Transcript DNP Education: Creative Approaches to Student Projects

DNP Education: Creative
Approaches to Student Projects
Kathleen R Delaney, PhD, PMH-NP, FAAN
Rush College of Nursing
What Process does the DNP involve?
Here at UW: Translational process
-Identification of a candidate health application for
Scientific discovery
-Assessment of the potential value of the application
-Development of an EBP guideline & moving it to practice
- Evaluating real world health care questions.
Cultivate clinical investigative skills
Indentifying practice question, evaluating evidence,
abstracting the theory of why practice work, finding a
structure for translation, identifying a method for
outcomes.
DNP at Rush College of Nursing
• 20+ years of experience
at the DNP
• Started with the
Nursing Doctorate in
early 80’s
• Continued with FNP
programs requiring NDs
in 90’s
• Moved into DNP in
Executive Leadership in
Experiences with the process helps in
various ways
• Practice at the process of developing a project idea
• Comfort with the process
• Spot fault lines in a project a bit quicker
Rush: addressing a problem in the
context of service delivery system
• Projects take on a problem in the context of
the service delivery system
– Medication errors in a particular hospital service
– Development of a nurse practitioner house call
program
– Enhancing quality through patient centered care
– ER protocol for detection of pressure ulcers
– Feasibility of early screening for post partum
depression.
Use Logic Model to Organize Projects
Has the best goodness of fit when explaining how a program should work
A visual tool used to align program inputs, activities, and outputs with the
intended outcomes for the intervention goals and objectives.
It communicates what is the intended causal pathway for creating the desired
change in the health condition of an population or in a system
Logic Model: Define problem or basis
for change
• Identify an outcome
you see a need to
change: increasing
patient participation in
treatment
• Considers the mission,
values of the system
Line up a set of Inputs
Required resources:
• Staff time
• Training materials
• Cost
• What other clinicians
will be involved
• Organizational supports
• Protocols needed
Think of the outputs of your activities
Direct result of your
project activities:
• Develop training
materials
• Establish reflective type supervision groups
• New groups for patient
self-management
• Community resource
board
Begin with the end in mind
• What is the current situation the student intends
to impact – (staff knowledge, staff skills, patient
decisional control, patient health status)
• What will it look like when he/she achieves the
desired situation
• What behaviors/situations need to change for
that outcome to be achieved OR
• What knowledge of skills do people need before
the behavior will change
• What new approach needs to be introduced for
that outcome to be achieved.
Simplified Logic Model
Programs & Services
Inputs
-Decrease Sitter
Time in ED
-Decrease time
Patient spends
Short Term
Intermediate
Long Term
Simplified Logic Model
Programs & Services
Inputs
-Decrease Sitter
Time in ED
-Decrease time
Patient spends
Short Term
Intermediate
Long Term
Simplified Logic Model
Programs & Services
Inputs
-Decrease Sitter
Time in ED
-Decrease time
Patient spends
Short Term
Intermediate
Long Term
How will students think?
• Cultivating critical thinking around clinical investigationdialogue around practice issue, methods to address,
mechanisms to investigate change
• Dialogue, building student cohorts, public presentation
of initial proposal, have a third eye look at data plans
• Take care not to box students in with EBP change
• Practice change has to be embedded in a clinical context
Different Models to Help Students
work through the process
• Flexible in where issue is identified
– Work place issue that needs to be addressed
• Match up with a faculty topic are of scholarship
–School based health
–Integrated Behavioral Health Care
–Health Care Homes
–Acute Psychiatric Models of Care
• Establish Successive projects in a clinical practice site
•Student A establishes data supporting need and evidence based
approach
•Student B implements program and sees initial data
•Student C investigates longer term outcomes and suggests
changes
For Larger Community Project
• Establish a project team led by a APHN
– Several DNP students would take a piece of this
larger endeavor
– Establish a team of DNP and our Graduate
Masters Entry students
Begin with the end in mind: Reset
conversation around NP education
• Establish the mutual benefit ratio of having a NP
student at your facility
• Teach students how to think
– Cultivate Scientific Reasoning- practice and refine
around theoretical framework of study
– Cultivate Clinical Reasoning- apply a base of clinical
practice knowledge to increasingly complex patient
situations
– Cultivating critical thinking around clinical
investigation- dialogue around practice issue,
methods to address, mechanisms to investigate
change