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Nursing problems implicit in the nursing research study
Post a response to the following prompts:
Identify nursing problems implicit in the nursing research study and the QI DNP project. Describe how the nursing problems define the gap in knowledge (research) and the gap in practice (QI and DNP projects). Compare and contrast how the problems are presented and potentially influence a positive nursing practice change. Identify one key measurement/variable used in each of the three studies/projects. Critique the question development tool presented in terms of the problem, the EBP question, and the measurement (Hicks, 2024).
Sample Answer
That's a great comprehensive question that requires an understanding of the distinctions between nursing research, Quality Improvement (QI), and Doctor of Nursing Practice (DNP) projects. Based on the common examples associated with these types of scholarly work, such as the Central Line-Associated Bloodstream Infection (CLABSI) rate project by Hicks (2024), here is the analysis:
🔬 Identifying Nursing Problems
The nursing problem implicit in all three types of scholarly work (Research, QI, DNP Project) is a suboptimal patient outcome or a deficiency in practice related to a specific clinical area.
Assuming the Hicks (2024) DNP project addresses the high Central Line-Associated Bloodstream Infection (CLABSI) rate at a specific facility, and using a general research example like pain assessment in non-verbal patients and a QI project on fall rates, the problems are:
Nursing Research Study (e.g., Pain Assessment): The problem is the lack of a validated, evidence-based method to accurately assess pain in non-verbal patients, leading to undertreatment or overtreatment.
QI Project (e.g., Fall Rates): The problem is a high incidence of patient falls within a specific unit/hospital, indicating a failure in the current local process/protocol.
DNP Project (Hicks, 2024 - e.g., CLABSI): The problem is an elevated rate of CLABSIs at the practice site, suggesting a gap in the consistent application of best practice (e.g., a CLABSI prevention bundle).
Key Measurement/Variable
Identifying a key measurement highlights the distinct focus of each method:
Nursing Research Study (e.g., Pain Assessment):
Key Variable: Pain Score Discrepancy (e.g., difference between observed behavioral pain score and physiological indicator score, or patient-reported score once verbal). This is an outcome variable used to test the efficacy of a new assessment tool/method.
QI Project (e.g., Fall Rates):
Key Measurement: Fall Rate (e.g., falls per 1,000 patient-days). This is a rate-based outcome measure used to track improvement over short cycles.
DNP Project (Hicks, 2024 - e.g., CLABSI):
Key Measurement/Variable: CLABSI Incidence Rate (e.g., CLABSIs per 1,000 central line days). This is the key outcome measure to evaluate the impact of the implemented evidence-based bundle. Another key measurement might be Compliance Rate with the CLABSI Bundle (a process measure).
📝 Critique of the Question Development Tool (Hicks, 2024)
Assuming the Hicks (2024) Question Development Tool is designed to assist in formulating a practice-focused EBP/QI question (like the PICO or PICOT formats), its critique centers on ensuring alignment between the problem, the question, and the measurement.