DQ: What Changes Will You Need To Make In Order To Have A Feasible Topic For Your PICOT-D?
DQ: What Changes Will You Need To Make In Order To Have A Feasible Topic For Your PICOT-D?
Sometimes topic ideas for a PICOT-D/DPI Project are intriguing, but not completely feasible for one reason or another. Based on the instructor feedback you have received, explain why you have, or do not have, a feasible topic for your PICOT-D. What changes will you need to make in order to have a feasible topic for your PICOT-D? If it is not feasible, what other topics are you considering
I’ve had several topics for my DPI Project. Over the past eight weeks, my topic/problem has changed multiple times. With feedback from Dr. Etheridge, I think I have a topic that may be workable. Changes incorporated from feedback:
P: End-stage renal disease- Medicare patients Health plan in Oregon that serves Medicare patients
I: Member engagement with a single point of contact for Case Management
C: pending
O: ED hospital utilization, improved self-management
Other options for quality improvement projects include access to healthcare through non-emergent transportation (NEMT).
My goal is to provide a quality improvement initiative, based on the needs of the health plan. The population will be a vulnerable population and my improvement will be to improve the health inequities of patients with social determinants (SODH) in vulnerable populations.
It’s important to remember to incorporate feedback from our instructors and to remember the focus of the final project. As stated by the American Association of Colleges of Nursing (AACN),:
Focus on a change that impacts healthcare outcomes either through direct or indirect care.
Have systems (micro-, meso-, or macro-level) or population/aggregate focus.
Demonstrate implementation in the appropriate arena or area of practice.
Include a plan for sustainability
DNP Projects should be designed so that processes and/or outcomes will be evaluated to guide practice and policy. Clinical significance is as important in guiding practice as statistical significance is in evaluating research.
Provide a foundation for future practice scholarship
American Association of Colleges of Nursing. Doctor of nursing practice/DNP tool kit. (2022) https://www.aacnnursing.org/DNP/Tool-Kit
Response
Hello Tommie! This is an outstanding and compelling post on your experiences in developing the DPI project. Creating a researchable question is among the challenging tasks a student encounters when initiating a DPI project. However, the utilization of the PICOT process is essential in assisting a student to develop a cautious and thoughtful question that facilitates the search for evidence (Eriksen & Frandsen, 2018). A well-rounded question makes it considerably straightforward to obtain and integrate the suitable terms required to represent the desired data in the query language of the available searching service (Zina, 2021). Once you have formulated a question using the PICO framework, you can consider the type of question you are asking and the kind of research that can provide an appropriate answer. The clinical question should be directly applicable to the clinical issue at hand and expressed in a way that fosters the search for a solution (Vandenbroucke & Pearce, 2018). PICO facilitates the process and is a mnemonic for the critical components of a sophisticated clinical question. It also assists in developing a search strategy through the recognition of the fundamental concepts that should be incorporated in the article to answer the question.
References
Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association: JMLA, 106(4), 420. DOI: 10.5195/jmla.2018.345
Vandenbroucke, J. P., & Pearce, N. (2018). From ideas to studies: how to get ideas and sharpen them into research questions. Clinical epidemiology, 10, 253. DOI: 10.2147/CLEP.S142940
Zina, O. (2021). The essential guide to doing your research project. Sage.
Before I started my proposed DPI project there are a lot of ideas I have in mind that I can think of to use. I am so happy that the one I chose to do is feasible enough for my PICOT-D project. I was able to discuss my proposed DPI project first with my mentor and seek for her advice if this will be a better project that I should be concentrating and she agreed with me. At first, I wanted to concentrate on mortality rate of sepsis and septic shock and when I first placed it in my PICOT-D Dr. Etheridge suggested that it will be difficult to just concentrate with it and I agree with her feedback.Per Dr. Etheridge feedback it is important that I have correct data and I should include statistics to show. My proposed project is implementing sepsis bundle for early identification for severe sepsis and septic shock. Sepsis is a huge problem in our organization and we don’t have any protocol to follow and guide us when it comes to Sepsis. It is important to identify septic patients in ICU and optimal treatment should be performed immediately. The goal of my proposed project is better outcome and bundle compliance of patients with severe sepsis and septic shock. Early detection and early management in sepsis patients will improve and compliance should be included,
If my proposed DPI project is not feasible I would suggest if patient flow from ED to their respective unit will be acceptable. Delays in patient flow and a shortage of bed are common in a hospital. Improving patient flow in any organization is important for patient outcome and patient satisfaction. Crowding can negatively affect patient and staff performance and this leads to problems. Patient flow is a problem in our facility and I am a part of the patient flow committee and I see it everyday. I am very passion in making sure that patient needs to be boarded as soon as bed is available for patient comfort and for staff role as well. To improve patient flow it includes removing unnecessary testings, duplicate orders and identifying what the problem really is, I think that this will be a good project too if I will not be able to do my first proposed project.
References:
Levy, M. M., Rhodes, A., Phillips, G. S., Townsend, S. R., Schorr, C .A. Surviving sepsis campaign: Assocition between performance metrics and outcomes in a 7.5year study. Intensive Care Med. 2014; 40:1623-1633. doe: 10.1007/s00134-014-3496-0.
Rojas-Garcia, A., Turner, S., Pizzo, E., Hudson, E., Thomas, J., Raine, R.; Impact and experience of delayed pdischarge: A mixed studies systematic review; Health Expect, vol. 21, no. 1, pp41-56; 2018.
