Part II: For Case Study Students

This PICOT question is the foundation for the following DNP project: For adult patients will the implementation of the Palouse Mindfulness Stress Management program impact perceived stress in 8-10 weeks.

Describe your simulated project implementation for Weeks 110. (Please note that the intervention must be implemented a full 8 weeks in your simulated plan).

Week 1: (05/03/2022) Education and Pre-implementation and data collection

During the first meeting, the project manager and participants will get to know each other. The DNP project manager will present Palouse Mindfulness-based stress reduction and will clarify the program step by step and how it will work out in the next eight weeks. In what way they can reach the project manager for questions or concerns will be discussed. The manager will clarify that joining is free and optional, but dedication is required. The consent and the pre-test will be completed, and participants will watch a 10-minute video on the introduction to mindfulness stress reduction. There will be time for questions and answers.

In the week one intervention phase, the compliance checklist will be started to monitor participants compliance. The first weeks practice will be on simple awareness per the Palouse curriculum. The participants will watch a video on The Power of Mindfulness. The video will emphasize the significance of not paying attention to our inner experience but paying attention with kindness. Misunderstanding mindfulness practice, or if our meditation is not peaceful and free of thoughts, we must be doing something wrong. It also discusses how the body, mind, and emotion are tied together. The next step is reading about body scan meditation, the seven myths of meditation, and why it is hard to meditate. Daily practice of meditation is the last stage for each day.

Week 2-9: (05/10/2022-06/21/2022) 8-week implementation plan

From week two to week nine, the project manager and the participants will continue the weekly gatherings online to practice Mindfulness stress reduction management. Week 2 is the steps on attention and the brain, the initial video sharing, readings, and daily practice. Week 3 deals with thoughts and the introduction of yoga. The first step is sharing videos, reading, and daily exercises on dealing with thoughts. Week 4 is Responding Vs. Reacting; it is about how to deal with stress. First, the project manager will share a video, reading, and daily practice with the participant. Week 5 discussed dealing with difficult emotions or physical pain, the first step of sharing videos, then readings about the topic, and daily practice. Week 6 evaluated Mindfulness and communication, listening, and dealing with conflict. The group will share a video on the subject, reading, and daily practice for the day. Week 7 discussed Mindfulness and compassion, loving-kindness meditation & walking meditation. The project manager will share videos, read, and practice the topic for the day. Week 8 is the conclusion and developing a practice of your video and readings. At the end of each session, the project manager will make time for questions, concerns, or clarification.

Week 10: (06/28/2022-07/05/2022) Post-implementation and data Analysis

In week ten, the project manager will collect the post-intervention PSS scores to compare with the pre-implementation results to determine the influence of Mindfulness on perceived stress. The DNP project manager will congratulate all participants for completing the program. Participants will be encouraged to share their views on the survey about the strengths and limitations of the program. To conclude the intervention, the program manager will present the programs findings to the internal and external stakeholders and the implications of the results.

How is the COVID-19 pandemic affecting organizational operations and how did COVID-19 affect the development of your project?

The Covid-19 pandemic impacted hospitals and clinics so much that the proposed practicum site for my DNP project was affected in many ways. The number of patients decreased because of curfews, social distancing, and the mask mandate. These facts made the initial intake for this project challenging. Most patients feared contracting COVID-19 and even those who got it went straight to the hospital for admission. Many visits changed to telehealth service, which would have been adequate for the mediation piece of the undertaking, but first enrolling the members office visits to gather the information would have been required. Hence, the primary reason I decided to do the Palouse Mindfulness stress reduction programs online program.

Not all participants (staff and/or patients) attended as planned and some staff were out sick.  How will you follow up with them?

My project is an online case study that will require very few staff, so if participants fail to show up, I will attempt to reach them via their contact information. We would make three calls, and should the members miss multiple meetings, they will be removed from the intervention as missing multiple weeks could negatively impact the results.

There are float nurses and traveler nurses on the unit. How will this impact your project plan? If this does not apply to your project please discuss another impact that has affected your implementation plan?

My project is an online program, so many staff, float, or travelers will not be involved. The project data will be given through telehealth introductions, dispersed alongside the handout, the PSS scales, and the end-of-program survey. While telehealth is convenient, some aspects impact the DNP project. As a result, each participant will have access to the DNP contact information, mobile phone, or email for different means of contacting and providing of feedback regarding the project.

Internet speed, access, and bandwidth are causing problems with virtual meetings you have set up. What is your backup plan?

If internet speed access becomes problematic, the backup plan should be to use a phone to discuss the goals and readings for that day. The patients would have a link that doubles as both a video call and a phone number to call in if the internet is not working. They will also be sent any presentation slides to be able to follow along with the weekly intervention plan. These options would remove a portion of the visual and personal atmosphere but would act as a method for achieving the objectives of the meeting effectively and keep the members on target.

Also, share an update on your implementation progress. Please share successes, challenges, barriers, and any concerns.

My DNP project update is that my IRB has been approved, and my evaluation log is continuously progressing. I am researching and obtaining my peer-reviewed articles for my project, utilizing all the steps learned from the librarian to acquire more and more level I, II, and III articles to complete evidence-based articles and Literature Synthesis. Challenges and barriers in this DNP project will not stop until the last day of the program. A larger barrier is trying to understand what is required for this new class, NR 707. It is totally different from other discussions in previous courses. After consulting with my professor and the Lets check-in by Dr. Schroetter, I gained a little more insight. It will get better now that we are hands-on with it.

Our discussion for this week is focused on the role of the DNP as a practice scholar. How have you demonstrated your role as a clinical scholar in your current position?

The role of a DNP practice researcher is to translate, make an interpretation, educate, train and lead others with a focus on the high outcome of patient care. DNP scholars have clinical advancements in the medical services, they are knowledgeable in complex problems. Moreover, the DNP-prepared nurse has a tremendous scope of the information they can use to handle these mystifying medical or mental matters. DNP researchers can lead clinical development by utilizing nursing resources. Implementing nursing knowledge (experimental information, moral knowing, and others), hypothetical models, and closing gaps inside the microsystem, mesosystem, and macrosystem work toward this (Zaccagnini et al., 2017). The DNP practice nurse can assume a fundamental part of authority as CNO, thereby affecting positive changes in the medical services framework, either by redesigning its plans or through methodical support envisaged approaches (Sherrod and Goda, 2016). The DNP researcher will impact change by impelling information and applying abilities as a teacher (Hammatt and Nies, 2015). AS a DNP practice nurse, I constantly utilize and navigate these systems advanced as a pioneer, expert, and in-between expert to enhance strategic improvement modifications at all levels that will lead to good quality patient outcomes.

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

To improve or upgrade my initiative capacity, I intend to incorporate the information and abilities (for instance, the eight DNP fundamentals and essentials) I got from my DNP training. I additionally anticipate working with my insightful organization by being centered around applying proof-based intercessions that will assist with working toward persistent results.

References

Hammatt, J. S., & Nies, M. A. (2015). DNPs: What Can We Expect? Nurse Leader, 13(6), 64-67. doi:10.1016/j.mnl.2015.03.014

Sherrod, B., & Goda, T. (2016). DNP-prepared leaders guide healthcare system change. Nursing Management (Springhouse), 47(9), 13-16. doi:10.1097/01.numa.0000491133.06473.92

Zaccagnini, M. E., & White, K. W. (2017). The Doctor of Nursing practice essentials: A new model for advanced practice nursing (3rd ed.). Jones & Bartlett.

I NEED A COMMENT FOR THIS DISCUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND USE AT LEAST 3 SOURCES NO LATER THAN 5 YEARS