Week 1 discussion
DQ1 Why I Chose to Pursue a DNP Degree
How did you decide on pursuing a doctorate? How did you
decide that a DNP was right for you and your career goals? What are your
short-term and long-term career goals? Include the goal you hope to accomplish
as a result of obtaining this degree.
DQ2 Practice Problem in Two Distinct Statements
You will be learning about your DNP project and perfecting
the ideas you have about this as you go along in the program — ideas will be
added and you’ll frame your project question in the PICOt format (more on that
later). For now, begin thinking about an organization that may need a practice
change or a quality improvement effort. You will build your project idea from
that base of awareness and information.
To begin, recognize that you have been gathering assessment
data for many years as a nurse. You are observing, listening, analyzing,
discussing situations in health care related to quality, leadership, safety,
cost and access. You have listened to patients and families, you have read
about issues that concern you, you have listened to subordinates and superiors
and you know inside your own mind, that there are possibilities that haven’t
been tapped yet to improve the health care system and delivery of care.
In this post please describe an idea you have (problem that
you have noticed) about an organizational need for practice change to improve
health outcomes, cost or access; or an organizational need for quality
What have you seen that could be addressed by a clinical
leader? Don’t worry about having a refined idea yet — just say what you see as
a problem, and suggest a set of ideas you may have for solving it.
An example might be that you have witnessed bullying in the
work place and you’d like to intervene by providing nurses with tools to interfere
with bullying when it happens and an “on the floor” coaching program
to facilitate the nursesâ€™ implementation of their anti-bullying tools.
Another example may be that clinic nurses are not addressing
smoking with stop smoking interventions and you’d like to intervene by teaching
the nurses ways to address smoking and encourage them to commit to addressing
every smoking patient with a smoking cessation intervention. You also want to
assure that this change takes place after intervention so you will audit the
charts and give feedback to the nurses on their progress.
What ideas to solve practice problems do you have? Review
the lesson for this week and remember to state the problem in two distinct
statements: (a) the problem and (b) the etiology. Finish your post by thinking
about and then writing, what kinds of interventions would work to resolve the
causes of the problem.
Week 2 discussion
DQ1 Nursingâ€™s Ways of Knowing
From the perspective of your practice change interest
(clinical outcomes, safety and quality, leadership or health policy) consider
the specific ways of knowing as they have played into your awareness of the
need for practice change?
Further, consider how intuitive/personal or ‘unknowing’
knowing dimensions of practice integrate with broader social, cultural and
theoretical dimension to create meaning and inform ideas for practice change.
Give two specific examples from your practice. For example,
let’s say that your practice change interest is in the way treatment decisions
are made in end-of-life care for elderly patients. Which ‘Ways of Knowing’ have
played primarily in to your observations and insights about this problem?
Examples of integration with broader social and cultural
dimensions in this scenario of treatment decisions in end-of-life care: how
does your intuitive/personal knowing integrate with what patients and families
say about their experiences? What do you know about the cost of care, access to
care or quality of care relative to the issue?
DQ2 Formatting your Problem Statement into a PICOT Question
In preparation for this discussion, first prepare interview
notes with the following questions:
I’d like to validate a problem statement and begin to
formulate a PICOT question with the needs of your organization in mind.
A problem I’d like to work to improve is _________ and some
of the causes of this problem seem to be _______________. Would you agree? Are
you asking questions within the organization about this problem? Do you have
additional insights to the specific problem statement and the etiology I’ve
come up with?
What Outcomes would you hope result from addressing this
Next make a phone interview (5-10 minute) appointment with a
nursing or other leader in your chosen organization. The purpose of your
interview will be to validate with the interviewee (from their point of view),
whether your initial problem statement agrees with their needs.
With this interview information validating or changing your
problem statement, you can move forward.Keeping the main ideas from the problem
statement you drafted in Week 1 wherein you identified the problem and the
etiology; now state the problem in the PICOT format.
What Population you will be working with to improve outcomes?
What intervention possibilities are there (these would be
aimed at the etiology portion of your statement)?
To what existing practice in health care are you comparing
the outcome of your intervention?What outcome do you expect to see as a result
of your intervention?
Week 3 discussion
DQ1 Nursing’s Theories and Conceptual Models
Explicate a selected nursing theory or conceptual model from
this weekâ€™s lesson and assigned readings and explain how you already do or how
you would apply the theory/conceptual model to your advanced nursing practice.
Identify whether your chosen theory or model falls within the totality or
simultaneity paradigm and explain why that view may be preferred in your
practice understandings. Finally, explicate in four single statements, how that
theory or model has guided and further developed your understanding of each
metaparadigm concept. In other words, how does the theory direct your
understanding of (a) person, (b) health, (c) environment and (d) nursing?
DQ2 Use of Nursing Theory to Guide DNP Projects
Conduct a literature search in one or more of the nursing
databases on the potential topic or problem of interest to you for your
eventual DNP Project. Select one article or paper and discuss how a particular
nursing theory or model was used as a framework for the research study or DNP
project. What insights has reading this article provided you in considering and
firming up, supporting the problem statements that you have formatted in Weeks
1 and 2?
Hint: If searching the Proquest Dissertations and Theses
database, use the search words: DNP (as author) and Nursing Theory (contained
Week 4 discussion
DQ1 Nursing Theories and Middle-Range Theories
Considering the nursing theory you discussed last week (or a
new one if you desire) describe how you would apply that nursing theory as a
basis for nursing actions related to your practice change idea (that you
developed in a problem statement and PICOT in weeks 1 and 2.
Specifically relate theoretical concepts to the elements of
your problem statement — how does the theory guide your ideas about the
problem, etiology, population, intervention and outcomes?
An example would be to explain how Roy’s adaptation model
describes the victim of lateral violence in the work place. How does the model
recommend assessing a victim’s adaptation range and what modes of assessment
(physiologic, self concept, role and interdependence) would the nurse use to
determine how positive coping can take place?
DQ2 Empiric Versus Aesthetic Critical Appraisal
List the elements of empiric and aesthetic critical
appraisal tools. Discuss your chosen theory in light of these two points of
view – consider whether or not you believe it is important to appraise a theory
from both perspectives and state why you think so. Be sure to integrate your
understanding of Carper’s Ways of Knowing into this discussion. What new
understandings do you have regarding implications of limited or expanded points
Week 5 discussion
DQ1 Application of Borrowed Theories to Advanced Nursing
Explicate a selected borrowed theory that you already know
or one that you read about in this week’s lecture, readings or other materials.
Provide an example of how this theoretical perspective has been used to frame
nursing knowledge, care or leadership in any health care setting.
List the concepts that constitute the theory and
Describe the relevance of those concepts to your advancing nursing
knowledge and practice.
In other words, you would not describe Maslow’s theory as it
relates to an entry-level, new graduate nursing assessment, but you could
consider how an advanced practice nurse, working on his or her doctoral degree
would use that theory to improve patient outcomes, quality and safety, access
Similarly you could talk about how using Albert Bandura’s
Self Efficacy concept facilitates more effective intervention in smoking
DQ2 Scholarship of Evidence-based Practice
Describe at least two examples of how EBP scholarship is
demonstrated either by you personally or by someone in your practice
environment. Include in your example descriptions, which type of scholarship
the example represents.
Recall from your lesson that the types of scholarship
include (a) discovery, (b) teaching or (c) application and integration. Which
type of scholarship do you think that your DNP project will be? Why do you
Further, projects can be categorized into (a) quality
improvements, (b) implementing practice guidelines, (c) evaluating practice
processes and policy, or (d) examining patterns of behavior.
Thinking about these categories of scholarship and project
type, how would you describe your potential project?
Week 6 discussion
DQ1 Evidence Supporting the Clinical Question and Suggested
Consider your inquiry and formulation of the clinical
question thus far.
Explicate at least two pieces of evidence (current
literature less than 5 years old) that support the idea that the problem you’re
naming exists and is significant. For example, here is a 2013 American Heart
Association article on predicting and preventing early readmission:
Be sure to also note what the evidence says about the
etiology or causative factors (what’s going on that influences this problem)?
For example, in the article above, early readmission rates are influenced
(caused by) situations such as psycho social and economic factors that limit
adherence as well as physiologic factors such as elevated filling pressures.
Finally, point to the evidence that suggests an intervention
that works to address the causes of the problem and to improve what we’re now
seeing in clinical practice on this topic. The AHA article named above suggests
that interventions such as comprehensive discharge planning, including patient
and caregiver education, guidance regarding sodium and fluid restriction,
collaboration with visiting nurses, and planned follow-up, may reduce early
readmission rates by as much as 25%.
In other words, for your problem, grounded in the
literature, what is the problem/etiology and what two pieces of current
literature provides evidence supporting those? Then what evidence supports the
intervention idea to improve this problem situation?
DQ2 Evidence-based Practice Change and Quality Improvement
Identify an evidence-based practice change model and a
quality improvement model that you could use for your eventual DNP project.
Explain how each model may be applied to create change
through your practicum and project efforts.
Illustrate your ideas with two examples; one example of
applying a change model, and one example of applying a quality improvement model.
Week 7 discussion
Collaboration for Improving Practice
Discuss the role of the DNP-prepared nurse in leading
interprofessional collaboration and partnership for promoting safe clinical
practice within healthcare systems.
Consider your reading this week from Chapters 6 and 10 in
Zaccagnini, M. E. & White, K.W. (2014); and in light of that reading,
discuss ways that you currently work in or have developed interprofessional
What more can you do relative to interprofessional
collaboration as you move through your DNP education? Give specific examples of
your current actions and future plans and tell why those actions are likely to
improve outcomes? Be specific.
DQ2 Emerging Roles for the DNP-Prepared Nurse
What emerging DNP roles do you imagine yourself in upon
completion of your degree? What skills and/or competencies do you think will be
most beneficial to you as you take on those advanced roles? Consider your
readings in Zaccagnini, Chapters 8 and 9 as you formulate your discussion post.
Compare your role in performing traditional advanced practice actions to what
is possible in emerging roles when you have completed your DNP degree.
Week 8 discussion
After reading the lesson and assignments for this week,
describe at least two examples of scholarship as demonstrated either by you
personally or by someone in your practice environment. You should describe which type of scholarship
the examples represent and why.