Dnp- 840a leadership for advanced nursing practice

TOPIC: Benchmark – Comprehensive Assessment Part Two: Outcomes and Reflection

Use the information collected in the competency matrix that you created for Comprehensive Assessment Part One to address the following prompts as directed. Each response should be 500-750 words. Your responses should concisely demonstrate synthesis of knowledge gained in the program and the relevant application of knowledge into your practice. You are further required to cite relevant and specific evidence from your coursework to demonstrate your achievement of these programmatic outcomes and corresponding competencies.

SEE FULL INSTRUCTIONS PLEASE ATTACHED

DNP-840A Leadership for Advanced Nursing Practice

TOPIC: Benchmark – Comprehensive Assessment Part Two: Outcomes and Reflection

Assessment Description

The DNP comprehensive assessment provides learners the opportunity to demonstrate their achievement of core and specialty DNP competencies. It is also an appraisal of learners’ ability to integrate and synthesize knowledge within the context of their scholarly and practice interests and their readiness to complete the DPI Project. The two-part comprehensive assessment includes evaluation of work completed throughout the program and a final synthesis and self-reflection demonstrating achievement of programmatic outcomes. In Part One of the assessment, learners were required to collect and review coursework deliverables and practice immersion hours completed in the program thus far. In Part Two, learners are required to synthesize and reflect on their learning and prioritize work for their DPI Project.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Doctoral learners are required to use APA style for their writing assignments.

· 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 to check for plagiarism.

Directions:

To complete Part Two of the DNP comprehensive assessment:

PLEASE ATTACHED- Comprehensive Assessment Part One

Outcome 1:

A DNP must integrate and apply appropriate nursing and science-based theories to evaluate and analyze health and health care phenomena and develop and implement innovative practice approaches.

QUESTION:
In what ways have you integrated and applied nursing and science-based theories in your coursework and practice during your DNP course of study? How will you apply what you have learned to your DPI Project? Cite specific evidence from your coursework and practice immersion hours in your response.

Outcome 2:

A DNP must provide the leadership to develop and implement health care and organizational policy based on regulatory and other external and internal factors and drive effective change within organizations.

QUESTION:
In what ways have you demonstrated leadership in the development and implementation of policy or policy change and contributed to quality improvement during your DNP studies? How have you used leadership skills to lead intraprofessional and interprofessional teams in the analysis and resolution of complex issues? How have you used principles of leadership, influence, advocacy, business, finance, economics, and health policy to develop and implement effective plans for practice-level or systemwide practice initiatives that will improve the quality of health care delivery? How will you apply what you have learned to your DPI Project? Cite specific evidence from your coursework and practice immersion hours in your response.

Outcome 3:

A DNP must be able use information systems to mine, analyze, and apply data for the purpose of improving information systems as well as patient and organizational outcomes.

QUESTION:
In what ways have you successfully designed, selected, utilized, and evaluated applied data analysis programs and health care information systems during your course of study? How have you used your conceptual ability and technical skills to develop and execute an evaluation plan? How have you analyzed health information systems and patient care technology for use in improving outcomes? How will you apply what you have learned to your DPI Project? Cite specific evidence from your coursework and practice immersion hours in your response.

Outcome 4:

A DNP must be able to articulate and implement strategy and to advocate for the ethical and equitable deployment of care delivery models for improvement of individual, aggregate, and population health management.

QUESTION:
In what ways have you articulated, deployed, or advocated for the ethical and equitable deployment of care delivery models for improvement in your coursework and practice immersion hours? In what ways have you analyzed individual, aggregate, and public health data? In what ways have you advocated for social justice, equity, and ethical policies within all health care arenas? How will you apply what you have learned to your DPI Project? Cite specific evidence from your coursework and practice immersion hours in your response.

Outcome 5:

A DNP must be able to evaluate practice outcomes and use research, national benchmarks, and other relevant findings from evidence-based practice to design, direct, utilize, and evaluate quality improvement methodologies that lead to improved patient-centered care.

QUESTION:
In what ways have you evaluated practice outcomes and participated in quality improvement initiatives in your coursework and practice immersion hours? How have you used strategies to design, direct, and evaluate quality improvement methodologies to promote safe, timely, effective, efficient, equitable, and patient-centered care? How will you apply what you have learned to your DPI Project? Cite specific evidence from your coursework and practice immersion hours in your response.

Self-Reflection:

QUESTION:
Based on an evaluation of your learning to date, assess your readiness for undertaking your DPI Project. How has what you have learned in your coursework, practice immersion hours, and application of learning in your practice informed your approach to your DPI Project? What do you need to revise in your 10 Strategic Points document or your Draft Prospectus to successfully implement your project? Reflect on your progress to this point and outline the steps necessary to successfully complete your DPI Project Proposal for the Institutional Review Board (IRB).

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

DNP

1.2: Apply science-based theories and concepts to determine the nature and significance of health and health care delivery phenomena.

1.3: Employ science-based theories and concepts to describe the actions and advanced strategies to enhance, alleviate, and ameliorate health and health care delivery phenomena as appropriate.

2.1: Employ principles of business, finance, economics, and health policy to develop and implement effective plans for practice-level or systemwide practice initiatives that will improve the quality of health care delivery.

2.2: Demonstrate leadership, influence, and advocacy in the development and implementation of institutional, local, state, federal, or international health policy.

2.3: Employ consultative and leadership skills to lead intraprofessional and interprofessional teams in the analysis and resolution of complex practice and organizational issues to create change in health care and complex health care delivery systems.

2.4: Provide leadership in the evaluation and resolution of policy, ethical, and legal issues within health care systems.

3.1: Demonstrate the conceptual ability and technical skills to develop and execute an evaluation plan involving data extraction from practice information systems and databases.

3.2: Evaluate current consumer health information sources for accuracy, timeliness, and appropriateness.

3.3: Analyze and communicate critical elements necessary to the selection, use, and evaluation of health information systems and patient care technology.

3.4: Design, select, use, and evaluate programs that monitor outcomes of care, care systems, and quality improvement, including consumer use of health care information systems.

4.1: Analyze epidemiological, biostatistical, environmental, and other appropriate scientific data related to individual, aggregate, and population health.

4.4: Advocate for social justice, equity, and ethical policies within all health care arenas.

5.2: Design and implement processes/strategies that evaluate outcomes of practice, practice patterns, and systems of care for individual, aggregate, and populations against national benchmarks.

5.3: Design, direct, and evaluate quality improvement methodologies to promote safe, timely, effective, efficient, equitable, and patient-centered care.

Comprehensive Assessment Part One: Competency Matrix

DNP-840

For each competency below, provide no more than one or two sentences to explain how you met the competency through selected coursework. You will expand upon these achievements in the Comprehensive Assessment Part Two: Outcomes and Reflection assignment.
Note: You are not required to complete every column for each competency. Select evidence from coursework relevant to that particular competency to discuss. Minimally, you should have one column completed for each competency.

DNP Program Competencies

Programmatic Coursework: Summary of Competency Achievement

Section One: Programmatic Assessments

Reflective Journals

Case Reports

Scholarly Activities

10 Strategic Points

DPI Project Draft Prospectus

Literature Review

Course Assignments With Practice Immersion Hours

(DNP-805 Through DNP-840:

Include Assignment Title)

1.2: Apply science-based theories and concepts to determine the nature and significance of health and health care delivery phenomena.

DNP 815A:

The theory of Neuman Systems Model (NSM) focusses on the interactions between clients and environments Example includes infants and newborns in the ICU environment . How this population group may be adapting to this stressful situation . How this stress represent threat

to the infants and how nurses prevent and protects the infants to ensure optimal outcomes.

DNP 820A:

The assignment provided knowledge about applied nursing Theories and the contribution to the healthcare. Peplau’s Interpersonal Relations Theory focuses on the nurse- client relationship and the therapeutic process that takes place.

DNP 805A:

Safety and quality measures are related to nursing science and have a relationship in the practice .The quality measures are essential in ensuring that the nursing science moves towards evidence-based practice.

This study source was downloaded by 100000834342598 from CourseHero.com on 03-01-2023 21:37:27 GMT -06:00

1.3: Employ science- based theories and concepts to describe the actions and advanced strategies to enhance, alleviate, and ameliorate health and health care delivery phenomena as appropriate.

DNP 815A: The

assignment facilitated the understanding of how Martha Rogers utilized her nursing hypothesis of “Study of Unitary Human Beings” to advance the nature of medicinal services conveyed to various patients

DNP 815A:

While the completion, it was discovered the behavioral system model by Dorothy Johnson advocates for effective and efficient behavioral functioning among the patients to prevent them from diseases.

DNP 820A:

The draft prospectus present two primary models for the project. Kurt Lewin’s change model and the health belief model. Attitudes are important to target because of their ability to inhibit health-seeking behavior.

DNP 820A:

Implementation of Pamphlet and Video Teaching

Ensuring that the implementation of teaching tools is essential since it safeguards patient health behaviors and enhances patient.

decision-making.

DNP 810A:

Withing the work it was discovered that the traditional education based on disciplinary specific is less marketable in today’s health care system, and it is imperative to change the focus of education into one that accommodates interdisciplinary experiences.

DNP 805A:

The purpose of this quantitative, quasi- experimental project is to determine if or to what degree the implementation of using audio- and video-materials with booklets would impact health literacy when compared to booklet strategy among 65 year and older Latino population in a primary care setting in Florida over the

DNP 810A:

I found that the demand for long-term care increases as the population ages and patient facing diseases with multiple comorbidities. The Medicaid program is meant to pay for the LTC costs of the elderly who have depleted or nearly depleted their assets.

2

course of one

month.

2.2: Demonstrate leadership, influence, and advocacy in the development and implementation of institutional, local, state, federal, or international health policy.

DNP 835A:

The doctorate in nursing should entail an appraisal of partnership and communication required to advance and sustainability of quality care.

However, such should be conducted with the knowledge of culture’s influence, which helps guide the professional nurse practitioners in offering medical services within their environments. These skills make the doctorates nurses exemptional administrators, and service providers in the care organizations, with cohesion and enthusiasm in giving quality, care their priority.

DNP 815A:

In a quality improvement project, the budget ensures that all the key resources are available; in leadership roles, its understanding assists in the management of the limited resources in an efficient way.

2.3: Employ consultative and leadership skills to lead intraprofessional and interprofessional

DNP 810A: During assignment completion it was

teams in the analysis and resolution of complex practice and organizational issues to create change in health care and complex health care delivery systems.

discussed the problem presented in the seminar as lack of effective communication among multiple disciplinary teams in new nurses and healthcare professionals. Health care professionals need to be able to function in integrating health care delivery systems, and they have to demonstrate a comprehensive, quality and cost- effective care that involves good communication among the interdisciplinary team.

2.4: Provide leadership in the evaluation and resolution of policy, ethical, and legal issues within health care systems.

DNP 835A:

ANPs have vast knowledge on diverse matters in healthcare. Essentially, the AACN recommends essential VIII to build full competence to nursing and doctor trainees. Indeed, an ANP is a fully skilled

DNP 825A:

Completion of the case report shows how to advocates for ethical healthcare policies, equity, and social justice for uninsured Americans. It advocates for the development of ethical medical policies by providing the current

and knowledgeable nurse who can understand the multiple health issues important for

administering care.

evidence on the problems of the uninsured and the ethical issues associated with them.

3.1: Demonstrate the conceptual ability and technical skills to develop and execute an evaluation plan involving data extraction from practice information systems and databases.

DNP 820A:

The assignment provided knowledge and review the medication orders in the Electronic Health Records by each provider and the teaching approach that the provider implemented and the date of the next visit to primary care office. Data will be collected with standardized data entry through electronic medical records.

DNP 805A:

Database management is one of the modern technologies applicable to healthcare facilities to offer a patient-centered care system. The database management approach proves vital for handling chronically ill patients, such as hypertensive patients, who require significant management and treatment.

3.2: Evaluate current consumer health

DNP 810A:

Through scientific

DNP 820A:

Introduction to

DNP 810A:

The genetic counseling

information sources for accuracy, timeliness, and appropriateness.

investigations and clinical trials, a discovery of CFTR modulators was made and identified as effective in managing the disease .Mutation specific drugs have helped in enhancing the well-being of the lungs.

Literature Review . The purpose of the review was to research about the

effectiveness of combining audio- video and booklet strategies compared to use of booklets only on patients’ outcomes and frequency of recurrent visits.

session provides information on the probability of inheritance and their reoccurrence risks, addressing the worries of families, patients, and healthcare providers. Furthermore, the genetic counselor provides support to the patients and their families in coping up with the genetic illnesses

3.3: Analyze and communicate critical elements necessary to the selection, use, and evaluation of health information systems and patient care technology.

DNP 805A:

The completion of the Journal showed me different approaches in using informatics.

DNP 820A:

While developing the 10 Point Strategy I decided to use quantitative to evaluate the relation between the teaching methods and decrease number in revisit to the primary care office.

DNP 801A:

Electronic health records, or EHRs, are real- time reports on a patient’s health and medical conditions. EHR will also prevent any incorrect dosage being administrated by a medical professional.

3.4: Design, select, use, and evaluate programs that monitor outcomes of care, care systems, and quality improvement, including consumer use of health care information systems.

DNP 805A:

The implementation of CDSS can also influence in economic outcomes by decreasing costs related to medication error. CDSS not only enhances the quality of care, but directly improves patient safety by decreasing common errors and preventing omissions that result in patient harm.

DNP 820A:

During the activity progress ,simulations tools were identified the improve the Hand off Process and to effectively communicate with other members of the healthcare team.

DNP 805A:

The essential information found in EHR includes treatment plans, patients’ medical history, dates of immunization, diagnosis, and lab-test results. An excellent electronic health record system should comply with Title II of the HIPAA Act, which demands that patient health information be kept safe and private.

4.1: Analyze epidemiological, biostatistical, environmental, and other appropriate scientific data related to individual, aggregate, and population health.

DNP 805A: I came across with applying data mining to the current pandemic. The mining of the rich health information provides doctors with a direct practical basis for the clinical diagnosis and treatments to apply to COVID 19 patients.

This approach may

DNP 810A: I learned that gene mutations in the CFTR gene are the primary cause of the CF disorder.

The Human Genome Project, for instance, developed both genetic and molecular technology. These tools can be of great

DNP 825A:

While developing the assignment I found that in public health, epidemiology is viewed as a fundamental tool in the preventive methodologies that used to extract information necessary to the public health policy.

Public health policy relay on an epidemiological

help the doctor to treat patients with comorbidities and different symptoms more accurately and

quickly.

help to identify a disease before the beginning of clinical symptoms.

study to identify a causative factor of a given disease to use the information in designing a preventive policy

towards the illness.

4.4: Advocate for social justice, equity, and ethical policies within all health care arenas.

DNP 810A:

Advocate for equity and ethical policies includes advocate for Fetal surgical repair of Myelomeningocele. This has been found to improve the neurological outcomes for MMC fetuses compared with postnatal operation

DNP 825A:

While completing the assignment, I noticed that implementing health preventive measures requires the government and the World Health Organization to grant the process opportunity to influence citizens’ activities to address health problems.

: Design and implement processes/strategies that evaluate outcomes of practice, practice patterns, and systems of care for individual, aggregate, and populations against national benchmarks.

DNP 835A:

Health care practitioners ought to use their therapeutic training to ensure the experience, skills, and knowledge acquired on drugs are utilized properly. A proper medication reconciliation procedure should be prioritized and this would also include seeking more

DNP 820A:

During draft prospectus development , I realized that the health literacy impact will be defined as a decrease in the numbers of revisits after the application of the method and improvement in medication adherence/reductio n of medication errors. The

5.2

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clarifications from more experienced healthcare colleagues once faced with doubts on certain medical procedures

video/audio materials will be defined as the methods of health literacy improvement that rely on audio and video approaches.

5.3: Design, direct, and evaluate quality improvement methodologies to promote safe, timely, effective, efficient, equitable, and patient- centered care.

DNP 825A:

DNP learners should understand the significance of corporations in healthcare, such as reducing adverse drug contraindications, transience and indisposition charges, and, importantly, heightening the suppository dosage.

DNP 815A:

Interviews are essential instruments to use in evaluating the effectiveness of the proposed solutions. They are especially appropriate to measure the patient’s level of health literacy.

They should be designed with questions that interrogate their level of knowledge they have about their health, the self-care methods they know, and whether they practice them.

Questionnaires can also help in measuring the effectiveness of the proposed methods.

I, Marian Alli, verify that I have completed and logged 10 clock hours in association with the goals and objectives for this assignment. I also have tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice preceptor/mentor before the end of the course.

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Benchmark Assignment – Comprehensive Assessment Part Two: Outcomes and Reflection
Marian Alli
Grand Canyon University
DNP- 840A Leadership for Advanced Nursing Practice
Dr. Guelsy Diaz
March 26, 2023.

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Leadership for Advanced Nursing Practice
In a complex healthcare system characterized by deteriorating health outcomes, there is a moral and ethical obligation for clinicians and other health professionals to practice their expertise and knowledge. The qualities of DNP-prepared nurses, as well as the programmatic competencies acquired in the DNP program, prepare them to become critical executive leaders, managers, researchers, and clinicians based on innovative science to meet the challenges of sustainable healthcare system transformation for the best health outcomes (Root et al., 2018). These competencies have been captured by the DNP program curriculum, preparing the student to be a pragmatic, highly valued contributor to healthcare bottom lines. The Direct Practice Improvement Project (DPI) is a cumulative assessment of Doctor of Nursing Practice (DNP) essentials that outlines core competencies for nationally recognized advanced nursing practice roles (VanderKooi, Conrad, & Spoelstra, 2018). American Association of Colleges of Nursing (AACN), 2020). Vanderkooi et al. (2018) further noted that the focus of DPI projects should be on improvements that can affect healthcare outcomes using direct and indirect care, quality improvement, and population change.
This is the second part of a two-part comprehensive assessment task designed to provide the student with an opportunity to demonstrate that they have achieved the core and specialty competencies of the DNP. In this second part, the student demonstrates his ability to integrate the knowledge acquired during the program and effectively apply it in practical situations. The student substantiates his arguments by citing relevant and concrete evidence from the course, demonstrating his expertise in achieving program outcomes and related competencies. Self- reflection demonstrating the achievement of competencies and assessing the student’s readiness to undertake the DPI project is provided.

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Outcome 1: Application of Appropriate Nursing and Science-based Theories (Competencies 1.2 and 1.3)
Nursing practice is firmly rooted in research based on theories, models, concepts, and frameworks, with no one theory considered best for application in practice or evidence-based decision-making. Various theories guide nursing practice for clinical decisions and health outcomes. Advanced practice nurses, such as DNP-prepared nurses, are expected to identify links from theories applicable to nursing and translate elements into practice.
The case study assignment in DNP-815 provided the student with an opportunity to identify a practical problem (coordination of patient care in home health). The practical problem was approached from a theoretical point of view and provided a thorough analysis and a detailed explanation of the synthesized findings from the literature. Based on a theoretical approach, it proposed a potential solution to solve the identified gaps and inefficiencies. In addition, a research tool was selected to assess the effectiveness of the recommended solutions; it was described how the tool could be used for measurement purposes. It was highlighted how the relationship-based care (RBC) model could facilitate effective care coordination for patients in the home health setting. The RBC model was highlighted as an intervention that can facilitate care transformation by prioritizing the patient and family as the center of care. This model of patient care delivery centers on the critical concept of relationships with self and others, as identified by Butts et al. (2018) and Nelson & Hozak (2018). To make this work for home health patients, the various members of the interprofessional team must work as a unified team. Huth and Kuo (2019) described how effective team-based care coordination is. Each team member must have skills and expertise to ensure that patient, and family experiences are seamless through a well-integrated and coordinated care delivery system. Effective care coordination requires the skills and expertise of a

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strong leader, such as a DNP-prepared nurse, who can transform or redesign the organizational structure of health care to bring about change to cultivate a better culture of collaborative relationships and effective communication among diverse teams. As part of the epidemiology paper for DNP-825, it was chosen the Health Belief Model (HBM) as a theoretical framework for implementing and evaluating prevention and health promotion programs targeting at-risk populations. The Chronic Disease Self-Management Program (CDSMP) has been identified as an evidence-based program that can reduce health risks in an identified at-risk population. The identified population is adults aged 65 and older, with data showing that 80% of this population has at least one chronic health condition (Olivari et al., 2018). Since the main focus of HBM is health motivation, the student argued that the model is suitable for addressing health issues such as modifiable risk behaviors associated with some chronic diseases. Thus, HBM offers a workable framework for creating short- and long-term behavior change strategies. The DNP-prepared nurse can use the HBM model to improve the implementation, effectiveness, and evaluation of a health promotion and disease prevention program.
Outcome 2: Development and Implementation of Healthcare and Organizational Policy (Competencies 2.1, 2.2, 2.4)
The student has successfully demonstrated the competencies acquired in DNP-835, 825, and 840 by effectively applying learned concepts to develop and implement practice-level initiatives to improve the quality of healthcare delivery. In one assignment, the student integrated business, finance, economics, and health policy principles to describe the essential role of quality and safety measures in nursing science. The student also identified the essential components of quality and safety needed to evaluate healthcare program outcomes.

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One of the main concepts the student learned and used as economic evaluation and methodology. Economic evaluation involves using analytical tools to assess the costs and outcomes of different options, thereby providing decision-makers with evidence to make informed investment decisions about interventions, programs, and care approaches (Cook et al., 2017). Economic methodology, on the other hand, is associated with cost-based analysis. The National Library of Medicine (NLM, 2016) has identified three primary economic evaluation methodologies, including cost-effectiveness analysis (CEA), cost-utility analysis (CUA), and cost- benefit analysis (CBA). CEA relates costs to a specific clinical or natural measure of effectiveness, such as reducing pain or daily activities.
Conversely, CUA can assess technical and allocative efficiency within the health sector using only health care costs (NLM, 2016). The Centers for Disease Control and Prevention (CDC, 2019) explained that CEA and CBA evaluate health outcomes. Still, CBA assigns a monetary value to these outcomes, allowing costs and benefits to be expressed in monetary terms.
Knowledge of these concepts is essential for nurse managers who manage organizational budgets and operations for cost containment. The DNP-prepared nurse needs the knowledge to navigate the healthcare system and related organizations and providers through cost containment and accountability to maintain the fiscal aspect of managing the organization. The student also recognizes the need for the DNP-prepared nurse to be familiar with all incentive payments, such as outcomes and payments measured by the accountable care organization, payment systems, and payments for value-based care.
DNP-825 focused on population health with concepts such as social justice, equity, and ethics in health care, applying public health concepts to practice, and building culturally diverse healthcare systems. The student used this knowledge to explain how a DNP-prepared nurse can

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make a positive impact through policy or advocacy and how a leader can create a new community health program. In DNP-840, the student had the opportunity to use her leadership role in promoting ethical and fair health care and quality patient care. Specifically, the student identified a health policy she wanted to change and created an objective brief to address health disparities in the U.S. population. Through a brief policy overview, the student highlighted the adverse effects of health disparities on population health and offered suggestions for addressing the issue.
To effect change, the student sent an official letter to a Texas state senator explaining her position on the policy issue and recommending strategies to advance the agenda outlined in the policy report. This activity demonstrated the student’s ability to engage in political, health, and patient advocacy, using her leadership position to promote ethical and equitable health care for all populations. The student recognized that health disparities negatively impact marginalized groups, population health in general, and how health disparities increase health care costs. This knowledge can assist the DNP-prepared nurse in guiding the implementation of evidence-based recommendations from experts and researchers to help reduce health disparities and ultimately achieve health equity for all. The need for collaboration with clinicians, patients, policymakers, and other stakeholders was highlighted to identify the causes of health disparities and effectively address them.
The work environment, finances, organizational culture, and resources available to the nurse manager are significant indicators of how the quality and safety of patient care can be affected. While these are all factors that promote or limit patient safety, it is advisable for nurse leaders and healthcare facilities to be aware of the effects of these components to achieve the best outcomes. The student explained the need for various interdisciplinary teams to understand

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overhead costs, incentive payments, payment systems and structures, and current billing practices (Jennings et al., 2016). All internal and external challenges and barriers to organizational resources that may challenge the smooth running of the organization must be understood and addressed for practical and cost-effective care delivery. Outcome 3: Utilization of Information Systems Analyze and Apply Data (Competencies 3.1, 3.2, 3.3, and 3.4)
In DNP-805, the student utilized an electronic health record (EHR) database and data management paper to explore the fundamental concepts underlying database design and the use of standardized languages. Specifically, the student explored clinical scenarios where data reuse is beneficial for increasing patient safety and improving the quality of outcomes. Today’s healthcare system is data-driven, so there is a significant need for comprehensive database and data management for seamless access to patient information and collaborative care delivery across the continuum of care by diverse interprofessional teams. The student emphasized the need for a better and more effective assessment of the provision of care by doctors, medical facilities, and health planning for the population requires quick and easy access. Data integration with information technology tools is a fundamental aspect of a healthcare database that supports more accurate and efficient patient care management. Today, healthcare providers typically use this tool to enter clinical and laboratory data, patient demographics, and other necessary health information. Sperl- Hillen et al. (2010) confirmed that EHR information improves key ongoing patient care outcomes in primary care settings and could be coordinated with other care improvement strategies in other healthcare sectors. Having health data recorded electronically is essential for various purposes, including, but not limited to, easy access to clinicians for more effective care coordination to support optimal patient care adequately (Shortliffe & Cimino, 2014).

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In addition, the student in DNP-805 created a health technology assessment paper in which she explored critical elements of the user-technology interface and their impact on workflow. The student specifically selected a patient population and health technology application, the EHR, and evaluated how it can improve patient engagement and patient outcomes in her future practice or work focus. The paper focused on identifying the potential benefits of the selected technology and how it could be effectively implemented to support the health needs of the selected patient population. The student also created a PowerPoint presentation on new technologies in DNP-805. The PowerPoint presentation was aimed at administrators and nurses providing direct patient care. The student identified diabetes as a clinical problem. Telemedicine and Telehealth technologies have been identified as technologies to improve health outcomes. In another paper in DNP-805, a student identified a clinical problem involving a specific drug (insulin) and designed a Clinical Decision Support System (CDSS) using a Computer Provider Order Entry (CPOE) system embedded in Electronic Health Records (EHR) that can help address the identified clinical problem. The student-designed an EHR-integrated CPOE CDSS with specific and structured data and prompts for clinicians to more accurately and efficiently manage diabetic patient care and insulin administration. This was intended to help promote effective management of insulin dosage and administration by clinicians in other areas to promote patient safety and reduce adverse effects such as hypoglycemia and hyperglycemia in diabetic patients. According to Balenton and Chiappelli (2017) According to Balenton et al. (2017), modern technologies such as information technology, telecommunications, and bioinformatics have enabled nurses to provide quality care to patients regardless of their geographic location, thereby maximizing effectiveness, efficiency, and effectiveness (p. 413).

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Additionally, with the necessary precautions and guidelines, patient data may be transmitted in various forms, including voice messages over the telephone, text messages over wireless networks to web interfaces, e-mail messages over the Internet, and live audio-video streaming over the Internet. These are ways that doctors and other associates can effectively support the fast, easy, and efficient delivery of care. Thus, information technology and data management can support timely, accurate patient-centered care, support access to care, advocate for patient self-management through technology, and support the ethical and effective integration of technology into care outcomes. There is also the potential for financial gain, reducing healthcare costs, regardless of the perceived high cost of implementing the technology. The overall economic impact is in the interest of all parties involved.
Outcome 4: Advocate for the Ethical and Equitable Deployment of Care Delivery Models (Competencies 4.1 and 4.4)
The DNP-825 epidemiology paper was a three-part assignment that allowed the student to explain the concept of descriptive epidemiology using theoretical knowledge of a specific condition to find patterns in data distribution and data collection concerning a disease population. The student provided a contemporary illustration of how descriptive epidemiology is used in public health nursing and described health disparity, how it occurs, and the factors contributing to it in at-risk populations. In the second part of the epidemiologic paper, the student identified a population at risk based on data analysis and determined how nursing science can affect health risks for this population. The student identified adults aged 65 and older with at least one chronic disease as an at-risk population. The knowledge obtained from the third part of the article was described in another part of this task.

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In DNP-810, the student was tasked with creating a three-part case study about a genetic disorder encountered in their practice and personal or family experience while highlighting the FDA guidelines and rationale for introducing new pharmaceutical agents for the disease. The student decided to focus on acute lymphoblastic leukemia (ALL) and demonstrated in the second part of the report whether the chromosomal analysis is indicated for ALL. They provided a detailed description of the disease and its origin regarding whether it is a single gene inheritance or a multifactorial inherited disorder. The report also addressed considerations for practice and patient education. In the third part, the student focused on the nutritional influence on the cause of ALL and the dietary assessment and counseling process concerning health, prevention, screening, diagnosis, prognostication, treatment selection, and monitoring the effectiveness of treatment modalities, or how genetics can influence political issues.
The report also addressed the competency to advocate for social justice, equity, and ethical policies in all areas of health care by examining the health issue facing the older population. The student chose elder abuse and neglect and discussed efforts to integrate solutions into public policy, identify barriers to implementation, analyze public and private funding options, and provide recommendations. The report proposed a multidisciplinary approach as one of the primary approaches to be encouraged in reporting elder abuse. Public awareness and education campaigns were also essential in solving this problem.
The report emphasized the need for physicians and other interdisciplinary teams to take greater responsibility in interpreting and implementing the Elder Abuse Act. Local, state, and federal governments were advised to prioritize policies that support older populations over abuse. The report also highlighted the importance of being aware of how to recognize and report elder abuse.

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Outcome 5: Evaluation of Practice Outcomes and Participation in Q.I. Initiatives (Competencies 5.2 and 5.3)
The DNP-830 student will engage in learning, research, and writing assignments to achieve competency in patient outcomes and sustainable change. The course was structured around topics such as safety and quality health care, innovative approaches to health care, theories of change, and sustainable change, focusing on how DNP students can create a culture of excellence through patient-centered consultation skills—models of care, health literacy and evaluation of health care outcomes.
For the practical implementation of the assignment in DNP-820, the student selected a topic from the AHRQ website related to his DPI project and critically evaluated all identified gaps between research findings and their implementation in practice. The topic chosen was medication management. The student discussed how resources available on the Agency for Healthcare Research and Quality (AHRQ) website can inform the shift from research to practice.
In DNP-835, the student created a case report focusing on the concepts of quality and safety. AHRQ and Institute of Medicine (IOM) reports, “To Err Is Human” and “Crossing the Quality Chasm,” were reviewed. The concepts of quality and safety were used to describe knowledge of the problem or situation being addressed. Nola Pender’s Health Promotion Model (HPM) was identified as the most interconnected intervention focusing on health literacy in promoting quality and patient safety. The healthcare system continues to struggle with poor quality of care and patient safety. Improving health literacy is critical to achieving better health outcomes for the population.
The student also wrote a quality and sustainability paper in DNP-835 that examined the quality outcomes and patient safety measures of a healthcare entity (home health agency) and

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identified safety and quality measurement programs such as the Home Health Quality Reporting Program (HH QRP) from the Centers for Medicare and Medicaid Services (CMS) and the Community Aging in Place: Advancing Better Living for Elders (CAPABLE) program. A Donabedian theoretical framework with shared evidence-based strategies was used for the intervention to ensure sustainability. As a DNP student, the individual recognizes the importance of promoting patient outcomes and sustainable change in healthcare. Through their courses, they have acquired knowledge and skills in various areas, including safety and quality healthcare, innovative approaches to healthcare, theories of change, and sustainable change that can be applied in the clinical setting. By critically evaluating research results, using available resources, and applying quality and safety concepts, the student can contribute to developing a culture of excellence in healthcare. In addition, the student recognizes the importance of addressing social determinants of health, such as health literacy, to achieve better health outcomes for populations. By utilizing evidence-based strategies and frameworks, the student can ensure the sustainability of interventions to promote quality and patient safety in health care.
Self-reflection
While the student may face the daunting task of rewriting her prospectus and ten strategic points due to her project topic and PICOT question being changed, the student recognizes this as a challenge to face with wisdom, courage, and commitment. , perseverance, and hard work. She also realizes this change will point her in the right direction before it’s too late. Therefore, while she may feel overwhelmed, the key to moving forward is focusing on what is at stake, what is powerful, and achieving her stated goals. However, the program so far has been rigorous and fulfilling at the same time. So much was learned, learned, and so many skills were gained from the

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faculty, interacting with peers and mentors, participating in discussion questions, working on assigned tasks, and writing papers. So many hours have been invested in conducting research guided by established clinical and research practice guidelines that will ultimately be used during the project implementation. At some point, finding the most appropriate information from various previous assignments, discussion board questions, feedback from various faculty members, and all the deliverables that were (and continue to be) worked on was challenging. ) on this DNP path and appropriately incorporate them into the prospectus and the project. The prospectus, in turn, presents an opportunity for the student to bring all of this data together to create a comprehensive and concise piece that will serve as a guide for expanding the project, as well as the Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guidelines, a framework developed to improve reporting health care improvement projects (Ogrinc et al., 2016). This framework was later revised to provide a thorough approach to identifying, evaluating, and studying interventions (Ogrinc et al., 2016). This highlights the importance of the DPI project in validating the rigor and quality of the nursing terminal practice degree (Ketron, 2019).
Although challenging, completing a DPI project is integral to the rigorous process DNP students must undergo to present a well-crafted project. According to Roush and Tesoro (2018), this process is systematic, organized, and thorough, focused on designing and implementing a project that solves a significant problem. This includes evaluating the right metrics for data collection and analysis using methods that provide a valid and reliable determination of project outcomes (Roush et al., 2018). Successful completion of the DPI project is critical for students to graduate from the program equipped with the advanced skills needed to practice at the highest level as practitioners and leaders in today’s complex healthcare system (Roush et al., 2018).

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Personal development and readiness for any task, such as implementing a DPI project, requires self-improvement through conscious individual commitment, effort, practices, and actions to achieve expected goals. The knowledge gained from the various competencies mentioned above and many more played a significant role in preparing the student to embark on the DPI project regardless of obstacles. This knowledge and skills will be appropriately applied during the project’s data collection and implementation phase. Ultimately, this knowledge has continued to shape students’ practices as healthcare professionals and will always be used to help transform the healthcare system and contribute to fair, ethical, evidence-based practice for the best health outcomes for populations.

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References Agency for Healthcare Research and Quality. (2016). Health literacy measurement tools (revised).
Agency for Healthcare Research and Quality. (2017). Medication management strategy: Intervention.
AgingInPlace. (2020). A comprehensive guide to medication management. Retrieved from
https://www.aginginplace.org/a-comprehensive-guide-to-medication-management/

American Association of Colleges of Nursing. (2020). DNP Essentials. Retrieved from
https://www.aacnnursing.org/DNP/DNP-Essentials

Balenton, N., & Chiappelli, F. (2017). Telenursing: Bioinformation cornerstone in healthcare for the 21st Century. Bioinformation. 13(12), 412–414. doi:10.6026/97320630013412
Butts, J. B., & Rich, K. L. (2018). Philosophies and Theories for Advanced Nursing Practice. (3rd Ed.). Burlington, MA. Jones & Bartlett Learning.
Center for Disease Prevention and Control. (n. d.). Family history and high blood pressure. Retrieved on September 21, 2019, from
https://www.cdc.gov/pcd/issues/2005/apr/pdf/04_0134_01.pdf

Center for Disease Control and Prevention. (2018). Surgeon general’s family history tool. Retrieved from
http://www.hhs.gov/familyhistory/portrait/index.html

Committee on Quality of Health Care in America, & Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st Century. National Academies Press.
Cook, W. A., Morrison, M. L., Eaton, L. H., Theodore, B. R., & Doorenbos, A. Z. (2017). A systematic review of the quantity and quality of economic evaluations in U.S. nursing research, 1997-2015. Nursing research. 66(1), 28–39.
https://doi.org/10.1097/NNR.0000000000000188

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Huth, K. B. & Kuo, D. Z. (2019). Using a team-based approach to improve care coordination. Retrieved from
https://www.aappublications.org/news/2019/10/10/focus101019

Institute for Healthcare Improvement. (2020). Across the chasm: Six aims for changing the health care system. Retrieved from
http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasmSixAimsforCha

ngingtheHealthCareSystem.aspx

Jennings, J. N. et al. (2016). Executive summary: Collaboration in practice: Implementing team- based care: Report of the American College of Obstetricians and Gynecologists Task Force on Collaborative Practice. Obstetric Gynecology. 127(3), 612-7. doi: 10.1097/AOG.0000000000001304. PMID: 26901331.
Ketron, C. J. (2019). What is it all about? Examining the sustainability of the DNP project. Journal of Doctoral Nursing Practice. 12(1), 93-95. DOI:10.1891/2380-9418.12.1.93
Loan, L. A., Parnell, T. A., Stichler, J. F., Allen, P., VanFosson, C. A., & Barton, A. J. (2018). Call for action: Nurses must be critical in enhancing health literacy. Practice Guidelines. 66(1), 97-100. DOI:
https://doi.org/10.1016/j.outlook.2017.11.003

National Library of Medicine (2016). An Introduction to the Principles of Critical Appraisal of Health Economic Evaluation Studies. Retrieved from
https://www.nlm.nih.gov/nichsr/edu/healthecon/04_he_03.htm

Nelson, J. W., & Hozak, M. A. (2018). Predictors of caring in the context of relationship-based care. Creative Nursing. 24(2):74-87. doi: 10.1891/1078-4535.24.2.74
Sperl-Hillen, J. M., Averbeck, B., Palattao, K., Amundson, J., Ekstrom, H., Rush, B., & O’Connor, P. (2010). Outpatient EHR-based diabetes clinical decision support that works: Lessons learned from implementing diabetes wizard. Diabetes Spectrum. 23(3): 150-154.

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VanderKooi, M. E., Conrad, D. M., & Spoelstra, S. L. (2018). An enhanced actualized DNP model to improve DNP project placements, rigor, and completion. Nursing education perspectives. 39(5), 299–301.
https://doi.org/10.1097/01.NEP.000000000000038

Roush, K., & Tesoro, M. (2018). Examining the rigor and value of final scholarly projects completed by DNP nursing students. Journal of Professional Nursing. 34(6), 437-443.
https://doi.org/10.1016/j.profnurs.2018.03.003

Schmeidel, A. N., Daly, J. M., Rosenbaum, M. E., Schmuch, G. A., & Jogerst, G. J. (2012). Health care professionals’ perspectives on barriers to elder abuse detection and reporting in primary care settings. Journal of Elder Abuse & Neglect. 24(1), 17–36. doi:10.1080/08946566.2011.608044
Shortliffe, E. H., & Cimino, J. J. (Eds.). (2014). Biomedical informatics: Computer applications in health care and biomedicine (4th ed.). New York: NY: Springer Science + Business Media.

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I, Marian Alli, verify that I have completed and logged 10 clock minutes/hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Lopes Activity Tracker for verification purposes and will be sure that all approvals are in place from my faculty and practice immersion preceptor/mentor before the end of the course.

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