SNHS Professional Doctorate

nDoctoral Project Prospectus – DPP Form

nLearners who are completing a Professional Doctoral Project will use this DPP Form to go through the process of mentor, committee, and school review. The goals of this process are:

nTo facilitate the planning of the details of your Doctoral project.

nTo ensure that the proposed project has rigor and allows for review.

nTo facilitate your progress through the project.

nThis is not an addition to your Doctoral project, but rather a step to assist you in obtaining mentor, committee, school, and IRB approval more efficiently. You will be assigned a mentor and committee member, and submit your project for school approval before submitting your IRB application.

nThe following criteria will be used to establish whether the proposed Doctoral Project meets the criteria and expectation for the degree. The purpose of the review is to determine if the proposed project:

nContributes to society by improving or changing practice, policy, or research utilization.

nDocuments the need for change by utilizing evidence-based needs assessment.

nMeets the HYPERLINK “http://www.aacn.nche.edu/dnp/Essentials.pdf”Essentials of Doctoral Education for Advanced Nursing Practice for DNP learners.

nMeets the industry expectations for Health Administration or Public Health.

nAccording to the American Association of Colleges of Nursing (AACN), Practice-focused graduates are prepared to generate new knowledge through innovation of practice change, the translation of evidence, and the implementation of quality improvement processes in specific practice settings, systems, or with specific populations to improve health or health outcomes. New knowledge generated through practice innovation, for example, could be of value to other practice settings. This new knowledge is considered transferrable but is not considered generalizable (2015, pp. 2-3).

nAmerican Association of Colleges of Nursing (2015). The doctor of nursing practice: Current ssues and clarifying recommendations. Washington, DC: Author.

nCharacteristics of SNHS Projects:

nFocus on a change or changes that positively impact(s) healthcare/public health outcomes.

nHave a systems (micro-, meso-, or macro- level) or population/aggregate focus.

nDemonstrate implementation in the appropriate arena or area of practice.

nInclude a plan for sustainability (e.g., financial, systems or political realities, not only theoretical abstractions).

nInclude an evaluation of processes and/or outcomes (formative or summative).

nAll SNHS Doctoral Projects should be designed so that processes and/or outcomes will be evaluated to guide practice, process and/or policy.

nReal world application is as important in guiding practice as statistical significance is in evaluating research.

nProvide a foundation for future practice scholarship.

nNote: DNP Projects based on nursing education topics are not permitted.

nIn the DHA and DrPH programs, the focus could be a quality improvement or process change project that may lead to recommendations for the sponsoring organization.

nSNHS Doctoral Plan Approval

nYour completed DPP Form will be approved, not approved, or deferred for major or minor revisions. Your mentor and committee will use the information you provide on the form to determine if your project meets the criteria for a Doctoral project. Your mentor and the committee will provide specific feedback designed to identify any issues that need to be resolved related to the project.

nObtaining committee and school approval does not guarantee you will obtain IRB approval. The IRB review will focus on ethical issues. A detailed ethical review will be conducted during the process of IRB approval.

nRecommendations for Using This Form

nThe DPP Form is intended to help you and your mentor plan the design and details of your Professional Doctoral Project.

nAfter your mentor approves your DPP Form, your entire committee will review the form for appropriateness for a Professional Doctoral Project. When the entire committee approves your inquiry project form, then it will be submitted for school approval. It is recommended that you use this form in a step-by-step way to help plan your design. Expect that you will go through a few revisions before your mentor and committee approve this form.

nTips for filling out the DPP form:

nPrepare your answers in a separate Word document to make editing and revising easier.

nCopy and paste items into the fields when they are ready.

nDont delete the descriptions!

nDont lock the form, because that will stop you from editing and revising within the form.

nLeave no blank spaces in the form. If an item does not apply to your project, type “NA” in its field.

nRead the item descriptions carefully. Items request very specific information. Be sure you understand what is requested (good practice for your IRB application).

nUse HYPERLINK “http://campustools.capella.edu/redirect.aspx?linkid=3814″primary sources to the greatest extent possible as references. Textbooks are not acceptable as the only references supporting methodological and design choices. Use them to track down the primary sources.

n

nDPP Form Part I

nLearner Name Learner Capella Email Address Learner Phone Mentor Name/Email Committee Member Name/Email Preceptor for DNP/Sponsor for DHA/MRPH Name/Email Project Working Title Site Selected Contact Information for Site Approver (if different from preceptor or sponsor) & Expected Approval Date PICOT Question

nState your PICOT question here. Use the elements of the PICOT sections below to describe each component. In your previous coursework, you may have read selections from Melnyk & Fineout-Overholts (2015) textbook, Evidence-Based Practice in Nursing & Healthcare. This book contains information about PICOT question choices.

nIn respiratory therapists working in the hospital settings (P), the use of effective clinical leadership (I), is essential in promoting a culture of open communication, collaboration and coordination (O), after 5-6 months (T), as compared to normal leadership (C) (Curry et al, 2016).

nGap in Practice, Policy or Programs

nWhat is the gap in practice, policy, or program at your organization that this question seeks to address?

nResearch has indicated that most health organizations are characterized by systemic and harmful failure in leadership to provide, safeguard, assure and monitor a culture of compassionate, quality and safety services and care (Wellman, Jeffries & Hagan, 2016). Therefore, they are unable to nurture an organizational culture among all stakeholders, which facilitates collaboration, open communication and coordination. Consequently, it negatively affects patients satisfaction, retention and opportunities for career growth.

nP (Target population or problem)

nWho is your target population or what problem will be addressed?

nThe study will target all respiratory therapists working in the hospital setting particularly in the intensive care and operating rooms (Rankin, 2016). Additionally, it will attempt to address the problem of poor leadership and management of healthcare in these hospitals, which contribute to deteriorating service delivery, lack of collaboration among the staff and patients dissatisfaction (McSherry & Pearce, 2016).

nI (Intervention)

nWhat are you planning to investigate or implement as a policy/process or program?

nWhat are you doing that is different than what is currently happening?

nIf this is a part of a larger project, what is your unique contribution?

nNote: Be very specific in your description.

nThe intervention will be use of effective clinical leadership, which facilitates successful organizational culture (Rankin, 2016). It will lead to provision of quality services such as the delivery of compassionate, quality and safe health care.

nC (Comparison)

nNot every PICOT question will have a comparison or control group (in which case there is no “C” in the question). If this is the case for your project, then describe the current state vs. the desired state in relationship to the problem and/or gap in practice.

nNote: A Doctoral project many times centers on a process improvement. Be cautious when determining what you will be comparing as this is not a research project.

nThe comparison in this study is lack of effective clinical leadership in hospital setting, which does not inspire collaboration, coordination and open communication among the staff.

nO (Outcomes to be measured)

nEvery project is required to have an evaluation plan.

nWhat outcomes are expected for your project?

nWhat outcomes will be measured?

nHow do you plan to do this?

nWill you be using a tool?

nFor doctoral projects that will use an established tool, be certain to include the published reliability and validity.

nBe sure your outcomes link to the identified problem.

nHow will you know if your intervention resulted in change?

nHow do you plan to look at your data?

nNote: If quantitative analysis is an appropriate outcome measurement, you may want to consult with your mentor or a statistician early in this process.

nThe outcomes of the study will include delivery of quality services because of improved collaboration, open communication, and coordination among the respiratory therapists. It will also lead to better mobilization of resources, attention and practices of people towards common outcomes, values and goals (McSherry & Pearce, 2016).

nT (Timeframe – Proposed)

nAs a leader, you need a project management plan. What is your timeframe? How long will your project take? Does your timeframe make sense when you consider the length of the program? Can you complete it in 8-12 weeks? Please be aware that data collection or implementation cannot occur until after IRB approval. Consider that your last few quarters should be devoted to data analysis and writing your final Doctoral Project paper.

nThe lifespan study will take 5-6 months. The time will be used in obtaining IRB approval, recruitment of study participants, implementation of the intervention, and data collection as well as data analysis.

nDetermining a Need

nHow did you determine this was a need at your organization/site of project implementation?

nWhat data is available from your site or organization to substantiate the identified need?

nNote: Citing supporting evidence from the literature is also important; however, be sure that the need fits your organization….do not try to make your organization fit a need found in the literature.

nA study by Wellman, Jeffries & Hagan, (2016), most health organizations are characterized by systemic and harmful failure in leadership to provide, safeguard, assure and monitor a culture of compassionate, quality and safety services and care. Therefore, there is need to introduce effective clinical leadership which encourages transformational health care.

nBenefits

nHow will this project benefit your organization/sponsoring site?

nHow might the outcomes or findings be sustained after project completion?

nWhy would your organization support this project?

nWhat potential benefits exist for the organization as a result of your project findings?

nWhat potential benefits exist for the identified population?

nIf the organization elects to continue what you have started….how will you, as the project leader, transition from the project after completion and allow it to continue on its own?

nThe project is beneficial because it seeks to introduce effective leadership, which supports the teams and individuals to grow (McSherry & Pearce, 2016). It also designs mechanisms to listen and reply to individuals aiming to optimize their chances in delivery of quality and safe health care. It also nurtures organizational culture that ultimately leads to high rate of patients satisfaction and retention. It also fosters collective understanding among different departments, mutual trust, open communication, and acceptance of diversity in terms of perspectives and opinions (Curry, et al, 2016).

nAreas of Expertise

nBy the end of this project, what will be your area of expertise?

nIn addition to leadership, what other area of expertise will this project foster for you?

nThe project will be useful in clinical practices because it will promote policy change and better management of respiratory therapists.

nPreceptor

nHow will the preceptor or sponsor you selected help you with achieving your project goals and with navigating your project implementation organization/site?

nWhat leadership position(s) does he or she hold?

nThe preceptor will provide guidance in the course of the project implementation. Moreover, he will play the supervisory role to ensure that the project is conducted as per the plan. He holds the position of a manager of the health facility.

nLeadership

nThe SNHS Professional Doctorate degree from Capella University is leadership focused.

nHow does this project demonstrate leadership?

nAlthough your project may have a clinical, policy or program focus, please describe how this project demonstrates leadership and a process change for your site or population of interest.

nThe project demonstrates leadership because it is aimed at improving the current state of affairs in the healthcare setting. The change of policy in the hospital demands focused and determined personnel who can transform the institution to realize robust organizational culture (Curry, et al, 2016).

nProject Level

nHow does the focus of this project qualify as a Doctoral level project as opposed to a Masters level?

nThe project qualifies as a doctoral level project as opposed to a Masters level because it is able to manipulate the dependent and independent variables to assess the outcomes. In this regard, employs interventional research design to determine the impacts of introducing the effective clinical leadership.

nTo be completed by mentor only:

nDPP Plan Part I Approved by Mentor Name of mentor: Date: End of DPP Form Part I

n

nSNHS DPP Form Part II

nEach section below must be filled out completely. Please address each section using the headers and explanation to guide your work. Learners should expect this to be an iterative process, requiring several revisions after consultation with your DNP/DHA, DRPH Mentor and Committee Member. This is considered your project proposal.

nA high level of detail as well as an exhaustive review of the literature is required. Use headings (Level 1 and 2) to present the different components of each section. Answer all of the questions in each section below.

nIntroduction to the Project

nIdentify the focus of the project.

nEstablish the significance.

nBe certain to include at least one or two background studies related to the topic.

nState the project aims and their relationship to your PICOT question.

nExplain how the project is relevant to Nursing, Health Administration or Public Health practice.

nNote: Be sure to include in-text citations in this section and a full reference page (in APA format) following Part II.

nIn the Respiratory Department how does cross training staff and decentralizing the department compare to having a centralized department affect the skills and knowledge of a therapist within 90 days of cross training to multiple areas in the hospital.

n According to this literature review nursing float pools and resource teams is a strategy used to cope with variable or inadequate staffing. This type of practice was a solution to the staffing shortages. Although there not much information on how resource teams and float pools work, are structured, or their impact it is known that it allows for improved staffing (Dziuba 2006).

nDziuba-Ellis, J. (2006). Float pools and resource teams: a review of the literature. Journal Of Nursing Care Quality, 21(4), 352-359.

n In the article , “Mechanical Ventilation in Mass Casualty” scenarios it stated that, A major concern of disaster preparedness in respiratory therapy focuses on responding to a sudden increase in the volume of patients who require mechanical ventilation. Strategies to address these situations include efforts to lower demand by transferring patients to other institutions as well as efforts to augment staffing levels. The last includes strategies to recruit local respiratory therapists who are currently in either non-clinical or non-hospital-based positions and policies that optimize existing respiratory therapy resources within an institution by canceling elective surgeries, altering shift structure, in addition to postponing vacations. Another method would employ non-respiratory-therapy staff to assist in the management of patients with respiratory failure Project XTREME which stands for Cross-Training Respiratory Extenders for Medical Emergencies is a cross-training program developed to facilitate training of non-respiratory-therapy health professionals to assist in the management of patients who require mechanical ventilation. Pilot testing of the program suggests it is effective (Hanley 2008).

nHanley, M., & Bogdan, G. (2008). Mechanical ventilation in mass casualty scenarios. Augmenting staff: Project XTREME…includes discussion. Respiratory Care, 53(2), 176-189.

nReview of the Literature

nConduct an exhaustive review of the literature.

nSynthesize the literature on the topic (provide evidence table as an appendix).

nSummarize how the study will contribute to knowledge by filling in gaps, validating, or testing knowledge.

nProvide details of your exhaustive search process. Be certain to list:

nAll of the keywords or search phrases.

nEach database used

nHow many articles were found.

nWhat the inclusion/exclusion criteria were.

nHow many articles were retained and why.

nThe synthesis should not be an annotated bibliography, but a description of the themes found in the literature, which are supported by clusters of evidence. In most cases, a minimum of 20 studies will be needed to support your project.

nNote: Be sure to include in-text citations in this section and a full reference page (in APA format) following Part II

nThe purpose of the research is to examine, “The Effectiveness of clinical leadership when it comes to changing the culture of a department or organization”. While assessing the employees perceptions of the changes in from the past to the present and expectations in the future. In a study titled, ”Leadership‘s Influence on Job Satisfaction” , the purpose of the study was to assess leadership styles of frontline medical imaging supervisors and examine relationships between leadership behaviors and motivational factors that influence job satisfaction of staffing in acute care setting. The result of the study identified that there are strong, positive relations between supervisors and transformational and contingent reward behaviors are intrinsic esteem motivators that influences the staffs job satisfaction. The results of the study indicated what employees need from leaders and organization that hire them (Watson 2009).

n Watson, L. (2009). Leadership’s influence on job satisfaction. Radiologic Technology,

n80(4), 297-308.

nIn another article titled, “The caring leader – What followers expect of their leaders and why? The author examines the moral standing of leaders from the perspective of the followers. The author claims that criteria used to judge leaders are rooted in fantasy and myths as well as early life experiences, and goes on to highlight the archetype of the caring leader This is a leader who offers personalized attention to his/her followers and is willing to go beyond the call of duty in dispatching his/her responsibilities. In conclusion by using some illustrations from hospital leadership, the paper concludes by identifying some of the difficulties that leaders face in meeting the exigencies of an ethic of care (Gabriel 2014).

nGabriel. (2014). “The caring leader – What followers expect of their leaders and

nwhy? “,Volume: 11 issue: 3, page(s): 316-334 May 1, 2014;Issue published: August 1,2015 Retrieved Feb, 19 2017 From https://doi-org.library.capella.edu/10.1177/1742715014532482

nFramework

nDescribe the theoretical framework or conceptual model to be used in the study.

nConnect the study aims and PICOT question to the framework or model.

nOperationally define study variables.

nProvide any study assumptions.

nNote: Be sure to include in-text citations in this section and a full reference page (in APA format) following Part II.

nTheoretical Foundation

n In this theory Katz also identified the level of importance that each of these three areas has for the many different levels of management. At the top-level of management the most important skills are human and conceptual. The most important skill for mid – level management are humans and the most important skills for supervisory management are technical and human. Katz goes further to mention that Mid-level managers need a fair degree of technical and conceptual skills, whereas technical skills are not as important for top level leadership and conceptual skills are not as important for supervisory management ( Coppola and Ledlow 2010 ).

nLedlow, Gerald R., M. Nicholas Coppola. Leadership for Health Professionals: Theory, Skills, and

nApplications. Jones & Bartlett Learning, 08/2010.

nMethod

nDescribe:

nThe project design, including detailed intervention information.

nThe setting.

nWhat data needs to collected?

nHow the data will be collected (include the validity and reliability of any instruments to be used).

nThe statistical or other evaluation methods to be used (as appropriate to your project).

nHow data will be measured.

nAnticipated findings.

nThe limitations of the study.

n*Please provide your data collection tool as an appendix. Remember that use of established tools will require evidence of permission by the author prior to IRB submission.

nNote: For those doing a quantitative analysis, consultation with a statistician is recommended prior to completing this section.

nVariables Measured:

nIndividuals -Increase the skills, knowledge and understanding of employees by assigning mentors and providing continuing education and competencies

nHealthcare Teams -Promote shared understanding of expectations among employees when decentralizing the department

nOrganization Encourage cross training with new hires

nSample

nWill your project include a sample? As appropriate, address the following:

nDescribe the sample for the project, including:

nInclusion and exclusion criteria.

nSample recruitment process.

nHuman subjects protection methods.

n The target population include, 171 staff respiratory therapist with educational background of Associate Degrees, Bachelor Degrees, Master Degrees , and Ph.D. The first group will be volunteers to sign up in 90 day increments to be cross trained throughout the year. First group of ten. Five preceptors and five cross trainers.

nTime Frame for Implementation

nProvide a step-by-step listing of activities from implementation through data collection and analysis, including proposed dates and duration.

nWeek 1-2- Solicit volunteers to precept and volunteers to cross train from the 171 employed respiratory therapists and develop a schedule that is consistent with training to critical care areas.

nWeek 2-10 -Will include cross training and skill competencies and staff interviews about progression of cross trainers and preceptor abilities

nWeek 10-12- After training is complete with the first 90 day group data will collected be analyzed then disseminated to the leadership team.

nEnd of Doctoral Project DPP Form Part II

nReferences in APA format should begin on the next page.

n

nReferences

n

nSECTION 4. DPP Form Part II Approvals (To be completed by Mentor only)

nMentor

nName: Committee Member

nName: Preceptor

nName: School level Review Date and Reason for Deferral

n(if needed)

nDPP Plan Part II Notes:

n

nAppendix A – Evidence Table

nCitation Conceptual

nFramework Design/

nMethod Sample/

nSetting Major Variables Studied and their Definitions Measurement Data

nAnalysis Findings Appraisal: Worth to Practice

nEXAMPLE

nHarne-Britner et al. (2011) Change theory in combination with aspects of behavioral, social science, and organizational theories by Bandura, Skinner, and Lewin Quantitative research

nQuasi-experimental study

nRandom assignment of 3 nursing units into 2 experimental groups and 1 control group

nAims of the study were to determine (1) the effectiveness of educational and behavioral interventions on improving HH adherence; (2) whether improvements in HH adherence were sustained 6 months post intervention; and (3) the relationships between HH adherence and HAI rates on study units. RNs and patient care assistants (PCAs) from 3 medical-surgical units within an urban health care system in Pennsylvania, USA

nA total of 1203 observations (633 RNs and 570 PCAs) were completed The control group received education in the form of a self-study module with a pre- and posttest. The experimental groups received the same education plus behavioral interventions. The Positive Reinforcement Experimental groups behavioral interventions included individual and unit rewards for improved HH adherence and unit-based recognition by peers on a sticker chart. The Risk of Nonadherence Experimental group received additional educational sessions about microorganisms that are transmitted via hands

nOBSERVATION =Watching one person having direct contact with a patient or handling patient equipment.

nCLEANED HANDS = Washed at a sink and/or used alcohol gel from a dispenser (e.g., wall mounted, pocket-sized, or a bottle that is not wall mounted) before or after having direct contact with a patient or handling patient equipment.

nAWARE OF MONITORING: You told the person youre going to observe them or they verbally acknowledge that you are monitoring them 18 data collection periods per nursing unit

nData were collected each month during 3 time frames (5 AM–7 AM, 7:30 AM–9:30 AM, and 3:30 PM–5:30 PM) reflecting high work volume to ensure a representative sample SPSS Statistics, Version 17.0

nChi-square analysis was used to determine whether the 3 nursing units had similar HH adherence rates before any intervention. The Fisher exact test was employed to determine whether the change in adherence rates on each unit was statistically significant.

nReported these data to the RN and PCA staff at monthly staff- and unit based quality meetings Education paired with positive reinforcement behavioral interventions improved HH adherence after the first month (χ2 = 4.27; P = .039); but the improvement was not sustained over 6 months. There were no differences in infection rates between the treatment and control groups. Strengths:

n-Randomized control group

n-Large sample size

nWeaknesses:

n-Length of study

nRanking:

nLevel II

nValid yes

nReliable yes

nApplicable yes

nOverall rank: High