Purpose: As Part One of the QI/EBP DNP Project the student will demonstrate an appropriate assessment of relevant structures and processes involved in a direct or indirect health care setting for an opportunity for improvement of an identified health/health related system problem. The student will examine available data, conduct an appropriate and comprehensive literature review, design an innovative improvement intervention, and perform a costbenefit analysis on the recommended intervention. Based on reflection of the cumulative evidence, the student will prepare a compelling argument to support a substantive DNP Project Proposal. Relevant Course Outcomes: 1, 2, 3, 4, 5, 6 Assignment Guidelines: 1.Title and Introduction: The title accurately reflects the essence and intent of the project: (Decreasing infection rates…). Describe the importance of the topic to be addressed from a broad perspective, and why it is important to the setting. Support statements and claims made using current citations. Engage the reader’s interest. Briefly describe the purpose of the paper. (The purpose of this paper is….) 2.Comprehensive Assessment of the Setting: Provide an overall process analysis of the system: the purpose of the system, services provided, types of patients seen or individuals who use the services provided, professionals/staff, processes, patterns, and structures. Analyze an opportunity for improvement within a direct or indirect health care setting/organization regarding a system problem or issue related to health care. Thoroughly assess the setting in which the problem or issue was identified. Incorporate internal aggregate data and/or publically available data about the organization in the assessment such as: OASIS, MDS, HCAHPS, CMS, Hospital Compare Websites. Describe the processes for how data were collected (aggregate data provided by setting and/or websites, discussions with QI director, manager, internal and external stakeholders). Include an assessment of organizational or departmental culture, and discuss the perspectives of the various stakeholders, such as the clinical and administrative teams, as well as the nature of the patient population or other individuals served in this setting, and their specific needs and agendas. What are the deficits that prevent quality outcomes? Design a fishbone (cause and effect) diagram with a clear, concise statement of the problem at the ‘head’ of the fish. Create a process flowchart of the current system process(es) related to the problem; be clear about where the process starts and ends as relevant to the quality improvement issue. (These illustrations will be placed as addenda to this written proposal). 3.Aim Statement and Outcomes Measure: Identify the improvement opportunity selected for this proposal and provide the rationale for its selection based on the setting assessment and ‘gap’ identified. Include an explanation as to why it is a substantive initiative for this setting. If applicable, describe why and how the focus of the improvement goal was narrowed for this initiative. Identify an outcomes measure(s) that will be used to evaluate success. Discuss what other measures were considered and why the one (or more than one) was/were selected? Create an aim statement using S.M.A.R.T. criteria.
4. Comprehensive Literature Review and Synthesis: Develop a search strategy. Conduct a comprehensive and current literature review of the best available evidence relative to the identified quality issue to explore ideas for a recommended intervention for improvement. Design a flow diagram of the articles retrieved. Discuss the strength of the scientific evidence (peerreviewed, primary research articles) found. Provide a summary of the evidence, tying sections together with transition sentences. If there are multiple perspectives, present each perspective logically and clearly, promoting ease of reading. Describe interventions others have implemented and studied that were successful. Create a simple summary table of the final selected articles used. Summarize and show insightful syntheses of the literature information, including analysis of gaps in and/or limitations of the research. Explain alternative options and provide a rationale for why the recommendation selected is the preferred strategy for the specific setting – in other words, what evidence in the literature supports the intervention and is also something that is likely to be acceptable and practical to implement in the workforce setting’s culture. Consider any potential unintended consequences of the planned improvement. 5.CostBenefit Analysis: Describe how the innovation is fiscally sound. Analyze the costeffectiveness of the proposed recommendation. Describe the benefits of the innovative intervention. Prepare an improvement plan that outlines costs and potential savings of the recommended innovation. Include the costbenefit analysis from a microlevel perspective (department, unit, office) and also from a macrolevel framework (organizational, hospital). Discuss the potential impact on providers, the health care population, and other stakeholders. If applicable, explain how the benefits outweigh the costs. Use graphic illustrations or tables to make selected points. 6. Potential Barriers to Change: Address specific barriers to change. This may include the history of the present organizational culture and climate, as well as project feasibility and specific requirements that the proposal will entail. Describe the plan to address these barriers, and how the plan will incorporate various team members to support the change. 7. Compelling and Persuasive Support for DNP Project Proposal Based on the above site assessment, opportunities for improvement identified, scientific evidence, and costbenefit analysis, determine and describe the innovative recommendation that best supports the proposed EBP/QI DNP Project. Provide a persuasive argument explaining why the innovative recommendation should be approved for implementation in the specific fieldwork setting. 8. Initial Next Steps: Using PlanDoStudyAct (PDSA) as a model, describes initial next steps for planning and implementing the DNP Project once the project is approved by the faculty, fieldwork site liaison, and other appropriate stakeholders at the site. 9. Conclusion: Write a final conclusion (paragraph or two) that persuasively summarizes major points of the proposal. 10. Writing Format and Style: Use the following format: APA 6th edition, (title page, headings, content, references, appendices); doublespaced, page minimum for content: 20 (e.g. not including title page, appendices, and references); 1 inch margins; Times New Roman, font size 12. Follow writing conventions, consistent, correct spelling; wellformed sentences; correct grammar; focused, clear, concise and engaging writing; demonstrate well organized content with smooth and appropriate transitions that move the reader from paragraph to paragraph and section to section. Learning Outcomes: Prepares the student to assess and plan a QI/EBP DNP project proposal. Method of Assessment: