NR700 Week 1 Discussion 1 & 2 Latest 2017 August

dq 1

Week 1: Why I Chose to Pursue a DNP Degree

1313 unread replies.4343 replies.

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.

dq 2

Week 1: Practice Problem in Two Distinct Statements

11 unread reply.4646 replies.

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 improvement.

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 nurses’ 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.

NR700 Week 2 Discussion 1 & 2 Latest 2017 August

dq 1

Week 2: Nursing’s Ways of Knowing

No unread replies.4747 replies.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?

dq 2

Week 2: Formatting your Problem Statement into a PICOT Question

22 unread replies.5151 replies.

In preparation for this discussion, first prepare interview notes with the following questions:

1. I’d like to validate a problem statement and begin to formulate a PICOT question with the needs of your organization in mind.

2. 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?

3. What Outcomes would you hope result from addressing this problem?

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.

WhatPopulation you will be working with to improve outcomes?

Whatintervention possibilities are there (these would be aimed at the etiology portion of your statement)?

To what existing practice in health care are youcomparing the outcome of your intervention?

Whatoutcome do you expect to see as a result of your intervention?

NR700 Week 3 Discussion 1 & 2 Latest 2017 August

dq 1

Week 3: Nursing’s Theories and Conceptual Models

1414 unread replies.4141 replies.

Explicate a selected nursing theory or conceptual model from this week’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?
dq 2

Week 3: Use of Nursing Theory to Guide DNP Projects

77 unread replies.3636 replies.

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 in abstract).

NR700 Week 4 Discussion 1 & 2 Latest 2017 August

dq 1

Week 4: Nursing Theories and Middle-Range Theories

1717 unread replies.3535 replies.

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 fornursing 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?

dq 2

Week 4: Empiric Versus Aesthetic Critical Appraisal

1616 unread replies.3636 replies.

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 of view?

NR700 Week 5 Discussion 1 & 2 Latest 2017 August

dq 1

Week 5: Application of Borrowed Theories to Advanced Nursing Practice

2020 unread replies.3939 replies.

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 or cost.
  Similarly you could talk about how using Albert Bandura’s Self Efficacy concept facilitates more effective intervention in smoking cessation initiatives.

dq 2

Week 5: Scholarship of Evidence-based Practice

2121 unread replies.3838 replies.

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 think so?

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?

NR700 Week 6 Discussion 1 & 2 Latest 2017 August

dq 1

Week 6: Evidence Supporting the Clinical Question and Suggested Interventions

1313 unread replies.3232 replies.

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: http://circ.ahajournals.org/content/126/4/501.full

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?

dq 2

Week 6: Evidence-based Practice Change and Quality Improvement Models

1212 unread replies.3232 replies.

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.

NR700 Week 7 Discussion 1 & 2 Latest 2017 August

dq 1

Week 7: Interprofessional Collaboration for Improving Practice

2323 unread replies.3838 replies.

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 collaboration.

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.

dq 2

Week 7: Emerging Roles for the DNP-Prepared Nurse

2727 unread replies.3838 replies.

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.

NR700 Week 8 Discussion Latest 2017 August

Week 8: Clinical Scholar

3636 unread replies.4747 replies.

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.

NR700 Week 5 Inquiry Paper Latest 2017 August

Inquiry Paper Guidelines

Purpose

The purpose of this paper is to present the story of your inquiry process thus far on the road to developing your DNP project. An inquiry essay differs from other traditional academic essays in that its purpose is not to argue for a specific idea, but rather to illustrate your inquiry and thinking process, and to demonstrate your understanding of how theoretical and process models guide your DNP project development

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcomes:

CO2: Identify practice problems at the microsystem, mesosystem and macrosystem levels of health care systems (PO #3).

CO3: Assimilate nursing’s ways of knowing and the development of nursing science (PO #3).

CO7: Analyze the implementation of selected theoretical perspectives into evidence-based practice. (PO #5)

CO11: Summarize scientific knowledge to determine the nature and significance of a practice problem (PO #3)

Points

This assignment is worth 275 points.

Due Date

Submit your completed application under the assignment submission area bySunday 11:59 p.m. MT ofWeek 5 as directed.

Requirements

1. To complete this application, you will need to access to the following databases: CINAHL, MEDLINE, Cochrane Library, and the Joanna Briggs Institute. You may access these databases through the Chamberlain College of Nursing Online Library. The PDF tutorials for database searches are in the “Need Help?” box on every library page. To ask for assistance from a librarian, use one of the contact methods in the “Ask A Librarian” box at the top right of every page.

2. When clicked, it reveals a list of “Tools” or PDFs on how to do conduct various searches of the required databases (CINAHL, MEDLINE, Cochrane, and JBI) through the portals (EBSCO and OVID) provided.

3. TheInquiry Paper is worth 275 points and will be graded on the required components as summarized in the directions and grading criteria/rubric.

4. Create your manuscript using the version of Microsoft Word required by Chamberlain College of Nursing. You can tell that the document is saved as a MS Word document because it will end in “.docx”

5. Follow the directions and grading criteria closely. Any questions about this paper may be posted under the Q & A Forum.

6. The length of the paper will be about between 5-7 pages excluding title page and reference pages.

7. A minimum of 5 scholarly references (not your text books but primary sources of theory and research).

a. The textbook required for this course may be used as a reference for this assignment but does not count towards the required minimum number of scholarly references.

8. APA format and effective writing is required for the paper. Use your APA manual or Purdue Owl to check and correct your formatting. Use Grammarly, Tutor.com found under General Resources on the Course Resources page or in the student portal, the grammar and spelling check on your Word Processor and criteria for effective writing (available through the Writing Call and Coaches) to assure that your paper well written.

Preparing the Paper

The following are best practices for preparing this paper:

1. Outline your paper at the beginning of the term and begin adding notes to the content headings as you read critically and begin to synthesize and as insights occur in your mind. Following your outline will help you establish and maintain context throughout the paper.

2. Review your studies, discussion and exercises from week 1 forward in this class. Keep the MEAL plan in mind as you begin drafting paragraphs.

3. Create purposeful structure throughout your paper and in your paragraphs, having a sense of introduction, development and conclusion. Your outline and notes will facilitate this purposeful structure.

4. Be sure that your content is original and appropriate to the topic as assigned. Validate your ideas with substantiated thinking and appropriate use of valid sources. In other words, provide evidence and examples to illustrate your statements.

5. Assure proper conventions and content: Check the usage, spelling, punctuation, sentence structure, format, citing and so on using tools such as Grammarly, Word Spell and Grammar Check, APA manual, Purdue Owl, Listening to the Writing Calls, Contacting your faculty or using a writing coach if necessary.

6. An effective conclusion shouldinclude the main ideas and major conclusions. Do not add new information in the conclusion.

NR700 Week 7: Practice Problem Summary with Annotated Bibliography Latest 2017 August

Practice Problem Summary with Annotated Bibliography Guidelines

Purpose

An annotated bibliography is an organizing tool that helps compile evidence sources; especially research, in one location when working on a research or evidence-based practice/quality improvement project. It also provides quick access to the information contained in each source as you move throughout the program.

The purpose of preparing an annotated bibliography is to allow you to further explore literature that supports the practice problem and intervention ideas that you have for your DNP project. (Hint: if you keep adding to this list throughout the program, your final project will become much easier since you will have already collected everything you need here to support your project).

Procedure

To complete this assignment, start by performing a literature search for initial sources of research and evidence related to your practice change (PICOT) question and intervention ideas.

1. Conduct a focused review of literature related to the identified clinical problem, including (a) description of the problem, (b) etiology, and (c) evidence based interventions.

2. Describe the problem and the significance of the problem as they show up in the literature and in your practice knowledge and insights.

3. State the practice question in PICOT format as you have worked it out this term.

4. Consider the quality of the sources you choose. Look at the date of publication, author/sponsor/publisher, and purpose of the reference. Include only the highest quality references.

5. Provide a summary of 5 scholarly peer-reviewed references (i.e., research, systematic reviews, etc.) regarding the proposed approaches to the identified clinical problem.

6. Clearly and succinctly synthesize the literature. Here is a tool to assist your practice in writing syntheses. https://writingcenter.fiu.edu/resources/synthesis-matrix-2.pdf

Requirements

The paper should be 8-10 pages in length in order to develop each section substantively without writing excessively. It should including the following sections:

1. An introduction, which tells your reader what the paper is about and briefly sets the context through discussion of the PICOT and clinical question.

a. As you write, direct what you say to your scholarly peers, and you may assume that they have only a casual familiarity with your topic or issue.

b. The introduction will present a description of the practice problem (recall two distinct statements from week 1, including the impact on patient/client and family, healthcare system, or society.

c. The Introduction is placed underneath the paper’s title, and it has no level heading. In other words, do not use the word “Introduction” as a title heading. Just head the paper with the title and begin writing the introduction text.

d. The introduction should be approximately 1-2 pages in length and may include a subheading for PICOT question section.

2. An annotated bibliography of at least five resources, approximately 3-5 pages in length (about half to 1 page per annotation) and include the following:

a. Write the source in APA format as you do a reference listing (this is your level 2 heading for each entry).

b. Follow the source listing in a new paragraph with a brief annotation that summarizes the source in your own words (not from the abstract of the article) in 3-5 sentences.

c. Include your assessment on the reference’s strengths and weaknesses.

d. Explain the sources relevance and importanceto your practice change project.

3. Synthesis of Evidence: Approximately 2 pages. Follow the annotations with asynthesis of the evidence related to the identified clinical problem and PICOT question. Here is a tool to facilitate the synthesis writing process:https://writingcenter.fiu.edu/resources/synthesis-matrix-2.pdf

4. Conclusion: Approximately 1 page or less. The conclusion restates your paper’s main idea (the problem you are going to address by using evidence found in the literature), refers to the synthesis points, and provides a final impression about your project.

5. Reference list that starts on the next page after the conclusion and includes each of the annotated bibliography references in addition to others you may have cited but chose not to include in the annotated bibliography.

NR700 Week 8 You Decide Reflection Latest 2017 August

You Decide Reflection Guidelines

Purpose

The purpose of this application is to provide the student an opportunity to reflect on selected DNP competencies acquired through the NR700 course.

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcomes:

· CO3:Assimilate nursing ways of knowing and the development of nursing science (PO 3).

· CO7: Analyze the implementation of selected theoretical perspectives into evidence-based practice (PO 5).

Points

This assignment is worth a total of 100 points.

Due Date

Submit your completed assignment byWednesday 11:59 p.m. MT ofWeek 8 as directed.

Requirements

1. TheYou Decide Reflection is worth 100 points and will be graded on quality of self-assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.

2. Create your essay using Microsoft Word (a part of Microsoft Office), which is the required format for all Chamberlain College of Nursing documents. You can tell that the document is saved as a MS Word document because it will end in “.docx”

3. Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum.

4. The length of the reflection is to be within three to six pages excluding title page and reference pages.

5. APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):

Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in thePublication manual of the American Psychological Association(2010, p. 63).

a. You Decide Reflection

b. Conclusion

Preparing Your Reflection

TheDNP Essentials (AACN, 2006) outline a number of scientific underpinnings for practicecompetencies for the DNP-prepared nurse. Reflect on the NR700 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

1. “Integrate nursing science with knowledge from ethics, the biophysical, psychosocial, analytical, and organizational sciences as the basis for the highest level of nursing practice.

2. Use science-based theories and concepts to: determine the nature and significance of health and health care delivery phenomena; describe the actions and advanced strategies to enhance, alleviate, and ameliorate health and health care delivery phenomena as appropriate; and evaluate outcomes.

3. Develop and evaluate new practice approaches based on nursing theories and theories from other disciplines” (AACN, 2006, p. 9).

Reference:

American Association of Colleges of Nursing [AACN]. (2006).The essentials of doctoral education for advanced nursing practice.Washington, DC: Author.