the Background and Significance of the Problem.
- Write the Purpose of the Project.
- Write the Clinical Question. You may write this as (1) a PICO question or (2) as SMART objectives for your Project: Specific, Measurable, Achievable, Relevant, and Time-oriented (stated timeline for project/outcome).
Writing to the Rubric
Look at the rubric for this assignment. Here is a hint-use headings for background and significance and purpose. Use subheadings for the elements of the paper. Use APA 7th Edition formatting for spacing and bold or not. This makes it easier to include all required items and easier to read.
SUBMITTING YOUR ASSIGNMENT
- SAVE your document, using this format: Assignment1_lastname.doc
- SUBMIT the completed document via Canvas, under the Assignments tab
GRADES
Submissions will be graded according to the Assignment #1 rubric.
Introduction_Purpose_Question
| Introduction_Purpose_Question | |
| Criteria | Ratings |
| Problem/need/issue/change clearly identified and stated | Satisfactory Needs Improvement Unsatisfactory/Missing |
| Background information supports the need to address this problem | Satisfactory Needs Improvement Unsatisfactory/Missing |
| Purpose statement is clear | Satisfactory Needs Improvement Unsatisfactory/Missing |
| Scope of project is realistic and appropriate for DNP | Satisfactory Needs Improvement Unsatisfactory/Missing |
| Question is clearly stated and appropriate. If objectives are used, they are stated in feasible and measurable terms. | Satisfactory Needs Improvement Unsatisfactory/Missing |
Assignment 2: Evidence Matrix
Review of Literature
The review of literature is the process used to evaluate the research to determine best evidence. Remember, not all published papers are good representatives of best evidence. The process is as follows:
- Identify the question from the purpose and PICO
- From the question, find the keywords to use to guide the search
- Access databases from the library's website. Note, the word databases in the sentence. The review of literature should include at least three (3) databases.
- As the papers emerge from the search, determine those that are to be included and those that will be excluded. Here is where you will apply inclusion criteria such as: research papers, published in peer reviewed journals, year from x-xx (this can be based on the papers that emerge), and printed in English.
- Keep a running total-how many papers emerged in the search and why? How many were excluded? Included? Someone who will read your paper may want to repeat the search. This information will let them know they are following your directions. Consider using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram. More information and the diagram can be found at PRISMA Statement
- Read the papers that emerged and included in the review of literature. Appraise the papers. A number of tools are available online for quantitative, qualitative, randomized clinical trial, and papers based on data science.(Refer to NGR6850)
- Use the appraisal to guide the development of the matrix. Several matrix models are available online. Make sure the following is included: citation, question, data collection method, method of analysis, results, identified limitations for best evidence, comments about the study, level of evidence. Use these items in the top row and in the rows below, complete the matrix. The following is an example:
| Sample Matrix | |||||
| Pub Year; Author's Last Name | Title | Type of Study Design | Sample/Setting | Main Outcomes/Findings | Support for or Link to Project |
| Content | Content | ||||
| Content | Content |
When writing the section of the review of literature, here is where you will turn to the notes taken during the process and describe the process used for obtaining the papers to include. We will be looking for a complete review of literature. Here is a troubleshooting guide:
- What if thousands of papers emerge? The keywords are far too broad, try narrowing them to reduce the number of papers.
- Only a few papers emerged, then what? The keywords maybe too narrow or little is known about the topic.
If either of these happened during your search, this must be described and what you did to narrow or broaden your search.
From the matrix, notice if some key themes emerged from the appraisals. These themes can be used then as subheadings to present the literature in a concise and synthesized manner. This is not a report on each paper, rather, this is a presentation of the sum of the papers. Remember, use the appraisal to guide for the process of writing this section.
The review of literature is the phase of the project where you make an argument for the problem and your idea of best evidence. From your literature matrix, pull out the themes that emerged from the papers. Use these as subheadings (refer to APA 7th ed) to structure this section of the paper. Synthesize the findings of the review of literature. This is NOT a summary. Remember writing a book report in grade school? That was a summary. Instead of summarizing each paper, synthesize the papers with commonalities and differences. For example, "Of the 14 papers included in the literature review, five paper (citations) explored the paternal influence of the disease process while nine approached the problem from an institutional perspective (citations)." There are a number of resources online to help distinguish between a summary and synthesis. We want a synthesis of the literature.
INSTRUCTIONS
Review the literature and complete an evidence matrix to summarize the literature. There are many formats for Literature Evidence Summaries/Matrices available for you to use. An example is given above. The advantage of a more comprehensive model is that you have more information from which to evaluate the article and its applicability to your proposed project.
The literature you cite should support your project topic, purpose, and/or methodology. Thus, it should include theoretical, methodological, and empirical articles as applicable to your project. Rate the level of evidence for each article using an established evidence-based rating system. Pay attention to the theoretical frameworks used in the articles; this will help you to identify relevant concepts and processes for your project. For projects focusing on practice change, include articles that demonstrate the implementation and impact of the proposed practice change in other settings. For projects focusing on Quality Improvement/Program Evaluation, include articles relevant to successful interventions and QI improvement in other settings and demonstrate the impact of the intervention(s) to improve similar QI measures.
The literature reviewed should be of high quality and recent (less than 5 years old), with the exception of older landmark/hallmark studies (which should be identified as such). DO NOT write about one article at a time but synthesize the findings into groups or themes that are identified as sub-headings.
Please review the online video to help guide you through this process. Refer to your textbook and your class materials from NGR 6101, 6850, and 6836. There are also multiple resources available on-line to clarify the process. You may also contact our Librarian, Maggie Ansell, for assistance. Her writing series is also posted on Canvas.
- Identify high quality articles and complete the Evidence Matrix.
- Complete your synthesis of literature from the Evidence Matrix
- Add your Evidence Matrix to the DNP Proposal template as an Appendix at the end of the document. Note that a sample template has been added to the Project Template. A page break has been inserted so that the Evidence Matrix is in landscape format to allow extra width. Be careful that you don’t delete that page section break.
SUBMITTING YOUR ASSIGNMENT
- SAVE your document, using this format: Assignment2_lastname.doc
- SUBMIT the completed document via Canvas, under the Assignments tab
GRADES
Submissions will be graded according to the Assignment #2 rubric.
Literature Appraisal and Review
| Literature Appraisal and Review | |||||||||
| Criteria | Ratings | ||||||||
| Literature appraisal supports the relevance of the issue/problem and the project | Satisfactory Needs Improvement Unsatisfactory/Missing | ||||||||
| Literature appraisal is complete | Satisfactory Needs Improvement Unsatisfactory/Missing | ||||||||
| Literature matrix thoroughly reviews high-quality articles | Satisfactory Needs Improvement Unsatisfactory/Missing | ||||||||
| Literature review provides a clear and concise basis for proposed study | Satisfactory Needs Improvement Unsatisfactory/Missing | ||||||||
| Literature Review is comprehensive and appropriate | Satisfactory Needs Improvement Unsatisfactory/Missing | ||||||||
| Literature review is well written. Literature is synthesized and includes a final summary of strengths/limitations/gaps in the literature | Satisfactory Needs Improvement Unsatisfactory/Missing | ||||||||
| Search process key words, databases, and inclusion/exclusion criteria are identified. Key terms are defined Assignment 3: Conceptual Framework INSTRUCTIONS The goal of the theory/conceptual framework is to identify a guiding theory/framework for your DNP project. The theory and the concepts should provide the foundation for your DNP Project. 1. Choose and write the Conceptual/Theoretical Framework section and add it the template. Describe the framework and its relevance to your project; include a brief discussion of the concepts and relationships relevant to your project. (1-2 paragraphs). SUBMITTING YOUR ASSIGNMENT
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Assignement 4 Methods in Quality Improvement
To understand methods in quality improvement, a contrast between research and quality improvement is necessary.
TABLE 1 Elements, Research and Quality Improvement
| Elements | Research | Quality Improvement |
| Origin of question | Can come from clinical, prior research, papers, conversation | Can come from clinical, prior research, papers, conversation |
| Process | Required IRB approval, protection of human subjects | IRB may be required for the organization, but human subjects not part of QI |
| Methods | Qualitative, Quantitative, Randomize Clinical Trials-experimental design | PDSA, Pre-Post Test, system assessment, for example |
| Analysis | Statistics, modeling, seeking causality, relationships | Descriptive statistics, comparison of words or text, for example |
| Goal | Answer research question, generalizability of results | Answer PICOT question, applicable to site |
Implementation-Here there must be a specific plan. Include detail from points A to B and onward. Describe each step like a recipe so anyone should be able to read this section and repeat the project in their institution. As readers (faculty) are looking for specifics.
1. If you are using PDSA from the IHI model-take a paragraph or so and describe what that is and what it means. Then describe the Plan and Do for the first cycle. You won't know the rest until after these are completed. Keep track of each phase of the cycle and take good notes of conversations and observations-for cycle 2, what will be adjusted towards success? In the final write up of the project, include tables for each cycle showing what was done and outcomes to reaching the goals.
2. Pre-post test-Include the tests in the appendix. These should be either well established tools or one you wrote. The intervention (education) should also be well described and included in the appendix. For the surveys be very specific as to how these will be administered-hard copy, electronic?
3. System assessment-Perhaps your project is assessing the organization to understand current processes. This should be done in detail-follow the process from start to finish. Explore the systems within the system. Draw the system if possible and include in the results along with other data-feedback loops, conversations, observations.
Evaluation-Here is your interpretation of what you found, outcomes, and/or cycle data. Including the over arching evaluation and strengths and limitations of the project-if you had it to it again, how would you adjust the project? We all can learn from projects-the best plans...
Sustain the project-How will the project be sustained? Is there buy in for this to continue after you step back or leave? Is there a champion? Do changes need to be made to the electronic health record to sustain the project?
Dissemination-Where and how will you share the project and outcomes? The site should be first on the list. Publications? Presentations? Professional organizations? Remember, you are about to be a leader in this area of work for your scholarship.
Policy-How will you move this project towards policy? What is your professional organization? This is a good place to start. Perhaps forming a work group and write up the policy and begin to gain motivation towards changing practice at the national level.
INSTRUCTIONS
Using the DNP Proposal template, begin to write the Methodology section for your proposed project. The methodology is like a recipe that you are providing so others could follow your project in their site. Include the following:
- Describe the proposed Design for your DNP Project. (1-2 sentences)
- Describe the Participants or Data Source for your Project. Modify this section as appropriate for your project (e.g., health policy project). If you are proposing a project that involves directly interacting with patients (e.g., educational intervention, practice change), include the following: description of the patients, how they will be selected, timeframe to obtain participants. Select the appropriate heading above, based on your project. (1-2 paragraphs).
- Describe the Setting for your project. Discuss how the project is appropriate for the setting and aligns with the vision and mission for the organization. Clearly define the stakeholders. Identify the agency consultant. (1-2 paragraphs)
- Describe the Intervention/Program and the Data Collection Procedures. Describe what will be done, how it will be done, who will be responsible for implementing the program or process change, and the duration and timing of the program. Modify this section as appropriate for your project (e.g., health policy project). Refer to class materials for more information. Modify the heading based on your project (2-3 paragraphs).
- Describe the Measures/Tools/Instruments. Discuss the project outcomes (variables) to be measured. Describe the measurement tool(s) that you will use to measure your variables. Discuss how the tools will be used (e.g., when & how administered). Be sure to include reliability and validity information, information about whether the tools have been used in similar populations or setting, and any other information that supports your use of this tool for this project. For projects that are using existing data, provide information about the variables that you will use to answer your question and how they were measured in the original dataset. Refer to class materials from NGR 6836. (1-2 paragraphs).
- Describe the Project Approvals needed before you can conduct your project. . Discuss plan to obtain signed Cooperative Agreement with your clinical agency/site/organization. If IRB approval is needed, include this sentence: “The University of Florida Internal Review Board (IRB) approval will be obtained prior to initiating the DNP Project.” If your clinical agency requires agency-specific IRB approval or Quality Improvement project registration (QIPR), please state this and state that these will be completed prior to initiating the project. QIPR is required for projects at UF Health.
- Develop the Implementation Timeline. Develop a Gant chart that includes the various activities to successfully implement the project. Project the amount of time for each activity, and chart the sequence of events. Include the projected start and end of entire project. (about ½ page, depending on the number of activities).
- Describe the Evaluation Plan. Describe how you plan to evaluate the results of the project and/or analyze the data. The evaluation plan should include the criteria that will be used to evaluate what worked and what may not have worked in the project. Refer to class materials from NGR6836 on how to evaluate QI projects.(1-3 paragraphs).
- Describe the Dissemination and Sustainability Plans. Describe your plan for disseminating your project results prior to graduation from the DNP Program. Plan should include discussion of how you will communicate your project results to the agency/site/organization and stakeholders. Also include a statement regarding your plans for sustainability of the changes and briefly discuss issues that may affect its sustainability. (1 paragraph)
SUBMITTING YOUR ASSIGNMENT
- SAVE your document, using this format: Assignment4_lastname.doc
- SUBMIT the completed document via Canvas, under the Assignments tab
GRADES
Submissions will be graded according to the Assignment #4 rubric in Canvas.