Author: Dr. Prince

Healthcare Systems Leadership – What is the impact of the DNP-prepared healthcare systems leader on the healthcare systems of today

Part I 

Please answer the following questions:

1. What is the impact of the DNP-prepared healthcare systems leader on the healthcare systems of today?

2. How do you anticipate integrating this role into your current or future career?

3. In your opinion, what is needed for successful professional identity formation in DNP students to achieve healthcare system leadership roles after graduation?

Part II: For Case Study Students

·       Please hear state your practice question in PICOT format to start. Please use the bullet points below as headings, bold the questions as headings, and respond separately to each question. Every week, please answer each bullet point.

 ***PICOT question:

In overweight adult patients in a primary care clinic, what is the impact of implementing the American Heart Association Diet and Lifestyle recommendations, compared to standard care, on body weight in 8-10 weeks?*****

·       Discuss best practices for implementing evidence-based practice guidelines with citations and matching references sufficient to support your discussion.

·       Discuss strategies for overcoming barriers in implementing evidence-based practice with citations and references to support strategies.

·       Discuss your formative evaluation plan to check intervention fidelity.

·       In Week 2, your formative evaluation plan reveals a few staff did not implement the evidence-based intervention as intended. What is your next step?

·       In your simulated Case Study, some staff state, “I am too busy” or “I do not see a need for change since the ‘way we have always done it’ works fine.” How will you address this?

·       You identify that stakeholders were not included in the project planning meetings and are resisting change.  How will you work with these stakeholders to turn their resistance into support?

·       Thinking about a live implementation, are there additional resources that may be necessary for a successful implementation?   If so, what are those resources?

Class, each week, when you share your implementation progress, successes, challenges, and barriers, your classmates may be feeling the same way, or have experienced a similar situation and can share their experiences as well. 

 Your post will be checked in Turnitin for plagiarism. Responses should be a minimum of 350 words, scholarly written, APA formatted, and referenced.  A minimum of 3 references are required (other than your textbook).  

****Weeks 2-9: Implementation: Project participants will follow the American Heart Association Diet and Lifestyle recommendations guidelines, that focus on knowing how many calories an individual should be eating and drinking to maintain body weight and aiming for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical exercise (or an equivalent combination of both) each week.

As a formative evaluation, the DNP student will call participants weekly to reinforce them to follow the diet and lifestyle recommendations, audit the smartphone Fitbit app, track their usage, and answer any questions. The DNP student will meet with staff weekly to discuss questions and concerns with calorie and activity tracking and offer support for the program. The DNP student will collect participants’ compliance data with app and tracker usage during each phone call.

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Formative and Summative Evaluation Sample

The other focus in in Week 2 of this course is articulating your formative evaluation you will use throughout your project implementation to check your intervention fidelity. 

Why are we using a formative and a summative evaluation? Why don’t we just measure the effects of our intervention and be done with the evaluation process?

>>Our DNP project leader told us that we need to conduct an audit to verify the intervention is correctly implemented. What was that called when the intervention is implemented exactly as discussed in the evidence? 

>>This is called intervention fidelity. The intervention fidelity is high when there is little variation. If there is a wide range of variation to how the nurses implement, the intervention fidelity is low. In other words, if the intervention fidelity is high, we are implementing the intervention as it is described in the evidence. 

So we want to ensure the fidelity is high. On the evening shift, the staff want to cut some corners because there is no medical receptionist. And we are having trouble scheduling patient care technicians to help with hourly rounding and vital signs. I’m concerned there is a wide variation in implementing hourly rounding on the evening shift. 

>> On the night shift, I am asking the staff to implement our rounding intervention exactly as we were educated.  At the end of each shift, we have a huddle to audit our implementation of the hourly rounding intervention. We audit if the staff were unable to conduct hourly rounding. 

We discuss the barriers and figure out solutions. Our team is committed to doing this right and ensuring intervention fidelity on the night shift.

>> During the day, we have many interruptions, I decided to use the formative evaluation checklist to audit each staff nurse, because there is a variation in the hourly rounding implementation between nurses.

I discussed variations with each nurse, so that each nurse understands how to correctly implement hourly rounding. 

>> Yes, using the checklist audit each nurses hourly rounding is a better way to conduct the formative evaluation. You are assessing the implementation fidelity for all nurses during our day shift. 

It hourly rounding is implemented in the same way by every nurse. There should be less variation in the outcomes. 

>> So I should use the checklist to audit each nurses hourly rounding instead of auditing all nurses together for the shift. I see how a variation in hourly rounding for each nurse might affect our outcome. I will speak to the staff and we can start auditing each nurse tonight. 

>> The DNP project leader said he will measure patient and nurse satisfaction rates at the end of the project implementation for the summative evaluation. 

>> Yes, I will be interested to know if nurse and patient satisfaction are improved during this implementation. 

>> So just to summarize my understanding here, the formative evaluation is a frequent audit conducted throughout the implementation to check the intervention fidelity. The formative evaluation frequently identifies variations in intervention fidelity, and we work to find solutions to those variations. 

The summative evaluation measures the effect of the intervention on the outcomes. So in this case, patient and nurse satisfaction were measured before the hourly rounding intervention was implemented and will be measured again after. We’re hoping that there is a significant difference in patient or nurse satisfaction after the implementation of hourly rounding. >> Yes, I am really hoping our hard work results in increased nurse and patient satisfaction.

Nursing Discussion Examples

Related FAQs

1. How does the role of the DNP prepared nurse advance the development of nursing science?

In this position, the DNP prepared nurse engages interprofessional teams to improve policies and procedures that affect patients as well as clinician practice by driving innovation, implementing policy changes, and improving evidence based skills across professions.

2. What is the role of the nurse in the healthcare system?

Nurses assess and observe patients, help doctors create a care plan, and carry out that care plan with medication and treatment administration. Nurses use a variety of medical equipment for both monitoring and performing treatments. They may also do diagnostic tests, take vitals and interpret the results

3. What is the role of the MSN prepared nurse in research?

Master’s programs prepare nurses to evaluate research findings and to develop and implement evidence-based practice guidelines. Their leadership skills enable them to form and lead teams within their agencies and professional groups.

4. What impact will the DNP have on the delivery and scope of health care in the United States?

Nurses who have completed the DNP are making significant impact on quality, efficiencies, and effectiveness of health care systems through their contributions in clinical practice, advocacy in health policy, implementation and evaluation of evidence-based practice, and contribution to nursing education.

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