Quinnipiac University: NUR 810 DNP Project Handbook

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Dear DNP Student,

Welcome to the Doctor of Nursing Practice (DNP) project! This handbook is designed to guide you through this transformative experience. The Institute of Medicine (IOM) Report, Crossing the Quality Chasm (2001) and the Future of Nursing (2011) provided a call for healthcare system change that requires DNP-prepared nurses with advanced knowledge, leadership skills and advanced competencies to collaborate with members of the interdisciplinary team to improve the quality of care. Nursing emphasis on holistic person-centered care, the lived experience of the patient and family, and clinically meaningful health outcomes provides a centering focus for nursing scholarship.

By completing the DNP project, you will enhance and refine your skills in many areas, including organizational assessment, systems thinking, knowledge synthesis, interdisciplinary collaboration, teamwork, leadership, change management, implementation science and using theory, research, written and oral communication, and data analysis to inform practice.

The DNP is a practice-focused terminal degree that prepares nurse leaders at the highest level of nursing practice to improve patient outcomes and population health. The DNP nurse scholar identifies the best evidence, and in conjunction with clinical expertise, patient values and insights emerging from the assessment of population and system needs and translates that knowledge into an implementable project with measurable outcomes in a clinical setting.

This journey requires a spirit of inquiry, a scholarly approach, and a commitment to both the nursing profession and interprofessional collaboration.

We wish you all the best as you embark on your exciting scholarship journey!

Sincerely,

School of Nursing Faculty

Revised: 8/23; 8/24; 1/25

DNP Project Overview

The DNP Project is conducted in the following courses: NUR 810, NUR 810PBL, NUR 812, NUR 812PBL and NUR 814PBL. The Essentials: Core Competencies for Professional Nursing Education from the American Association of Colleges of Nursing (AACN, 2021) and accreditation standards from the Commission on Collegiate Nursing Education (CCNE, 2024) influence Quinnipiac University’s DNP Project standards. Faculty maintain rigorous oversight and evaluation of all aspects of the DNP Project. The DNP Project demonstrates the student’s mastery of the AACN Essentials Advanced-Level Nursing Education Competencies.

The DNP Project is a scholarly work that aims to improve clinical practice and is therefore required of students completing a practice doctorate in nursing. It contains the following key elements:

Problem identification.
Search, analysis, and synthesis of the literature and evidence.
Translating evidence to construct a strategy or method to address a problem. • Designing a plan for implementation and actual implementation.
Evaluation of the outcomes, process, and/or experience.

(AACN, 2021, p. 25)

The DNP Project may address a direct or indirect practice issue. Students collaborate with key stakeholders at the practice site to assess, plan, design, implement, and evaluate a process improvement over four semesters. DNP Projects may be conducted in diverse health-related settings such as clinics, schools, hospitals, same-day surgery suites, extended care facilities, and home health agencies.*

The DNP student identifies a quality gap through an analysis of de-identified aggregate data that is of interest to the student and of value to the organization. An organizational assessment is conducted using quality improvement (QI) methodology and tools to identify opportunities for improvement, map the process and conduct root cause analysis. The DNP student uses advanced skills to search for the best evidence to inform practice, to appraise and synthesize that evidence, and to use implementation models and implementation science to translate that evidence into a feasible, robust improvement plan.

The DNP Project is completed over four semesters as part of NUR 810, NUR 810PBL, NUR 812, NUR 812PBL, NUR 814 PBL, and NUR 811 PBL if needed. The student integrates advanced skills gained in NUR 800 (Evidence-Based Practice), NUR 810 (Clinical Scholarship and Inquiry in Nursing), and graduate specialty courses appropriate to the clinical track. In NUR 812PBL, the DNP student uses advanced knowledge and leadership skills gained in NUR 812 (Leadership and Collaboration for Change in Healthcare) and other courses to facilitate cycles of improvement. The student uses change theory and a valid implementation model to guide this phase of the project. The student evaluates outcomes, plans for sustainability of the improvement, disseminates findings of the project, and defends their doctoral work at Quinnipiac University. Each step is guided by the faculty (DNP Project Chair). If barriers occur in the planning or implementation process, the student uses leadership skills to navigate these issues. The student proactively seeks guidance from faculty and/or the clinical site preceptor/mentor. The DNP Project ends with the creation of a well-written, scholarly manuscript and dissemination of the findings.

The DNP student gains ongoing skills in QI and evidence-based practice. Reflective skills are heightened through the DNP Project experience as the student learns to critically embrace systems

thinking and process improvements that can positively influence health care. *Other clinical sites may be approved by the course faculty and Program Director

The DNP Evidence-Based QI project is not a continuation of any other clinical practice hours that you have completed in NUR 813, 815, 817 or NUR 820, 822, 823. It is not a part of a prior proposal that you have written for another course or a project that you have been assigned or working on for your employer. The DNP Evidence-Based QI project is a distinct requirement for partial fulfillment of the DNP degree.

Prerequisites to NUR 810 - (Clinical Scholarship & Inquiry in Nursing) (Chapter 1 – Local Problem)

Successful completion of NUR 800 Evaluation and Synthesis of Scientific Evidence for Practice (2 credits)
Approval of clinical practice site contract
Completion of all clinical compliance requirements and documented in Exxat • Corequisite: 20 clinical practice hours

Prerequisites to NUR 812 - (Leadership for Change in Healthcare)

Successful completion of NUR 810 Clinical Scholarship & Inquiry in Nursing (2 credits) and 20 clinical practice hours documented and approved in Exxat.

Prerequisites to NUR 810PBL - DNP Project I (Chapters 1-2)

Successful completion of NUR 810 Clinical Scholarship & Inquiry in Nursing (2 credits) and 20 clinical practice hours.
Maintained clinical compliance requirements.
Maintained active clinical practice site contract
Corequisite: 100 clinical practice hours.

Prerequisites to NUR 812PBL - DNP Project II (Chapters 3-5, proposal submission, project implementation)

Successful completion of NUR 810PBL DNP Project I (2 credits)
Successful completion of NUR 812 Leadership and Collaboration for Change in Healthcare (2 credits)
Maintained clinical compliance requirements
Maintained active clinical practice site contract
Corequisite: 120 clinical practice hours.

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Prerequisites to NUR 814PBL - DNP Project III (Chapters 6-7, abstract, project completion, dissemination, defense)

Successful completion of NUR 812PBL DNP Project I (2 credits)
Maintained clinical compliance requirements
Maintained active clinical practice site contract
Corequisite: 20 clinical practice hours.

Prerequisites to NUR 811PBL – DNP Project Continuation

Grade of IP in either NUR 810PBL, 812PBL, or 814PBL.
Maintained clinical compliance requirements
Maintained active clinical practice site contract
Corequisite: completion of clinical practice hours and all written work of associated course

Composition of DNP Project Committee

A minimum of two faculty will make up the DNP Project Committee – one DNP Project Chair and one Project Committee Co-Chair. The DNP Project Chair will provide academic guidance and mentoring to the DNP students regarding the project and the writing of the manuscript. The student is expected to communicate regularly with the DNP Project Chair regarding project development, implementation, analysis, dissemination of results, and plan for sustainability.

Clinical Practice Site Determination

In preparation for the DNP EBP QI project which takes place in NUR 810, NUR 810PBL, NUR 812PBL, NUR 814PBL, and if necessary, NUR 811PBL, the DNP student must identify a clinical practice site for the project. The DNP EBP QI project focuses on an existing quality gap at the clinical site that is supported by de-identified aggregate data and that the project is of interest to the student and the organization.

DNP Site Mentor/Preceptor

After a clinical site is identified for the DNP Project, the student chooses a doctorally prepared nurse who is an employee of the site to serve as their site mentor/preceptor. The student is responsible for following all site-specific requirements or processes for identifying a mentor/preceptor. The site mentor/preceptor is required to be a nurse with a doctoral degree who is committed to mentoring the DNP student through the clinical practice experience in their DNP EBP QI Project. They are experientially qualified and knowledgeable about policies, procedures, and requirements in the facility/organization/practice that the student must fulfill prior to implementing the project. The site mentor/preceptor’s Curriculum Vitae (CV) and verification of active RN license is submitted to the QU Clinical Placement Coordinator (through Exxat) and the Doctor of Nursing Practice (DNP) Project: Site Mentor/Preceptor and Student Responsibilities form is signed at the beginning of each semester and submitted in the Blackboard site of each respective course. Site mentors/preceptors are evaluated by the student and all evaluations are reviewed by course faculty.

DNP Site Mentor/Preceptor Responsibilities

Assist the student to identify appropriate resources and stakeholders to complete an assessment of organizational strengths, opportunities, policies, standards, and needs.

Inform the student of quality improvement committees, organizational structures, processes, personnel and/or aggregate data that would enable the student to identify a meaningful, actionable, measurable quality gap.
Inform the student of any site required review committees such as a scientific review council or IRB.
Maintain availability to the student during clinical practice hours.
Seek opportunities for the student’s learning and professional development. • Guide the student to navigate challenges that arise with team members and/or project. • Meet (in-person, telephonic or virtual) periodically (at least monthly) with the student to review progress and mitigate any barriers to completion.
Communicate with the QU DNP Project Chair at least once per semester to review the QU DNP project standards, student progress and professionalism.
Review the final implementation plan.
Explore opportunities for the student to showcase DNP work.
Review and approve student fieldwork hours in Exxat Prism.
Complete student evaluation at mid- and end- semester in Exxat Prism.
Sign Doctor of Nursing Practice (DNP) Project: Site Mentor/Preceptor and Student Responsibilities form each semester (Appendix A).
Submit CV, RN or APRN license, and required documents to QU SON as requested.

The DNP student is required to complete 260 clinical practice hours toward the DNP Evidence Based Quality Improvement Project.

Those hours are distributed across:

NUR 810 - 20 hours

NUR 810PBL - 100 hours

NUR 812PBL - 120 hours

NUR 814PBL - 20 hours

Clinical Practice Hours are planned clinical practice experiences that enable students to integrate new knowledge and demonstrate attainment of program outcomes. This includes direct care experiences (i.e., care provided to individuals, families, groups, and/or communities). Required clinical practice hours are defined in each course and are evaluated by faculty.

Clinical Site Readiness Support

The DNP student submits a request to conduct clinical practice hours for the DNP Project during NUR 800. Students may not begin their clinical practice hours for the DNP Project, which begins in the second half of NUR 810, until the affiliation agreement between the site and Quinnipiac University is approved.

Affiliation agreements are managed by the School of Nursing (SON) Assistant Dean for Clinical Education and the Clinical Compliance Officer. Affiliation Agreements can take weeks to months to complete. Please ensure timely submittal of requests to reduce delays and the potential inability to progress in a timely manner. Clinical readiness activities must be complete, and documentation must be up-to-date and on file before a student may begin clinical practice hours. Students should refer to the Affiliation Agreement/Contract Process Policy (see SON Graduate Student Handbook and Policy Manual).

Project Implementation

During NUR 810PBL, the student completes necessary revisions to their problem of interest and begins a project proposal per the DNP Handbook and course guidelines. The project proposal is submitted for review and approval by the DNP Project Chair and the QU Scientific Review Committee during the subsequent course, NUR 812PBL. In addition, the site mentor collaborates with the student and the DNP Project Chair to ensure that the proposed project is approved at the site. This may involve submission to an institutional review board (IRB) or another site-specific scientific review committee, with a required letter of approval submitted to QU. Once the student receives final approval from the DNP Project Chair, the student implements their project and collects post implementation data for a minimum of three months. After data analysis and approval of required manuscript chapters by the DNP Project Chair, the student will disseminate their project and complete the doctoral project defense process at QU in the final semester during NUR 814PBL.

NUR 810 Clinical Scholarship & Inquiry in Nursing

This course focuses on improvement methods used to identify organizational systems’ process problems affecting practice (direct and indirect care). Building on prior knowledge of evidence-based practice and appraisal of scientific evidence, students critically evaluate additional relevant information, and consider cost implications to create meaningful, substantive innovations intended to improve systems. This course provides the opportunity for students to identify a health organization or system’s opportunity for process improvement based on available aggregate data. There are required 20 clinical practice hours associated with this course. Prerequisite: NUR 800. Every Year, Spring Online

NUR 810PBL DNP Project I Course Description

Students begin to develop a substantial and meaningful scholarly DNP Project Proposal that is innovative and evidence-based, reflects the application of credible research findings, is financially sound, feasible, sustainable, and demonstrates value to the organization and population(s) served. There are 100 clinical practice hours required with this course. The course is graded on a pass/fail basis. Prerequisites: NUR 800, NUR 810. Every Year, Summer Online

NUR 811PBL DNP Project Continuation Course Description

This course is intended for students who have not yet completed the required work of either NUR 810PBL, NUR 812PBL, or NUR 814PBL. This continuation course allows students to finish the requirements of the related DNP project course, including writing of chapters and clinical practice hours. Students will collaborate with course faculty to establish specific goals and a timeline for completion of the required work. A student may enroll in this course a total of three times with one allowed enrollment for each related course (NUR 810PBL, NUR 812PBL, NUR 814PBL). This course is graded on a pass/fail basis. Prerequisites: NUR 810PBL, or NUR 812PBL, or NUR 814PBL. Every semester, Online

NUR 812 Leadership and Collaboration for Change in Health Care Course Description This course focuses on developing advanced practice nursing leaders who can generate pragmatic responses to health care policy, systems, and practice inquiry problems through a collaborative approach. Prerequisite NUR 810, Every Year, Summer Online

NUR 812PBL DNP Project II Course Description

Students continue experiential learning to create and sustain change through implementation of the approved, scholarly DNP Project Proposal and implementation of the project using appropriate leadership concepts, interdisciplinary team collaboration, and change theory. There are 120 clinical practice hours required with this course. This course is graded on a pass/fail basis. Prerequisites: NUR 800, NUR 810, NUR 810PBL, NUR 812. Every Year, Fall Online

NUR 814PBL DNP Project III

This is the final course in the DNP project. Students continue experiential learning and focus on data analysis, project sustainability, and project dissemination. Students complete an oral DNP doctoral defense of their project and submit the written final manuscript. Additionally, project outcomes are disseminated to key stakeholders at the clinical practice site using a variety of media. There are 20 clinical practice hours in this course. This course is graded on a pass/fail basis. Prerequisites: NUR 800, NUR 810, NUR 810PBL, NUR 812, NUR 812PBL. Every semester online

DNP Student Expectations

The student is responsible for keeping the DNP Project Chair appraised of project progression. Communication with the DNP Project Chair is crucial to the student’s success. Therefore, it is strongly recommended that the student submit projected goals, objectives, timelines, drafts and completed project progression. A meeting with the DNP Project Chair must be conducted at least twice per semester. It is the student’s responsibility to ensure that this requirement is met.

Each course must be completed, including writing, clinical practice hours, and any other course expectations for the student to progress in the project, and to the next course. If a student is not progressing as expected, the DNP Project Chair will contact the student and if necessary, the site mentor/preceptor, to discuss the situation and offer support. The Director of the Online Graduate Programs will be informed if non- progression continues.

Grading criteria are outlined within the specific course syllabi. Courses are graded as Pass or Fail. Guidelines for course completion, continuation, or failure include:

A student who successfully completes the required work of the course within the dates of the semester will earn a grade of “P”.
If all of the required work of the course is not complete, the grade of “In Progress” is assigned, and the student is required to register for NUR 811PBL during the following semester. The student must submit a detailed plan and timeline for completing the work of this course during NUR 811PBL. If work is not completed by the end of NUR 811PBL, the grade of “IP” reverts to an “F” for both courses. For DNP program progression, one “F” counts per pair of courses (ex: *NUR 812PBL “F” with associated NUR 811PBL “F” counts as one failing course).
Completion of clinical practice hours according to the course guidelines that are documented, approved, and signed by the site mentor and course faculty in Exxat Prism, are part of the required work of the course.
Students who have not completed clinical practice hours will receive an "Incomplete (I)". If hours are not completed within 4 weeks after the end of the semester, the grade of “I” reverts to an “F”.
Failure to follow clinical practice hour guidelines and instructions will result in a grade of “F”.

Students are expected to familiarize themselves with specific deadlines that are presented within the course syllabi.

A withdrawal from a DNP Project Course may require the student to start their project again with NUR 810PBL and identification of a new quality gap. Students in this situation are required to meet with the Director of Online Graduate Programs before course registration for further direction.

Expected Role of DNP Student

Meet University and academic unit requirements for degree completion.
Follow policies as outlined in the University Student Handbook and the SON Graduate Handbook and Policy Manual.
Follow the policies of Academic Integrity as outlined by Quinnipiac University in the Academic Catalog.
Follow the policy for clinical practice site contracts.
Follow the policy for requirements clinical compliance prior to beginning clinical practice hours. • Present self in a professional manner
Follow disciplinary and scholarly codes of ethics in course work, practicum, and synthesis project activities.
Practice honesty and integrity according to university and federal guidelines in collecting and maintaining data.
Seek regulatory approval for projects.
Meet periodically with the site preceptor/mentor and communicate at least monthly. • Meet with project chair per syllabus guidelines.
Submit all project requirements and signed approval forms on time.
Submit all assignments on time as specified in the syllabi.
Be aware of and familiar with the requirements of the clinical practice site for conducting a quality improvement project in their organization.
Complete planned clinical practice hours. These hours may NOT be completed during the student’s work hours and are NOT part of their job responsibilities if the student is an employee at the clinical practice site.
Complete a self-evaluation and evaluation of the site mentor at mid-semester and the end of the semester in Exxat Prism.

DNP Project Proposal Approval

The DNP student must pass Chapter 3, submit proposals, complete Collaborative Institutional Training Initiative (CITI) training, obtain written approvals from the QU SON Scientific Review Committee and/or the QU Institutional Review Board (IRB), and the clinical practice site. Approval from the clinical practice site may require IRB or other review boards. The student may not begin their project until receiving all approvals and clear written communication from the DNP Project Chair.

DNP Project Dissemination

The DNP student will disseminate their project findings at the completion of their project. The dissemination of the project is a requirement for completing the DNP program. Various venues may be chosen to fulfill this requirement. The DNP student in consultation with the DNP Project Chair will determine the appropriate venue for the project. The student may also disseminate results to the organization or clinical practice site stakeholders.

Potential venues to disseminate the student’s work may include: Quinnipiac University Interprofessional Poster Education (IPE) day, Eastern Nursing Research Society DNP Poster presentation, CT APRN Spring Conference, Sigma Theta Tau Annual Collaborative Research Day, Quinnipiac University School of Nursing Student Scholarship Presentations, Yale New Haven Health Research and EBP Conference, CT Research Alliance Annual EBP Conference, Organizational Nursing Grand Rounds, and others. The goal of these presentations is to engage communities of interest, disseminate knowledge and provide opportunities for feedback and ongoing development.

DNP Project Defense

After approval from the DNP Project Chair, the student schedules their DNP Project defense. This is an oral presentation with visual aids, as approved by the DNP Project Chair. Students may invite their site mentor or other stakeholders to attend the project defense with representatives from the SON nursing faculty and student communities. The criteria to receive a grade of “Pass” on the DNP Project Defense is in NUR 814PBL.

DNP Project Manuscript

The DNP Project is a scholarly project designed to address a direct or indirect practice problem affecting groups of patients, health care organizations, or health care systems. Students collaborate with stakeholders to assess, plan, design, implement, and evaluate an evidence-based quality improvement project. The following guidelines describe the key elements that must be present to achieve a “Pass” for each section of the DNP Project manuscript.

Writing format and style to be used throughout the manuscript:

The APA 7th edition is used for the manuscript, (title page, headings, content, references, and appendices); double-spaced, 1-inch margins; Arial font size 11 or Times New Roman font size 12. Follow writing conventions, using consistent, correct spelling; well- formed sentences; correct grammar; focused, clear, concise, and engaging writing. Demonstrate well organized content with smooth and appropriate transitions from paragraph to paragraph and section to section.

Final manuscript page sequence (see Appendix B)

a. Title page – title accurately reflects the project intent.

b. Approval page – signatures are required prior to uploading into the DNP repository.

c. Dedication page (optional) – a personal tribute to a person or a group of people. For example, “To my family….” There is no heading. The dedication begins 2 -3 lines below the top line.

d. Acknowledgments page (optional) – a professional tribute to a person or people (place who have contributed to your current success and/or who are important to your work. The acknowledgement page has a bolded heading centered on the top line, Acknowledgements, and is double-spaced.

e. Abstract

f. Table of Contents

g. Chapters 1-7 (see chapter titles and descriptions below)

h. References

i. Appendices

Chapter 1: Background and Significance

Introduction to the National and/or Global Problem of Interest

Clearly describe the problem of interest, the population affected, and why this is a problem on the global and/or national level.
Explain the significance of this problem using relevant epidemiological data, morbidity/mortality, cost, and the overall impact on individual and population health.
Provide a compelling description of the clinical importance of the problem to health systems and society. Consider clinical, social, financial, system and policy outcomes.
Explain how addressing this problem fits within the IHI Quadruple Aim.
Include substantial support from literature and scholarly sources. Engage the reader’s interest! • End this section with the problem statement. An example is: (Problem) is an issue for (population) because (provide supporting rationale, evidence, data).

Local Problem

Conduct an organizational assessment. Include the values, needs, mission, history, culture, priorities and processes of the larger healthcare system. Describe how the organization monitors and benchmarks performance (quality indicators, dashboards, reports, data sources). Reference publicly available data about the organization (OASIS, MDS, HCAHPS, CMS, National Certification Registries, Leapfrog, Dartmouth Atlas or Hospital Compare Websites. Please de identify the name of the practice site. Max 1000 words.
Assess the service line, specialty area, department, unit, clinic, etc.* as applicable to the project. Identify key team members involved in the delivery of care and/or the multi-step process that is the focus of the DNP project. Consider all individuals/groups who are affected by the process and/or who shape the process, as well as those who may be affected by any change/innovation. Each of these individuals/groups is a stakeholder.
Assess the perspectives of the various stakeholders, such as the clinical and administrative teams, as well as the nature of the patient population or other individuals served in this setting, and their specific needs and agendas. Describe the perspectives of the stakeholders on the deficits that prevent quality outcomes.
Describe the clinical area for this project using the “5 P’s” method (Purpose, Patients, Professionals, Processes, Patterns).
Identify and describe an in-depth QI assessment of a process that is the focus for improvement. Explain each tool used including at a minimum an Ishikawa (fishbone) diagram, process map, and root cause analysis. Describe the outcomes of this assessment that identify opportunities for improvement. The methods used to assess the process, problems and contributors to the problem are described in the narrative. Diagrams, tables or figures are included in the appendices.
Identify a source of deidentified aggregate data that provides a baseline measure of a quality gap (the local problem). If appropriate, this data may be displayed (chart, table, graph).
Explain how this data was obtained (aggregate data provided by setting and/or websites, discussions with QI director, manager, internal and external stakeholders).

*If there is a health system requirement for DNP students to address quality issues and problems at a macrosystem level instead of a microsystem level, please notify your faculty chair.

Purpose of the Project

Identify the purpose of the project. This builds on the problem statement but does not yet include evidence-based interventions. Include an outcome measure. For example, the purpose of this project is to implement a process to decrease transabdominal surgical site infection rates in an adult surgical intensive care unit by 20% over 4 months.

The purpose must contain a measurable outcome, and SMART aim statements are often used. Time frames appropriate for this project are between 3-5 months.

Chapter 2: Review of the Literature

The goal of the literature review is to synthesize the literature that supports project interventions. • Describe the search strategy, search criteria, search terms and search results.
Include the following language: An organized search was conducted to support this project’s interventions. A population, intervention, comparison, outcome, time (PICOT) question was used to guide this literature search: (describe). Selected databases for this review included (list databases). Utilizing the key terms (list), the following combinations were entered (list), resulting in a total of # articles. The results were further narrowed by (inclusion/exclusion criteria). After applying these limitations, a total of # articles were selected for review. A synthesis of the findings is presented here.
Review course content from earlier DNP courses. Consult with the nursing research librarian about appropriate databases, possible modifications to search terms, and strategies to optimize the identification of “best evidence.”
Collaborate with your DNP Project Chair regarding the search strategy prior to completing the full search.

Review and appraisal of the best evidence related to the problem/process.

After using the Johns Hopkins Tools for Research Appraisal, prepare a scientific table of evidence using a minimum of 10-12 peer-reviewed primary source articles. Do not use systematic reviews, integrated reviews, meta-analyses, descriptive recommendations or other secondary sources.
If the topic has been extensively researched, consult with the DNP Project Chair about the judicious use of systematic reviews and meta-analyses.
If the topic is the subject of a paucity of prior research, consult with the DNP Project Chair regarding the judicious use of quality improvement studies and grey literature.
Collaborate with the DNP Project Chair regarding the contents of the scientific table of evidence prior to writing the synthesis of the literature.
Attach the scientific table of evidence as an Appendix. See Appendix C for Sample Johns Hopkins Nursing Evidence-Based Practice Individual Evidence Summary Tool.

Synthesis of Literature.

Each piece of evidence is appraised for strengths, limitations and interpreted for its implications for the DNP Project.
Synthesize the research evidence identifying recommendations that have strong evidence/support and recommendations that have limited or no research evidence/support.

Consider the levels of evidence based on study design, number of studies, generalizability and potential for bias.
Write a compelling synthesis of the state of the science that will be used to gain support for an evidence-based quality improvement project.

Chapter 3: Proposed Evidence-Based Recommendations for Practice and Process Improvement Plan and Cost-Benefit Analysis

Collaborate with mentor/preceptor and the team of stakeholders to identify actionable, feasible ideas for change/improvement/innovation that are also supported by research evidence.
Develop a cost-benefit analysis that identifies the cost of continuing with the “current state” related to the problem compared to the cost of the desired “future state.”
Include the costs of human resources (paid time for administrative support, clinicians, staff, others involved in the implementation/innovation), startup costs (photocopies, charts, posters, educational materials, etc.), capital costs (equipment, supplies), operational costs (other ongoing costs related to the implementation), potential revenue or savings related to the future state.
Include the non-financial costs and benefits (e.g., patient satisfaction, quality of life or improved clinical outcomes).
If applicable, explain how the benefits outweigh the costs. Use graphic illustrations or tables to make selected points. Explain alternative options and provide a rationale for why certain ideas were included or excluded based on evidence, feasibility, cost, etc.

Theoretical Framework for Change

Provide a description of the selected change theory and explain the rationale for its use in this situation and setting.
Identify the potential barriers to change. This may include the history of the present organizational culture and climate, as well as project feasibility and specific project requirements.
Describe the plan to address these barriers, and how the plan will incorporate various team members to support the change.
Include a description of the expected role of the DNP student and other stakeholder/team roles in the change process.

Plan for Implementation

Provide a description of the quality improvement methodology.
Describe the proposed improvement and how the QI methodology will be used to implement the plan.
Include a clear roadmap of project steps (who, what, when, why, how).
If staff education is part of the plan, prepare a content outline, and include it in an Appendix. See Appendix D for an Educational Outline template. Provide a rationale for education materials planned for use. Specify the sources of these materials, with an appropriate reference. Include a letter of permission for use or documents if the information was freely available. If there is a charge, describe how the unit, department, facility plans to purchase. Additionally, describe how

these materials will be designed for sustainable use. Lastly, specify the expected attendees of the education sessions, the frequency of the sessions to effectively reach the target audience, and the instructors who will conduct the sessions.

Describe how both process and outcomes are being measured.
Specify what de-identified data will be collected.
Include data collection tools (if needed) in an Appendix.
If any existing, valid, reliable, published survey tools are used, also include permission to use from the author.
Include plan for data analysis.

Describe detailed steps taken to protect data security (storage, transferring, confidentiality, accessibility).

DNP Project Approval

After receiving a grade of “P” on Chapters 1-3, complete the project application and submit to the QU SRC and/or QU IRB. Once approved by QU, then submit any site-specific application. If there is no IRB/review committee at the site, then email the appropriate authority at the site for email approval of the DNP Project. Include both QU and site approvals as an Appendix.

Chapter 4: Leadership Style

Identify the leadership style that you used to guide and implement the project.
Describe effective leadership skills and traits that you used in this project through a search of the literature, utilizing three to four scientific articles to provide support and rationale for this leadership style, skills, and traits.
Describe how you used whole-heartedness and daring leadership to embrace and cultivate a high performing project team. Explain what worked and want needed improvement.
Explain how your own leadership skills aided in the guidance of the team and the implementation of the project. Describe how you addressed your strengths and weaknesses from the AONL self leadership assessment during the project implementation phase.
Discuss how your chosen leadership style aligned with the project and supported the building of relationships within the organization to facilitate and guide the project team through implementation and analysis of outcomes.
Provide positives and negatives of leading this project and include how you addressed barriers and challenges. .

Chapter 5: Ethics

Describe in detail the ethical considerations of the intervention, the implementation process, analyzing the process, and how each were addressed. Consider the American Nurses Association (ANA) Code of Ethics and the principles of healthcare ethics.
Include any conflicts of interest, and formal ethics reviews.
Attach CITI Training as an Appendix.

Chapter 6: Results and Sustainability

Describe the measurable project outcome(s) Use appropriate QI tools to display data (ex: control chart, run chart, pareto chart, histogram, scorecard). In some cases, tables or charts can be embedded into the text to add greater clarity for the reader. All other data visualizations should be attached as an Appendix.
Describe any unintended outcomes of the intervention after it was implemented and how these relate to the primary intended outcome. Describe the impact on system/processes/patient outcomes.
Describe the response to the initial change, the anticipated and/or unanticipated outcomes, and any modifications to the original plan.
Identify project limitations.
Discuss implications for practice within the organization, including recommendations based upon project outcomes.
Describe the plan for sustainability.

Chapter 7: Project Dissemination and Conclusion

Identify the selection process and rationale used to determine where to disseminate the DNP Project and outcomes. Invite DNP Project Chair.
Describe participants, roles, and accountabilities in project implementation. Include location of meetings or educational sessions conducted, as well as the number/ roles of participants.
Describe participant reactions to the presentation.
In conclusion, describe how the project addressed the quality of care in a complex and changing healthcare environment. Include rationale for importance to the nursing profession. Explain how the project demonstrated scientific rigor, applicability, and impact.
End with a one to two paragraph summation of the entire project.

Abstract

Write an abstract for placement at the beginning of the manuscript and for potential submission to conference presentation (podium and/or poster) opportunities. The abstract includes background, purpose, methods, results, implications for practice, conclusion, and sustainability plan in 300 words or less.
Refer to resources posted in NUR 814PBL course for abstract guidelines. If guidelines are provided by the presentation venue, follow their abstract application guidelines.

References

American Association of Colleges of Nursing (2021). The essentials: Core competencies for professional nursing education.

https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

Commission on Collegiate Nursing Education (2024). Standards for accreditation of baccalaureate and graduate nursing programs.

https://www.aacnnursing.org/Portals/0/PDFs/CCNE/CCNE-Education-Standards-2024.pdf

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. The National Academies Press. https://nap.nationalacademies.org/catalog/10027/crossing-the quality-chasm-a-new-health-system-for-the

Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. The National Academies Press. http://books.nap.edu/openbook.php?record_id=12956&page=R1

Appendix A

Doctor of Nursing Practice (DNP) Project: Site Mentor/Preceptor and Student Responsibilities Course

Semester

This document provides an overview of the project and describes the responsibilities of the site mentor/preceptor and student.

The DNP project is a scholarly evidence-based quality improvement project under the guidance of a Quinnipiac University (QU) faculty project chair (DNP Project Chair) and is supported by a doctorly prepared nurse in the role of site mentor at an approved clinical site. The project starts with the identification of a site-specific quality gap supported by de-identified aggregate data. The identified quality gap should be of interest to the student and an organizational priority. During the first project course, NUR 810PBL, the student completes necessary revisions to their problem of interest and begins a project proposal per the DNP Handbook and course guidelines. The project proposal is submitted for review and approval by the DNP Project Chair and the QU Scientific Review Committee during the subsequent course, NUR 812PBL. In addition, the site mentor collaborates with the student and the QU DNP Project Chair to ensure that the project is approved at the site. This may involve submission to an institutional review board (IRB) or another site-specific scientific review committee, with a required letter of approval submitted to QU. Once the student receives final approval from the DNP Project Chair, the student implements the quality improvement project and collects post-implementation data for a minimum of three months. After data analysis and approval of required manuscript chapters by the QU DNP Project Chair, the student will disseminate their project and complete the doctoral project defense process at QU in the final semester during NUR 814PBL. Clinical practice hours are activities conducted in support of the proposal (on-site and off site). The site mentor is not required to be present during all clinical practice hours.

To facilitate this work, the site mentor will:

assist the student to identify appropriate resources and stakeholders to complete an assessment of organizational strengths, opportunities, policies, standards, and needs.
inform the student of quality improvement committees, organizational structures, processes, personnel and/or aggregate data that would enable the student to identify a meaningful, actionable, measurable quality gap.
inform the student of any required review committees such as a scientific review council or IRB. • maintain availability to the student during clinical practice hours.
seek opportunities for the student’s learning and professional development. • guide the student to navigate challenges that arise with team members and/or project. • meet (in-person, telephonic or virtual) periodically (at least monthly) with the student to review progress and mitigate any barriers to completion.
communicate with the QU DNP Project Chair at least once per semester to review the QU DNP project standards, student progress and professionalism.
review the final implementation plan.
explore opportunities for the student to showcase DNP work.
review and approve student clinical practice hours in Exxat Prism.

complete the student evaluation at mid-semester and the end of the semester in Exxat Prism

To facilitate this work, the DNP student will:

present self in a professional manner.
comply with all organizational policies and standards.
seek opportunities for learning and professional development.
express needs, set goals, seek out the appropriate people or resources, communicate effectively, meet objectives and deadlines.
prepare for meetings.
meet periodically with the site mentor and communicate at least monthly. • meet with DNP Project Chair per syllabus guidelines.
complete 100 clinical practice hours devoted to the organizational assessment, project planning, systematic review of the evidence and preparation of the DNP Project Proposal. These hours may NOT be completed during the student’s work hours and are NOT part of their job responsibilities if the student is an employee at the clinical practice site.
complete a self-evaluation and evaluation of the site mentor at mid-semester and the end of the semester in Exxat.

The site mentor is welcome to contact the QU Project Chair at any time during the proposal, implementation, or evaluation phases of the project for information or clarification of processes and/or to address concerns or report successes. The QU Project Chair contact information will be provided to the site mentor at the beginning of (course).

DNP Student Name DNP Student Signature Date Site Mentor Name Site Mentor Signature Date

Appendix B

Template for Final Manuscript

(Remove title and Appendix B from actual manuscript)

Paper Title

Student Name

BSN, School Name, 20XX

MSN, School Name, 20XX

A Doctor of Nursing Practice Project

Submitted in Partial Fulfillment of the

Requirements for the Degree of

Doctor of Nursing Practice

Quinnipiac University

Month 2026

Quinnipiac University

School of Nursing

This is to certify that the Doctor of Nursing Practice Project presented by

Student Name and Credentials

is complete and satisfactory in all respects,

and that all revisions required by

this review committee have been made.

Review Committee

Dr. xxxxxx, Committee Chair, School of Nursing Faculty

Dr, xxxxx, Committee Co-Chair, School of Nursing Faculty

Committee Chair Signature: __________________________________________________ Co-Chair Signature: _________________________________________________________

Quinnipiac University

2026

Table of Contents

FRONT MATTER

Content Page Number Title x Approval x Dedication x Acknowledgements x Abstract x Table of Contents x

PART I

Chapter One x Chapter Two x Chapter Three x

PART II

Chapter Four x Chapter Five x Chapter Six x Chapter Seven x

References x Appendix A. Fishbone Diagram x Appendix B. Process Flow Map x Appendix C. Title of Appendix x

Appendix C

Sample Johns Hopkins Nursing Evidence-Based Practice Individual Evidence Summary Tool

Article

Author & Date

Evidence Type

Sample, Size, and

Setting

Study Findings

Observable

Measures

Limitations

Evidence

Level

Marufu, T. C., Bower, R., Hendron, E., & Manning, J. C. (2022). Nursing interventions to reduce medication errors in paediatrics and neonates: Systematic review

and meta-analysis. Journal of Pediatric Nursing, 62, e139-e147. https://doi.org/10.1016/j.pedn.2021.08.024

Systematic

review and

meta-analysis

18 studies were

reviewed for this meta analysis.

From these 18 studies, seven interventions

were identified to

reduce medication

errors: education

programs, medication information in-services, clinical pharmacist

involvement, double checking, barriers to reduce interruptions, implementation of smart

pumps, and

improvement strategies.

Medication errors are multi-faceted, and the cause of the errors needs to be identified prior to implementation. Medication safety education proves to be an integral part of error

reduction. Interdisciplinary

collaboration in the medication process contributes to reduction of medication errors.

The meta-analysis showed a 64%

associated

reduction in

medication errors.

A bundle

intervention

approach has an

advantage in

reducing

medication errors when compared to individual

intervention.

Embracing patient safety culture in

conjunction with lecture and

simulation-based education is

needed to promote maintainable

changes.

The type of

medication error may be

influenced by

more than one

healthcare

professional

group.

Mohanna, Z., Kusljic, S., & Jarden, R. (2022). Investigation of interventions to reduce nurses’ medication errors in adult intensive care units: A systematic review. Australian Critical Care, 35(4), 466-479. https://doi.org/10.1016/j.aucc.2021.05.012

Systematic

review

11 studies were

reviewed for this

systematic review.

From these 11 studies, six interventions were reviewed to reduce

medication errors: pre filled syringes, barcode assisted medication

administration,

automated dispensing system, nursing

education programs,

protocolized program logic form, and

pharmacists supported supervision.

Findings reveal that prefilled

syringes and nurses’ education programs were most effective in reducing medication errors.

Simulation-based learning reduced medication errors from 30.8% to

4.0%.

Utilizing pre-filled syringes reduced medication error rates from 34% to 25.5%.

The studies

included in this review are

susceptible to

risk of bias.

Within the

studies, there is a lack of blinding and lack of

randomization.

Several of the

studies had a

short post

intervention

assessment

period.

Appendix D

Appendix (list appendix letter in sequence of all appendices from all chapters. Appendix is bolded, title is not. Both are centered of the top of the page)

Educational Outline Title

Title of Program:

Program Dates:

List Month, day, time for each

[In most cases there will be multiple sessions of the same plan to ensure meeting with all staff.]

Anticipated Length of Session:

[Less than 30-minutes can be difficult to include all content to kick-off the project effectively and more than 30-minutes is often not doable given staff responsibilities. Think carefully how best to manage time in conjunction with the need-to-know information]

Location:

[Conference room, unit, etc.]

Learning Objectives:

Example:

Discuss the impact of medication errors.
Recall the 8 Rights of Medication Administration
List the correct process for utilizing Knowledge-Based-Medication Administration (KBMA) • Describe the nursing responsibilities associated with medication administration and dispensing as stated in the nursing policy.
Define ways to mitigate errors in high-alert medications and look-alike/sound-alike medications.
Explain ways to incorporate mindfulness practice into medication administration.

Content Outline:

[Each session should clearly address each learning objective so that by the end of the Educational Plan all learning objectives have been achieved.]

Time Frame	Time in Minutes	Title of Session	Expected Outcome	Teaching Method	Speaker/Presenter




	Total = xx minutes

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