Our focus on learning this week has been related to defining health care policy, invested stakeholders, and ways in which the practice scholar can advocate for change. As you consider the readings and learning activities this week, it is time to apply these activities to your proposed DNP Project. Answer the following questions as it relates to your DNP Project:
Have you met with the decision-makers at the practicum site to determine the type of problem they are having and ways in which your project might be developed to address this problem? What was the outcome of this meeting?
My practicum site is my workplace, specifically the Women’s Health Clinic I work in as a Nurse Practitioner. I have identified the problem that so many young women here have abnormal cervical cancer screening (pap tests), which is secondary to the Human Papilloma Virus (HPV). HPV screening is an important part of cervical cancer cytology for appropriate age groups, and educating patients on the testing is merely one part (Dignan & Kruse-Diehr, 2021). Meeting with the important decision-makers for my clinic, Physician OBGYN, and DNP-prepared staff nurse, I was able to get eager buy-in for my proposed practice problem. How do I reduce abnormal paps? Narrowed to how do I reduce HPV? Further, narrowed to how can we increase HPV vaccination rates?
I was very happy to have positive professional support from my peers for my proposed practice problem and potential for intervention. My Women’s Health peers are very supportive as they appreciate the severity of the issue and support my professional knowledge working towards transformation.
Please share your proposed PICOT question in question format. Is this PICOT question likely to change in the future?
I worked hard to narrow down my PICOT question for my DNP project and feel it is a solid question for my planned interventional changes. I hope that it does not change, and my DNP mentor at my clinic site also feels it stands well as it is. However, I do worry that it may be changed as I have heard from those in practicum courses that instructors can sometimes change PICOT from class to class. But, at this time, I feel it is not likely to change.
For active-duty females, ages 18-26, would a proactive process of HPV vaccine-related chart review and intentional education (compared to none) improve HPV vaccination initiation, within the next 8 weeks?
Describe the translation science model you will be using or are considering using as a part of your project.
Knowledge to Action framework is the translation science model I am considering for my practice project. This is ideal to me because we begin with identifying the problems, implementation, and of course post outcome evaluation (White, et al., 2020). By using this framework I can really stay focused with my intentional intervention, and it focuses on more than simply education alone.
What is the current priority you have for the development of your project and do you believe you have support for this project from the practicum site decision-makers?
While I have interdepartmental and colleague buy-in, I do not have the support that I need to advocate for change from a systems-level at this military installation. COVID has created a backlog for pretty much any subject, need, paperwork, etc. and there is also a reduction on allowing students. For reference, I have been awaiting a form to be signed since March so I can perform colposcopies and it keeps getting routed, lost, and resubmitted. This is not a polished machine prioritizing Women’s Health, unfortunately. I have decided to move to the case study option for this reason. It is not that I do not want to make a change, it is just that right now it is darn near impossible. My main priority is finding the supporting evidence to support my project and continuing forward as able, with a goal to implement in clinic post-education if that is my only option.
Dignan, M. & Kruse-Diehr, A. (2021). Increasing cervical cancer prevention through HPV testing: Challenges in developing persuasive messages. Cancer Prevention Research. 14(9); 823-24. doi: 10.1158/1940-6207.CAPR-21-0179
White, M. et al. (2020). Using the Knowledge to Action framework to describe a nationwide implementation of the WHO surgical safety checklist in Cameroon. Anesthesia & Analgesia. 130(5), 1425-1434 doi: 10.1213/ANE.0000000000004586