“Scholarly writing” is a term that indicates a set of standards are used or required for professional writing. In the DNP program, learners are expected to use scholarly writing for all coursework and in the development of their Direct Practice Improvement (DPI) Project. Standards for scholarly writing for this program are:
Develop a clear thesis.
Maintain an objective or unbiased perspective.
Incorporate appropriate evidence for support (peer-reviewed research and other scholarly sources).
Present original writing (written in one’s own words and properly citing authors for ideas, findings, etc.).
Write and synthesize in an organized and logical manner.
Format in APA style.
The purpose of this assignment is to familiarize the learner with the overall expectations of scholarly writing and the tools available to help you succeed. Learners in this program are expected to demonstrate scholarly writing throughout the program. Quality Improvement And Research Essay
Review the topic Resources prior to completing this assignment.
Use the “Searching Nursing Databases,” located on the Doctor of Nursing Practice page in the GCU Library, to assist you in completing this assignment.
Refer to the “DNP Direct Practice Improvement Project Recommendations,” located in the DC Network, to assist in completing the assignment.
A minimum of one peer-reviewed research article, published within 5 years of your anticipated graduation date, is required to complete this assignment.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Learners will submit this assignment using the assignment dropbox in the digital classroom. In addition, learners must upload this deliverable to the Learner Dissertation Page (LDP) in the DNP PI Workspace for later use.
The GCU DNP program requires learners to develop a Direct Practice Improvement (DPI) Project for successful completion of the program. The purpose of the DPI Project is to identify a valid patient practice problem at your practice site and propose an evidence-based intervention shown by current and authoritative research to improve the nursing practice problem.
Write an essay of 750-1,000 words, address the following:
Discuss the differences between quality improvement and research.
Explain why your DPI Project for this program is considered quality improvement and not research.
Describe a patient practice problem at your practice site that you are considering for your DPI Project. Explain why this would be considered a patient practice problem, how it can be addressed though a quality improvement intervention, and why it would be appropriate and feasible for your practice site.
Provide support for your proposed intervention with at least one peer-reviewed research article from the GCU Library. The article must be published in the United States and within 5 years of your anticipated graduation date.
Scholarly Writing Using Research – Quality Improvement & Research
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The gold standard for nursing practice for the DNP-prepared nurse at the moment is evidence-based practice or EBP. EBP is the clinical practice in which the efficacy of all interventions that are used on patients is backed by scholarly evidence. This evidence has to be peer-reviewed and recently published (Melnyk & Fineout-Overholt, 2019). EBP is the product of quality improvement (QI) which in itself is the determination of the best evidence-based interventions that can solve quality shortfalls in clinical practice (Spath, 2018). According to the Agency for Healthcare Research and Quality (AHRQ, 2018), there are six domains of healthcare quality that any intervention must meet. These were first proposed by the Institute of Medicine (IOM) and they are that quality healthcare must be safe, timely, patient-centered, effective, efficient, and equitable. There is a close nexus between quality improvement and research. This is because it is research that provides the evidence to support interventions that are effective. The purpose of this paper is to present the difference between research and quality improvement for the DNP-prepared nurse in practice. Quality Improvement And Research Essay
Differences Between Quality Improvement (QI) and Research
Research is the generation of new knowledge through planned systematic and scientific investigation of independent variables on dependent variables. The results of research must therefore be reliable and valid for them to be applicable in practice and inform the same (Patino & Ferreira, 2018). Quality improvement on the other hand is the application of the evidence derived from the results of research in solving practice problems by way of interventions that have been proven by research to be effective. There are a number of differences between QI and research. They include the following:
- Research generates knowledge that is new and was hitherto unknown; while QI uses the knowledge generated from research to solve practice performance problems.
- Research follows a laid down methodology that includes sampling, collecting data with specified tools, and analyzing the data using statistical tools. Quality improvement on the other hand follows the process of clinical inquiry that involves formulating a PICOT question and searching recently published research articles from reputable research databases. These are the research articles that inform the application of the interventions that improve the quality of practice.
- Research results have to be statistically significant for them to have any meaning but not necessarily clinically significant. QI on the other hand only uses current research literature whose results are both statistically significant and clinically significant (applicable to practice).
Why the DPI Project Is Considered Quality Improvement and Not Research
The DPI project for this program is considered as QI and not research because it seeks to improve practice in a particular area. This is improvement from common practice to best practice. Best practice means that the intervention that will be implemented during the project is supported by evidence from research. The DPI project is therefore using the outcomes of research to improve practice by first identifying the problem and then searching published research literature for the solution that has to be evidence-based.
Description of a Patient Practice Problem at the Practice Site
A patient practice problem at my practice site that I am considering for my DPI project is that of accidental patient falls. This is a patient practice problem because it is considered by regulatory bodies as a preventable occurrence that should not occur. For instance, the Centers for Medicare and Medicaid Services or CMS since October of 2008 stopped remitting reimbursements to providers for care given to falls patients (Fehlberg et al., 2017). What this means is that it is the providers that would themselves shoulder the cost of healthcare for these patients that have suffered falls within their premises. On top of that, the patient may also litigate for compensation in terms of damages for professional negligence and malpractice. According to Enema et al. (2019), the national benchmark in the United States for falls is 3.44 falls per 1,000 patient stays. Quality Improvement And Research Essay
The practice problem of patient falls can be addressed through the process of quality improvement by interventions determined through clinical inquiry. By searching research databases, the following interventions have been found to be effective in preventing falls because there is sufficient evidence to support their efficacy. They are (Guirguis-Blake et al., 2018):
- The performance of purposeful hourly rounding to troubleshoot patient problems and assess fall risk.
- The training and education of nursing and other staff on fall risk identification and the prevention of falls; and
- The use of intelligent bedside alarms to alert nurses when a patient who is at risk of falls attempts to get out of bed without assistance.
The above three interventions are to be used together as a bundle and not separately because the evidence shows that this is the only way that the interventions will have an impact on the problem of falls. The bundle will be appropriate and feasible to apply in my practice setting because we have patients that are at risk of falls especially those that are older and frail. Support for this bundled intervention as presented above is provided by the work of Guirguis-Blake et al. (2018).
Quality improvement and research are related but different. QI seeks to use the outcome of research to entrench best practice; while research generates the new knowledge or evidence that is used in QI. The problem of falls at the practice site is one QI that my DPI project can address. There is enough evidence to support hourly rounding, staff education, and the use of alarms as a bundle that can prevent patient falls.
Agency for Healthcare Research and Quality [AHRQ] (2018). Six domains of health care quality. https://www.ahrq.gov/talkingquality/measures/six-domains.html
Fehlberg, E.A., Lucero, R.J., Weaver, M.T., McDaniel, A.M., Chandler, M., Richey, P.A., Mion, L.C., & Shorr, R. I. (2017). Impact of the CMS no-pay policy on hospital-acquired fall prevention related practice patterns. Innovation in Aging, 1(3), 1-7. http://dx.doi.org/10.1093/geroni/igx036
Guirguis-Blake, J., Michael, Y., Perdue, L., Coppola, E., & Beil, T. (2018). Interventions to prevent falls in older adults. JAMA, 319(16), 1705. https://doi.org/10.1001/jama.2017.21962
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Patino, C.M., & Ferreira, J.C. (2018). Internal and external validity: Can you apply research study results to your patients? Jornal Brasileiro de Pneumologia, 44(3), 183. https://doi.org/10.1590/S1806-37562018000000164
Spath, P.L. (2018). Introduction to healthcare quality management, 3rd ed. Health Administration Press.
Venema, D.M., Skinner, A.M., Nailon, R., Conley, D., High, R., & Jones, K.J. (2019). Patient and system factors associated with unassisted and injurious falls in hospitals: An observational study. BMC Geriatrics, 19(348), 1-10. https://doi.org/10.1186/s12877-019-1368-8
Quality Improvement And Research Essay