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Running Head: STAFF EDUCATION 1

STAFF EDUCATION 9

Staff Education to reduce overcrowding in the Emergency Department (ED)

Name: Joslynn James

Institutional Affiliation: Walden University

Date:08/14/2020

Staff Education to reduce overcrowding in the Emergency Department (ED)

All employees want to feel valued and supported in their field, which is the same for the nurses. Additional education and training are essential to help nurses grow in their obligations within the institutions that, in the end, realize job satisfaction and enhance the commitment to the job they do. Moreover, education and training to the nursing staff are important to improve their knowledge and skills to facilitate efficient care delivery. With the increasing technology and the outbreak of the different disease conditions, the staff nurses must be continually updated through training programs to improve their knowledge and skills of the nurses to help them tackle the different conditions within the healthcare environment. For instance, the coronavirus pandemic that has currently hit the world has posed a serious challenge to the medical providers across the globe. Even though series of researches have been done to realize the effective vaccine for the virus, there have been series of education on the nurses to help contain the virus from spreading and claiming more lives, a great example of the reason the nursing staff should consistently get an education on the medical provision.

Worst still, overcrowding at the emergency department (ED) is a serious concern for the nursing staff and has significantly compromise how they deliver medical services. The current coronavirus pandemic has even placed the lives of the individuals in the ED at risk since one of the primary precautions is to maintain the social distance that can be difficult to achieve when there is overcrowding. Also, the long wait hours at the ED has resulted in high mortalities due to negligence, and the staff nurses not having the needed knowledge to handle the large numbers in the ED. The impact is enhanced pressure on the staff nurses to get the needed training to ensure that such mortalities and risks that the other individuals get exposed to due to contact and the long wait hours are reduced. It is, therefore, mandatory that the nursing staff get equipped with the needed knowledge to help ease patient flow in the ED to help save lives and deliver quality care services. Also, continuous education will help the providers to get equipped with the needed skills and the knowledge that will help them confront the arising issues in the medical field.

Problem Statement

Over their careers, the nurses always attempt to provide excellent care and make a meaningful difference in others’ lives. Yet, the same nurses have also been faced with challenges where they face high mortalities, especially in the ED due to failure to attend to the patients in the critical conditions in time, some leaving the ED without being seen after long wait hours while some parents leave with their kids upon discharge without receiving any significant counselling due to lack of time. All these problems arise from poor patient flow in the ED and failure to establish the needed educational programs for the that the nursing staff should be put to address the issues (Herron, 2017). Some nursing staff areis young individuals who have recently graduated and have not been in the field for a long time to apply the needed strategies to ease the patient flow. Also, most medical facilities have not implemented the right programs to help the young staff on what needs to be done to help with the flow in the ED. At the same time, some of the organizations have also attempted to use programs that have entirely failed in the end.

The enhancement of patient flow is a worthwhile pursuit for staff nurses. However, the pursuit may seem completely unachievable, with limited financial resources and leadership opportunities. There is a need to establish nursing educational programs that will help in the establishment of strategies to help improve the flow in the ED. The nursing staff has significant roles to play in ensuring that the overcrowding and the wait time in the ED are minimized to help reduce the dangers such as high mortalities that are associated with the poor flow (Johnson & Winkelman, 2011). Moreover, the strategies establish within the medical centers should reflect what the nurses have learned in practice. The educational programs should have a primary focus on the changes that will enhance efficiency and the optimization of the resources. Also, the nursing staff should be made ready to be able to handle the rising cases of pandemics in the world. While coming up with the educational programs, the safety of the nurses should also be a primary focus.

In the past, numerous methods have been used by staff nurses to help ease patient flow. One of the primary strategies that have been in use in the ED is to reduce bed holds. The staff nurses are always encouraged to keep a bed or two at all times for emergencies, a concept called “bed holding.” Even though this practice has been practical in numerous instances, it also comes with certain challenges. It can result in more patients leaving the ED without getting attended to, or seen or cause long delays in care, which enhances poor patient flow.

Furthermore, even the placement of the patients in the ED beds by the staff nurses can result in longer wait hours and additional time in the waiting rooms over the day. For the ED staff nurses, the limitation of the amount of time the ED beds are held and enhancing the general flow of the patients in the department can be ensured by making certain integral changes that may include filling the beds despite the wait times of the physicians (Chan, & Stackhouse, 2014). Even though the method implies that the patients may not be seen right away, they would be accessible to the physicians right away once they are ready. The placement also ensures that the staff can monitor the patients and offer time to prepare for the assessments.

The second practice that has been put in place to ensure the staff nurses ease the patient flow in the ED is to provide educational materials with efficient and timely discharge teaching. The poor communication in signaling the end of the visit and answering the questions has been one of the primary drawbacks to the staff nurses ensuring a good flow of patients in the ED. Poor communication has created a dilemma where the patients in the ED do not know when to leave. However, with the educational guide, the staff nurse can effectively access information that will help ensure that they learn about the patients who need assistance with the dressing, mobility aide, or those who require phones before they get discharged. Having the staff nurse in place to aid in completing such tasks can help enhance the flow. However, this can only help with sufficient information and guidance to help the staff nurses step up to complete these tasks to enhance patient flow in the ED.

Purpose Statement

This proposal aims to establish the most effective educational program for staff nurses to improve patient flow in the emergency department. The issue of the poor flow in the emergency departments has been associated with the lack of education for the staff nurses. The fact that different hospitals have different operational cultures should mean that the staff nurses coming in should be put into programs that will acquaint them with the processes and practices at their new workplaces. The research will aim to establish which measures and a staff teaching program s that the nurses should be able to applyput to ensure that they familiarize themselves with the existing culture. Also, the familiarization can get enhanced through their interaction with their co-workers. However, this is not enough as the co-workers should also get updated due to the rising pandemics in the world full of uncertainties and requiring new strategies to help combat them from spreading and affecting new numerous individuals.

This research proposes the use ( I am unclear. Is this your proposal within the newly developed staff education program? Are there any references that could be added to support the idea?) of steering committees who are charged with facilitating the ED change and recommends the inclusion of the nursing staff. The nurses should jump at the chance to sit with the committees so that they are educated on the identification of the changes that may occur in the ED. The nurses within the committees will also learn how any change will impact the nurses, enabling them to advocate for enhancements in patients flow from the perspective of the nurses. Ideally, upon the conceptualization of the changes and obtaining the staff teaching from the committees, the staff nurses should get educated based on the streaming process. The process will involve grouping or teaming up the nurses based on a given discipline or disease suffered by a particular group of people. Every group will be assigned an educator that helps update them on the various changes in disease conditions and the measures they need to have in place to handle the conditions within the shortest time possible. The approach will further have facilitated by the pivot nurses at the ED who asks about the patient’s condition and give appropriate directions to different groups of staff nurses based on the condition of the patient.

Research Objectives

To establish the most effective educational program that will help the staff nurses ease patient flow at the ED.

To establish the effectiveness of the streaming process in reducing overcrowding under the help of pivot nurses. (Do you plan on implementing your teaching strategy and measure actual outcomes of crowding? )

Practice Focused Question (s)

Does stay in the loop on ED changes by the staff nurses improve flow in the ED? How effective is the inclusion of the staff nurses in the steering committees charged with the ED change-facilitation to help reduce overcrowding in ED?

Does the allocation of similar patients to given work stream help improve flow in the ED? (Are you measuring this for this study?)

Social Change

The effective application of the educational practice to the staff nurses has a significant implication on social change. The focus of the two research questions is to bring the staff nurses together and work as a unit. Even though the streaming process involves the allocation of patients with different disease conditions to a particular group of the nurses or physicians, the various units are linked to particular pivot nurses at the ED who communicate on the various conditions and get directions to the right group of staff nurses. The approach fosters collaboration and teamwork, which is an integral social change. Also, with the facilitation for the fast medical delivery to the patients, the staff nurses aim to reduce the wait time in the ED that will, in turn, minimize the anxieties amongst the affected people and, worries and for the betterment of the medical conditions. The approach aims to will result in the reduction of the number of deaths that are a social problem. The new protocols imply that the nurses will be in a pole position to offer faster medical care to improve the ED’s health conditions. The approach will boost the confidence of the people within the communities on their health facilities and believe in the care provided within the hospital. Effective provision of care in a timely and with great quality is a significant social change.

Moreover, this project supports the mission of Walden’s University in its bid in the promotion of social change. The project aims to improve the skills and the knowledge of the staff nurses to offer diverse, timely, and quality care to promote a positive change in the health care system. Also, the project improves the belief of the community members in their healthcare system with the improvement of the quality care provided to the patients. The implication of the streaming system and nursing staff education is bringing hope to the ED. This will make the members of the community have faith and belief in the emergency department and seek to get the health services with no fear of long wait times or enhanced mortalities. Thus, the project is crucial for timely and quality care, which is the primary goal of Walden’s University.

Literature Review

Poor patient flow at the emergency department has been an issue over a long period in most health provision facilities and has resulted in massive mortalities over time. Numerous providers have made efforts, all focused on the reduction in the wait times and overcrowding, while having their focus on the patients (Herron, 2017). The patients’ focus has resulted in massive failure in most hospital facilities because there are no adequate strategies placed on the nursing staff. The nursing staffs are essential resources when it comes to easing the patent flow in the ED. Numerous research has been done on how the patient flow can be enhanced in the ED through the education of the nursing staff and pivot nurse.

According to Jarvis (2016), one of the surest ways to ensure that the nursing staff improves the patient flow at the ED is through the streaming process. Streaming refers to the allocation of patients with similar conditions (concerning the nature or severity of the disease) to a given workstream (Jarvis, 2016). The process involves evaluating the patients by the nursing staff in a given geographical area with the emergency department. A good example is “see and treat,” an example of a streaming process where the patients with less severe disease conditions are allocated to a dedicated clinical area and then get an assessment and treatment from a clinical team from the only “see and treat” patients. The aspect implies that an organization must establish a system where the medical providers are grouped based on their knowledge and skills or the area in the medical field where they are more interested. The firm then sets a training program that is geared towards their areas of specialization (Johnson, & Winkelman, 2011). However, the organization must ensure that the different teams get staffed by nurse practitioners, physician assistants, senior doctors, or even a combination of all to ensure that the nurse staff has the right education regarding their areas of specialization.

The nursing staff’s division to different groups is associated with a significant reduction in the waiting times and realizes shorter journey times when compared to the non-streamed systems. This method’s efficiency is ensured on how the patients get signposted in the different streams by the pivot nurses within the ED. The pivot nurses should be trained to ensure that they can immediately communicate with the patients when they get into the ED and learn about their conditions. They will then immediately direct to the various streams where the nursing staff with the needed knowledge to handle their conditions are placed. This will ensure that the flow is improved as the attendance will be directed by the nurses with the needed knowledge about the disease conditions. Also, with the experiences in dealing with the areas of specialization, the treatment plans will be enhanced, and this will mean that the patients spent the limited time possible as they get assessed. If the case is critical, they then get transferred to the appropriate health facilities or areas, and this will ease the flow that has been a problem over time. This method’s efficiency is further enhanced by adequate staffing and the physical space available in the health care centers to help meet the demand of the increasing and different cases in every individual work stream. However, with the right education and direction, this method will effectively help improve the flow. The organizations must ensure that they get the senior doctors with the right knowledge to impart to the nurse staff and the pivot nurses.

Moreover, the nurse staff must be included in the committees that decide on the training processes. The practice involves staying in the loop on the ED changes. It is important to realize that changes occur every time in the emergency department, which often affects the nurses’ work and has a significant influence on the patient flow. Before, the nurse managers and the physicians did not significantly predict how the changes will influence nursing, or did they know how to advocate for the enhancements in the patient flow from the perspective of staff nurses. Thus, the research recommends the establishment of steering committees charged with the facilitation of any changes in the ED to include the nursing staff who should take any chance to sit on the committees to ensure that they get updated on how to handle different cases with the changes in the ED and to help tackle the emergencies in the form of the pandemic.

The advantage of joining these committees is that the nurses joining these communities will have a chance to share their concerns and educate other colleagues on how nursing roles affect the flow of the patients in the ED. For instance, if a nurse in the steering committee foresees a change being unpopular among the ED nurses, then the nurse should be in a position to forward the ideas that should be implemented to enhance the implementation success or the areas that the educational practices should focus on to realize success and improve the flow (Derlet, Richards, & Kravitz, 2001). The ideas involved may incorporate seeking assistance from the organizations that are trusted and selecting the staff nurses that are respected to help foster or pilot the change. In the committees, the nursing staff will be adequately represented in the steering communities. Since they interact with the patients, they are in better positions to determine what should be done and the needed changes that can help improve the patient flow. Also, with the application of the knowledge of the nurses or the inclusion of the nurses in this decision making, they will feel part of the process and have up to date information on the happenings, and this will be a massive benefit to the ED.

The context for the Doctoral Project and Methodology

The research will primarily employ the use of a survey as the main method of data collection. The use of a survey will be integral as a measure to the staff nurses within the emergency department, determining the areas of weakness and what needs to get improved to realize the quality and timely care to the patients. The practice makes it feasible for the project to be accomplished in the ED due to the verse information offered by the medical providers and their educators. The research will strive to involve every individual with no bias in the collection of data, and this will ensure that the information provided is just.

Apart from the surveys, the literature review will also be complemented through the use of different search engines on the internet and also the library database. In the process, the researcher will use various keywords such as nursing staff, improving flow, decreased provider timeframe, streaming in ED, and other relevant terminologies that will help support the research findings. However, the search for this information must be directed towards using reliable sources such as PubMed, EBSCOhost, CINAHL, and the Journal of Emergency Nursing. Most importantly, the research on the secondary sources of data will be done using the Walden University Library. The secondary information will be important because they help the researchers establish the concepts and the theories that have been used to describe the concept of strategies that can be used by the nursing staff to enhance patient flow in the ED. Moreover, the information will include the various methodologies that have been used in the past to strive and address the issue, including those that have been feasible and those that have failed and the reason some have not worked.

The intended setting for the doctoral project is in Regional One Hospital (Regional One Hospital, 2016). I think it is feasible to accomplish this project by performing a survey study in the hospital among the health workers (nursing staff) through the recommendations on the teaching practices that can be applied to enhance the patient flow in the emergency department. Also, since the project setting involves a Regional One hospital, I believe the validity and the reliability of the information will be assured. The involvement of the hospital stakeholders at this point will enable understanding the patient care processes at the facility and help determine the shortcomings and the possible causes (Regional One Hospital, 2016). It will help in the explanation of the reasons for the provision of low-quality care and the poor patient flow in the emergency department (Chan & Stackhouse, 2014). Such information will be integral in implementing the process to implement the nursing staff’s educational practices. Also, it will be essential to use the information in the application of possible solutions.

Ethics

Will this project protect human subjects? Yes, this project will protect the human subjects as this is a survey to observe for improvement in flow and care. The project’s primary goal is to ensure that the subjects are satisfied with the services they get from the medical providers and that the information they give the nurses remains confidential. Also, the process is aimed to enhance the low self-esteem that most patients have suffered from and thus perfect for the protection of the human subjects. Besides, the enhancement of the number of nurses through pivot nurse will ensure that the number of practitioners attending to the patients is improved (Burt & McCaig, 2006). This will ensure that every patient is satisfied with the services offered to them with equal service delivery without leaving them stranded in the waiting rooms. At the same time, they are hurt without the nurses giving them the needed care. The confidentiality that the individuals can get from the nurses can help establish the trust that is significant in giving information about the condition of the patient.

Are there potential ethical issues that may present problems for the completion of this project?

This project has no perceived negative impact on the ED nurse staff, patients, or others associated with the ED. The project is primarily a quality improvement practice that did not involve any nurse staff markers or identifiers. The only data that will be extracted in the process is the ED metrics. Moreover, the data that will be extracted for use in this project is public knowledge available in the public domain. Also, the individuals will be set to give an honest opinion based on the survey questions used and provide the primary issues that limit the efficiency of the nurse staff in the ED, compromising the patient flow. Thus, the project will not have any negative consequences on the staff working at the emergency department, and the other individuals associated with the emergency department. Also, the process will not involve any bias on the people getting surveyed. The survey questions will be given randomly to the individuals to ensure there are no discriminative practices or bias in choosing the respondents. The practice will ensure that the respondents’ answers are accurate and will be a significant directive to realizing the project’s goal of the project.

Moreover, no individual will get surveyed without their consent. The survey questions will not require the staff nurses to provide their personal or private information, but it will be exclusively professional and focus on the main pointers that can be used to eliminate the staff nurses to help with the improvement of the patient flow in the ED. Also, they will not be asked to share their patient data but will give a general overview of the primary factors that influence the provision of timely and quality care and how the use of the streaming process will enhance the enhancement of the patients in the ED.

Alignment

Do the various aspects of the prospectus align overall?

This project aims to establish an educational program and a strategy that will ensure that the nurse staff gets the needed knowledge and implementation of the required strategy to improve patient flow in the ED. The improvement of the patient flow through streaming process and inclusion of the nursing staff in the steering committees involved in the implementation of changes will help with the improvement in the patient flow that will result in the enhancement of the health outcomes, and this aligns the various aspects of the prospectus to the research study (Herron, 2017). The prospectus attempt to illustrate the various issues that have influenced the crowding and long waiting hours in the emergency department and strive to establish the various measures that can be used to address the problems. Most of the prospectus’ recommendations directly influence the issues raised and aim to give real and long-lasting solutions to the various processes and thus are relevant.

Moreover, the ED metric timeframes will be analyzed and evaluated before the implementation. The prospectus also suggests that after the implementation, the lead project management and the stakeholder will re-evaluate the process and establish the changes that have been made and their effectiveness (Burt & McCaig, 2006). The practice will ensure that the practice is relevant to the various concerns. The stakeholders will also be tasked with placing the pivot nurse in the waiting room to improve patient flow. Since this project involves both the pre and post evaluation, the aspects discussed will be ensured to align with the primary objective. The pivot nurse’s (is this role part of the streaming process?) utilization in reducing the timeframes will help the staff visualize the quality improvement plan’s reality.

Conclusion

Nurse Staff education is an integral component of ensuring quality and timely care in every hospital facility. Most hospitals have faced problems of poor patient flow in the ED, and this has resulted in high mortalities. Most of the strategies that have been put in place have failed since most of the staff nurses do not have enough information on the strategies and thus failing to implement them in the organizations to ease the flow in the ED. However, in this research, we have recommended using the streaming process where the staff nurses are grouped and equipped on specific knowledge and skills on the provision of care. The patients with particular disease conditions are directed to particular groups with the needed knowledge for their condition. Also, there will be the use of the pivot nurses at the ED to help direct the patients upon consultation to the right treatment area, and this will facilitate the faster provision of medical services. Also, the research the recommends the establishment of steering committees charged with the facilitation of any changes in the ED to include the nursing staff who should take chances to be part of the community to ensure that they get updated on how to handle different cases with the changes in the ED and to help tackle the emergencies in the form of the pandemic such as the Coronavirus that has claimed numerous lives all over the world.

References

Burt, C. W., & McCaig, L. F. (2006). Staffing, capacity, and ambulance diversion in emergency departments, United States, 2003-04.

Chan, P., & Stackhouse, S. (2014). Improving Patient Safety and Quality of Care in a

Community Department by Incorporating Evidence into Practice: Using a Pivot Nurse to

Improve Access to the Appropriate Level of Care. Vancouver Coastal Health.

Derlet, R. W., Richards, J. R., & Kravitz, R. L. (2001). Frequent overcrowding in US emergency departments. Academic Emergency Medicine8(2), 151-155.

Herron, K. (2017). Improve Emergency Department Efficiency | Webinars | Intelligent Insights. Retrieved from: https://intelligentinsites.com › Events & Webinar

Jarvis, P. R. E. (2016). Improving emergency department patient flow. Clinical and experimental emergency medicine3(2), 63.

Johnson, K. D., & Winkelman, C. (2011). The effect of emergency department crowding on patient outcomes: a literature review. Advanced Emergency Nursing Journal33(1), 39-54.

Regional One Hospital. (2016). Mission Statements. Retrieved from: www.Regionalonehospital.org

Walden University

Doctoral Project Prospectus Guide Doctor of Nursing Practice

DNP Doctoral Project Prospectus Guide Page i

For internal use only.

Walden University

Academic Offices

100 Washington Avenue South, Suite 900

Minneapolis, MN 55401

1-800-WALDENU (1-800-925-3368)

Walden University is accredited by The Higher Learning Commission, https://www.hlcommission.org/.

© 2018 Walden University, LLChttps://www.hlcommission.org/

DNP Doctoral Project Prospectus Guide Page ii

Contents Doctoral Project Prospectus …………………………………………………………………………………………….. 1

Purpose of the Prospectus …………………………………………………………………………………………….. 1

Completing the Prospectus …………………………………………………………………………………………… 2

Submitting the Prospectus…………………………………………………………………………………………….. 2

My Doctoral Research (MyDR) …………………………………………………………………………………….. 2

An Annotated Outline …………………………………………………………………………………………………….. 3

Ten Tips for Writing a Quality Prospectus ………………………………………………………………………….. 6

DNP Project Prospectus Rubric ………………………………………………………………………………………… 9

DNP Doctoral Project Prospectus Guide Page 1

Doctoral Project Prospectus The Doctoral Project is the final component of the Doctor of Nursing Practice (DNP) program

and focuses on addressing improvement of health care delivery. Students are given an opportunity

to demonstrate competence by constructing, designing, and completing an evidence-based

scholarly project related to the advancement of nursing practice. As such, this project must reflect

critical-thinking skills; application of principles of inquiry; synthesis of knowledge and skills

learned and developed during the DNP program; recommendations for future initiatives; and

outcomes for benefitting individual patients, groups of patients, communities, or systems.

DNP doctoral projects are scholarly contributions that must address the needs of the practice

setting and the nursing profession. Relying on a model of evidence-based decision-making, the

primary purpose of the doctoral project is to create the overall design and provide the framework

for the use of existing evidence to address local problems in nursing practice. The doctoral project

may be a response to a needs assessment, an organizational goal, a clarification of approaches to

injuries/illness, an identified need in the health care system that has not been previously addressed

locally, or it may be in response to a need identified by a professional health or nursing related

organization. Ethical, legal, political, and economic factors may be integrated as appropriate.

Examples of acceptable types of doctoral projects include, but are not limited to, the following:

• Evaluation of existing quality improvement projects

• Staff education projects

• Clinical practice guidelines development

• Systematic review of the literature

Manuals are available for the four project types listed above. Each manual contains the required

steps for that project type, as well as the forms/procedures that must be used if the student wants

to take advantage of Institutional Review Board (IRB) preapproval. Additional details about

doctoral project requirements are presented in the DNP Project Process Guide and the DNP

project checklist. Please note that if a student wants to use an alternative approach to the DNP

project process or add more data points (such as observations or interviews), the manual’s

data/evidence collection procedures/agreements and the IRB preapproved manuals cannot be

used. The student will need to follow the standard ethics approval request process.

Purpose of the Prospectus

The DNP Doctoral Project Prospectus is used in two ways:

• To identify a preliminary topic for your DNP Doctoral Project. This topic should be the product of initial investigation on your part but will be subject to change and refinement

as you develop your proposal.

• To help identify the faculty members who will guide the development of your DNP Doctoral Project Proposal.https://academicguides.waldenu.edu/researchcenter/osra/dnphttps://academicguides.waldenu.edu/researchcenter/osra/dnphttps://academicguides.waldenu.edu/researchcenter/osra/dnp

DNP Doctoral Project Prospectus Guide Page 2

Completing the Prospectus

The Doctoral Project Prospectus consists of 10 parts: title, problem statement, practice-

focused question(s), social change, context for the doctoral project, sources of evidence,

approach or procedural steps, ethical, alignment, and references. The annotated outline

provided on pages 3–5 can be used to create your prospectus document.

Your primary goal for the prospectus is to narrow your topic such that you have provided a

general sense of the direction of your doctoral project. At the prospectus stage, you do not need

to know everything about the doctoral project, especially the details of the approach and

procedural steps you will use. Those decisions are made during proposal development.

This prospectus is intended to be succinct. It is used to determine the feasibility and

appropriateness of the doctoral project prior to development of the full DNP Doctoral Project

Proposal. Your prospectus should be three to five pages in length, follow Publication Manual of

the American Psychological Association (sixth edition) guidelines, and be saved in either .doc,

.docx, or .rtf file formats.

Submitting the Prospectus

The prospectus will be completed in NURS 8700 under the direction of your committee chair.

Once the prospectus is ready for further review, the chair will request that the DNP research

coordinator set up a doctoral committee for you. After your NURS 8700 faculty member and

your newly assigned committee member approve your prospectus, you will upload your

prospectus to the Committee Prospectus Rubric Analysis in Taskstream for formal review by

your chair and committee member using the DNP Prospectus Rubric (located at the end of this

guide).

Once the prospectus has been approved by the committee chair and member, it will be reviewed

by the DNP program director or designee. Upon approval of your prospectus by the DNP

program director or designee, you should continue to work with your DNP committee to develop

the DNP Doctoral Project Proposal.

My Doctoral Research (MyDR)

As you are working on your DNP Doctoral Project Prospectus, you should also begin

familiarizing yourself with the My Doctoral Research (MyDR) system resources and other useful

resources on the Center for Research Quality website. The MyDR system was designed to assist

you and your supervisory committee in navigating your doctoral capstone journey, from the very

beginning through the final approval. The various landing pages in MyDR will track your

progress and will serve as a central location for resources to support that progress. The

Taskstream element of the MyDR system is used to establish a process flow tool in which you

exchange and store DNP committee evaluations of and feedback on your work as you progress

along that journey.http://academicguides.waldenu.edu/researchcenter

DNP Doctoral Project Prospectus Guide Page 3

An Annotated Outline The Prospectus document includes a title page (page 1) followed by pages containing the

required elements. Please use the Prospectus template on the DNP page of the Doctoral

Capstone Form and Style website.

Title Page

The recommended title length is 12 words or fewer to include the topic and the critical

keywords from the project. Double-space the title if it is more than one line of type, and center it

under the word “Prospectus.” Capitalize each major word in the title.

Include your name, your program (Doctor of Nursing Practice), and your Student ID number—

double spaced and centered under the title. Use the prospectus template on the DNP Resources

page.

Please note that your doctoral project title will likely change as the project evolves, so allow

yourself the flexibility to adapt your title, as necessary.

Title Start with “Prospectus” and a colon, and then include the title as it appears on the title page.

Double-space if it is more than one line of type, and center it at the top of the page.

Problem Statement

State the practice focused problem that your project will address. Provide a one- to two-

paragraph statement that establishes the relevance of this problem:

1. Summarize preliminary, supporting evidence that provides justification that this problem is meaningful and relevant to the local setting as well as the broader field of nursing

practice, citing key scholarly sources.

2. Explicitly state the gap in nursing practice or problem that will be the focus of this doctoral project.

3. Describe the problem as it relates to the target population for the project.

Note: Students may not work directly with patients in a clinical setting, with patient

interventions, or with students or faculty in academic settings.

Practice-Focused Question(s)

Describe the meaningful gap-in-practice that this doctoral project addresses. State the guiding

practice-focused question(s) for the doctoral project. Briefly explain the practice focused

question as it is relevant to the identified gap in practice.http://academicguides.waldenu.edu/formandstyle/programs/dnphttps://academicguides.waldenu.edu/formandstyle/programs/dnphttps://academicguides.waldenu.edu/formandstyle/programs/dnp

DNP Doctoral Project Prospectus Guide Page 4

Social Change

Describe how this project will impact social change for healthcare consumers, organizations, and

the profession. State how this project supports Walden University’s mission to promote positive

social change.

Specify who might benefit from the project and in what ways the information from the project

might result in positive social change.

Context for the Doctoral Project

Briefly describe the intended setting for the doctoral project. Explain how this project can be

accomplished in the identified setting or context.

Note: Students may not work directly with patients in a clinical setting, with patient

interventions, or with students or faculty in academic settings.

Sources of Evidence

Include relevant evidence that supports the need to address the identified problem at the local and

broader context. Examples of evidence include current EBP guidelines, literature preferably from

the past 5 years, and de-identified anecdotal data (refer to the DNP manuals for IRB approved

data sources for specific project types). Describe how the evidence justifies that this problem is

important to the nursing profession.

Approach or Procedural Steps

Identify your possible approach/procedural steps, summarize possible strategies to obtain the

data and resources needed to complete the doctoral project. Examples may include anonymous

participant questionnaires (for more information see DNP IRB approved data types for each of

the four project types in the DNP manuals). Is this project from among the acceptable types

listed on the DNP Resources page?

Note: Evidence or data cannot be collected prior to approval by the full committee and the IRB.

Ethical

Describe how this project will provide protection for human subjects.

Note: Direct patient interventions or projects in an academic setting with students or faculty are

restricted due to DNP program certification requirements.

Describe the region of the data source(s) without stating the specific location. Withhold

descriptors of participants such as titles, demographics, etc. to ensure that participants are not

identifiable. (Check with the IRB if unsure.).https://academicguides.waldenu.edu/researchcenter/osra/dnphttps://academicguides.waldenu.edu/researchcenter/osra/dnphttps://academicguides.waldenu.edu/researchcenter/osra/dnpmailto:irb@waldenu.edu

DNP Doctoral Project Prospectus Guide Page 5

State any potential ethical issues that may present problems for the completion of this project. If

none, clarify.

Note: See IRB section of the respective DNP manual to determine ethical requirements.

Alignment

Do the various aspects of the prospectus align overall? State what credible sources support the

practice problem. Describe how the practice-focused question(s) and the approach or procedural

steps will address the practice problem you describe in the problem statement.

References

Use American Psychological Association (APA) format for this prospectus. Include a minimum

of five APA-formatted peer-reviewed references to support in-text citations in the Doctoral

Project Prospectus.

Note: References should be within the last 5 years.https://academicguides.waldenu.edu/researchcenter/osra/dnp

DNP Doctoral Project Prospectus Guide Page 6

Ten Tips for Writing a Quality Prospectus Prospectuses tend to be as unique as the students writing them, so specific strategies are hard to

offer. Based on a recent institutional analysis of prospectuses, the following general tips are

provided to support successful approval. Students should ask themselves the following questions:

1. Is it complete? One of the most common reasons that a prospectus is sent back is one of the simplest to

fix: Some pieces are missing. You should ask yourself, “Did I effectively respond to every

item on the annotated outline?”

2. Is it well written? Your prospectus is the first time that your scholarly writing style is on full display for

your committee. The prospectus needs to be a preview of what they can expect when they

agree to work with you. Certainly, if your writing is unclear, your supervisory committee

will have a difficult time ascertaining whether you have met the quality indicators. If you

need added support with your writing, now is the time to find it. The Walden Writing

Center offers webinars and multimedia resources to help students improve their academic

writing, and the Academic Skills Center offers courses to help students improve their

writing skills. If you need refreshers and support with key research concepts, the Center

for Research Quality site has additional resources.

3. Are the parts and sections aligned? Of all the quality indicators, alignment tends to be one of the more challenging because it

transcends the content in the prospectus. Some examples of misalignment include

reviewing the evidence on children when the project is concerned with adults, identifying

a target group or organization that does not seem appropriate to provide information to

address the identified problem or gap in nursing practice, and identifying an approach

or procedural steps that will not address the project question. Importantly, all the parts—

not just some—need to align.

4. Is the topic relevant to my discipline and program of study? Doctoral students are encouraged to explore scholarship from a variety of disciplines as

they formulate their questions. When choosing their actual project topic, however, they

need to be especially careful to not go beyond their own disciplinary program of study

area.

5. Did I answer the “So what?” question? Too often what is obvious to the student is not always captured in what is written in the

prospectus. Ironically, one area that seems to get neglected is the social change statement,

because the writer assumes that the reader understands the full impact of the situation and

how this project will have potential for a positive impact. Make sure you are clear on whyhttps://academicguides.waldenu.edu/writingcenterhttps://academicguides.waldenu.edu/writingcenterhttps://academicguides.waldenu.edu/academicskillscenterhomehttps://academicguides.waldenu.edu/researchcenterhttps://academicguides.waldenu.edu/researchcenter

DNP Doctoral Project Prospectus Guide Page 7

so many people, including your committee and your participants, need to invest their time

in this project.

6. Is the prospectus presented in an objective manner? Students are encouraged to develop a deep understanding of the problem and the people

affected by it. When coupled with experiences gained through one’s work as a

practitioner, however, it is tempting to lose sight of your own objectivity. You should not

offer solutions before the project has been completed (“I know what needs to happen

here”) or suggest an answer before you have started the project (“I know this guideline

will improve practice”). Scholarship has a way of humbling us and showing us the error

in jumping to conclusions.

7. Did I do my “homework”? Although the prospectus sets the stage for a more in-depth examination of your project

topic, students are still expected to conduct a preliminary literature review. Be careful to

not equate “Here’s a gap in the evidence” with “I haven’t looked at the evidence.”

Students are sometimes shocked at how much scholarship has already been done on a

topic after they start digging into it, even if more scholarship is needed.

8. Have I identified a project question? A common mistake that new scholar-practitioners make is to confuse the broader social

problem with the project question that will be the focus of the DNP project, because the

two are related. Although much is often known about the scope and nature of the

problem, less information is available on how to address the problem; otherwise, it would

not be a problem or gap in practice. What is often lacking in the situation is some piece of

information or understanding that can be used to address the problem. That question or

gap is what your project will address.

9. Is my topic too broad? Most doctoral students have overly ambitious project goals at the beginning, and we

rarely have to ask someone to “do more.” Usually, the struggle is to identify a focused,

doable question that fits within the expectations of a doctoral project. Exploring the

evidence-based literature is one way to see how other scholar-practitioners have shaped

their questions. Keep in mind that a focused, tightly conceived, well-executed project on

one project question is better than a project that tries to answer a bunch of tangentially

related questions with a variety of approaches.

10. Have you considered the feasibility of the project? The prospectus is a plan to develop the proposal, and the proposal is where many key

project decisions are finalized. Still, it is never too early to start thinking about feasibility,

which is why it is one of the quality indicators for your prospectus. Like all the

indicators, feasibility is a quality that you will revisit as the project evolves. At the

prospectus stage, you need to show your supervisory committee that you are considering

your choices in light of previous scholarship and what you have learned about the

scholarly process in your courses.

DNP Doctoral Project Prospectus Guide Page 8

Self-Check Item on Partner Site Masking

Walden capstones typically mask the identity of the partner organization. The methodological

and ethical reasons for this practice, as well as criteria for exceptions, are outlined in Guidance

on Masking Partner Organizations in Walden Capstones.

If you perceive that your partner organization’s identity would be impossible to mask or if there

is a strong rationale for naming the organization in your capstone, the program director must

review your request for an exception. If granted, that exception will need to be confirmed by the

IRB during the ethics review process. The IRB will also ensure that your consent form(s) and/or

site agreement(s) permit naming the organization.https://academicguides.waldenu.edu/researchcenter/orec/documents#s-lg-box-19529598https://academicguides.waldenu.edu/researchcenter/orec/documents#s-lg-box-19529598

DNP Doctoral Project Prospectus Guide Page 9

DNP Project Prospectus Rubric The key indicators in the DNP Project Prospectus are used to assure the overall quality of the

DNP project at this point in the development process. Students should use this rubric to guide

development of their DNP Project Prospectus. Committee members should use the rubric to

give ongoing feedback and to document their final acceptance of the prospectus.

Faculty Instructions

For each item, choose “met” or “not met” if the DNP Project Prospectus meets that quality

indicator. For items marked “not met,” please indicate ways in which the prospectus can be

improved to meet the standard and forward the rubric to the student.

1 Met

Not

Met Complete?

Does the prospectus contain all the required elements? Refer to the

Annotated Outline in the DNP Project Prospectus Guide to review the

required parts of the DNP Project Prospectus document.

Comments: If not met, which items are missing?

2 Met

Not

Met

Meaningful?

Has a meaningful problem or gap in nursing practice been identified

and explicitly stated? In other words, is addressing this problem the

logical next step, given the previous evidence on this issue.

Comments: If not met, what is the reasoning for this assessment?

3 Met

Not

Met

Social Change Impact?

Does this proposed project have potential to affect positive social

change? The anticipated findings should have the potential to support

Walden University’s mission to promote positive social change.

Comments: If not met, how could the project address social change more directly?

4 Met

Not

Met

Alignment?

Do the various aspects of the prospectus align overall? The problem

should be supported by sources of evidence and should align with the

practice-focused question and the approach or procedural steps.

Comments: If not met, in what areas is additional evidence needed?

DNP Doctoral Project Prospectus Guide Page 10

5

Met

Not

Met

Feasible in This Context?

Is it feasible to accomplish this project in the identified setting or

context? The student has considered access to resources, data, and

participants needed for the project.

Comments: If not met, in what ways could the context of the project be better described?

6 Met

Not Met

Supported With Evidence?

Do the sources of evidence support the need to address the identified

problem? There is relevant evidence to support the identified problem,

and the evidence justifies that this problem is important to the profession.

Comments: If not met, what issues are identified with the sources of evidence?

7 Met

Not

Met

Ethical?

Will this project provide protection for human subjects? Any potential

ethical issues that may present problems for the completion of this project

have been identified. (i.e., ability to meet Walden IRB requirements,

approval from your organizations’ IRBs, access to the organizations’

deidentified data)

Comments: If not met, how could this project be changed to provide for protection of human subjects?

8 Met

Not

Met

Appropriate Approach or Procedural Steps?

Are the identified approach and/or procedural steps appropriate to

the problem? The proposed strategies demonstrate that the student has

selected the best approach that has potential to address the problem. Is this

project from among the acceptable types listed on page 1 of the DNP

Prospectus Guide?

Comments: If not met, how could the project be changed to demonstrate an appropriate approach or procedural steps?

9 Met

Not Met

Writing?

Does this prospectus meet the minimum standards for professional

writing? Are appropriate references included? Has APA been correctly

utilized?

Comments: If not met, please refer student to the Walden Writing Center resources.