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The DNP Project: Implementation


PICOT Question:
In adult oncology patients at an infusion Center at Queens Hospital Center, does the implementation of a music therapy program compared to current practice impact pain scores during chemotherapy over 8-10 weeks?
The discussion for this week is focused on project implementation. Review the steps in your change process and your implementation schedule, identify milestones, and discuss how you will ensure the achievement of these milestones. How has your implementation plan changed, if at all? Why were these changes necessary? Have you started implementation?
 The DNP project is a summative evaluation of many essentials learned throughout the curriculum. The projects focus on changes that can bring positive health outcomes. It includes implementing evidence-based practice, evaluating outcomes, and making a sustainability plan. Often the DNP students encounter many barriers to implementing evidence-based practices secondary to lack of site support.  Many studies were done to improve project implementation. An enhanced model for DNP projects was tested in six DNP projects and found to improve the completion of assignments, defense, and graduation (VanderKooi et al., 2018).
Developing a clear timeline with all the tasks listed with special attention to time and costs and making a project schedule is critical for the success of any project (Baum and Swig, 2017). The final scholarly project indicates if the graduate acquired all the essential skills needed to be a leader in clinical practice (Roush & Tesoro,2018). The proposed project will be implemented over eight to ten weeks, and the detailed activities during pre-planning, implementation, data analysis, and dissemination are included in the Gantt chart
A meeting will be held with critical stakeholders on week one to brief the project thoroughly. The DNP student will offer an educational session for registered nurses at the infusion center on the effectiveness of music intervention as an adjunct treatment for cancer pain and demonstrate the implementation process. Participants will be selected from the infusion center schedule based on inclusion and exclusion criteria. Selected participants will be contacted in person if possible or via telephone and asked about their willingness to participate in the project. Those willing to participate will receive a brief education about the music intervention, media player (MP3 player), visual analog scale, and be allowed to select their preferred music from a list of choices. Additionally, the participant will be informed that the proposed music intervention will be given during their next chemotherapy session. Participants will be recruited until week eight to satisfy the proposed sample size.
Week two through nine:
The implementation phase will begin on week two and continue through week nine. Participants will receive a single session of music intervention during chemotherapy. Informed consent will be obtained, and all questions and concerns will be answered for the participants. Therapeutic music will be provided to the participants, and pain scores will be assessed before and after the intervention using a visual analog scale for pain. Instructions will be given to ensure an accurate assessment of pain level. Pain scores will be documented in the electronic medical record. All the collected data will be stored in a locked file cabinet and a password-protected computer at the practicum site. The DNP student will be physically available during the project implementation to ensure compliance. Further, a compliance checklist will be utilized to document the correct implementation process. A retrospective chart review also will be done to ascertain the implementation process. The DNP student will perform formative evaluation from week two through nine by directly observing the implementation process and frequent huddling with the project team members. The preceptor will be updated about the project’s progress every day, and the course instructor will be contacted weekly or as needed. The DNP student will conduct a biweekly conference with stakeholders to update the progress. Daily staff meetings will be conducted with the health care team of the infusion center and oncology department administration. During the meeting, staff can provide feedback regarding the project, and the DNP student will update the project’s progress.
Post-implementation phase
The DNP student will thank all the participants and the health care team for their participation and support. All collected data will be analyzed with the help of a statistician. A retrospective chart review will be conducted to ascertain project implementation compliance. Project presentation before the Chamberlain faculty and sharing the results with practicum site stakeholders.
  Major milestones identified in my project are a) educating the staff and b) recruiting the participants, c) implementation, d) data management, e) data analysis, f) project presentation, and sharing the results with the stakeholders at the practicum site.  The project manager will use a compliance checklist and a retrospective chart review to ensure project compliance. The Gaant chart also provides an organized schedule for the smooth implementation process. There are no changes in the project implementation plan. Implementation will begin on the first week of NR 707.
Please provide your instructor and student colleagues with an update on the implementation phase of your DNP Project. Share any successes, challenges, or barriers you experienced this week.
The project implementation, planning, and preparation are progressing well. The DNP student is not foreseeing any barriers to the planned implementation of the project.
Baum, N., & Swig, B. (2017). Project management for healthcare practices: costs and timing. The Journal of Medical Practice Management, 32(4), 271–275.  (Links to an external site.)https://www.proquest.com/docview/1930760068?parentSessionId=GgAgfndYvaWOJq5AAkHSCbrELfT7tKDlVF%2BSxK1VBuM%3D&pq-origsite=primo&accountid=147674 (Links to an external site.)
Roush, K & Tesoro, M. (2018). An examination of 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
VanderKooi, M., 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.0000000000000384



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