PICOt: Hemodialysis Nurses (P), who walk three times a week (I), compared to usual care (C) decrease depression by 3 points on PHQ9 Scale (O), within 6 weeks (t).

PICOt: Hemodialysis Nurses (P), who walk three times a week (I), compared to usual care (C) decrease depression by 3 points on PHQ9 Scale (O), within 6 weeks (t).

PICOt: Hemodialysis Nurses (P), who walk three times a week (I), compared to usual care (C) decrease depression by 3 points on PHQ9 Scale (O), within 6 weeks (t).

08-06-2018: tch & bw Doctorate of Nursing Practice (DNP) Clinical Scholarly Project (CSP) Handbook 2018-2019 08-06-2018: tch & bw Message from the Dean Welcome to the Musco School of Nursing and Health Professions! We realized that you did not make the decision to return to school lightly; to subject yourselves to the rigors of doctoral education coursework will be a challenge and we appreciate that you have chosen Brandman University! Our task is to provide you with the tools to become innovative and evidence-based practitioners for best patient outcomes, no matter where you are providing care. The one thing we would like you to please remember is that we are all nurses at the heart of whatever we do. The American Nurses Association (ANA) tells us that a doctorate of nursing practice (DNP) educates “nurses for enhanced clinical roles, leadership roles, management and teaching, health policy, and areas of specialization such as integrative health and healing” (ANA, 2012, p. 1), but we know that becoming doctorally-prepared is much more than that. We are answering the call of the Affordable Care Act (ACA) to meet the needs of our patients as primary care providers, while advancing our profession as expert clinicians and health policy leaders (ANA, 2012). Please enjoy your journey, embrace evidence-based change for best patient outcomes and become the best nurse practitioners you can be. Inquire, innovate and inspire others to do the same. Wishing you great success in the completion of your clinical scholarly project experience and please feel free to contact me with any challenges you encounter and to share your “aha” moments and successes. Thank you again for choosing Brandman University and welcome aboard! Warm regards, Clinical Scholarly Project Handbook 08-06-2018: tch & bw 1 Table of Contents I. Introduction……………………………………………………………………………………..3 II. Mission, Vision and Core Values………………………………………………………..4 III. Accreditation, Memberships and DNP Program Essentials…………………..5 IV. DNP Program Learning Outcomes…………………………………………………….6 V. Purpose of the Clinical Scholarly Project……………………………………………8 VI. Overview of the Clinical Scholarly Project Process………………………………8 VII. Clinical Scholarly Project Chair…………………………………………………………8 VIII. Guidelines for CSP Timeline………………………………………………………………9 IX. Clinical Scholarly Project Committee…………………………………………………13 X. Clinical Scholarly Project Progression……………………………………………….13 XI. Writing the DNP CSP Manuscript……………………………………………………..15 XII. Writing the DNP CSP White Paper…………………………………………………….19 XIII. Guidelines for the Oral Defense…………………………………………………………23 XIV. Guidelines for Library Submission of Project Manuscript……………………28 References……………………………………………………………………………………….30 Appendices………………………………………………………………………………………31 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 2 List of Appendices Appendix A: DNPU 706 Formal Project Proposal…………………………………..33 Appendix B: DNPU 710 Individualized Learning Plan……………………………..35 Appendix C: Affiliation Agreement………………………………………………….38 Appendix D: DNPU 707, 709 or 711 DNP CSP Clinical Hour PROPOSAL……….39 Appendix E: DNPU 707, 709 or 711 DNP CSP Clinical Hour LOG……………….41 Appendix F: Guidelines for BUIRB Completion and On-line Application………..43 Appendix G: Leatherby Library Checklist for Manuscript Formatting…………..53 Appendix H: Directions on How to Change a Grade in Banner……………………55 Appendix I: Sample DNP CSP Manuscript Template……………………….,….….54 Appendix J: Sample White Paper Template…………………………………………66 Appendix K: DNP CSP Cover Sheet and Rubric for Oral Defense…………………80 Appendix L: DNP CSP PPT Template……………………….…………………………83 Appendix M: DNP White Paper PPT Template……………..………….………….……84 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 3 I. Introduction A student in the Brandman University (BU) Musco School of Nursing and Health Professions (MSNaHP) Doctorate of Nursing Practice (DNP) program is required to complete an evidence-based Clinical Scholarly Project (CSP). The CSP is a faculty-guided, scholarly experience that provides confirmation of the student’s critical thinking abilities and the application of research principles to a clinical problem. The student will typically identify a problem, propose a solution, implement an intervention and evaluate the proposed solution. This manual offers a guide to the successful completion of doctoral-level CSP, as defined by the American Association of the Colleges of Nursing (AACN) (2006) Essentials for Doctoral Education in Nursing Practice: The final DNP project produces a tangible and deliverable academic product that is derived from the practice immersion experience and is reviewed and evaluated by an academic committee. The final DNP product documents outcomes of the student’s educational experiences, provides a measurable medium for evaluating the immersion experience, and summarizes the student’s growth in knowledge and expertise. The final DNP product should be defined by the academic unit and utilize a form that best incorporates the requirements of the specialty and the institution that is awarding the degree. Whatever form the final DNP product takes, it will serve as a foundation for future scholarly practice (p. 20). Clarifications to the DNP Project are addressed in the AACN (2015) The Doctor of Nursing Practice: Current Issues and Clarifying Recommendations white paper: Scholarly Product: The product of the DNP Project may take on various final forms depending on the academic institution’s requirements and the student’s area of advanced nursing practice. Programs are encouraged to support innovation in the design and dissemination of the final project and product to reflect the changing healthcare environment; the elements of the DNP Project should be the same for all students and include planning, implementation, and evaluation components. As an outcome of the program, students must have the opportunity to integrate all DNP Essentials into practice, though not all Essentials have to be demonstrated within the DNP Project. However, all DNP Projects should: a. Focus on a change that impacts healthcare outcomes either through direct or indirect care. b. Have a systems (micro-, meso-, or macro- level) or population/aggregate focus. c. Demonstrate implementation in the appropriate arena or area of practice. d. Include a plan for sustainability (e.g. financial, systems or political realities, not only theoretical abstractions). e. Include an evaluation of processes and/or outcomes (formative or summative). 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. f. Provide a foundation for future practice scholarship (p. 4). Clinical Scholarly Project Handbook 08-06-2018: tch & bw 4 The Difference between a Doctor of Philosophy (PhD) Dissertation and a DNP Scholarly Project Currently, there are two recognized terminal degree programs in nursing: a researchfocused and practice-focused doctorate. Most research-focused doctoral level nursing programs culminate in a Doctor of Philosophy (PhD) degree, whereas practice-focused doctoral study most often results in a Doctor of Nursing Practice (DNP) degree. The focus of the PhD dissertation is to utilize all components of the research process to generate new knowledge, whereas the primary focus of the DNP clinical scholarly project consists of using newly generated or interpreted evidence to improve practice or patient outcomes. In the following paragraph, the AACN (2006) discusses differences between the PhD dissertation and the DNP scholarly project: …practice-focused programs understandably place greater emphasis on practice, and less emphasis on theory, meta-theory, research methodology, and statistics than is apparent in research-focused programs. Whereas all research-focused programs require an extensive research study that is reported in a dissertation or through the development of linked research papers, practice focused doctoral programs generally include integrative practice experiences and an intense practice immersion experience. Rather than a knowledge generating research effort, the student in a practice-focused program generally carries out a practice application-oriented ‘final DNP project,’ which is an integral part of the practice experience (p. 3). II. Mission, Vision and Core Values The mission of MSNaHP is to provide dynamic education that focuses on inquiry and innovative practice relevant to an ever-changing healthcare system. Vision As leaders of healthcare change, our graduates will embrace the spirit of inquiry to identify evidence-based strategies, create innovative solutions and inspire others while optimizing patient care. • To that end, clinical scholarly projects are expected to go beyond the stated requirements and exceed in each of these three ideals. Exemplary projects are nominated by DNP CSP chairs and are voted on by faculty to receive one of three outstanding i 3 awards, which are presented at the MSNaHP pinning and hooding ceremony in the spring of each academic year. Core Values • Respect – Respect for each other, our students, our communities, and the environment. • Integrity – Our personal and professional behavior is guided by honesty, ethics and conscience. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 5 • Teamwork – By supporting each other, we can accomplish more than what is possible individually. • Service-Orientation – Through instruction and guidance we serve the needs of our students with knowledge and skills, putting others before ourselves. • Innovation – We value new, viable ideas and rigorously promote them. III. Accreditation, Memberships and DNP Program Essentials Accreditations: Brandman University is accredited by: *Western Association of Schools and Colleges (WASC) The Musco School of Nursing and Health Professions is accredited by: *Commission on Collegiate Nursing Education (CCNE) for: Bachelor of Science in Nursing (BSN) Doctor of Nursing Practice (DNP). *California Board of Nursing for: Continuing Education Credit Units (CEUs). Memberships: *American Association of Colleges of Nursing *California Association of Colleges of Nursing *National League for Nursing *National Organization of Nurse Practitioner Faculty *Western Institute of Nursing Clinical Scholarly Project Handbook 08-06-2018: tch & bw 6 IV. DNP Program Learning Outcomes (PLOs): AACN (2006) Essentials of Doctoral Education for Advanced Nursing Practice I. Scientific underpinnings for practice Recognizes the philosophical and scientific underpinnings essential for the complexity of nursing practice at the doctoral level. II. Organizational and systems leadership for quality improvement and system thinking Recognizes the competencies essential for improving and sustaining clinical care and health outcomes, eliminating health disparities, and promoting patient safety and excellence in care. III. Clinical scholarship and analytical methods for evidence-based practice Recognizes competencies essential for translation of research into practice, evaluation of practice, practice improvement, and the development and utilization of evidencebased practice. IV. Technology and information for the improvement and transformation of patient-centered health care Recognizes competencies essential to manage, evaluate, and utilize information and technology to support and improve patient care and systems. V. Health care policy for advocacy in health care Recognizes the responsibility nurses practicing at the highest level have to influence safety, quality, and efficacy of care, and the essential competencies required to fulfill this responsibility. VI. Interprofessional collaboration for improving patient and population health outcomes Recognizes the critical role collaborative teams play in today’s complex health care systems and the competencies essential for doctoral prepared nurses to play a central role on these teams. VII. Clinical prevention and population health for improving the nation’s health Recognizes nursing’s longstanding focus on health promotion and disease prevention within the context of current national calls for all health educators to respond to the changing needs of the population and include this content in curricula. VIII. Advanced Nursing Practice Recognizes the essential competencies reflective of the distinct, in-depth knowledge and skills that form the basis for nursing practice at the highest level regardless of practice role. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 7 References American Association of Colleges of Nursing (AACN). (2006, October). Essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf American Association of Colleges of Nursing (AACN). (2015, August). The doctor of nursing practice: Current issues and clarifying recommendations. Retrieved from http://www.aacn.nche.edu/aacn-publications/white-papers/DNP-Implementation-TFReport-8-15.pdf National Organization of Nurse Practitioner Faculty. (2008). The consensus model on APRN regulation: Licensure, accreditation, certification and education. Retrieved from http://www.nonpf.org/associations/10789/files/APRNConsensusModelFinal09.pdf National Task Force on Quality Nurse Practitioner Education. (2012). Criteria for evaluation of nurse practitioner programs. Retrieved from http://www.nonpf.org/resource/resmgr/docs/ntfevalcriteria2012final.pdf Clinical Scholarly Project Handbook 08-06-2018: tch & bw 8 V. Purpose of the Clinical Scholarly Project The purpose of the CSP is to integrate the knowledge and skills achieved in the DNP program to identify evidence-based strategies, create innovative solutions and inspire others while optimizing patient care. The project culminates with a formal written manuscript and/or white paper, and an oral defense of the project. VI. Overview of the Clinical Scholarly Project Process The CSP is a demonstration of a student’s the ability to obtain, analyze/synthesize and utilize research literature in a scholarly process. The CSP follows a logical sequence beginning with the development of a Problem or Population, Intervention, Comparison and Outcome with optional time (PICOt) question to identify keywords to be utilized in an exhaustive literature. The results are critically appraised and synthesized to identify evidence-based studies that support approaches to the problem and determines the focus and format of the CSP. Activities related to the foundational literature search that informs the CSP may include: • Collection of appropriate and accurate data to generate evidence for nursing practice; • Analysis of data from clinical practice; • Selection of interventions based on evidence; • Prediction and analysis of outcomes; • Identification of gaps in evidence for practice; • Selection of data analysis method/s relevant to intervention • Evaluation criteria of collected data and findings to determine and implement best practices. A chair is then assigned and the student and CSP Chair develop a timeline for completion. Timeline and Method of Evaluation The CSP timeline is designed so the student completes the project as he/she progresses through DNPU coursework. The timeline for completion may vary depending upon such factors as: • Individualized Education Plan • Implementation timing due to CSP residency placements • Other factors as identified VII. Clinical Scholarly Project Chair The role of the CSP chair is to mentor, guide and support the student in the development and implementation of the CSP. The doctorally-prepared Chair is assigned from Brandman MSNaHP full-time or adjunct faculty. The selection is based upon the student’s CSP topic and faculty interest/area of expertise. The CSP chairs are responsible for: Clinical Scholarly Project Handbook 08-06-2018: tch & bw 9 • Providing primary guidance and feedback to the student throughout manuscript development, project completion and preparation for the final oral presentation/defense in consultation with other committee members, when applicable • Assisting in the selection of committee members, when applicable • Determining when drafts of the manuscript are ready for submission to committee members for their review, when applicable • Assisting with BUIRB and facility (prn) preparation and submission • Reviewing drafts and final manuscript for eSignature approval by committee members and the Dean • Referring the student to the Brandman Online Math and Writing Center (OMWC https://www.brandman.edu/current-students/resources/online-writing-community) or a professional editor for assistance with scholarly writing, APA (2010) and/or other formatting needs • Scheduling the DNP CSP oral defense • Reviewing and approving the manuscript per Leatherby Library checklist before submission to committee members and the Dean for final eSignature • Submitting final “P” DNPU 708 grade to Banner Most students will have CSP Chair assigned at the end of DNPU 706 – Transforming Healthcare through Outcome Management, based on faculty availability. The student and the Chair will complete a written timeline as part of his or her Individualized Learning Plan (ILP) (Appendix B) by the end of the following session. The ILP may be amended at any time based on mutual agreement of the student and Chair and will be formally reviewed in DNPU 710. VIII. Guidelines for CSP Timeline The following table can be used as a guideline for students, faculty and CSP Chairs as they progress through the program: Table 1 CSP Timeline Course CSP Benchmark CSP Chair Responsibilities DNPU 704 – Evidence-Based Thinking for Scholarship and Practice • Completion of Chapter I: Background and Significance • Development of PICOt. • Academic and professional guidance for Chapter II PICOt, Literature Review and Evidence Synthesis. • N/A DNPU 703 – Leading through Innovation • Continued academic and professional guidance for manuscript Chapter II. • N/A Clinical Scholarly Project Handbook 08-06-2018: tch & bw 10 DNPU 702 – Innovation in Technology and Information Access • Continued academic and professional guidance for manuscript Chapter II. • Submit title of DNP CSP Project or White Paper to instructor to forward to DNP Support Specialist for Chair Assignment • N/A DNPU 706 – Transforming Healthcare through Outcomes Management • Design study implementation plan • Propose data collection plan • Review manuscript and refer to OMWC as needed (https://www.brandman.edu/whybrandman/dedicated-resources/academicsupport/online-writing-and-math-center) • Initial meeting with student, review DNPU 706 formal project proposal (Appendix A) • Using the DNPU 710 Individualized Learning Plan (ILP), develop a DNP CSP timeline (Appendix B) to set up future meetings and CSP milestones via Blackboard, phone, videoconference, or in person. • Complete an affiliation agreement (Appendix C) and submit to the clinical coordinator for processing • Review Chapters 1-2 and refer to OMWC for writing assistance if needed DNPU 701 – Biostatistics for Clinical Practice • Review and improve data collection plan • Draft of Chapter III: Methodology and refer to OMWC as needed for writing and/or statistical assistance (https://www.brandman.edu/whybrandman/dedicated-resources/academicsupport/online-writing-and-math-center) • Complete agreed upon meetings per ILP by phone, videoconference or in person Review and approve Chapter III: Methodology and refer to OMWC for writing or statistical assistance if needed. DNPU 700 – Health Care Policy, Organization and Delivery • Continue data collection • Identify potential meetings for abstract submission • Identify potential peer reviewed journals for manuscript submission • Complete agreed upon meetings per ILP as needed by phone, videoconference or in person DNPU 705 – Health Communications • Continue data collection • Complete agreed upon meetings per ILP as needed by phone, videoconference or in person Clinical Scholarly Project Handbook 08-06-2018: tch & bw 11 DNPU 710 – Seminar in Evidence-Based Thinking for Scholarship and Practice • Complete, submit and receive approval from BUIRB (https://irb.brandman.edu/Pages/Home.as px) • Review ILP and revise as necessary • Complete one meeting per week with each student by phone, videoconference or in person as needed • Review and approve BUIRB application (Appendix F) and submit to MSNaHP IRB prereview representative at least 1 month prior to BUIRB meeting date • Upload MSNaHP preapproved BUIRB application 2 weeks prior to BUIRB meeting date • Assign a “P” grade for DNPU 710 if BUIRB application, action plan and required attachments are approved by BUIRB • Assign a “SP” grade for DNPU 710 if IRB application, action plan and required attachments are not submitted or approved by BUIRB (please see Appendix H for how to change the SP grade to a P when all course requirements are met). DNPU 707 – Clinical Residency I & DNPU 709 – Clinical Residency II OR DNPU 711– Clinical Residency for BSN-DNP or PM-DNP adding Specialty • Begin and complete CSP implementation activities • Begin data analysis and synthesis as needed • Review ILP and revise as necessary • Complete agreed upon meetings per ILP as needed by phone, videoconference or in person as needed • eSign CSP clinical hours PROPOSAL (Appendix D) and forward to instructor in DNPU 707, 709 or DNPU 711 • eSigned CSP clinical hours LOG (Appendix E) and forward to instructor of DNPU 707, 709 or DNPU 711 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 12 • Provide statistics referral as needed (OMWC) • Review and approve Chapter IV: Results • Review application of DNP Essentials I-XIII to CSP in preparation of Chapter V: Discussion DNPU 708 – Application of DNP Clinical Scholarly Project • Complete manuscript and oral defense • Submit letter of inquiry to peer review journal and/or national conference if indicated • Submit completed manuscript to TurnItIn to validate academic integrity • Submit eSigned manuscript AND eSigned checklist to BU Leatherby Library (http://chapman.libguides.com/dissertations) • Complete a minimum of one meeting per week with each student by phone, videoconference or in person as needed • Verify submission of CSP manuscript to TurnItIn • Assist in preparation of PPT for defense (guidelines for PPT found in Section XIII) • Schedule and attend DNP CSP defense • Review CSP manuscript applying Leatherby Library formatting checklist (Appendix G) • Review, approve and eSign final manuscript • Forward final manuscript to Dean for eSign • Assign a “P” grade for DNPU 708 upon Leatherby Library acceptance email forwarded by student • Assign a “SP” grade for DNPU 708 if all of the above benchmarks are not met by the end of the 8- week session (please see Appendix H for how to change the SP grade to a P when all course requirements are met). It is important to remember that while the DNP student and CSP Chair team is a collaborative arrangement, the student is ultimately responsible for successfully completing the CSP in a timely manner. This includes all related coursework, IRB approval/s, initiating appropriate affiliation agreements, conducting data collection and analysis, preparing the final manuscript and oral defense presentation. If, at any time, the student or project chair feels that their working relationship is no longer productive, Clinical Scholarly Project Handbook 08-06-2018: tch & bw 13 either party may initiate a request for a Chair reassignment through a petition submitted through the student’s Academic Advisor or by the chair through the MSNaHP DNP Support Specialist. A new chair will be assigned based on faculty availability. *It is highly recommended that the student completes his or her manuscript PRIOR to setting a date for the oral defense. IX. Clinical Scholarly Project Committee The student should choose at least one additional committee member to serve as a part of the DNP CSP Committee. The committee member may be the student’s program director, other Brandman or alternate University faculty, a content expert, and/or the clinical site mentor. Committee members are expected to communicate with both the student and Chair to avoid conflicting information that may undermine the completion of the CSP. CSP committee members will receive a certificate of appreciation, but no financial compensation. Committee member responsibilities may include: • Providing guidance as requested by the student or chairperson, related to any aspect of the project • Critically reviewing the manuscript and completed project • Participating in committee meetings • Attending the DNP CSP oral defense • Other duties as identified by the student, chair and committee member X. Clinical Scholarly Project Progression Step 1: Written Proposal Prior to beginning the CSP, each student will develop a formal project proposal in DNPU 706: Transforming Healthcare through Outcomes Management. The formal proposal (Appendix A) should be presented to the project chair (usually assigned by the end of course DNPU 706) at the first DNP CSP meeting (see Timeline above) Step 2: Project Timeline and Tasks Students find it helpful to develop a schedule for keeping up-to-date with work for the CSP. Although DNP students will master the didactic content and complete some tasks necessary for undertaking the clinical project through formal coursework, completion of the implementation and written manuscript for the project itself will be completed outside of the structure of formal coursework. The CSP Chair should review and approve the student’s timeline so that efforts are coordinated and assistance can be received when needed. It is also important to understand the timeline is flexible in response to life events, but the CSP Chair must be notified to facilitate modifications. When developing a schedule and timeline for the CSP, it is important to leave sufficient time to obtain a clinical affiliation agreement (Appendix C) if required. There must also be sufficient time for writing and revisions of the manuscript or white paper. Unlike a Clinical Scholarly Project Handbook 08-06-2018: tch & bw 14 course paper, the project manuscript will need to be revised until it is acceptable to the CSP Chair and in Leatherby Library format. Each submitted draft requires a reasonable amount of time for the project chair to review it (a minimum of 7 days). It is wise to allow for multiple extensive revisions in addition to a final edit. Timely completion of the project is the student’s responsibility. Step 3: Obtaining Institutional Review Board Approval The Brandman University Institutional Review Board (BUIRB) must approve all CSPs before data collection may begin. In addition to BUIRB approval, the IRB of the agency where the project will be conducted may also require approval before data collection may begin. For information about each individual agency’s IRB process and application procedures, the student should contact the agency directly. Brandman University is committed to safeguarding the rights and welfare of all people who participate in studies conducted by faculty and students. BU supports responsible experimentation that promises to increase knowledge and understanding while demanding the highest ethical standards among BU scholarly investigators. The process to submit an application to the BUIRB includes the following: 1. The National Institutes of Health (NIH) Protecting Human Research Participants Program. This online self-learning activity is located at http://phrp.nihtraining.com/users/login.php. When completed, the student must save the certificate of completion to submit with the BUIRB application; 2. Completion of the BUIRB Application (Appendix F) with the DNP CSP Chair as well as required attachments; 3. Submission of the draft Application to the MSNaHP pre-Review IRB representative/s by the DNP CSP Chair for review and approval to complete the online BUIRB application 4. Completion of the MSNaHP approved online BUIRB Application, along with any required attachments to the Brandman University IRB committee (https://my.brandman.edu/teams/academicaffairs/IRB/Lists/IRBApplication/Item/ newifs.aspx). It is recommended that prior to the development of the online BUIRB application and any other required forms, the student and CSP Chair visit and review the BUIRB webpage together since the procedures, calendar, application, action form and other sample documents may be found there (https://irb.brandman.edu/Pages/Home.aspx). In addition, there is a step-by-step document (Appendix F) outlining the online BUIRB submission document which must be completed by the student and submitted to MSNaHP pre-review BUIRB representatives prior to formal submission. There are also trainings available for faculty and students to better understand the electronic submission process. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 15 For students: YouTube tutorial: use of the BUIRB electronic application https://youtu.be/lMqzUZ5L6W8 YouTube tutorial: “Mock” School of Education electronic BUIRB application https://my.brandman.edu/teams/academicaffairs/IRB/Lists/IRBApplication/Item/newifs.a spx?DefaultView=Immersion. For faculty: YouTube tutorial: Chair Instructions for Using BUIRB Application Templates with Students at https://youtu.be/x0NyrQwsXWY YouTube tutorial: Chair Review Process for BUIRB Electronic Applications training tutorial at https://youtu.be/6PQzril3MxA to develop a clear understanding of the process. Step 4: Completing the Clinical Scholarly Project Students are expected to complete their projects (intervention, data collection and data analysis) by the end of the DNPU 708 course work. If a student is unable to complete his or her CSP oral dissertation defense, finalize the manuscript or white paper with successful submission to the Leatherby Library during DNPU 708, he or she will be enrolled in a continuing course, DNPU 799. DNPU 799 is a “0” credit course, with a $500 continuing candidacy fee, that allows continued access to the library and DNP CSP Chair. If a student is able to complete the DNP 708 requirements by the end of the first week of the initial DNPU 799 term, he or she will not be required to pay for the course and the DNPU 799 will be dropped from registration. The grade issued for DNPU 799 is always a “P,” unless there is an Academic Integrity violation review or as directed differently by the Dean or Dean’s Designee. If a student is unable to complete the DNP requirements after the first 8-week enrollment session of DNPU 799, he or she will be enrolled in subsequent sessions until he or she is able to complete all degree requirements or the maximum 7-year rule is reached. Please communicate directly with the DNP CSP Chair for further instructions and guidelines for assignments due for this course since each student will require individualized support. The grade issued for DNPU 799 is always a “P,” unless there is an Academic Integrity violation review or as directed differently by the Dean or Dean’s Designee. Step 5: Oral Defense Each student will deliver an oral defense PowerPoint presentation of the CSP during DNPU 708 – Application of Clinical Scholarly Project. The presentation will be scheduled by the Chair in coincidence with faculty (and the Dean’s schedule as often as possible (see Section XIII for additional details about the oral defense) Clinical Scholarly Project Handbook 08-06-2018: tch & bw 16 XI. Writing the DNP CSP Manuscript (sample template found in Appendix I) The project manuscript is a required dissertation-style document that outlines all of the elements of the CSP. It is essential that the manuscript be both original, substantial and demonstrates critical thinking. A discussion of the data-driven conclusions and professional lessons learned throughout the project should also be included. The manuscript must be in proper English using correct grammar and punctuation in APA format. Each sentence must be defensible in a logical and scientific sense. If the student struggles with writing, it is recommended that he/she obtain assistance from the Brandman University Online Writing Community https://my.brandman.edu/student/OWC/Pages/Home.aspx. However, some students may need to employ a professional editor or other technical assistance as determined in mutual discussion with the Chair. Attempting to write the manuscript all at one time is an overwhelming task. The manuscript should be written during DNPU coursework. Many students find writing the discussion/implications sections to be particularly challenging. Consultation with the DNP CSP Chair and even peers can be helpful during this phase of the project work. For the manuscript, the final format will follow the checklist as directed by the Leatherby Library. The manuscript must follow national guidelines and be a comprehensive DNP CSP as outlined by the AACN (2006, 2016). DNP CSP Manuscript Chapters I-V: A Closer Look Introduction The Introduction sets the stage for the specifics of the project. It should begin with the global setting in which the problem exists, and then move systematically through a “funnel,” narrowing down the problem from the macro setting to the micro. Hence, the introduction provides an overall view of the subject or general problem and shows how it relates to a larger field of thought. The introduction provides the reader with a context for the problem and typically does not exceed 1-2 pages. Chapter I: Background and Significance Chapter I of the DNP CSP may include the following subsections: Background and Significance, Assessment of the Phenomena (Problem Statement), Historical and Societal Perspective, Incidence and Prevalence, Healthcare Cost, and Introduction of PICOt question to provide key words for the literature search. Not every project includes all of these subsections, or the same order of the subsections. The specific order of this chapter will ultimately depend on the kind of project being conducted; the student’s chair will approve the subsections and order of this chapter. Despite its importance, Chapter I is usually short, no more than 10 pages in length. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 17 Background and Significance. The background section of Chapter I provides the research foundation leading to the problem and purpose statements. This section presents the most relevant pieces of research (citations) that support the project. This section is usually 2-4 pages in length. Assessment of the Phenomena (problem statement). The underlying justification and greater need for further study of your potential project should be discussed in this section. After reading the background, the reader should be informed precisely why the project is being conducted and be convinced of its importance. The reader should be convinced that there is a pressing problem or requires a closer examination or improvement Historical and Societal Perspective. This section provides an in-depth examination of the historical events that have led to the current problem and attempts to provide insight and clarity as to why changes need to be made. It may also address the societal impact and views that have contributed to the current state of the problem or examine the problem from different social angles to grasp the depth and breadth in an attempt to present a comprehensive solution. Incidence and Prevalence. This section should precisely describe the incidence and prevalence of the identified problem at hand. Use of national and local statistics is required. Healthcare Cost. This section examines the cost burden to patients and stakeholders and should be one or two paragraphs in length f applicable. Supporting references in APA format should be included. Introduction of PICOt Foundation. This is where the student summarizes the previous background information and leads the reader to understand how the PICOt question was developed. Chapter II. Literature Review Introduction of PICOt Question This introduction to the literature review chapter describes what a PICOt question is, what the elements mean (i.e., P = population, I = intervention, etc.) and how it informed the key words that guided the literature search for a solution to the identified problem. The first paragraph should conclude with the actual PICOt question that guided the literature review. The next paragraph should describe the data bases used (i.e., PubMed, CINAHL, Cochrane Library, etc.) and what was found using the keywords identified from the PICOt question. Include the number of articles found and the specific themes. Next, talk about how they keywords may have been refined to identify and locate research specifically relevant to the proposed solution to the problem. Finally, discuss the number of articles chosen that support the argument for change. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 18 Synthesis of the Literature. This section begins with a brief introduction to the topics researched and an explanation of major elements of the literature being reviewed. The review of literature requires more than just listing and summarizing all the studies that relate to the project. It should be an orderly, cohesive, well-sequenced narrative that relates the problem under investigation to a body of scholarly work that supports the change in practice. Subheadings should be used to identify each of the themes or categories. They organize the material into shorter, more easily comprehensible blocks of information for the reader. Transitions from one theme or category to another should be smooth and appropriate. In the review of literature, the main theories, explanations, and findings that are generally accepted and represented in the literature should be presented along with any contradictory evidence or points of view that may have caused discussion or debate. The review of the literature must include works that outline the change in understanding of the research topic and how the proposed solution will improve outcomes. Literature reviewed and discussed should focus on work published within the past 5 years. At the conclusion of Chapter II, a final section should be included that summarizes the literature in a coherent manner. Contradictions should also be highlighted. The significance of the proposed project in light of the reviewed research should be emphasized. The readers should feel that the review of the literature has yielded new insights and suggested a direction for change in the chosen issue. Theoretical Framework For this section, use the nursing theory you identified in NURU 600 or one that you are familiar with and whose concept and/or framework supports and/or informs your CSP or white paper. Remember that your choice of theory should be a best fit of nursing practice with the outcome of your CSP or white paper argument. As you learned in class a nursing or other complementary discipline’s theory may be used. In the first paragraph, give a summary of your theory. You may even wish to include a figure to visually explain the concept or frame work. The next paragraph should explain how it informs your CSP or white paper. It should include your purpose for using this specific theory (i.e., is it for quality patient care, to improve a system or process, to frame a CSP study or white paper, to educate patients, providers, interprofessional group, to inform administrators or politicians, to justify a change, etc.). A final paragraph should summarize your salient points and the section should be limited to 2 pages maximum. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 19 Chapter III. Methodology. Study Design. Chapter III should begin with the study design, and whether the project will be quantitative, qualitative or a combination. It should be sufficiently detailed to enable others to understand the step-by-step account of what will be done, in what order, how and by whom. Population and Sample. In this section, provide a summary of the sample and the population from which the sample is drawn. A description of their defining characteristics and the procedures used to recruit them should be included. Instrumentation. In this section, describe the *instruments that were obtained or modified for this project. Surveys or questionnaires designed by others should be valid and reliable and credit should be cited for the original authors, as well as any permissions obtained to use the instrument/s. *Please note it is not within the scope of study within the DNP CSP at Brandman University MSNaHP to develop a new questionnaire, survey or other data collection instrument. Data collection. Outline in detail the methods that will be used to collect information. Describe the procedures that will be used to collect the required data from participants. In short, list all activities needed to gather information for the project (including IRB approval and assurance of confidentiality) and describe each activity in enough detail so another competent researcher could duplicate the project. Data analysis. Describe how data will be scored and analyzed; identifying appropriate statistical methods . If the proposed project is to employ qualitative methods, identify the ways in which the data will be processed and analyzed. Summary. A brief summary of the chapter may be included in this section. Chapter IV. Findings In this section only the statistical findings are given without interpretation. The findings chapter should include participant demographics and SPSS statistical findings including tables, figures, charts or graphs appropriate to the statistical test used. Students and DNP CSP Chairs are encouraged to review Chapter 5 and section 2.07 in the APA Manual (2010) for additional information (p. 32) with visual samples on pp, 52-53. Chapter V. Discussion This chapter describes the implications, limitations, sustainability, application to the DNP Essentials and dissemination of the project and its results. Implications. This section describes what the results of this project mean in relation to future practice. Are the results statistically and/or clinically significant? In Clinical Scholarly Project Handbook 08-06-2018: tch & bw 20 what way/s? Will the results of the project support the body of evidence existing in its call for change? In what way/s? Supporting Evidence for Advanced Practice Registered Nursing. In this section, describe the key role APRNs can play in the improvement in practice related to the specific problem at hand. Limitations. The limitations are those characteristics of the project that may constrain generalizability, internal and/or external validity. The two most common limitations are related to small sample size and time constraints of the project. Sustainability. Describe the plan/s to keep the practice change going (or not)? Include the necessary costs and stakeholder buy-in to sustain your findings. Dissemination. This subsection tells how the project results will be distributed for others to read, understand support and utilize the practice change. Additional plans may include presenting results to stakeholders, submitting an abstract to a peer-review journal, presenting at a local APRN or national conference (poster, podium, armchair discussion, etc.), among other scholarly or leadership activities. Application to the Essentials. Begin with an overall description of what the DNP Essentials (AACN, 2006) are and then write 3 to 4 specific paragraphs for the top 3 or 4 Essentials that were met while engaging in the CSP. XII. Writing the DNP CSP White Paper (sample template found in Appendix J) The following is a guideline for the five recommended chapters of a white paper: DNP CSP White Paper Chapters I-V: A Closer Look Introduction The introduction sets the stage for the specifics of the argument and begins with a global setting in which the problem exists. It then systematically moves to the specific problem being addressed. The introduction provides an overview of the subject area or general problem and provides the reader with a context for the proposed argument for practice change. The introduction is typically 1-2 pages maximum. Chapter I: Background and Significance Chapter I of the white paper will include an in-depth description of the overall problem being addressed. Most white papers will need to include the following subsections: Background and Significance, Assessment of the Phenomena (Problem Statement), Historical and Societal Perspective, Incidence and Prevalence, Healthcare Cost, and introduction of PICOt question that will provide keywords for the literature search. The specific order of these subsections will ultimately depend on the type of white paper being researched and Clinical Scholarly Project Handbook 08-06-2018: tch & bw 21 presented. Despite its importance, Chapter I is generally no more than 10 pages in length. Background and Significance. The background section of Chapter I provides the research foundation leading to the problem and purpose statements. This section presents the most relevant pieces of research (with citations in APA [2010] format) that describes the overall problem being investigated and current solutions that support the white paper argument. This section is usually 2-4 pages in length. Assessment of the Phenomena (problem statement). The underlying justification and greater need for a change should be discussed in this section. After reading this section, the reader should know precisely why the white paper is being written and be convinced of the argument’s importance. Historical and Societal Perspective. This section provides an in-depth examination of the historical events that have led to the current issue and attempts to provide insight and clarity as to what changes have been made for improvement in the past. It should also address the societal impact and views that have contributed to the current state of practice. The student should also present different social angles in order to describe the depth and breadth of the overall situation in an attempt to support the comprehensive solution if applicable. Incidence and Prevalence. This section can be brief and precisely discuss what the title suggests: What is the incidence and prevalence of the problem at hand? It is important to make sure the reader knows the problem needs solving and the plan of action involves evidence-based research. Healthcare Cost. The cost of healthcare is a complicated matter. In this section, the student will examine the past cost burdens and how it is part of the white paper argument, if applicable. Summary. This is where the student summarizes the previous background information and leads the reader to understand how the PICOt question was developed. Chapter II. Literature Review Introduction of PICOt Question This introduction to the literature review chapter describes what a PICOt question is, what the elements mean (i.e., P = population, I = intervention, etc.) and how it informed the key words that guided the literature search for a solution to the identified problem. The first paragraph should conclude with the actual PICOt question that guided the literature review. The next paragraph should describe the data bases used (i.e., PubMed, CINAHL, Cochrane Library, etc.) and what was found using the keywords identified from the PICOt question. Include the number of articles found and the specific themes. Next, talk Clinical Scholarly Project Handbook 08-06-2018: tch & bw 22 about how they keywords may have been refined to identify and locate research specifically relevant to the proposed solution to the problem. Finally, discuss the number of articles chosen that support the argument for change. Synthesis of the Literature. Subheadings can be used to identify each of the themes or categories. Subheadings also organize the material into shorter, more easily comprehensible blocks of information for the reader. Transitions from one theme or category to another should be smooth and appropriate. In the review of the literature, the main theories, explanations, and findings that are generally accepted and represented in the literature should be presented along with contradictory evidence and points of view that may have caused intellectual tension in the field. Comparisons and contrasts among cited works are important. Unless an article presents a landmark study, the research should have been conducted and/or published within the past 5 years. At the conclusion of Chapter II, a final section should be included that summarizes the literature a coherent manner. Contradictions should also be highlighted. The significance of the proposed argument, in light of the reviewed research, should be emphasized. The readers should feel that the review of the literature has yielded new insights and suggested a direction for change in the chosen issue. Theoretical Framework For this section, use the nursing theory you identified in NURU 600 or one that you are familiar with and whose concept and/or framework supports and/or informs your CSP or white paper. Remember that your choice of theory should be a best fit of nursing practice with the outcome of your CSP or white paper argument. As you learned in class a nursing or other complementary discipline’s theory may be used. In the first paragraph, give a summary of your theory. You may even wish to include a figure to visually explain the concept or frame work. The next paragraph should explain how it informs your CSP or white paper. It should include your purpose for using this specific theory (i.e., is it for quality patient care, to improve a system or process, to frame a CSP study or white paper, to educate patients, providers, interprofessional group, to inform administrators or politicians, to justify a change, etc.). A final paragraph should summarize your salient points and the section should be limited to 2 pages maximum. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 23 Chapter III. Argument for the Proposed Change Introduction The introduction of this section begins with a restatement of the argument and specific solution/s. The rationale for the argument is also restated and should be sufficiently explanatory and detailed to enable the readers to understand the proposal solution. Overview. In this section, the student will give a step-by-step account of what will be done, in what order, how, and by whom. Here the student will include the physical activities he or she will participate in to support the argument change. Examples of activities may include, but are not limited to: • Community and/or Specialty focus group/s • Stakeholder/s town hall/s • Visit/s to legislator/s • Meeting/s with healthcare facility administrators Students who chose to complete a white paper must account for a minimum of 255 of the total 510 hours engaged in face-to-face activities. Population. This section should include the population/stakeholders that will be affected by the change. It provides a description of characteristics of the population chosen and the process used to select them as the recipients of the change (identified in the literature review). Leaders/stakeholders responsible for implementing the change should also be described. Process. Using the Titler, et al. (2001) Iowa Model of Evidence-Based Practice to Promote Quality Care or other change model, describe the process used to support the change including environment, population and cost. All conceptual models should be included in an appendix to the white paper. Change analysis. Explain how the change will be measured and analyzed for success. Chapter IV. Discussion This chapter describes the plan barriers and limitations of the proposed change and solutions to overcome the limitations of the change, including how the proposed change will be sustained. Subsections titles should include: Barriers and limitations. Sustainability. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 24 Chapter V. Dissemination and Application to the DNP Essentials This final chapter tells how the white paper will be published for others to read, understand and support it. In a separate section the application of meeting the DNP Essentials are also addressed. Dissemination. This subsection tells how the white paper will be published for others to read, comprehend and support. Additional plans may include presenting the practice change to stakeholders, politicians, community leaders or healthcare providers if applicable. Application to the Essentials. Begin with an overall description of what the DNP Essentials (AACN, 2006) are and then write 3 to 4 specific paragraphs for the top 3 or 4 Essentials that were met while engaging in the white paper activities. XIII. Guidelines for the Oral Defense Once the date has been confirmed with the DNP Support Specialist, the DNP Support Specialist will complete the top portion of the DNP CSP Grading Rubric and email a .pdf copy to the Chair to include as an attachment in the DNP CSP Defense announcement on the Brandman University Microsoft Office Calendar using the following instructions and formatting: Clinical Scholarly Project Handbook 08-06-2018: tch & bw 25 Under the details section, the title of the event should be: DNP CSP (or White Paper) Defense for Name of Student. The location box should contain the following Adobe room link: https://brandman.adobeconnect.com/_a1107013947/dnp_project_defenses/ The start and End dates and times should be filled in based on the approved date and time confirmed by the DNP Support Specialist. The Time Zone should always be set to Pacific Time (US & Canada). In the Add an Agenda section and using the template below complete the following information and click “Save:” DNP Clinical Scholarly Project Defense The Title of the Student’s Defense Student’s Name Date: Day of Week, Date Time: XX a.m. PST/XX p.m. MST/XX p.m. CST/XX p.m. EST Location: http://brandman.adobeconnect.com/dnp_project_defenses/ Conference Call: 866.526.3019 Code: 5997756134 CSP Chair: Dr. CSP Chair’s Name The oral defense will conducted in the aforementioned Adobe Connect virtual classroom. Students are required to use both audio and video portions within Adobe Connect to present their work. The defense is recorded and will be made available to the student. Required members attending the presentation include the CSP Chair, outside preceptor/mentor, committee member(s), the Dean or the Dean’s Designee and at least 2 other DNP-prepared faculty. Other participants may include additional faculty, students, colleagues, family and other guests. DNP CSP (or White Paper) PowerPoint Recommended Guidelines for the DNP CSP Defense PPT (all slides and formatting to be approved by the CSP Chair; guidelines found below). Plan on approximately 1 minute per slide. Some make take less time and others will be longer (i.e., your title slide will only take 10 to 15 seconds and only 5 seconds per each Reference/s slide, but your literature review may take 90 seconds): Clinical Scholarly Project Handbook 08-06-2018: tch & bw 26 Label Slide 1 with: -Title of CSP (or White Paper) -Student Name -Brandman University Label Slides 2-3: Problem Statement -Summarize background and significance including a general statement of problem -Highlight historical and society perspectives (if applicable) -Include incidence and prevalence among specified or general population -Summarize healthcare cost/s to patients and/or the community -Provide a transition slide of how the overall problem literature led the student to start the project (or White Paper argument) and development of the PICOt question Label Slide 4: PICOt (pronounced PEA’ kō) -Write out the PICOt question including the identification of each element in parentheses (P, I, C, O, t) -Discuss the key words used for the literature search that supported/investigated the CSP (or White Paper argument for a practice change) Label Slides 5-7: Literature Review -Identify the data bases search and number of articles found and any necessary changes to the key words to narrow the search -Provide an evidence synthesis (common themes and 4-6 key articles that support the CSP (or White Paper argument) Label Slide 8: CSP Objective (or White Paper Argument) -Give a brief statement of what you expected to find as your final outcome (or the expected change/outcome from your White Paper argument) Label Slides 9-10: Theoretical Framework -Provide a summary of theoretical framework (may include diagram) -Explain the application to CSP (or White Paper argument) Label Slides 11-13: Methodology -Include steps involved in participant (or White Paper focus group) recruitment; -Steps involved in intervention (or White Paper activities) -Steps involved in data analysis (or steps needed to implement White Paper practice change) Label Slides 14-16: Findings -Provide SPSS results (or impact of White Paper practice change) including: -Participant demographics (or population influenced by White Paper practice change) -Summary of statistical findings (or measurement of White Paper practice change) -Summary of statistical findings (or measurement of White Paper practice change) Label Slides 17-19: Implications -Provide statistical or clinical significance -Connection to literature search (does it match what other author’s found) -Application to APRN practice Clinical Scholarly Project Handbook 08-06-2018: tch & bw 27 Label Slide 19: Limitations -Describe the limitations of the CSP and recommendations for future studies (or obstacles to White Paper practice change and recommendations to remove barriers) Label Slide 20: Sustainability -Describe the cost to keep the practice change going -Describe the plan/s to keep the practice change going (or not) -Include all needed stakeholder buy-in Label l Slide 21: Plan/s for Dissemination Label Slide 22: Application to DNP Essentials -DNP Essentials (highlight 3 or 4 essentials maximum as the most applicable) Label Slide 23: Acknowledgements (optional) Label Slides 24-26: References -Should be in APA Format Label Slide 27: Thank you and Questions Recommended Timing for CSP Defense in Adobe Connect (all times are approximate): Introduction of Student by Chair (1 – 2 minutes) CSP PPT Defense Presentation (18 – 20 minutes*) *Students who exceed 20 minutes will be noted during faculty deliberations; students who exceed 30 minutes will be asked to discontinue their presentation and reschedule. Audience Questions (5 – 10 minutes) Candidate and Guests are excused (1 – 2 minutes) Faculty Discussion and Deliberations (5 – 10 minutes) Candidate recalled and determination given (1 – 2 minutes) (30 to 45 minutes total) Faculty will use the following rubric, which will be distributed to attending faculty via the DNP CSP Chair attached to the MS Office Defense invitation (please see Section XIII. Guidelines for the Oral Defense above) to evaluate a DNP candidate’s oral defense (also found in Appendix K): Clinical Scholarly Project Handbook 08-06-2018: tch & bw 28 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 29 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 30 If a student has not completed the CSP and project defense by the end of DNPU 708 and the Project Chair deems that satisfactory work is progressing, a student will be given a grade of satisfactory progression (SP). All students who have not completed their CSP will be enrolled in additional 8-week extension session as necessary (DNPU 799), until they have successfully completed the project requirements within the seven year rule. The grade issued for DNPU 799 is always a “P,” unless there is an Academic Integrity violation review or as directed by the Dean or Dean’s Designee. XIV. Guidelines for Library Submission of Project Manuscript or White Paper The final step for the DNP CSP is for the student to electronically submit the project manuscript to the Brandman University Leatherby Library. The student will follow the Musco School of Nursing and Health Professions (MSNaHP) DNP Clinical Scholarly Project Manuscript Library Submission. The MSNaHP requires students to provide an electronic online submission to the library. Step 1 – Visit the Chapman/Brandman Leatherby Library for rules and guidelines for submission. Chapman University / Brandman University Dissertation / Thesis Guidelines http://www1.chapman.edu/library/info/rules/ThesisGuidelines.html Step 2 – Download the MSNaHP DNP CSP manuscript library submission checklist (Appendix G). Marybelle and S. Paul Musco School of Nursing and Health Professions DNP Clinical Scholarly Project Manuscript Library Submission Checklist https://my.brandman.edu/teams/msnahp/Dr%20Smiths%20Documents%20for%20PM%2 0to%20DNP/Clinical%20Scholarly%20Project/Library%20Submission%20Checklist%2 0for%20DNP%20CSP%20Product.pdf Step 3 – Revise the DNP CSP manuscript per library submission guidelines and have it reviewed by the DNP CSP Chair for Accuracy Step 4 – Complete the Library Format Submission Checklist (Appendix G) to be eSigned by both the student and the Chair (failure to complete this step may result in repeated requests for signatures and submissions to the library). Step 5 – Submit manuscript for signatures to: DNP CSP Chair, Committee Member/s (if applicable), PM-DNP Program Director (if applicable) and MSNaHP Dean. Step 6 – Submit manuscript to the Leatherby Library, along with the eSigned Library Format checklist for acceptance and receipt of approval email. Step 7 – Forward approval email to DNP CSP Chair, who will change the DNPU 708 grade from “SP” to “P” if all other requirements for a passing grade have been met*. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 31 Please note: Students may apply for degree conferment with their Academic Advisor only after providing the Library Submission Email Confirmation to the student’s Clinical Scholarly Project Chairperson and Academic Advisor. *DNP CSP Chairs: Please see Appendix H and/or the MSNaHP Faculty Manual for how to submit a grade change. Thank you! Clinical Scholarly Project Handbook 08-06-2018: tch & bw 32 References American Association of Colleges of Nursing (AACN). (2006). Clinical scholarship and analytical methods for evidence-based practice. In AACN, The essentials of doctoral education for advanced nursing practice. Washington D.C.: Author. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf American Psychological Association (APA). (2010). Publication manual (6th ed.). Washington D.C.: Author. American Nurses Association. (2012). Frequently asked questions about the doctorate of nursing practice. Retrieved from http://www.nursingworld.org/DNPFAQ Shen, Q. (2009). Case study in contemporary educational research: Conceptualization and critique. Cross-cultural Communication, 5(4), 21-31. Retrieved from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact =8&ved=0CB4QFjAA&url=http%3A%2F%2Fwww.cscanada.net%2Findex.php%2Fccc %2Farticle%2Fdownload%2Fj.ccc.1923670020090504.003%2F769&ei=wz7U5_4AcrloATG54DgCw&usg=AFQjCNFWGxJ51_uQz_nITMwlAFZmcIynw&bvm=bv.74035653,d.cGU Zaccagnini, M. E., & Waud-White, K. (2013). The doctor of nursing practice essentials: A new model for advanced practice nursing. Sudbury, MA: Jones and Bartlett. 08-09-2018: tch & bw 33 Appendix A DNPU 706 Formal Project Proposal Week 8 Assignment Outcomes Synthesis Proposal — Signature Assignment Points: 300 American Association of Colleges of Nursing: DNP Essentials: I, II, III, IV, VI, VII Course Learning Objectives: 1-6 Purpose: To develop students’ plans for outcomes measurement and cost effectiveness analysis related to the DNP project, and its relationship to the quality movement at the national level. Please read the assignment in its entirety prior to initiating the activity. Directions: This assignment is the final assignment in the course. It is an outcomes synthesis portfolio summarizing how the concepts, processes, and procedures studied during the course have been synthesized and applied to an evidence-based practice project. The portfolio is the equivalent of a 12-15 page paper (not counting the abstract or references). The paper will apply a style similar to that described for methodological articles in the APA Publication Manual (6th ed., p. 10-11). However, it will be prepared as an ePortfolio using a template in LiveText. Go to LiveText to find the template instructions, an example, and the rubric. Go to https://c1.livetext.com/c1_help/for_students/ to get help in how to prepare a professional portfolio, paste from Word into the LiveText template, insert images into the LiveText template, and submit a completed template for grading. Although students will have discussed their projects on the discussion boards and collaborated with classmates during the design and conduct of the project, this final assignment is not a group project. It should be written by the student as an individual project and reflect the student’s unique perspective and method of expression. The ePortfolio will have 10 sections: 1. Abstract – (120 to 200 words) 2. Statement of the Problem – Explanation of the question that will be answered by the project (200 to 400 words) 3. Background and Significance – Brief overview of the evidence base for the project and the impact of a successful project (300 to 500 words) 08-09-2018: tch & bw 34 4. Systems Context – Brief overview of the organizational system within which the project will be conducted – describe how stakeholders will be involved in the project and what feedback loops will be used to sustain stakeholder involvement and support (200 to 400 words) a. Attach an illustration/diagram of the system 5. Definition of Clinical, Satisfaction, and Cost Outcomes – Description of each major outcome that will be used to appraise the success of the project and how it contributes to answering the question (75 to 125 words per outcome) a. Attach a data collection plan (table) 6. Methods of Measuring Clinical, Satisfaction, and Cost Outcomes – Description of each metric that will be used to measure each major outcome and what is known about its reliability and validity (100 to 200 words per outcome) 7. Implications of Outcomes for Quality Management – Explanation of how the outcomes relate to current local, regional, or national QM initiatives (300 to 700 words) 8. Ethical Balance – Description of ethical choices addressed in project design (300 to 500 words) 9. Sustainability Plan for Translating Evidence into Practice – Explanation of how a successful project would be translated into a sustainable change in practice (300 to 700 words) 10. References The portfolio will be graded using the following rubric Criteria Exemplary – 4 Proficient-3 Developing-2 Emerging-1 Introduction 12 points (48/300) Clear and concise introduction of CSP. Adequate introduction of CSP. Unclear description of introduction of CSP. No description of introduction of CSP. Review of the Literature and Theoretical Framework 25 points (100/300) Insightful review of the literature and theoretical framework. Some effort to review the literature and theoretical framework. Limited review the literature and theoretical framework. No review the literature and/or theoretical framework. Design and Methods 25 points (100/300) Insightful and detailed description of proposed design and methods. Adequate description of proposed design and methods. Limited description of proposed design and methods. No description of potential proposed design and methods. APA Format and Style 13 points (52/300) Excellent flow throughout presentation; clear and engaging style Presentation well organized and delivered smoothly Limited description of proposed design and methods. Flat, unconvincing presentation 08-09-2018: tch & bw 35 Appendix B DNPU 710 Individualized Learning Plan DNPU 710 Individualized Learning Plan and Timeline for DNP CSP or White Paper Completion (CLOs 1-3) Students will work with their CSP Chairs to complete an approved individualized Learning Plan. Evaluation on the achievement of expected outcomes may be reviewed in weeks 3, 5, 7 and 8 and/or as needed. A sample Learning Plan is presented below: Student Name: DNP CSP Chair: Date: Learning Objective: Complete DNP CSP or White Paper BUIRB submission, manuscript, PPT for defense, create a poster presentation for a professional nursing conference or send letter of inquiry to peer reviewed journal, Leatherby Library acceptance per formatting requirements, etc. Actions Target Date Date Complete 1. ILP will be completed by…. XX/XX/XX XX/XX/XX 2. ILP will be reviewed per the DNP CSP Student/Chair Meeting table during weeks/session/s… XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX 3. BUIRB Application, Action Plan and Attachments folder will be completed by… XX/XX/XX XX/XX/XX 4. BUIRB MSNaHP Pre-Review will be completed by… XX/XX/XX XX/XX/XX 5. BUIRB Submission will be completed by… XX/XX/XX XX/XX/XX 6. BUIRB Acceptance Email will be received by… XX/XX/XX XX/XX/XX 7. CSP data collection or White Paper activities will be completed by… XX/XX/XX XX/XX/XX 8. Manuscript will be completed by… XX/XX/XX XX/XX/XX 9. PPT Defense Presentation will be completed by… XX/XX/XX XX/XX/XX 10. Defense Presentation will be completed by… 11. Poster presentation in preparation for a national conference or abstract submission to a national journal will be completed by… XX/XX/XX XX/XX/XX 12. All manuscript or white paper eSignatures will be received by… XX/XX/XX XX/XX/XX 13. Leatherby Library acceptance per formatting requirements will be received by… XX/XX/XX XX/XX/XX 14. Other XX/XX/XX XX/XX/XX 08-09-2018: tch & bw 36 1. Criteria for Success: Student will complete ILP and meeting table during meeting scheduled with DNP CSP Chair in Week 1 by the noted due date 2. Criteria for Success: Student and DNP CSP Chair will meet per the table determined in 1 above and make adjustments to the ILP as needed 3-6. Criteria for Success: BUIRB paperwork will be completed, submitted x2 (MSNaHP pre-review and BUIRB) and with approval received by noted due date 7. Criteria for Success: All activities related to the DNP CSP (e.g., intervention, data collection and analysis, etc.) or White Paper (e.g., town hall meetings, legislators, health care administration, etc.) will be completed by noted due date 8. Criteria for Success: A completed manuscript or white paper will be completed by the noted due date 9-10. Criteria for Success: The PPT presentation of the DNP CSP or White Paper will be completed and successfully defended by the noted due date 11. Criteria for Success: A professional poster, abstract or 2-page recommendation/s for improved results dissemination submitted with a response by… 12. Criteria for Success: The DNP CSP Manuscript or White Paper with all eSignatures in place will be received by noted due date 13. Criteria for Success: A Leatherby Library acceptance email will be sent to the DNP CSP Chair be the noted due date 14. Criteria for Success: Other as determined by DNP CSP Chair and student EXAMPLE EVALUATIONS: 1-2. Evaluation: Initial DNP CSP Chair and student meeting was held and the ILP and meeting table was completed. DNP CSP Chair sent MS Outlook calendar invitations to student per noted time/s and date/s 3-6. Evaluation: A completed BUIRB Application , Action Plan and Attachments were approved by the noted due date 7. Evaluation: All activities related to the DNP CSP (e.g., intervention, data collection and analysis, etc.) or White Paper (e.g., town hall meetings, legislators, health care administration, etc.) were completed by noted due date 8. Evaluation: A completed manuscript or white paper was completed by the noted due date 9-10. Evaluation: The PPT presentation of the DNP CSP or White Paper was completed and successfully defended by the noted due date 11. Criteria for Success: A professional poster, abstract or 2-page recommendation/s for improved results dissemination was submitted with a response by the noted due date 12. Criteria for Success: The DNP CSP Manuscript or White Paper with all eSignatures in place was completed by the noted due date 13. Criteria for Success: A Leatherby Library acceptance email was sent to the DNP CSP Chair on the noted due date 14. Criteria for Success: Other as determined by DNP CSP Chair and student 08-09-2018: tch & bw 37 DNP CSP Student/Chair Meetings Student Name: ______________________________________Session:__________________ *Repeat table below as necessary for additional sessions (fall 1, fall 2, etc.). Student Signature: __ Date: Chair/Mentor eSignature: Date: _______________ *Meeting Wk Date Notes/Progress/Revisions 1 2 3 4 5 6 7 8 08-09-2018: tch & bw 38 Appendix C Affiliation Agreement 08-09-2018: tch & bw 39 Appendix D DNPU 707, 709 or 711 DNP CSP Clinical Hour PROPOSAL Clinical Scholarly Project Residency Hours PROPOSAL (Objectives 1 & 3) Students will work with their DNP CSP Chair to identity activities related to the completion of their DNP project to account for 255 unique clinical scholarly project (CSP) hours. 1. Using the SAMPLE table format listed below, cut and paste a copy into a new word document and save it as Last name_First name_CSP hour PROPOSAL (Ex: Hanisch_Tyke_CSP hour PROPOSAL) 2. Next, meet with your chair and please fill in the categories that you and your chair agree upon as relevant to your CSP. (*Hint: Using your Moran (2013) text may help you identify appropriate DNP CSP activities) 3. Using the AACN (2006) DNP Essentials, also determine which Essential is being met by your activity, noting that you may not meet all of the Essentials in this course 4. Once you have completed the word doc proposal with your chair: a. Remove the SAMPLE watermark b. Delete this first page of directions c. Save it as a .pdf copy as identified above (Last name_First name_CSP hour PROPOSAL [Ex: Hanisch_Tyke_CSP hour PROPOSAL]). 5. Email the .pdf copy to your Chair and please have him or her eSign the document in the designated box and return to you so that you can upload the PROPOSAL to BB for review by the DNPU 711 instructor (*Note: you will repeat this process in week 8, using the same format, by adding dates and changing the word Proposal to LOG to verify the proposed hours you have identified on this form). 40 Musco School of Nursing and Health Professions CSP Residency Hours PROPOSAL DNPU 711 – Clinical Residency (255 hours) Student Name_____________________________________________ Date: _____________ CSP Chair_______________________ e-signature: Institution Clinical Preceptor Description of Activity AACN DNP Essentials Expected Hours Mercy Hospital APRN Jane Doe, DNP Attended EBP conference for determining the best evidence for CSP Essential I 10 Mercy Hospital APRN Jane Doe, DNP Attended facility meetings for CSP design and plan; include interdisciplinary team Essential II, Essential VI 40 Mercy Hospital APRN Nancy Nurse, DNP Meet with hospital administrators and Risk Management for preapproval of DNP CSP Essential II 20 Brandman University BUIRB CSP Chair Preparation of BUIRB documents Essential I 40 Mercy Hospital IRB Hospital IRB Committee Preparation of hospital IRB documents Essential I 40 Mercy Hospital Risk Management Sam Spade, DNP Develop and implement a point-of-care clinical reference resource Essential VIII 100 Brandman University Statistician Data Analysis Essential III 50 Mercy Hospital Prepare and present findings to hospital administration to change hospital policy and procedure Essential IV, Essential VIII 20 Total = 320 hours 41 Appendix E DNPU 707, 709 or 711 DNP CSP Clinical Hour LOG Clinical Scholarly Project Residency Hours LOG (Objectives 1 & 3) 1. Using your word document copy of your PROPOSAL table, change the word PROPOSAL to LOG 2. Next change the word Expected to Completed in Column 5 3. Then add a Dates column (OR cut and paste the entries into the table below) 4. Next, contact your chair and review the number of hours in your proposal; change any of the actual number of hours you completed (may be more or less) 5. Remove this first page of directions AND the last 2 pages of how to insert a .pdf document 6. Save as a word doc as Last name_First Name_CSP Hour LOG (EX: Kerr_Linda_CSP Hour LOG 7. Finally save the document as a .pdf and send it to your Chair 8. Please have him or her eSign the document and return to you so that you can upload the PROPOSAL to BB for review by the instructor AND *insert a copy of the .pdf into your final paper as Appendix B (a copy of your .pdf LOG will be inserted as Appendix A). *Directions on how to insert a .pdf into a word doc are found on the last page of these directions. 42 Musco School of Nursing and Health Professions CSP Residency Hours LOG DNPU 711 – Clinical Residency (255 hours) Student Name_____________________________________________ Date: _____________ CSP Chair_______________________ e-signature: Institution Clinical Preceptor Description of Activity AACN DNP Essentials Completed Hours Date/s (range & future dates okay) Mercy Hospital APRN Jane Doe, DNP Attended EBP conference for determining the best evidence for CSP Essential I 10 01-30-2018 Mercy Hospital APRN Jane Doe, DNP Attended facility meetings for CSP design and plan; include interdisciplinary team Essential II, Essential VI 40 02-2018 through 05-2018 Mercy Hospital APRN Nancy Nurse, DNP Meet with hospital administrators and Risk Management for preapproval of DNP CSP Essential II 20 02-2018 through 05-2018 Brandman University BUIRB CSP Chair Preparation of BUIRB documents Essential I 40 06-20187 through 07-2018 Mercy Hospital IRB Hospital IRB Committee Preparation of hospital IRB documents Essential I 40 06-2018 through 07-2018 Mercy Hospital Risk Management Sam Spade, DNP Develop and implement a point-of-care clinical reference resource Essential VIII 100 02-2018 through 07-2018 Brandman University Statistician Data Analysis Essential III 50 11-2018 Mercy Hospital Prepare and present findings to hospital administration to change hospital policy and procedure Essential IV, Essential VIII 20 11-2018 through 12-2018 Total = 320 hours 43 Appendix F Guidelines for BUIRB Completion and SAMPLE CSP On-line Application Word Application DNP SAMPLE Template Institutional Review Board Part 1 – Administrative Information This form is to be used for requesting IRB review of any new project. IRB approval is required before any research involving human subjects may be initiated. Full details must be provided and all necessary documentation submitted. Brandman University is committed to safeguarding the rights and welfare of all people who participate in research conducted by Brandman faculty and students. Brandman University supports responsible experimentation which promises to increase knowledge and understanding, and encourages the highest ethical standards among Brandman researchers. The central aim of the BUIRB is to protect the rights of human participantsin research studies, including their rightsto give informed consent and to have their safety protected from undue risk. The BUIRB has the responsibility and authority to review and approve all research projects by Brandman faculty and students involving human or animal participants. It will approve only research that conformsto the professional standards as understood within the relevant discipline. The BUIRB Application becomesthe researcher’s record of compliance with laws and regulations protecting the rights and welfare of human participants in research described in the Department of Health and Human Services (DHHS) regulations 45 CFR 46, as specified in the Office for Protection from Research Risks (OPRR) 1983 report on Protection of Human Subjects. Institutional Review Board Application IMPORTANT: Please respond to all the questions. Do not leave any items blank. Responding to each question on this application fulfills one of the requirementsfor the ethical conduct of researchers. If a question does not pertain to your study, indicate not applicable (NA) following the question. Do not delete or modify questionsfrom this application. Please note that incomplete applications will be returned without review. 44 Part 1A: Research Information Research Information Researcher’s Assurance: I certify that the information provided in this application is complete and correct. I understand that as principal researcher, I have ultimate responsibility for the conduct of the study, adherence to ethical standards, and protection of the rights and welfare of human participants. I agree to: (1) Conduct the study according to the approved protocol; (2) Make no changes to the approved study without prior IRB approval; (3) Use the approved procedure and form(s) for obtaining informed consent; and, (4) Promptly report any significant adverse events to the IRB within five working days of occurrence. Part 1B: Application Information Title of proposed research study: A Quality Improvement Intervention to Improve the Effectiveness of Diabetic Patient SelfManagement Goal Rates by Primary Care Providers through Implementation of an Electronic Medical Record Documentation Tool Type of Review Requested: ☐ Exempt Review: As defined in 45 CFR 46, there are six exemptions to the regulatory requirements described in section 46.101(b) of 45 CFR 46. See BUIRB Research Review Policy for “exempt” review requirements. ☒ Expedited Review: Surveys considered minimal risk; research on individual or group behavior or characteristics where research does not cause stress to subject and confidentiality is maintained; research involving deception that poses no more than minimal risk; performance of non-invasive tests; collection of data using noninvasive procedures; collection of blood samples by finger stick or venipuncture by trained personnel; research using existing documents, records, pathological specimens, or diagnostic specimens. 45 ☐ Full BUIRB Review: Research with greater than minimal risk; research of a sensitive nature; research with vulnerable populations (children, prisoners, pregnant women, mentally disabled, elderly individuals, non-English or English as second language speakers, or economically/educationally disadvantaged individuals); research involving invasive procedures; research inducing physical pain or potential injury. Type of Research: ☐ Institutional Research ☒ Graduate Research ☐ Undergraduate Research Principal Researcher Position: ☐ Faculty ☒ Doctoral Student ☐ Master’s Student ☐ Brandman Staff Member ☐ Non Brandman Researcher Principal Researcher’s College Affiliation: ☐ Arts and Sciences ☐ Business and Professional Studies ☐ Education ☒ Nursing and Health Professions Category that applies to your research: ☐ Doctoral Dissertation ☐ Master’s Thesis ☐ Faculty Professional/Academic Research ☐ Course Project ☒ DNP Clinical Scholarly Project Part 2 – Study Design, Methods and Procedures Provide a summary of the study, including the purpose and research questions: Purpose: To determine if implementation of an electronic medical record (EMR) documentation tool will result in a change in primary care provider documentation rates of patient defined selfmanagement goals for their diabetic patients. 46 PICOt question: Will implementation of a new EMR tool designed to aid documentation of patient defined self-management goals (I) change the documentation rates of these goals (O) by primary care providers in a CRMC clinic (P) compared to prior standard of care charting (C)? Summary: This project will evaluate primary care providers’ adherence to a standard of care related to documentation of adult diabetic patient self-management goals. The American Diabetes Association (ADA) publishes revised standards of care annually and the 2014 standards of care reaffirm the health benefits and cost effectiveness of lifestyle modifications through patient centered healthy lifestyle goal attainment. The Centers for Disease Control and Prevention (CDC) also strongly advocate for collaborative patient-centered lifestyle modifications in the Diabetes Prevention Program (2017). The long-term follow up of the Diabetes Prevention Program Outcomes Study (DPPOS) has demonstrated the effectiveness of lifestyle modification through high quality randomized control trials (CDC, 2017). An abundance of evidence supporting both the health outcome and cost-effectiveness of lifestyle modifications is a central component of emerging healthcare delivery models. The United States Department of Health and Human Services (USDHHS) is funding a five-year pay-forperformance quality improvement program throughout the state of California (2016). This program is titled the Delivery System Reform Incentive Program (DSRIP). The DSRIP specifies numerous outcome-based healthcare measures that are tied to specific dollar rewards for reaching specific measureable population health goals. Collaborating with patients to identify, monitor, reassess, and refine self-management goals for diabetic patients are one of the DSRIP goals. Currently, the primary care clinics of a large County Regional Medical Center (CRMC) does not have a standardized HER method documentation of patient self-management goals. Adding a patient self-management goal tool in the EMR will act as a clinical reminder for providers to identify, assess, and reassess patient self-management goals. Over time, assessment of self-management goals will become a routine part of the provider-patient interactions. The outcomes for the diabetic patients treated in the CRMC clinics as self-management goals will be a central part of each patient’s plan of care to improved outcomes. Additionally, this project will result in leaving a permanent documentation tool in place that will provide the clinics with an ongoing reevaluation process that produces reliable evidence of their patient self-management goal documentation. Describe briefly how this study will contribute to existing knowledge in the field: This quality improvement project will contribute to existing knowledge by demonstrating the effectiveness of improving crucial documentation through implementation of a target specific documentation tool into the existing EMR. Specifically, it will demonstrate rates of change in documentation of information that is clearly linked to real-world quality improvement and healthcare outcomes. This quality improvement project will also analyze the effectiveness of provider adoption of new EMR clinical tools. 47 Description of Human Subjects Target Population Primary Care Providers (Physicians, Physician Assistants and Nurse Practitioners) in a County Regional Medical Center. Number of Participants or Sample Size Twenty to thirty providers. Characteristics of Population Males and females of various ethnic backgrounds, with varied years of experience. Specify Age of Subjects Adults, 21 years-of-age and older. Do your subjects include any of the following: ☐ Pregnant women/neonates ☐ Minors ages seven through seventeen ☐ Infants or children younger than seven years of age ☐ Cognitively impaired ☐ Inmates or prisoners ☐ Elderly/aged persons ☐ Non-English speaking persons ☐ Economically or socially disadvantaged ☐ Adults with physical or mental disabilities ☐ Patients ☐ Other special populations targeted in the study protocol ☒ None of the Above Recruitment Specify how you will gain access to, recruit and select your subjects? Describe when, where and how participants will be contacted. How will potential participants be initially identified? From what sources will participants be identified, i.e., school, business, health care, law enforcement, non-profit organization, etc. Attach letters or email from all organizations on official letterhead granting permission or IRB approval from the organization. Attach all recruitment documents i.e., flyers, brochures, bulletin boards, media, electronic media, social media, etc. Formatted: Font color: Red 48 This quality improvement project does not require any recruitment of subjects. A random sampling of the clinic’s diabetic population charts will be reviewed for presence or absence of self-management goal documentation. The clinic providers at the CRMC teaching hospital based clinics are already fully informed participants of ongoing quality improvement projects as a regular and usual part of their practice in the teaching hospital setting. The proposed project is fully supported by the clinic’s chief of staff, and the clinic administration. The proposed chart review does not constitute any unusual or elevated level of scrutiny above the standard level of review of the provider’s documentation. The Chief of Family Medicine has the project and intent to fulfill the USDHHS initiative. Enthusiastic support for the proposed project has been received by the providers and clinic administration. Data Collection In-person Interview In-person Questionnaire Observation Mail Survey/Questionnaire Telephone Survey/Interview Experimental Procedure Biometric Data Archival Data Electronic Survey Audio/Video Recording Analysis Focus Group Interview Standardized/Educational Test List all instruments, assessments, tests, questionnaires, interviews or other materials developed specifically for this research. If no special assessments were developed and used in this study, state “non- applicable” or NA . In Part 6 of this application, attach copies of any materials listed here, and attach verification of permission to use the materials in this research. Participant Data Collection Form List the titles of all instruments, assessments, tests, questionnaires, interviews or other materials developed commercially or by a third party. If no commercially developed materials were used in this study, state “non-applicable” or NA. In Part 6 of this application, attach copies of any materials listed here, and attach verification of permission to use the materials in this research. PHQ-9 Webb Brilliance Assessment Tool Describe in detail and in sequence the study procedures that involve human participants, including tests, treatments and research interventions This quality improvement project has five basic phases: 1. Determine baseline self-management goal documentation rates and impl 49 EMR tool designed to assist in documentation of self-management goals 2. Obtain a random sampling of the CRMC Family Care Clinic’s diabetic population records, to be reviewed to determine whether or not a provider has documented selfmanagement goals for that patient. 3. Deliver a provider education program explaining the new EMR tool for documentation of diabetic patient self-management goals 4. Repeat sampling and evaluate implementation rate comparison. 5. Disseminate results to all CRMC stakeholders within the clinic and hospital system through staff and USDHHS Delivery System Reform Incentive Payment (DSRIP) meetings. Are you offering payment or other inducements to participants in this study? ☒ No ☐ Yes Describe the amount of the payment or inducement and how it will be received. Will participation in the study involve any cost to the participant? ☒ No ☐ Yes If yes, indicate the anticipated costs and rationale. Part 3 – Risks and Benefits Please select all of the potential risks that are involved in your study. ☐ Use of private records (such as educational or medical records) ☐ Manipulation of psychological or social state such as sensory deprivation, social isolation, psychological stress ☐ Probing for personal or sensitive information in surveys or interviews such as private behaviors or employer assessments ☐ Presentation of materials which some participants may consider sensitive, offensive, threatening or degrading ☐ Possible invasion of privacy of subject’s family ☐ Social or economic risk (reputation, cultural, employability, etc.) ☐ Identification of child, spousal, or elder abuse ☐ Identification of illegal activity ☐ Risk of injury or bodily harm ☒ None of the Above Please indicate other risks in the field provided above. What level of risk does this research present to dignity, rights, health, welfare, or privacy of the participants? ☒ Less than Minimal Risk to Participants – Justify your rating below 50 ☐ Minimal Risk to Participants – Justify your rating below ☐ More than Minimal Risk to Participants – Explain and specify risks below Describe the steps that will be taken to minimize risks or harms and to protect the welfare of participants. Include a description of how you will handle an adverse or unexpected outcome that could be potentially harmful against any risk. Minimal risk is expected. However, there may be an emotional reaction to perceived individual practice feedback. In the event that this occurs, the CRMC Medical Director will be called in for consultation and reassurance that the results will be reported in aggregate only. Describe any benefits that individuals may reasonably expect from participation. If there are none, state “None.” As a result of the use of the reminder in the EMR, it is anticipated that providers will include this within their visit/s with their patients leading to improved evidence-based practice. Since the literature supports that diabetic patient self-management goal setting leads to better disease management, it is further expected that this will lead to improved patient outcomes. Describe any anticipated benefits of this study to society, academic knowledge or both. This study will provide information related to a gap in the literature regarding the meaningful use of EMRs for documentation beyond standard of care. Publishing the results will fill a part of that gap and also meets one of the Healthy People 2020 Objective D-14: Increase the proportion of persons with diagnosed diabetes who receive formal diabetes education (USDHHS, 2016) and will benefit society by reducing health care costs in those patients who learn about, practice and meet self-management goals. Part 4 – Privacy and Confidentiality Will you or any member of your research team collect or have access to any of the personal identifiers listed below? Select all that apply. ☒ Name ☒ Date of Birth ☐ Mailing or email address ☐ Phone numbers ☐ Social Security number ☐ Medical records ☒ License ☐ IP address ☐ Photos/images/audio recording ☐ Signatures, handwriting samples ☐ N/A 51 Any unique identifier not mentioned above: Gender, Race/Ethnic group; Years in Practice and years in current practice at the clinic. Describe the procedures for how the subject’s privacy will be maintained during the study. What provisions have been made to protect the confidentiality of participants? Where will you securely store data and research records? How will you dispose of signed consent, data and research records after the research is completed? While there are no participant’s in this study, any provider demographics and collected data from the electronic medical records will be stored on a password protected laptop computer, accessible only by the principle investigator. Disposal of the recorded information will be deleted at the end of the study. Findings will only be reported in the aggregate, in compliance with HIPAA, IRB and other clinic protocols. Part 5 – Consent Process Include any of the following attachments applicable to this application: Informed Consent The entire informed consent process involves giving a subject adequate information concerning the study, providing adequate opportunity for the subject to consider all options, responding to the subject’s questions, ensuring that the subject has comprehended this information, obtaining the subject’s voluntary agreement to participate, and continuing to provide information as the subject or situation requires. Identify and describe the procedures you will use to obtain Informed Consent. Attach a copy of the informed consent form in Part 6 (see Brandman University requirements and Sample Informed Consent form) and include the script of oral explanations. Include any Informed Consent forms required by other participating organizations. ☐ Consent Required: Participant informed consent required ☐ Consent Required: Written assent for children and individuals under 18 ☐ Consent Required: Parent/Guardian permission for children and individuals under 18 ☒ Consent not required Write Informed Consent Procedures While written consent is not required since this is a Quality Improvement Project and Providers have signed a general release to the clinic to participate in such activities, however, all providers attended an information session, where the project plan was introduced and an opportunity was given for any questions to be answered. Part 6 – Attachments Include your NIH Certificate (found at https://phrp.nihtraining.com/users/login.php) and any of the following attachments applicable to this application: 52 • Consent/Assent Forms (All parental/guardian consent forms, Information sheets for Waiver of Consent, Internet Consents, Verbal Consent scripts, etc.) • Screening Materials (Demographic questionnaires or measures used in screening subjects for inclusion or exclusion) • Site Permission/Support Letters (Letters form agency or organization granting permission – on official letterhead) • Recruitment Materials • Data Collection Instruments (Questionnaires, copyrighted tests, focus group questions, interview questions, scripts, etc.) Part 7 – Assurance I agree: • To comply with all BUIRB policies, decisions, conditions and requirements. • This study protocol has been designed, to the best of my knowledge, to protect human participants engaged in research in accordance with the applicable principles, policies, regulations, and laws governing the protection of human subjects in research. • To obtain prior approval from the BUIRB before amending the research protocol or the approved consent/assent form. • To report to BUIRB any adverse event(s) and/or unanticipated problem(s) involving risks to participants. • To submit the Annual Review Form as needed. ☒ I have completed the NIH Certificate and included a copy with the proposal. [Please Check NIH Certificate box.] Researcher’s Typed Signature: Dora N. Proposal Date: 01-21-2018 53 Appendix G Leatherby Library Checklist for Manuscript/White Paper Formatting (fillable template available at: http://chapman.libguides.com/ld.php?content_id=35720472) 54 55 Appendix H Directions on How to Change a Grade in Banner Here are the step-by-step directions to change a grade by faculty, when students have successfully completed their coursework: 1. Access the Grade Change landing page through the Banner Faculty link 2. Enter the students i.d. (B00——) number and hit TAB 3. The student’s information will populate and you will want to scroll down to REQUEST INFORMATION section. 4. Looking at the TERM LEGEND, identify the term that the course was taken. 5. Use the drop down arrow on the “Session when enrolled in course:” box and click on the term code so it appears in the box. 6. Next, scroll down and click on QUERY FOR COURSES link. 7. After the program brings up the courses for that session, you will be able to click on the drop down arrow in the “Please select a course from the list” box. 8. Select the course and when you scroll down, the information about the grade and instructor will populate. 9. Data enter the new grade and a description that states that the student has completed all work to earn a “P” grade (or other grade if you are changing a grade for a letter grade course in the future) 10. Click on submit and you will see a page that shows all grade changes that you have submitted. 11. Look for a confirmation email that states that you have submitted a grade change. It may take up to 24 hours to get the grade to change and another 24 hours for the grade change to show on the student’s Degree Works audit, but they are even quicker about it on most days. 56 Appendix I Sample DNP CSP Manuscript (fillable template found at: http://chapman.libguides.com/ld.php?content_id=37639438) Full Title of Clinical Scholarly Project A Clinical Scholarly Project by John Q. Student Brandman University Marybelle and S. Paul Musco School of Nursing and Health Professions Irvine, California Submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice Month and Year of Manuscript Submission Committee in charge: Firstname Lastname, Chair, Credentials Firstname Lastname2, Credentials Firstname Lastname3, Credentials 57 The Clinical Scholarly Project of John Q. Student is approved. D _______________________________________ D ________________________________________ D _______________________________________ _ Month and Year of Defense 58 Full Title of Clinical Scholarly Project Copyright © 2018 (year of submission) by John Q. Student 59 ACKNOWLEDGEMENTS (optional page) Insert all your acknowledgement text here. 60 ABSTRACT Full Title of Clinical Scholarly Project by John Q. Student Abstract text goes here. Double spaced. No more than 250 words. Keywords: Listed here using semi-colon between words and no italics 61 TABLE OF CONTENTS (optional page) Chapter 1 1 Subheading 1.1 2 Subheading 1.2 3 Chapter 2 10 Subheading 2.1 11 Subheading 2.2 13 References 75 Appendices 76 62 Chapter 1 Here is some sample text to begin your chapter. If you wish to start a new chapter, you can either copy and paste the above chapter heading into the appropriate place and then adjust the text, or insert a new chapter heading by clicking the “Title” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.1 To add additional subheadings to your chapter, you can either copy and paste the above subheading to the appropriate place and then adjust the text, or insert a new subheading by clicking the “Subtitle” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.2 Once you are done adding new subheadings, be sure to go to the References tab above, then click “Update Table” on the Table of Contents tab to update your Table of Contents. You may need to manually readjust the spacing between chapters in your Table of Contents after doing this. 1 63 Chapter 2 Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nulla malesuada, massa quis posuere laoreet, nunc neque convallis diam, sagittis auctor nibh eros in eros. Integer dignissim elit quis ante efficitur, nec condimentum purus laoreet. Interdum et malesuada fames ac ante ipsum primis in faucibus. Donec pretium ante vel justo volutpat, commodo venenatis mi eleifend. Cras non ultricies lacus. Vivamus lacinia molestie semper. Nunc ullamcorper vulputate tortor, iaculis blandit nisi rhoncus sit amet. Maecenas facilisis quis enim id malesuada. Aenean vitae cursus nisl. Praesent interdum a velit venenatis eleifend. Vestibulum ac mi a lorem tincidunt tincidunt. Subheading 2.1 Nunc convallis leo ac blandit rhoncus. Curabitur convallis, urna ac porttitor interdum, ipsum nulla facilisis odio, in consequat ante magna porta risus. Fusce aliquet turpis sapien, in lobortis mi feugiat nec. Phasellus porttitor magna rutrum ligula efficitur lobortis. Nunc lacus lectus, sagittis non risus at, blandit feugiat orci. Suspendisse posuere nisl ac efficitur pellentesque. Aliquam malesuada, est sed condimentum convallis, metus purus egestas tortor, et blandit ante dui at nisi. Vivamus et arcu augue. Vivamus ligula ante, dictum ac erat sit amet, tincidunt consectetur justo. Suspendisse viverra nisl id hendrerit lacinia. Quisque metus orci, feugiat quis justo maximus, dignissim suscipit dolor. Suspendisse leo nulla, tincidunt sed interdum eget, sollicitudin a orci. Vestibulum vel eros ipsum. Quisque euismod turpis et laoreet laoreet. Pellentesque sem purus, eleifend vitae dapibus id, consequat quis ligula. Maecenas id imperdiet augue. Phasellus est orci, eleifend a dolor at, varius consectetur dolor. Mauris vel arcu vel libero gravida molestie ac sed odio. Phasellus id tempus velit, nec ultricies ante. Nam at iaculis est, vitae gravida augue. Etiam turpis leo, tristique quis 64 nisl id, sodales porta tellus. Cras aliquet erat eu odio porttitor vulputate vel sed magna. Ut et dapibus magna. Mauris eget justo non magna venenatis vulputate. Vivamus vitae sollicitudin lacus, quis tempus neque. Subheading 2.2 Etiam faucibus nisl ligula, molestie porta diam suscipit quis. Sed ut interdum diam, sed bibendum ipsum. Donec fermentum ultrices odio, at porta lectus accumsan nec. Nulla eleifend ex non faucibus tempor. In purus nisi, consequat in sodales non, varius sit amet diam. Nulla facilisi. Duis aliquet mi eget ante venenatis, nec feugiat lectus vestibulum. Ut eget mollis orci. Duis elit ipsum, dictum vitae odio vel, imperdiet maximus tortor. Vestibulum placerat rutrum diam, et consectetur lacus luctus in. Aliquam sem enim, volutpat ac malesuada eget, vulputate id tortor. Ut mi ligula, tincidunt sit amet condimentum a, eleifend sit amet tellus. Nulla venenatis sapien nunc, in malesuada enim tincidunt sed. Donec vel vestibulum nulla. 65 References 66 Appendix A Title of Appendix in Correct Upper and Lower Case Words 67 Appendix B Title of Appendix in Correct Upper and Lower Case Words 68 Appendix J Sample White Paper Template (fillable template found at: http://chapman.libguides.com/dissertations) Full Title of White Paper A White Paper by John Q. Student Brandman University Marybelle and S. Paul Musco School of Nursing and Health Professions Irvine, California Submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice Month and Year of Manuscript Submission Committee in charge: Firstname Lastname, Chair, Credentials Firstname Lastname2, Credentials Firstname Lastname3, Credentials 69 The White Paper of John Q. Student is approved. D ________________________________________ D ________________________________________ D Month and Year of Defense 70 Full Title of White Paper Copyright © 2018 (year of submission) by John Q. Student 71 ACKNOWLEDGEMENTS (optional page) Insert all your acknowledgement text here. 72 ABSTRACT Full Title of White Paper by John Q. Student Abstract text goes here. Double spaced. No more than 250 words. Keywords: Listed here using semi-colon between words and no italics 73 TABLE OF CONTENTS (optional page) Chapter 1 1 Subheading 1.1 2 Subheading 1.2 3 Chapter 2 10 Subheading 2.1 11 Subheading 2.2 13 References 75 Appendices 76 74 Chapter 1 Here is some sample text to begin your chapter. If you wish to start a new chapter, you can either copy and paste the above chapter heading into the appropriate place and then adjust the text, or insert a new chapter heading by clicking the “Title” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.1 To add additional subheadings to your chapter, you can either copy and paste the above subheading to the appropriate place and then adjust the text, or insert a new subheading by clicking the “Subtitle” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.2 Once you are done adding new subheadings, be sure to go to the References tab above, then click “Update Table” on the Table of Contents tab to update your Table of Contents. You may need to manually readjust the spacing between chapters in your Table of Contents after doing this. 1 75 Chapter 2 Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nulla malesuada, massa quis posuere laoreet, nunc neque convallis diam, sagittis auctor nibh eros in eros. Integer dignissim elit quis ante efficitur, nec condimentum purus laoreet. Interdum et malesuada fames ac ante ipsum primis in faucibus. Donec pretium ante vel justo volutpat, commodo venenatis mi eleifend. Cras non ultricies lacus. Vivamus lacinia molestie semper. Nunc ullamcorper vulputate tortor, iaculis blandit nisi rhoncus sit amet. Maecenas facilisis quis enim id malesuada. Aenean vitae cursus nisl. Praesent interdum a velit venenatis eleifend. Vestibulum ac mi a lorem tincidunt tincidunt. Subheading 2.1 Nunc convallis leo ac blandit rhoncus. Curabitur convallis, urna ac porttitor interdum, ipsum nulla facilisis odio, in consequat ante magna porta risus. Fusce aliquet turpis sapien, in lobortis mi feugiat nec. Phasellus porttitor magna rutrum ligula efficitur lobortis. Nunc lacus lectus, sagittis non risus at, blandit feugiat orci. Suspendisse posuere nisl ac efficitur pellentesque. Aliquam malesuada, est sed condimentum convallis, metus purus egestas tortor, et blandit ante dui at nisi. Vivamus et arcu augue. Vivamus ligula ante, dictum ac erat sit amet, tincidunt consectetur justo. Suspendisse viverra nisl id hendrerit lacinia. Quisque metus orci, feugiat quis justo maximus, dignissim suscipit dolor. Suspendisse leo nulla, tincidunt sed interdum eget, sollicitudin a orci. Vestibulum vel eros ipsum. Quisque euismod turpis et laoreet laoreet. Pellentesque sem purus, eleifend vitae dapibus id, consequat quis ligula. Maecenas id imperdiet augue. Phasellus est orci, eleifend a dolor at, varius consectetur dolor. Mauris vel arcu vel libero gravida molestie ac sed odio. Phasellus id tempus velit, nec ultricies ante. Nam at iaculis est, vitae gravida augue. Etiam turpis leo, tristique quis nisl id, sodales porta tellus. Cras aliquet erat eu odio porttitor vulputate vel sed magna. Ut et 76 dapibus magna. Mauris eget justo non magna venenatis vulputate. Vivamus vitae sollicitudin lacus, quis tempus neque. Subheading 2.2 Etiam faucibus nisl ligula, molestie porta diam suscipit quis. Sed ut interdum diam, sed bibendum ipsum. Donec fermentum ultrices odio, at porta lectus accumsan nec. Nulla eleifend ex non faucibus tempor. In purus nisi, consequat in sodales non, varius sit amet diam. Nulla facilisi. Duis aliquet mi eget ante venenatis, nec feugiat lectus vestibulum. Ut eget mollis orci. Duis elit ipsum, dictum vitae odio vel, imperdiet maximus tortor. Vestibulum placerat rutrum diam, et consectetur lacus luctus in. Aliquam sem enim, volutpat ac malesuada eget, vulputate id tortor. Ut mi ligula, tincidunt sit amet condimentum a, eleifend sit amet tellus. Nulla venenatis sapien nunc, in malesuada enim tincidunt sed. Donec vel vestibulum nulla. 77 References 78 Appendix A Title of Appendix in Correct Upper and Lower Case Words 79 Appendix B Title of Appendix in Correct Upper and Lower Case Words 80 Appendix K MSNaHP DNP CSP Cover Sheet and Rubric for Oral Defense MSNaHP DNP CSP Rubric for Oral Defense -COVER SHEETStudent Name: ____________________________________ Date: ________________________ Title of project: ________________________________________________________________ ______________________________________________________________________________ Project White Paper Other: _________________________________ Project Chair: ______________________ Reviewer: ___________________________________ Recommendation: Pass Pass with revisions No pass i3 Award Category: N/A Inquire Innovate Inspire Additional Comments: ___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Student Name: __________________________________ Date: ________________________ Project Chair: _____________________ Reviewer: ________________________ 81 MSNaHP DNP CSP Rubric for Oral Defense MSNaHP DNP CSP Rubric for Oral Defense Content (as applicable) Exemplary (4) Proficient (3) Developing (2) Emerging (1) Comments and Points Awarded 1. Description of problem 2 points (8/100) Clear and concise Adequate and supported Incomplete or inaccurate Inappropriate or missing 2. PICOt 2 points (8/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 3. Lit review analysis 4 points (16/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 4a. CSP summary, including method, objectives and theoretical framework 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing -OR- 4b. Clear description of Position and activity 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 5a. Statistical methods, demographics and results 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing -OR- 5b. Clear description of argument against 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 6a. Implications (clinical significance, limitations, etc.) 2 points (8/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing -OR- 6b. Impact (social, health, financial, etc.) 2 points (8/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 7. Sustainability of outcomes and recommendations 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 8. Synthesis and application of the AACN Essentials (maximum of 3) 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 9. Plans for dissemination 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate 82 *Student must obtain 80% of the total points to pass the oral defense (i.e., 80/100)* Presentation Exemplary (4) Proficient (3) Developing (2) Emerging (1) Comments and Points Awarded 1. Organization: Logical sequence; easily followed 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 2. PPT Appearance: Clear and professional font and graphics with correct APA format 1 point (4/100) Professional appearance with no visible errors Adequate appearance with minor errors Irregular font and/or other visible errors Inappropriate or poor format with obvious errors 3. Presentation Skill: Voice 1 point (4/100) Audible and Clear Minor errors or areas of confusion Multiple errors or inaccurate information Inarticulate 4. Professional Image 1 point (4/100) Professional Casual Disheveled Inappropriate 5. Knowledge: Answers additional question/s with clear and concise elaboration 1 point (4/100) Clear and concise answers Adequate answers Incomplete or inaccurate answers Inappropriate or unable to answer 6. Time: Maintained time limit of 20 minutes 1 point (4/100) ≤15 minutes <10 minutes or >20 <7 minutes or >25 <5 minutes or >30 Total: _____ 83 Appendix L PPT Template for DNP CSP Manuscript Defense template for dnp csp oral defense brandman.potx 84 Appendix M PPT Template for DNP White Paper Defense template for dnp csp white paper brandman.ppt

PICOt: Hemodialysis Nurses (P), who walk three times a week (I), compared to usual care (C) decrease depression by 3 points on PHQ9 Scale (O), within 6 weeks (t).

08-06-2018: tch & bw Doctorate of Nursing Practice (DNP) Clinical Scholarly Project (CSP) Handbook 2018-2019 08-06-2018: tch & bw Message from the Dean Welcome to the Musco School of Nursing and Health Professions! We realized that you did not make the decision to return to school lightly; to subject yourselves to the rigors of doctoral education coursework will be a challenge and we appreciate that you have chosen Brandman University! Our task is to provide you with the tools to become innovative and evidence-based practitioners for best patient outcomes, no matter where you are providing care. The one thing we would like you to please remember is that we are all nurses at the heart of whatever we do. The American Nurses Association (ANA) tells us that a doctorate of nursing practice (DNP) educates “nurses for enhanced clinical roles, leadership roles, management and teaching, health policy, and areas of specialization such as integrative health and healing” (ANA, 2012, p. 1), but we know that becoming doctorally-prepared is much more than that. We are answering the call of the Affordable Care Act (ACA) to meet the needs of our patients as primary care providers, while advancing our profession as expert clinicians and health policy leaders (ANA, 2012). Please enjoy your journey, embrace evidence-based change for best patient outcomes and become the best nurse practitioners you can be. Inquire, innovate and inspire others to do the same. Wishing you great success in the completion of your clinical scholarly project experience and please feel free to contact me with any challenges you encounter and to share your “aha” moments and successes. Thank you again for choosing Brandman University and welcome aboard! Warm regards, Clinical Scholarly Project Handbook 08-06-2018: tch & bw 1 Table of Contents I. Introduction……………………………………………………………………………………..3 II. Mission, Vision and Core Values………………………………………………………..4 III. Accreditation, Memberships and DNP Program Essentials…………………..5 IV. DNP Program Learning Outcomes…………………………………………………….6 V. Purpose of the Clinical Scholarly Project……………………………………………8 VI. Overview of the Clinical Scholarly Project Process………………………………8 VII. Clinical Scholarly Project Chair…………………………………………………………8 VIII. Guidelines for CSP Timeline………………………………………………………………9 IX. Clinical Scholarly Project Committee…………………………………………………13 X. Clinical Scholarly Project Progression……………………………………………….13 XI. Writing the DNP CSP Manuscript……………………………………………………..15 XII. Writing the DNP CSP White Paper…………………………………………………….19 XIII. Guidelines for the Oral Defense…………………………………………………………23 XIV. Guidelines for Library Submission of Project Manuscript……………………28 References……………………………………………………………………………………….30 Appendices………………………………………………………………………………………31 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 2 List of Appendices Appendix A: DNPU 706 Formal Project Proposal…………………………………..33 Appendix B: DNPU 710 Individualized Learning Plan……………………………..35 Appendix C: Affiliation Agreement………………………………………………….38 Appendix D: DNPU 707, 709 or 711 DNP CSP Clinical Hour PROPOSAL……….39 Appendix E: DNPU 707, 709 or 711 DNP CSP Clinical Hour LOG……………….41 Appendix F: Guidelines for BUIRB Completion and On-line Application………..43 Appendix G: Leatherby Library Checklist for Manuscript Formatting…………..53 Appendix H: Directions on How to Change a Grade in Banner……………………55 Appendix I: Sample DNP CSP Manuscript Template……………………….,….….54 Appendix J: Sample White Paper Template…………………………………………66 Appendix K: DNP CSP Cover Sheet and Rubric for Oral Defense…………………80 Appendix L: DNP CSP PPT Template……………………….…………………………83 Appendix M: DNP White Paper PPT Template……………..………….………….……84 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 3 I. Introduction A student in the Brandman University (BU) Musco School of Nursing and Health Professions (MSNaHP) Doctorate of Nursing Practice (DNP) program is required to complete an evidence-based Clinical Scholarly Project (CSP). The CSP is a faculty-guided, scholarly experience that provides confirmation of the student’s critical thinking abilities and the application of research principles to a clinical problem. The student will typically identify a problem, propose a solution, implement an intervention and evaluate the proposed solution. This manual offers a guide to the successful completion of doctoral-level CSP, as defined by the American Association of the Colleges of Nursing (AACN) (2006) Essentials for Doctoral Education in Nursing Practice: The final DNP project produces a tangible and deliverable academic product that is derived from the practice immersion experience and is reviewed and evaluated by an academic committee. The final DNP product documents outcomes of the student’s educational experiences, provides a measurable medium for evaluating the immersion experience, and summarizes the student’s growth in knowledge and expertise. The final DNP product should be defined by the academic unit and utilize a form that best incorporates the requirements of the specialty and the institution that is awarding the degree. Whatever form the final DNP product takes, it will serve as a foundation for future scholarly practice (p. 20). Clarifications to the DNP Project are addressed in the AACN (2015) The Doctor of Nursing Practice: Current Issues and Clarifying Recommendations white paper: Scholarly Product: The product of the DNP Project may take on various final forms depending on the academic institution’s requirements and the student’s area of advanced nursing practice. Programs are encouraged to support innovation in the design and dissemination of the final project and product to reflect the changing healthcare environment; the elements of the DNP Project should be the same for all students and include planning, implementation, and evaluation components. As an outcome of the program, students must have the opportunity to integrate all DNP Essentials into practice, though not all Essentials have to be demonstrated within the DNP Project. However, all DNP Projects should: a. Focus on a change that impacts healthcare outcomes either through direct or indirect care. b. Have a systems (micro-, meso-, or macro- level) or population/aggregate focus. c. Demonstrate implementation in the appropriate arena or area of practice. d. Include a plan for sustainability (e.g. financial, systems or political realities, not only theoretical abstractions). e. Include an evaluation of processes and/or outcomes (formative or summative). 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. f. Provide a foundation for future practice scholarship (p. 4). Clinical Scholarly Project Handbook 08-06-2018: tch & bw 4 The Difference between a Doctor of Philosophy (PhD) Dissertation and a DNP Scholarly Project Currently, there are two recognized terminal degree programs in nursing: a researchfocused and practice-focused doctorate. Most research-focused doctoral level nursing programs culminate in a Doctor of Philosophy (PhD) degree, whereas practice-focused doctoral study most often results in a Doctor of Nursing Practice (DNP) degree. The focus of the PhD dissertation is to utilize all components of the research process to generate new knowledge, whereas the primary focus of the DNP clinical scholarly project consists of using newly generated or interpreted evidence to improve practice or patient outcomes. In the following paragraph, the AACN (2006) discusses differences between the PhD dissertation and the DNP scholarly project: …practice-focused programs understandably place greater emphasis on practice, and less emphasis on theory, meta-theory, research methodology, and statistics than is apparent in research-focused programs. Whereas all research-focused programs require an extensive research study that is reported in a dissertation or through the development of linked research papers, practice focused doctoral programs generally include integrative practice experiences and an intense practice immersion experience. Rather than a knowledge generating research effort, the student in a practice-focused program generally carries out a practice application-oriented ‘final DNP project,’ which is an integral part of the practice experience (p. 3). II. Mission, Vision and Core Values The mission of MSNaHP is to provide dynamic education that focuses on inquiry and innovative practice relevant to an ever-changing healthcare system. Vision As leaders of healthcare change, our graduates will embrace the spirit of inquiry to identify evidence-based strategies, create innovative solutions and inspire others while optimizing patient care. • To that end, clinical scholarly projects are expected to go beyond the stated requirements and exceed in each of these three ideals. Exemplary projects are nominated by DNP CSP chairs and are voted on by faculty to receive one of three outstanding i 3 awards, which are presented at the MSNaHP pinning and hooding ceremony in the spring of each academic year. Core Values • Respect – Respect for each other, our students, our communities, and the environment. • Integrity – Our personal and professional behavior is guided by honesty, ethics and conscience. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 5 • Teamwork – By supporting each other, we can accomplish more than what is possible individually. • Service-Orientation – Through instruction and guidance we serve the needs of our students with knowledge and skills, putting others before ourselves. • Innovation – We value new, viable ideas and rigorously promote them. III. Accreditation, Memberships and DNP Program Essentials Accreditations: Brandman University is accredited by: *Western Association of Schools and Colleges (WASC) The Musco School of Nursing and Health Professions is accredited by: *Commission on Collegiate Nursing Education (CCNE) for: Bachelor of Science in Nursing (BSN) Doctor of Nursing Practice (DNP). *California Board of Nursing for: Continuing Education Credit Units (CEUs). Memberships: *American Association of Colleges of Nursing *California Association of Colleges of Nursing *National League for Nursing *National Organization of Nurse Practitioner Faculty *Western Institute of Nursing Clinical Scholarly Project Handbook 08-06-2018: tch & bw 6 IV. DNP Program Learning Outcomes (PLOs): AACN (2006) Essentials of Doctoral Education for Advanced Nursing Practice I. Scientific underpinnings for practice Recognizes the philosophical and scientific underpinnings essential for the complexity of nursing practice at the doctoral level. II. Organizational and systems leadership for quality improvement and system thinking Recognizes the competencies essential for improving and sustaining clinical care and health outcomes, eliminating health disparities, and promoting patient safety and excellence in care. III. Clinical scholarship and analytical methods for evidence-based practice Recognizes competencies essential for translation of research into practice, evaluation of practice, practice improvement, and the development and utilization of evidencebased practice. IV. Technology and information for the improvement and transformation of patient-centered health care Recognizes competencies essential to manage, evaluate, and utilize information and technology to support and improve patient care and systems. V. Health care policy for advocacy in health care Recognizes the responsibility nurses practicing at the highest level have to influence safety, quality, and efficacy of care, and the essential competencies required to fulfill this responsibility. VI. Interprofessional collaboration for improving patient and population health outcomes Recognizes the critical role collaborative teams play in today’s complex health care systems and the competencies essential for doctoral prepared nurses to play a central role on these teams. VII. Clinical prevention and population health for improving the nation’s health Recognizes nursing’s longstanding focus on health promotion and disease prevention within the context of current national calls for all health educators to respond to the changing needs of the population and include this content in curricula. VIII. Advanced Nursing Practice Recognizes the essential competencies reflective of the distinct, in-depth knowledge and skills that form the basis for nursing practice at the highest level regardless of practice role. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 7 References American Association of Colleges of Nursing (AACN). (2006, October). Essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf American Association of Colleges of Nursing (AACN). (2015, August). The doctor of nursing practice: Current issues and clarifying recommendations. Retrieved from http://www.aacn.nche.edu/aacn-publications/white-papers/DNP-Implementation-TFReport-8-15.pdf National Organization of Nurse Practitioner Faculty. (2008). The consensus model on APRN regulation: Licensure, accreditation, certification and education. Retrieved from http://www.nonpf.org/associations/10789/files/APRNConsensusModelFinal09.pdf National Task Force on Quality Nurse Practitioner Education. (2012). Criteria for evaluation of nurse practitioner programs. Retrieved from http://www.nonpf.org/resource/resmgr/docs/ntfevalcriteria2012final.pdf Clinical Scholarly Project Handbook 08-06-2018: tch & bw 8 V. Purpose of the Clinical Scholarly Project The purpose of the CSP is to integrate the knowledge and skills achieved in the DNP program to identify evidence-based strategies, create innovative solutions and inspire others while optimizing patient care. The project culminates with a formal written manuscript and/or white paper, and an oral defense of the project. VI. Overview of the Clinical Scholarly Project Process The CSP is a demonstration of a student’s the ability to obtain, analyze/synthesize and utilize research literature in a scholarly process. The CSP follows a logical sequence beginning with the development of a Problem or Population, Intervention, Comparison and Outcome with optional time (PICOt) question to identify keywords to be utilized in an exhaustive literature. The results are critically appraised and synthesized to identify evidence-based studies that support approaches to the problem and determines the focus and format of the CSP. Activities related to the foundational literature search that informs the CSP may include: • Collection of appropriate and accurate data to generate evidence for nursing practice; • Analysis of data from clinical practice; • Selection of interventions based on evidence; • Prediction and analysis of outcomes; • Identification of gaps in evidence for practice; • Selection of data analysis method/s relevant to intervention • Evaluation criteria of collected data and findings to determine and implement best practices. A chair is then assigned and the student and CSP Chair develop a timeline for completion. Timeline and Method of Evaluation The CSP timeline is designed so the student completes the project as he/she progresses through DNPU coursework. The timeline for completion may vary depending upon such factors as: • Individualized Education Plan • Implementation timing due to CSP residency placements • Other factors as identified VII. Clinical Scholarly Project Chair The role of the CSP chair is to mentor, guide and support the student in the development and implementation of the CSP. The doctorally-prepared Chair is assigned from Brandman MSNaHP full-time or adjunct faculty. The selection is based upon the student’s CSP topic and faculty interest/area of expertise. The CSP chairs are responsible for: Clinical Scholarly Project Handbook 08-06-2018: tch & bw 9 • Providing primary guidance and feedback to the student throughout manuscript development, project completion and preparation for the final oral presentation/defense in consultation with other committee members, when applicable • Assisting in the selection of committee members, when applicable • Determining when drafts of the manuscript are ready for submission to committee members for their review, when applicable • Assisting with BUIRB and facility (prn) preparation and submission • Reviewing drafts and final manuscript for eSignature approval by committee members and the Dean • Referring the student to the Brandman Online Math and Writing Center (OMWC https://www.brandman.edu/current-students/resources/online-writing-community) or a professional editor for assistance with scholarly writing, APA (2010) and/or other formatting needs • Scheduling the DNP CSP oral defense • Reviewing and approving the manuscript per Leatherby Library checklist before submission to committee members and the Dean for final eSignature • Submitting final “P” DNPU 708 grade to Banner Most students will have CSP Chair assigned at the end of DNPU 706 – Transforming Healthcare through Outcome Management, based on faculty availability. The student and the Chair will complete a written timeline as part of his or her Individualized Learning Plan (ILP) (Appendix B) by the end of the following session. The ILP may be amended at any time based on mutual agreement of the student and Chair and will be formally reviewed in DNPU 710. VIII. Guidelines for CSP Timeline The following table can be used as a guideline for students, faculty and CSP Chairs as they progress through the program: Table 1 CSP Timeline Course CSP Benchmark CSP Chair Responsibilities DNPU 704 – Evidence-Based Thinking for Scholarship and Practice • Completion of Chapter I: Background and Significance • Development of PICOt. • Academic and professional guidance for Chapter II PICOt, Literature Review and Evidence Synthesis. • N/A DNPU 703 – Leading through Innovation • Continued academic and professional guidance for manuscript Chapter II. • N/A Clinical Scholarly Project Handbook 08-06-2018: tch & bw 10 DNPU 702 – Innovation in Technology and Information Access • Continued academic and professional guidance for manuscript Chapter II. • Submit title of DNP CSP Project or White Paper to instructor to forward to DNP Support Specialist for Chair Assignment • N/A DNPU 706 – Transforming Healthcare through Outcomes Management • Design study implementation plan • Propose data collection plan • Review manuscript and refer to OMWC as needed (https://www.brandman.edu/whybrandman/dedicated-resources/academicsupport/online-writing-and-math-center) • Initial meeting with student, review DNPU 706 formal project proposal (Appendix A) • Using the DNPU 710 Individualized Learning Plan (ILP), develop a DNP CSP timeline (Appendix B) to set up future meetings and CSP milestones via Blackboard, phone, videoconference, or in person. • Complete an affiliation agreement (Appendix C) and submit to the clinical coordinator for processing • Review Chapters 1-2 and refer to OMWC for writing assistance if needed DNPU 701 – Biostatistics for Clinical Practice • Review and improve data collection plan • Draft of Chapter III: Methodology and refer to OMWC as needed for writing and/or statistical assistance (https://www.brandman.edu/whybrandman/dedicated-resources/academicsupport/online-writing-and-math-center) • Complete agreed upon meetings per ILP by phone, videoconference or in person Review and approve Chapter III: Methodology and refer to OMWC for writing or statistical assistance if needed. DNPU 700 – Health Care Policy, Organization and Delivery • Continue data collection • Identify potential meetings for abstract submission • Identify potential peer reviewed journals for manuscript submission • Complete agreed upon meetings per ILP as needed by phone, videoconference or in person DNPU 705 – Health Communications • Continue data collection • Complete agreed upon meetings per ILP as needed by phone, videoconference or in person Clinical Scholarly Project Handbook 08-06-2018: tch & bw 11 DNPU 710 – Seminar in Evidence-Based Thinking for Scholarship and Practice • Complete, submit and receive approval from BUIRB (https://irb.brandman.edu/Pages/Home.as px) • Review ILP and revise as necessary • Complete one meeting per week with each student by phone, videoconference or in person as needed • Review and approve BUIRB application (Appendix F) and submit to MSNaHP IRB prereview representative at least 1 month prior to BUIRB meeting date • Upload MSNaHP preapproved BUIRB application 2 weeks prior to BUIRB meeting date • Assign a “P” grade for DNPU 710 if BUIRB application, action plan and required attachments are approved by BUIRB • Assign a “SP” grade for DNPU 710 if IRB application, action plan and required attachments are not submitted or approved by BUIRB (please see Appendix H for how to change the SP grade to a P when all course requirements are met). DNPU 707 – Clinical Residency I & DNPU 709 – Clinical Residency II OR DNPU 711– Clinical Residency for BSN-DNP or PM-DNP adding Specialty • Begin and complete CSP implementation activities • Begin data analysis and synthesis as needed • Review ILP and revise as necessary • Complete agreed upon meetings per ILP as needed by phone, videoconference or in person as needed • eSign CSP clinical hours PROPOSAL (Appendix D) and forward to instructor in DNPU 707, 709 or DNPU 711 • eSigned CSP clinical hours LOG (Appendix E) and forward to instructor of DNPU 707, 709 or DNPU 711 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 12 • Provide statistics referral as needed (OMWC) • Review and approve Chapter IV: Results • Review application of DNP Essentials I-XIII to CSP in preparation of Chapter V: Discussion DNPU 708 – Application of DNP Clinical Scholarly Project • Complete manuscript and oral defense • Submit letter of inquiry to peer review journal and/or national conference if indicated • Submit completed manuscript to TurnItIn to validate academic integrity • Submit eSigned manuscript AND eSigned checklist to BU Leatherby Library (http://chapman.libguides.com/dissertations) • Complete a minimum of one meeting per week with each student by phone, videoconference or in person as needed • Verify submission of CSP manuscript to TurnItIn • Assist in preparation of PPT for defense (guidelines for PPT found in Section XIII) • Schedule and attend DNP CSP defense • Review CSP manuscript applying Leatherby Library formatting checklist (Appendix G) • Review, approve and eSign final manuscript • Forward final manuscript to Dean for eSign • Assign a “P” grade for DNPU 708 upon Leatherby Library acceptance email forwarded by student • Assign a “SP” grade for DNPU 708 if all of the above benchmarks are not met by the end of the 8- week session (please see Appendix H for how to change the SP grade to a P when all course requirements are met). It is important to remember that while the DNP student and CSP Chair team is a collaborative arrangement, the student is ultimately responsible for successfully completing the CSP in a timely manner. This includes all related coursework, IRB approval/s, initiating appropriate affiliation agreements, conducting data collection and analysis, preparing the final manuscript and oral defense presentation. If, at any time, the student or project chair feels that their working relationship is no longer productive, Clinical Scholarly Project Handbook 08-06-2018: tch & bw 13 either party may initiate a request for a Chair reassignment through a petition submitted through the student’s Academic Advisor or by the chair through the MSNaHP DNP Support Specialist. A new chair will be assigned based on faculty availability. *It is highly recommended that the student completes his or her manuscript PRIOR to setting a date for the oral defense. IX. Clinical Scholarly Project Committee The student should choose at least one additional committee member to serve as a part of the DNP CSP Committee. The committee member may be the student’s program director, other Brandman or alternate University faculty, a content expert, and/or the clinical site mentor. Committee members are expected to communicate with both the student and Chair to avoid conflicting information that may undermine the completion of the CSP. CSP committee members will receive a certificate of appreciation, but no financial compensation. Committee member responsibilities may include: • Providing guidance as requested by the student or chairperson, related to any aspect of the project • Critically reviewing the manuscript and completed project • Participating in committee meetings • Attending the DNP CSP oral defense • Other duties as identified by the student, chair and committee member X. Clinical Scholarly Project Progression Step 1: Written Proposal Prior to beginning the CSP, each student will develop a formal project proposal in DNPU 706: Transforming Healthcare through Outcomes Management. The formal proposal (Appendix A) should be presented to the project chair (usually assigned by the end of course DNPU 706) at the first DNP CSP meeting (see Timeline above) Step 2: Project Timeline and Tasks Students find it helpful to develop a schedule for keeping up-to-date with work for the CSP. Although DNP students will master the didactic content and complete some tasks necessary for undertaking the clinical project through formal coursework, completion of the implementation and written manuscript for the project itself will be completed outside of the structure of formal coursework. The CSP Chair should review and approve the student’s timeline so that efforts are coordinated and assistance can be received when needed. It is also important to understand the timeline is flexible in response to life events, but the CSP Chair must be notified to facilitate modifications. When developing a schedule and timeline for the CSP, it is important to leave sufficient time to obtain a clinical affiliation agreement (Appendix C) if required. There must also be sufficient time for writing and revisions of the manuscript or white paper. Unlike a Clinical Scholarly Project Handbook 08-06-2018: tch & bw 14 course paper, the project manuscript will need to be revised until it is acceptable to the CSP Chair and in Leatherby Library format. Each submitted draft requires a reasonable amount of time for the project chair to review it (a minimum of 7 days). It is wise to allow for multiple extensive revisions in addition to a final edit. Timely completion of the project is the student’s responsibility. Step 3: Obtaining Institutional Review Board Approval The Brandman University Institutional Review Board (BUIRB) must approve all CSPs before data collection may begin. In addition to BUIRB approval, the IRB of the agency where the project will be conducted may also require approval before data collection may begin. For information about each individual agency’s IRB process and application procedures, the student should contact the agency directly. Brandman University is committed to safeguarding the rights and welfare of all people who participate in studies conducted by faculty and students. BU supports responsible experimentation that promises to increase knowledge and understanding while demanding the highest ethical standards among BU scholarly investigators. The process to submit an application to the BUIRB includes the following: 1. The National Institutes of Health (NIH) Protecting Human Research Participants Program. This online self-learning activity is located at http://phrp.nihtraining.com/users/login.php. When completed, the student must save the certificate of completion to submit with the BUIRB application; 2. Completion of the BUIRB Application (Appendix F) with the DNP CSP Chair as well as required attachments; 3. Submission of the draft Application to the MSNaHP pre-Review IRB representative/s by the DNP CSP Chair for review and approval to complete the online BUIRB application 4. Completion of the MSNaHP approved online BUIRB Application, along with any required attachments to the Brandman University IRB committee (https://my.brandman.edu/teams/academicaffairs/IRB/Lists/IRBApplication/Item/ newifs.aspx). It is recommended that prior to the development of the online BUIRB application and any other required forms, the student and CSP Chair visit and review the BUIRB webpage together since the procedures, calendar, application, action form and other sample documents may be found there (https://irb.brandman.edu/Pages/Home.aspx). In addition, there is a step-by-step document (Appendix F) outlining the online BUIRB submission document which must be completed by the student and submitted to MSNaHP pre-review BUIRB representatives prior to formal submission. There are also trainings available for faculty and students to better understand the electronic submission process. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 15 For students: YouTube tutorial: use of the BUIRB electronic application https://youtu.be/lMqzUZ5L6W8 YouTube tutorial: “Mock” School of Education electronic BUIRB application https://my.brandman.edu/teams/academicaffairs/IRB/Lists/IRBApplication/Item/newifs.a spx?DefaultView=Immersion. For faculty: YouTube tutorial: Chair Instructions for Using BUIRB Application Templates with Students at https://youtu.be/x0NyrQwsXWY YouTube tutorial: Chair Review Process for BUIRB Electronic Applications training tutorial at https://youtu.be/6PQzril3MxA to develop a clear understanding of the process. Step 4: Completing the Clinical Scholarly Project Students are expected to complete their projects (intervention, data collection and data analysis) by the end of the DNPU 708 course work. If a student is unable to complete his or her CSP oral dissertation defense, finalize the manuscript or white paper with successful submission to the Leatherby Library during DNPU 708, he or she will be enrolled in a continuing course, DNPU 799. DNPU 799 is a “0” credit course, with a $500 continuing candidacy fee, that allows continued access to the library and DNP CSP Chair. If a student is able to complete the DNP 708 requirements by the end of the first week of the initial DNPU 799 term, he or she will not be required to pay for the course and the DNPU 799 will be dropped from registration. The grade issued for DNPU 799 is always a “P,” unless there is an Academic Integrity violation review or as directed differently by the Dean or Dean’s Designee. If a student is unable to complete the DNP requirements after the first 8-week enrollment session of DNPU 799, he or she will be enrolled in subsequent sessions until he or she is able to complete all degree requirements or the maximum 7-year rule is reached. Please communicate directly with the DNP CSP Chair for further instructions and guidelines for assignments due for this course since each student will require individualized support. The grade issued for DNPU 799 is always a “P,” unless there is an Academic Integrity violation review or as directed differently by the Dean or Dean’s Designee. Step 5: Oral Defense Each student will deliver an oral defense PowerPoint presentation of the CSP during DNPU 708 – Application of Clinical Scholarly Project. The presentation will be scheduled by the Chair in coincidence with faculty (and the Dean’s schedule as often as possible (see Section XIII for additional details about the oral defense) Clinical Scholarly Project Handbook 08-06-2018: tch & bw 16 XI. Writing the DNP CSP Manuscript (sample template found in Appendix I) The project manuscript is a required dissertation-style document that outlines all of the elements of the CSP. It is essential that the manuscript be both original, substantial and demonstrates critical thinking. A discussion of the data-driven conclusions and professional lessons learned throughout the project should also be included. The manuscript must be in proper English using correct grammar and punctuation in APA format. Each sentence must be defensible in a logical and scientific sense. If the student struggles with writing, it is recommended that he/she obtain assistance from the Brandman University Online Writing Community https://my.brandman.edu/student/OWC/Pages/Home.aspx. However, some students may need to employ a professional editor or other technical assistance as determined in mutual discussion with the Chair. Attempting to write the manuscript all at one time is an overwhelming task. The manuscript should be written during DNPU coursework. Many students find writing the discussion/implications sections to be particularly challenging. Consultation with the DNP CSP Chair and even peers can be helpful during this phase of the project work. For the manuscript, the final format will follow the checklist as directed by the Leatherby Library. The manuscript must follow national guidelines and be a comprehensive DNP CSP as outlined by the AACN (2006, 2016). DNP CSP Manuscript Chapters I-V: A Closer Look Introduction The Introduction sets the stage for the specifics of the project. It should begin with the global setting in which the problem exists, and then move systematically through a “funnel,” narrowing down the problem from the macro setting to the micro. Hence, the introduction provides an overall view of the subject or general problem and shows how it relates to a larger field of thought. The introduction provides the reader with a context for the problem and typically does not exceed 1-2 pages. Chapter I: Background and Significance Chapter I of the DNP CSP may include the following subsections: Background and Significance, Assessment of the Phenomena (Problem Statement), Historical and Societal Perspective, Incidence and Prevalence, Healthcare Cost, and Introduction of PICOt question to provide key words for the literature search. Not every project includes all of these subsections, or the same order of the subsections. The specific order of this chapter will ultimately depend on the kind of project being conducted; the student’s chair will approve the subsections and order of this chapter. Despite its importance, Chapter I is usually short, no more than 10 pages in length. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 17 Background and Significance. The background section of Chapter I provides the research foundation leading to the problem and purpose statements. This section presents the most relevant pieces of research (citations) that support the project. This section is usually 2-4 pages in length. Assessment of the Phenomena (problem statement). The underlying justification and greater need for further study of your potential project should be discussed in this section. After reading the background, the reader should be informed precisely why the project is being conducted and be convinced of its importance. The reader should be convinced that there is a pressing problem or requires a closer examination or improvement Historical and Societal Perspective. This section provides an in-depth examination of the historical events that have led to the current problem and attempts to provide insight and clarity as to why changes need to be made. It may also address the societal impact and views that have contributed to the current state of the problem or examine the problem from different social angles to grasp the depth and breadth in an attempt to present a comprehensive solution. Incidence and Prevalence. This section should precisely describe the incidence and prevalence of the identified problem at hand. Use of national and local statistics is required. Healthcare Cost. This section examines the cost burden to patients and stakeholders and should be one or two paragraphs in length f applicable. Supporting references in APA format should be included. Introduction of PICOt Foundation. This is where the student summarizes the previous background information and leads the reader to understand how the PICOt question was developed. Chapter II. Literature Review Introduction of PICOt Question This introduction to the literature review chapter describes what a PICOt question is, what the elements mean (i.e., P = population, I = intervention, etc.) and how it informed the key words that guided the literature search for a solution to the identified problem. The first paragraph should conclude with the actual PICOt question that guided the literature review. The next paragraph should describe the data bases used (i.e., PubMed, CINAHL, Cochrane Library, etc.) and what was found using the keywords identified from the PICOt question. Include the number of articles found and the specific themes. Next, talk about how they keywords may have been refined to identify and locate research specifically relevant to the proposed solution to the problem. Finally, discuss the number of articles chosen that support the argument for change. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 18 Synthesis of the Literature. This section begins with a brief introduction to the topics researched and an explanation of major elements of the literature being reviewed. The review of literature requires more than just listing and summarizing all the studies that relate to the project. It should be an orderly, cohesive, well-sequenced narrative that relates the problem under investigation to a body of scholarly work that supports the change in practice. Subheadings should be used to identify each of the themes or categories. They organize the material into shorter, more easily comprehensible blocks of information for the reader. Transitions from one theme or category to another should be smooth and appropriate. In the review of literature, the main theories, explanations, and findings that are generally accepted and represented in the literature should be presented along with any contradictory evidence or points of view that may have caused discussion or debate. The review of the literature must include works that outline the change in understanding of the research topic and how the proposed solution will improve outcomes. Literature reviewed and discussed should focus on work published within the past 5 years. At the conclusion of Chapter II, a final section should be included that summarizes the literature in a coherent manner. Contradictions should also be highlighted. The significance of the proposed project in light of the reviewed research should be emphasized. The readers should feel that the review of the literature has yielded new insights and suggested a direction for change in the chosen issue. Theoretical Framework For this section, use the nursing theory you identified in NURU 600 or one that you are familiar with and whose concept and/or framework supports and/or informs your CSP or white paper. Remember that your choice of theory should be a best fit of nursing practice with the outcome of your CSP or white paper argument. As you learned in class a nursing or other complementary discipline’s theory may be used. In the first paragraph, give a summary of your theory. You may even wish to include a figure to visually explain the concept or frame work. The next paragraph should explain how it informs your CSP or white paper. It should include your purpose for using this specific theory (i.e., is it for quality patient care, to improve a system or process, to frame a CSP study or white paper, to educate patients, providers, interprofessional group, to inform administrators or politicians, to justify a change, etc.). A final paragraph should summarize your salient points and the section should be limited to 2 pages maximum. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 19 Chapter III. Methodology. Study Design. Chapter III should begin with the study design, and whether the project will be quantitative, qualitative or a combination. It should be sufficiently detailed to enable others to understand the step-by-step account of what will be done, in what order, how and by whom. Population and Sample. In this section, provide a summary of the sample and the population from which the sample is drawn. A description of their defining characteristics and the procedures used to recruit them should be included. Instrumentation. In this section, describe the *instruments that were obtained or modified for this project. Surveys or questionnaires designed by others should be valid and reliable and credit should be cited for the original authors, as well as any permissions obtained to use the instrument/s. *Please note it is not within the scope of study within the DNP CSP at Brandman University MSNaHP to develop a new questionnaire, survey or other data collection instrument. Data collection. Outline in detail the methods that will be used to collect information. Describe the procedures that will be used to collect the required data from participants. In short, list all activities needed to gather information for the project (including IRB approval and assurance of confidentiality) and describe each activity in enough detail so another competent researcher could duplicate the project. Data analysis. Describe how data will be scored and analyzed; identifying appropriate statistical methods . If the proposed project is to employ qualitative methods, identify the ways in which the data will be processed and analyzed. Summary. A brief summary of the chapter may be included in this section. Chapter IV. Findings In this section only the statistical findings are given without interpretation. The findings chapter should include participant demographics and SPSS statistical findings including tables, figures, charts or graphs appropriate to the statistical test used. Students and DNP CSP Chairs are encouraged to review Chapter 5 and section 2.07 in the APA Manual (2010) for additional information (p. 32) with visual samples on pp, 52-53. Chapter V. Discussion This chapter describes the implications, limitations, sustainability, application to the DNP Essentials and dissemination of the project and its results. Implications. This section describes what the results of this project mean in relation to future practice. Are the results statistically and/or clinically significant? In Clinical Scholarly Project Handbook 08-06-2018: tch & bw 20 what way/s? Will the results of the project support the body of evidence existing in its call for change? In what way/s? Supporting Evidence for Advanced Practice Registered Nursing. In this section, describe the key role APRNs can play in the improvement in practice related to the specific problem at hand. Limitations. The limitations are those characteristics of the project that may constrain generalizability, internal and/or external validity. The two most common limitations are related to small sample size and time constraints of the project. Sustainability. Describe the plan/s to keep the practice change going (or not)? Include the necessary costs and stakeholder buy-in to sustain your findings. Dissemination. This subsection tells how the project results will be distributed for others to read, understand support and utilize the practice change. Additional plans may include presenting results to stakeholders, submitting an abstract to a peer-review journal, presenting at a local APRN or national conference (poster, podium, armchair discussion, etc.), among other scholarly or leadership activities. Application to the Essentials. Begin with an overall description of what the DNP Essentials (AACN, 2006) are and then write 3 to 4 specific paragraphs for the top 3 or 4 Essentials that were met while engaging in the CSP. XII. Writing the DNP CSP White Paper (sample template found in Appendix J) The following is a guideline for the five recommended chapters of a white paper: DNP CSP White Paper Chapters I-V: A Closer Look Introduction The introduction sets the stage for the specifics of the argument and begins with a global setting in which the problem exists. It then systematically moves to the specific problem being addressed. The introduction provides an overview of the subject area or general problem and provides the reader with a context for the proposed argument for practice change. The introduction is typically 1-2 pages maximum. Chapter I: Background and Significance Chapter I of the white paper will include an in-depth description of the overall problem being addressed. Most white papers will need to include the following subsections: Background and Significance, Assessment of the Phenomena (Problem Statement), Historical and Societal Perspective, Incidence and Prevalence, Healthcare Cost, and introduction of PICOt question that will provide keywords for the literature search. The specific order of these subsections will ultimately depend on the type of white paper being researched and Clinical Scholarly Project Handbook 08-06-2018: tch & bw 21 presented. Despite its importance, Chapter I is generally no more than 10 pages in length. Background and Significance. The background section of Chapter I provides the research foundation leading to the problem and purpose statements. This section presents the most relevant pieces of research (with citations in APA [2010] format) that describes the overall problem being investigated and current solutions that support the white paper argument. This section is usually 2-4 pages in length. Assessment of the Phenomena (problem statement). The underlying justification and greater need for a change should be discussed in this section. After reading this section, the reader should know precisely why the white paper is being written and be convinced of the argument’s importance. Historical and Societal Perspective. This section provides an in-depth examination of the historical events that have led to the current issue and attempts to provide insight and clarity as to what changes have been made for improvement in the past. It should also address the societal impact and views that have contributed to the current state of practice. The student should also present different social angles in order to describe the depth and breadth of the overall situation in an attempt to support the comprehensive solution if applicable. Incidence and Prevalence. This section can be brief and precisely discuss what the title suggests: What is the incidence and prevalence of the problem at hand? It is important to make sure the reader knows the problem needs solving and the plan of action involves evidence-based research. Healthcare Cost. The cost of healthcare is a complicated matter. In this section, the student will examine the past cost burdens and how it is part of the white paper argument, if applicable. Summary. This is where the student summarizes the previous background information and leads the reader to understand how the PICOt question was developed. Chapter II. Literature Review Introduction of PICOt Question This introduction to the literature review chapter describes what a PICOt question is, what the elements mean (i.e., P = population, I = intervention, etc.) and how it informed the key words that guided the literature search for a solution to the identified problem. The first paragraph should conclude with the actual PICOt question that guided the literature review. The next paragraph should describe the data bases used (i.e., PubMed, CINAHL, Cochrane Library, etc.) and what was found using the keywords identified from the PICOt question. Include the number of articles found and the specific themes. Next, talk Clinical Scholarly Project Handbook 08-06-2018: tch & bw 22 about how they keywords may have been refined to identify and locate research specifically relevant to the proposed solution to the problem. Finally, discuss the number of articles chosen that support the argument for change. Synthesis of the Literature. Subheadings can be used to identify each of the themes or categories. Subheadings also organize the material into shorter, more easily comprehensible blocks of information for the reader. Transitions from one theme or category to another should be smooth and appropriate. In the review of the literature, the main theories, explanations, and findings that are generally accepted and represented in the literature should be presented along with contradictory evidence and points of view that may have caused intellectual tension in the field. Comparisons and contrasts among cited works are important. Unless an article presents a landmark study, the research should have been conducted and/or published within the past 5 years. At the conclusion of Chapter II, a final section should be included that summarizes the literature a coherent manner. Contradictions should also be highlighted. The significance of the proposed argument, in light of the reviewed research, should be emphasized. The readers should feel that the review of the literature has yielded new insights and suggested a direction for change in the chosen issue. Theoretical Framework For this section, use the nursing theory you identified in NURU 600 or one that you are familiar with and whose concept and/or framework supports and/or informs your CSP or white paper. Remember that your choice of theory should be a best fit of nursing practice with the outcome of your CSP or white paper argument. As you learned in class a nursing or other complementary discipline’s theory may be used. In the first paragraph, give a summary of your theory. You may even wish to include a figure to visually explain the concept or frame work. The next paragraph should explain how it informs your CSP or white paper. It should include your purpose for using this specific theory (i.e., is it for quality patient care, to improve a system or process, to frame a CSP study or white paper, to educate patients, providers, interprofessional group, to inform administrators or politicians, to justify a change, etc.). A final paragraph should summarize your salient points and the section should be limited to 2 pages maximum. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 23 Chapter III. Argument for the Proposed Change Introduction The introduction of this section begins with a restatement of the argument and specific solution/s. The rationale for the argument is also restated and should be sufficiently explanatory and detailed to enable the readers to understand the proposal solution. Overview. In this section, the student will give a step-by-step account of what will be done, in what order, how, and by whom. Here the student will include the physical activities he or she will participate in to support the argument change. Examples of activities may include, but are not limited to: • Community and/or Specialty focus group/s • Stakeholder/s town hall/s • Visit/s to legislator/s • Meeting/s with healthcare facility administrators Students who chose to complete a white paper must account for a minimum of 255 of the total 510 hours engaged in face-to-face activities. Population. This section should include the population/stakeholders that will be affected by the change. It provides a description of characteristics of the population chosen and the process used to select them as the recipients of the change (identified in the literature review). Leaders/stakeholders responsible for implementing the change should also be described. Process. Using the Titler, et al. (2001) Iowa Model of Evidence-Based Practice to Promote Quality Care or other change model, describe the process used to support the change including environment, population and cost. All conceptual models should be included in an appendix to the white paper. Change analysis. Explain how the change will be measured and analyzed for success. Chapter IV. Discussion This chapter describes the plan barriers and limitations of the proposed change and solutions to overcome the limitations of the change, including how the proposed change will be sustained. Subsections titles should include: Barriers and limitations. Sustainability. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 24 Chapter V. Dissemination and Application to the DNP Essentials This final chapter tells how the white paper will be published for others to read, understand and support it. In a separate section the application of meeting the DNP Essentials are also addressed. Dissemination. This subsection tells how the white paper will be published for others to read, comprehend and support. Additional plans may include presenting the practice change to stakeholders, politicians, community leaders or healthcare providers if applicable. Application to the Essentials. Begin with an overall description of what the DNP Essentials (AACN, 2006) are and then write 3 to 4 specific paragraphs for the top 3 or 4 Essentials that were met while engaging in the white paper activities. XIII. Guidelines for the Oral Defense Once the date has been confirmed with the DNP Support Specialist, the DNP Support Specialist will complete the top portion of the DNP CSP Grading Rubric and email a .pdf copy to the Chair to include as an attachment in the DNP CSP Defense announcement on the Brandman University Microsoft Office Calendar using the following instructions and formatting: Clinical Scholarly Project Handbook 08-06-2018: tch & bw 25 Under the details section, the title of the event should be: DNP CSP (or White Paper) Defense for Name of Student. The location box should contain the following Adobe room link: https://brandman.adobeconnect.com/_a1107013947/dnp_project_defenses/ The start and End dates and times should be filled in based on the approved date and time confirmed by the DNP Support Specialist. The Time Zone should always be set to Pacific Time (US & Canada). In the Add an Agenda section and using the template below complete the following information and click “Save:” DNP Clinical Scholarly Project Defense The Title of the Student’s Defense Student’s Name Date: Day of Week, Date Time: XX a.m. PST/XX p.m. MST/XX p.m. CST/XX p.m. EST Location: http://brandman.adobeconnect.com/dnp_project_defenses/ Conference Call: 866.526.3019 Code: 5997756134 CSP Chair: Dr. CSP Chair’s Name The oral defense will conducted in the aforementioned Adobe Connect virtual classroom. Students are required to use both audio and video portions within Adobe Connect to present their work. The defense is recorded and will be made available to the student. Required members attending the presentation include the CSP Chair, outside preceptor/mentor, committee member(s), the Dean or the Dean’s Designee and at least 2 other DNP-prepared faculty. Other participants may include additional faculty, students, colleagues, family and other guests. DNP CSP (or White Paper) PowerPoint Recommended Guidelines for the DNP CSP Defense PPT (all slides and formatting to be approved by the CSP Chair; guidelines found below). Plan on approximately 1 minute per slide. Some make take less time and others will be longer (i.e., your title slide will only take 10 to 15 seconds and only 5 seconds per each Reference/s slide, but your literature review may take 90 seconds): Clinical Scholarly Project Handbook 08-06-2018: tch & bw 26 Label Slide 1 with: -Title of CSP (or White Paper) -Student Name -Brandman University Label Slides 2-3: Problem Statement -Summarize background and significance including a general statement of problem -Highlight historical and society perspectives (if applicable) -Include incidence and prevalence among specified or general population -Summarize healthcare cost/s to patients and/or the community -Provide a transition slide of how the overall problem literature led the student to start the project (or White Paper argument) and development of the PICOt question Label Slide 4: PICOt (pronounced PEA’ kō) -Write out the PICOt question including the identification of each element in parentheses (P, I, C, O, t) -Discuss the key words used for the literature search that supported/investigated the CSP (or White Paper argument for a practice change) Label Slides 5-7: Literature Review -Identify the data bases search and number of articles found and any necessary changes to the key words to narrow the search -Provide an evidence synthesis (common themes and 4-6 key articles that support the CSP (or White Paper argument) Label Slide 8: CSP Objective (or White Paper Argument) -Give a brief statement of what you expected to find as your final outcome (or the expected change/outcome from your White Paper argument) Label Slides 9-10: Theoretical Framework -Provide a summary of theoretical framework (may include diagram) -Explain the application to CSP (or White Paper argument) Label Slides 11-13: Methodology -Include steps involved in participant (or White Paper focus group) recruitment; -Steps involved in intervention (or White Paper activities) -Steps involved in data analysis (or steps needed to implement White Paper practice change) Label Slides 14-16: Findings -Provide SPSS results (or impact of White Paper practice change) including: -Participant demographics (or population influenced by White Paper practice change) -Summary of statistical findings (or measurement of White Paper practice change) -Summary of statistical findings (or measurement of White Paper practice change) Label Slides 17-19: Implications -Provide statistical or clinical significance -Connection to literature search (does it match what other author’s found) -Application to APRN practice Clinical Scholarly Project Handbook 08-06-2018: tch & bw 27 Label Slide 19: Limitations -Describe the limitations of the CSP and recommendations for future studies (or obstacles to White Paper practice change and recommendations to remove barriers) Label Slide 20: Sustainability -Describe the cost to keep the practice change going -Describe the plan/s to keep the practice change going (or not) -Include all needed stakeholder buy-in Label l Slide 21: Plan/s for Dissemination Label Slide 22: Application to DNP Essentials -DNP Essentials (highlight 3 or 4 essentials maximum as the most applicable) Label Slide 23: Acknowledgements (optional) Label Slides 24-26: References -Should be in APA Format Label Slide 27: Thank you and Questions Recommended Timing for CSP Defense in Adobe Connect (all times are approximate): Introduction of Student by Chair (1 – 2 minutes) CSP PPT Defense Presentation (18 – 20 minutes*) *Students who exceed 20 minutes will be noted during faculty deliberations; students who exceed 30 minutes will be asked to discontinue their presentation and reschedule. Audience Questions (5 – 10 minutes) Candidate and Guests are excused (1 – 2 minutes) Faculty Discussion and Deliberations (5 – 10 minutes) Candidate recalled and determination given (1 – 2 minutes) (30 to 45 minutes total) Faculty will use the following rubric, which will be distributed to attending faculty via the DNP CSP Chair attached to the MS Office Defense invitation (please see Section XIII. Guidelines for the Oral Defense above) to evaluate a DNP candidate’s oral defense (also found in Appendix K): Clinical Scholarly Project Handbook 08-06-2018: tch & bw 28 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 29 Clinical Scholarly Project Handbook 08-06-2018: tch & bw 30 If a student has not completed the CSP and project defense by the end of DNPU 708 and the Project Chair deems that satisfactory work is progressing, a student will be given a grade of satisfactory progression (SP). All students who have not completed their CSP will be enrolled in additional 8-week extension session as necessary (DNPU 799), until they have successfully completed the project requirements within the seven year rule. The grade issued for DNPU 799 is always a “P,” unless there is an Academic Integrity violation review or as directed by the Dean or Dean’s Designee. XIV. Guidelines for Library Submission of Project Manuscript or White Paper The final step for the DNP CSP is for the student to electronically submit the project manuscript to the Brandman University Leatherby Library. The student will follow the Musco School of Nursing and Health Professions (MSNaHP) DNP Clinical Scholarly Project Manuscript Library Submission. The MSNaHP requires students to provide an electronic online submission to the library. Step 1 – Visit the Chapman/Brandman Leatherby Library for rules and guidelines for submission. Chapman University / Brandman University Dissertation / Thesis Guidelines http://www1.chapman.edu/library/info/rules/ThesisGuidelines.html Step 2 – Download the MSNaHP DNP CSP manuscript library submission checklist (Appendix G). Marybelle and S. Paul Musco School of Nursing and Health Professions DNP Clinical Scholarly Project Manuscript Library Submission Checklist https://my.brandman.edu/teams/msnahp/Dr%20Smiths%20Documents%20for%20PM%2 0to%20DNP/Clinical%20Scholarly%20Project/Library%20Submission%20Checklist%2 0for%20DNP%20CSP%20Product.pdf Step 3 – Revise the DNP CSP manuscript per library submission guidelines and have it reviewed by the DNP CSP Chair for Accuracy Step 4 – Complete the Library Format Submission Checklist (Appendix G) to be eSigned by both the student and the Chair (failure to complete this step may result in repeated requests for signatures and submissions to the library). Step 5 – Submit manuscript for signatures to: DNP CSP Chair, Committee Member/s (if applicable), PM-DNP Program Director (if applicable) and MSNaHP Dean. Step 6 – Submit manuscript to the Leatherby Library, along with the eSigned Library Format checklist for acceptance and receipt of approval email. Step 7 – Forward approval email to DNP CSP Chair, who will change the DNPU 708 grade from “SP” to “P” if all other requirements for a passing grade have been met*. Clinical Scholarly Project Handbook 08-06-2018: tch & bw 31 Please note: Students may apply for degree conferment with their Academic Advisor only after providing the Library Submission Email Confirmation to the student’s Clinical Scholarly Project Chairperson and Academic Advisor. *DNP CSP Chairs: Please see Appendix H and/or the MSNaHP Faculty Manual for how to submit a grade change. Thank you! Clinical Scholarly Project Handbook 08-06-2018: tch & bw 32 References American Association of Colleges of Nursing (AACN). (2006). Clinical scholarship and analytical methods for evidence-based practice. In AACN, The essentials of doctoral education for advanced nursing practice. Washington D.C.: Author. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf American Psychological Association (APA). (2010). Publication manual (6th ed.). Washington D.C.: Author. American Nurses Association. (2012). Frequently asked questions about the doctorate of nursing practice. Retrieved from http://www.nursingworld.org/DNPFAQ Shen, Q. (2009). Case study in contemporary educational research: Conceptualization and critique. Cross-cultural Communication, 5(4), 21-31. Retrieved from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact =8&ved=0CB4QFjAA&url=http%3A%2F%2Fwww.cscanada.net%2Findex.php%2Fccc %2Farticle%2Fdownload%2Fj.ccc.1923670020090504.003%2F769&ei=wz7U5_4AcrloATG54DgCw&usg=AFQjCNFWGxJ51_uQz_nITMwlAFZmcIynw&bvm=bv.74035653,d.cGU Zaccagnini, M. E., & Waud-White, K. (2013). The doctor of nursing practice essentials: A new model for advanced practice nursing. Sudbury, MA: Jones and Bartlett. 08-09-2018: tch & bw 33 Appendix A DNPU 706 Formal Project Proposal Week 8 Assignment Outcomes Synthesis Proposal — Signature Assignment Points: 300 American Association of Colleges of Nursing: DNP Essentials: I, II, III, IV, VI, VII Course Learning Objectives: 1-6 Purpose: To develop students’ plans for outcomes measurement and cost effectiveness analysis related to the DNP project, and its relationship to the quality movement at the national level. Please read the assignment in its entirety prior to initiating the activity. Directions: This assignment is the final assignment in the course. It is an outcomes synthesis portfolio summarizing how the concepts, processes, and procedures studied during the course have been synthesized and applied to an evidence-based practice project. The portfolio is the equivalent of a 12-15 page paper (not counting the abstract or references). The paper will apply a style similar to that described for methodological articles in the APA Publication Manual (6th ed., p. 10-11). However, it will be prepared as an ePortfolio using a template in LiveText. Go to LiveText to find the template instructions, an example, and the rubric. Go to https://c1.livetext.com/c1_help/for_students/ to get help in how to prepare a professional portfolio, paste from Word into the LiveText template, insert images into the LiveText template, and submit a completed template for grading. Although students will have discussed their projects on the discussion boards and collaborated with classmates during the design and conduct of the project, this final assignment is not a group project. It should be written by the student as an individual project and reflect the student’s unique perspective and method of expression. The ePortfolio will have 10 sections: 1. Abstract – (120 to 200 words) 2. Statement of the Problem – Explanation of the question that will be answered by the project (200 to 400 words) 3. Background and Significance – Brief overview of the evidence base for the project and the impact of a successful project (300 to 500 words) 08-09-2018: tch & bw 34 4. Systems Context – Brief overview of the organizational system within which the project will be conducted – describe how stakeholders will be involved in the project and what feedback loops will be used to sustain stakeholder involvement and support (200 to 400 words) a. Attach an illustration/diagram of the system 5. Definition of Clinical, Satisfaction, and Cost Outcomes – Description of each major outcome that will be used to appraise the success of the project and how it contributes to answering the question (75 to 125 words per outcome) a. Attach a data collection plan (table) 6. Methods of Measuring Clinical, Satisfaction, and Cost Outcomes – Description of each metric that will be used to measure each major outcome and what is known about its reliability and validity (100 to 200 words per outcome) 7. Implications of Outcomes for Quality Management – Explanation of how the outcomes relate to current local, regional, or national QM initiatives (300 to 700 words) 8. Ethical Balance – Description of ethical choices addressed in project design (300 to 500 words) 9. Sustainability Plan for Translating Evidence into Practice – Explanation of how a successful project would be translated into a sustainable change in practice (300 to 700 words) 10. References The portfolio will be graded using the following rubric Criteria Exemplary – 4 Proficient-3 Developing-2 Emerging-1 Introduction 12 points (48/300) Clear and concise introduction of CSP. Adequate introduction of CSP. Unclear description of introduction of CSP. No description of introduction of CSP. Review of the Literature and Theoretical Framework 25 points (100/300) Insightful review of the literature and theoretical framework. Some effort to review the literature and theoretical framework. Limited review the literature and theoretical framework. No review the literature and/or theoretical framework. Design and Methods 25 points (100/300) Insightful and detailed description of proposed design and methods. Adequate description of proposed design and methods. Limited description of proposed design and methods. No description of potential proposed design and methods. APA Format and Style 13 points (52/300) Excellent flow throughout presentation; clear and engaging style Presentation well organized and delivered smoothly Limited description of proposed design and methods. Flat, unconvincing presentation 08-09-2018: tch & bw 35 Appendix B DNPU 710 Individualized Learning Plan DNPU 710 Individualized Learning Plan and Timeline for DNP CSP or White Paper Completion (CLOs 1-3) Students will work with their CSP Chairs to complete an approved individualized Learning Plan. Evaluation on the achievement of expected outcomes may be reviewed in weeks 3, 5, 7 and 8 and/or as needed. A sample Learning Plan is presented below: Student Name: DNP CSP Chair: Date: Learning Objective: Complete DNP CSP or White Paper BUIRB submission, manuscript, PPT for defense, create a poster presentation for a professional nursing conference or send letter of inquiry to peer reviewed journal, Leatherby Library acceptance per formatting requirements, etc. Actions Target Date Date Complete 1. ILP will be completed by…. XX/XX/XX XX/XX/XX 2. ILP will be reviewed per the DNP CSP Student/Chair Meeting table during weeks/session/s… XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX XX/XX/XX 3. BUIRB Application, Action Plan and Attachments folder will be completed by… XX/XX/XX XX/XX/XX 4. BUIRB MSNaHP Pre-Review will be completed by… XX/XX/XX XX/XX/XX 5. BUIRB Submission will be completed by… XX/XX/XX XX/XX/XX 6. BUIRB Acceptance Email will be received by… XX/XX/XX XX/XX/XX 7. CSP data collection or White Paper activities will be completed by… XX/XX/XX XX/XX/XX 8. Manuscript will be completed by… XX/XX/XX XX/XX/XX 9. PPT Defense Presentation will be completed by… XX/XX/XX XX/XX/XX 10. Defense Presentation will be completed by… 11. Poster presentation in preparation for a national conference or abstract submission to a national journal will be completed by… XX/XX/XX XX/XX/XX 12. All manuscript or white paper eSignatures will be received by… XX/XX/XX XX/XX/XX 13. Leatherby Library acceptance per formatting requirements will be received by… XX/XX/XX XX/XX/XX 14. Other XX/XX/XX XX/XX/XX 08-09-2018: tch & bw 36 1. Criteria for Success: Student will complete ILP and meeting table during meeting scheduled with DNP CSP Chair in Week 1 by the noted due date 2. Criteria for Success: Student and DNP CSP Chair will meet per the table determined in 1 above and make adjustments to the ILP as needed 3-6. Criteria for Success: BUIRB paperwork will be completed, submitted x2 (MSNaHP pre-review and BUIRB) and with approval received by noted due date 7. Criteria for Success: All activities related to the DNP CSP (e.g., intervention, data collection and analysis, etc.) or White Paper (e.g., town hall meetings, legislators, health care administration, etc.) will be completed by noted due date 8. Criteria for Success: A completed manuscript or white paper will be completed by the noted due date 9-10. Criteria for Success: The PPT presentation of the DNP CSP or White Paper will be completed and successfully defended by the noted due date 11. Criteria for Success: A professional poster, abstract or 2-page recommendation/s for improved results dissemination submitted with a response by… 12. Criteria for Success: The DNP CSP Manuscript or White Paper with all eSignatures in place will be received by noted due date 13. Criteria for Success: A Leatherby Library acceptance email will be sent to the DNP CSP Chair be the noted due date 14. Criteria for Success: Other as determined by DNP CSP Chair and student EXAMPLE EVALUATIONS: 1-2. Evaluation: Initial DNP CSP Chair and student meeting was held and the ILP and meeting table was completed. DNP CSP Chair sent MS Outlook calendar invitations to student per noted time/s and date/s 3-6. Evaluation: A completed BUIRB Application , Action Plan and Attachments were approved by the noted due date 7. Evaluation: All activities related to the DNP CSP (e.g., intervention, data collection and analysis, etc.) or White Paper (e.g., town hall meetings, legislators, health care administration, etc.) were completed by noted due date 8. Evaluation: A completed manuscript or white paper was completed by the noted due date 9-10. Evaluation: The PPT presentation of the DNP CSP or White Paper was completed and successfully defended by the noted due date 11. Criteria for Success: A professional poster, abstract or 2-page recommendation/s for improved results dissemination was submitted with a response by the noted due date 12. Criteria for Success: The DNP CSP Manuscript or White Paper with all eSignatures in place was completed by the noted due date 13. Criteria for Success: A Leatherby Library acceptance email was sent to the DNP CSP Chair on the noted due date 14. Criteria for Success: Other as determined by DNP CSP Chair and student 08-09-2018: tch & bw 37 DNP CSP Student/Chair Meetings Student Name: ______________________________________Session:__________________ *Repeat table below as necessary for additional sessions (fall 1, fall 2, etc.). Student Signature: __ Date: Chair/Mentor eSignature: Date: _______________ *Meeting Wk Date Notes/Progress/Revisions 1 2 3 4 5 6 7 8 08-09-2018: tch & bw 38 Appendix C Affiliation Agreement 08-09-2018: tch & bw 39 Appendix D DNPU 707, 709 or 711 DNP CSP Clinical Hour PROPOSAL Clinical Scholarly Project Residency Hours PROPOSAL (Objectives 1 & 3) Students will work with their DNP CSP Chair to identity activities related to the completion of their DNP project to account for 255 unique clinical scholarly project (CSP) hours. 1. Using the SAMPLE table format listed below, cut and paste a copy into a new word document and save it as Last name_First name_CSP hour PROPOSAL (Ex: Hanisch_Tyke_CSP hour PROPOSAL) 2. Next, meet with your chair and please fill in the categories that you and your chair agree upon as relevant to your CSP. (*Hint: Using your Moran (2013) text may help you identify appropriate DNP CSP activities) 3. Using the AACN (2006) DNP Essentials, also determine which Essential is being met by your activity, noting that you may not meet all of the Essentials in this course 4. Once you have completed the word doc proposal with your chair: a. Remove the SAMPLE watermark b. Delete this first page of directions c. Save it as a .pdf copy as identified above (Last name_First name_CSP hour PROPOSAL [Ex: Hanisch_Tyke_CSP hour PROPOSAL]). 5. Email the .pdf copy to your Chair and please have him or her eSign the document in the designated box and return to you so that you can upload the PROPOSAL to BB for review by the DNPU 711 instructor (*Note: you will repeat this process in week 8, using the same format, by adding dates and changing the word Proposal to LOG to verify the proposed hours you have identified on this form). 40 Musco School of Nursing and Health Professions CSP Residency Hours PROPOSAL DNPU 711 – Clinical Residency (255 hours) Student Name_____________________________________________ Date: _____________ CSP Chair_______________________ e-signature: Institution Clinical Preceptor Description of Activity AACN DNP Essentials Expected Hours Mercy Hospital APRN Jane Doe, DNP Attended EBP conference for determining the best evidence for CSP Essential I 10 Mercy Hospital APRN Jane Doe, DNP Attended facility meetings for CSP design and plan; include interdisciplinary team Essential II, Essential VI 40 Mercy Hospital APRN Nancy Nurse, DNP Meet with hospital administrators and Risk Management for preapproval of DNP CSP Essential II 20 Brandman University BUIRB CSP Chair Preparation of BUIRB documents Essential I 40 Mercy Hospital IRB Hospital IRB Committee Preparation of hospital IRB documents Essential I 40 Mercy Hospital Risk Management Sam Spade, DNP Develop and implement a point-of-care clinical reference resource Essential VIII 100 Brandman University Statistician Data Analysis Essential III 50 Mercy Hospital Prepare and present findings to hospital administration to change hospital policy and procedure Essential IV, Essential VIII 20 Total = 320 hours 41 Appendix E DNPU 707, 709 or 711 DNP CSP Clinical Hour LOG Clinical Scholarly Project Residency Hours LOG (Objectives 1 & 3) 1. Using your word document copy of your PROPOSAL table, change the word PROPOSAL to LOG 2. Next change the word Expected to Completed in Column 5 3. Then add a Dates column (OR cut and paste the entries into the table below) 4. Next, contact your chair and review the number of hours in your proposal; change any of the actual number of hours you completed (may be more or less) 5. Remove this first page of directions AND the last 2 pages of how to insert a .pdf document 6. Save as a word doc as Last name_First Name_CSP Hour LOG (EX: Kerr_Linda_CSP Hour LOG 7. Finally save the document as a .pdf and send it to your Chair 8. Please have him or her eSign the document and return to you so that you can upload the PROPOSAL to BB for review by the instructor AND *insert a copy of the .pdf into your final paper as Appendix B (a copy of your .pdf LOG will be inserted as Appendix A). *Directions on how to insert a .pdf into a word doc are found on the last page of these directions. 42 Musco School of Nursing and Health Professions CSP Residency Hours LOG DNPU 711 – Clinical Residency (255 hours) Student Name_____________________________________________ Date: _____________ CSP Chair_______________________ e-signature: Institution Clinical Preceptor Description of Activity AACN DNP Essentials Completed Hours Date/s (range & future dates okay) Mercy Hospital APRN Jane Doe, DNP Attended EBP conference for determining the best evidence for CSP Essential I 10 01-30-2018 Mercy Hospital APRN Jane Doe, DNP Attended facility meetings for CSP design and plan; include interdisciplinary team Essential II, Essential VI 40 02-2018 through 05-2018 Mercy Hospital APRN Nancy Nurse, DNP Meet with hospital administrators and Risk Management for preapproval of DNP CSP Essential II 20 02-2018 through 05-2018 Brandman University BUIRB CSP Chair Preparation of BUIRB documents Essential I 40 06-20187 through 07-2018 Mercy Hospital IRB Hospital IRB Committee Preparation of hospital IRB documents Essential I 40 06-2018 through 07-2018 Mercy Hospital Risk Management Sam Spade, DNP Develop and implement a point-of-care clinical reference resource Essential VIII 100 02-2018 through 07-2018 Brandman University Statistician Data Analysis Essential III 50 11-2018 Mercy Hospital Prepare and present findings to hospital administration to change hospital policy and procedure Essential IV, Essential VIII 20 11-2018 through 12-2018 Total = 320 hours 43 Appendix F Guidelines for BUIRB Completion and SAMPLE CSP On-line Application Word Application DNP SAMPLE Template Institutional Review Board Part 1 – Administrative Information This form is to be used for requesting IRB review of any new project. IRB approval is required before any research involving human subjects may be initiated. Full details must be provided and all necessary documentation submitted. Brandman University is committed to safeguarding the rights and welfare of all people who participate in research conducted by Brandman faculty and students. Brandman University supports responsible experimentation which promises to increase knowledge and understanding, and encourages the highest ethical standards among Brandman researchers. The central aim of the BUIRB is to protect the rights of human participantsin research studies, including their rightsto give informed consent and to have their safety protected from undue risk. The BUIRB has the responsibility and authority to review and approve all research projects by Brandman faculty and students involving human or animal participants. It will approve only research that conformsto the professional standards as understood within the relevant discipline. The BUIRB Application becomesthe researcher’s record of compliance with laws and regulations protecting the rights and welfare of human participants in research described in the Department of Health and Human Services (DHHS) regulations 45 CFR 46, as specified in the Office for Protection from Research Risks (OPRR) 1983 report on Protection of Human Subjects. Institutional Review Board Application IMPORTANT: Please respond to all the questions. Do not leave any items blank. Responding to each question on this application fulfills one of the requirementsfor the ethical conduct of researchers. If a question does not pertain to your study, indicate not applicable (NA) following the question. Do not delete or modify questionsfrom this application. Please note that incomplete applications will be returned without review. 44 Part 1A: Research Information Research Information Researcher’s Assurance: I certify that the information provided in this application is complete and correct. I understand that as principal researcher, I have ultimate responsibility for the conduct of the study, adherence to ethical standards, and protection of the rights and welfare of human participants. I agree to: (1) Conduct the study according to the approved protocol; (2) Make no changes to the approved study without prior IRB approval; (3) Use the approved procedure and form(s) for obtaining informed consent; and, (4) Promptly report any significant adverse events to the IRB within five working days of occurrence. Part 1B: Application Information Title of proposed research study: A Quality Improvement Intervention to Improve the Effectiveness of Diabetic Patient SelfManagement Goal Rates by Primary Care Providers through Implementation of an Electronic Medical Record Documentation Tool Type of Review Requested: ☐ Exempt Review: As defined in 45 CFR 46, there are six exemptions to the regulatory requirements described in section 46.101(b) of 45 CFR 46. See BUIRB Research Review Policy for “exempt” review requirements. ☒ Expedited Review: Surveys considered minimal risk; research on individual or group behavior or characteristics where research does not cause stress to subject and confidentiality is maintained; research involving deception that poses no more than minimal risk; performance of non-invasive tests; collection of data using noninvasive procedures; collection of blood samples by finger stick or venipuncture by trained personnel; research using existing documents, records, pathological specimens, or diagnostic specimens. 45 ☐ Full BUIRB Review: Research with greater than minimal risk; research of a sensitive nature; research with vulnerable populations (children, prisoners, pregnant women, mentally disabled, elderly individuals, non-English or English as second language speakers, or economically/educationally disadvantaged individuals); research involving invasive procedures; research inducing physical pain or potential injury. Type of Research: ☐ Institutional Research ☒ Graduate Research ☐ Undergraduate Research Principal Researcher Position: ☐ Faculty ☒ Doctoral Student ☐ Master’s Student ☐ Brandman Staff Member ☐ Non Brandman Researcher Principal Researcher’s College Affiliation: ☐ Arts and Sciences ☐ Business and Professional Studies ☐ Education ☒ Nursing and Health Professions Category that applies to your research: ☐ Doctoral Dissertation ☐ Master’s Thesis ☐ Faculty Professional/Academic Research ☐ Course Project ☒ DNP Clinical Scholarly Project Part 2 – Study Design, Methods and Procedures Provide a summary of the study, including the purpose and research questions: Purpose: To determine if implementation of an electronic medical record (EMR) documentation tool will result in a change in primary care provider documentation rates of patient defined selfmanagement goals for their diabetic patients. 46 PICOt question: Will implementation of a new EMR tool designed to aid documentation of patient defined self-management goals (I) change the documentation rates of these goals (O) by primary care providers in a CRMC clinic (P) compared to prior standard of care charting (C)? Summary: This project will evaluate primary care providers’ adherence to a standard of care related to documentation of adult diabetic patient self-management goals. The American Diabetes Association (ADA) publishes revised standards of care annually and the 2014 standards of care reaffirm the health benefits and cost effectiveness of lifestyle modifications through patient centered healthy lifestyle goal attainment. The Centers for Disease Control and Prevention (CDC) also strongly advocate for collaborative patient-centered lifestyle modifications in the Diabetes Prevention Program (2017). The long-term follow up of the Diabetes Prevention Program Outcomes Study (DPPOS) has demonstrated the effectiveness of lifestyle modification through high quality randomized control trials (CDC, 2017). An abundance of evidence supporting both the health outcome and cost-effectiveness of lifestyle modifications is a central component of emerging healthcare delivery models. The United States Department of Health and Human Services (USDHHS) is funding a five-year pay-forperformance quality improvement program throughout the state of California (2016). This program is titled the Delivery System Reform Incentive Program (DSRIP). The DSRIP specifies numerous outcome-based healthcare measures that are tied to specific dollar rewards for reaching specific measureable population health goals. Collaborating with patients to identify, monitor, reassess, and refine self-management goals for diabetic patients are one of the DSRIP goals. Currently, the primary care clinics of a large County Regional Medical Center (CRMC) does not have a standardized HER method documentation of patient self-management goals. Adding a patient self-management goal tool in the EMR will act as a clinical reminder for providers to identify, assess, and reassess patient self-management goals. Over time, assessment of self-management goals will become a routine part of the provider-patient interactions. The outcomes for the diabetic patients treated in the CRMC clinics as self-management goals will be a central part of each patient’s plan of care to improved outcomes. Additionally, this project will result in leaving a permanent documentation tool in place that will provide the clinics with an ongoing reevaluation process that produces reliable evidence of their patient self-management goal documentation. Describe briefly how this study will contribute to existing knowledge in the field: This quality improvement project will contribute to existing knowledge by demonstrating the effectiveness of improving crucial documentation through implementation of a target specific documentation tool into the existing EMR. Specifically, it will demonstrate rates of change in documentation of information that is clearly linked to real-world quality improvement and healthcare outcomes. This quality improvement project will also analyze the effectiveness of provider adoption of new EMR clinical tools. 47 Description of Human Subjects Target Population Primary Care Providers (Physicians, Physician Assistants and Nurse Practitioners) in a County Regional Medical Center. Number of Participants or Sample Size Twenty to thirty providers. Characteristics of Population Males and females of various ethnic backgrounds, with varied years of experience. Specify Age of Subjects Adults, 21 years-of-age and older. Do your subjects include any of the following: ☐ Pregnant women/neonates ☐ Minors ages seven through seventeen ☐ Infants or children younger than seven years of age ☐ Cognitively impaired ☐ Inmates or prisoners ☐ Elderly/aged persons ☐ Non-English speaking persons ☐ Economically or socially disadvantaged ☐ Adults with physical or mental disabilities ☐ Patients ☐ Other special populations targeted in the study protocol ☒ None of the Above Recruitment Specify how you will gain access to, recruit and select your subjects? Describe when, where and how participants will be contacted. How will potential participants be initially identified? From what sources will participants be identified, i.e., school, business, health care, law enforcement, non-profit organization, etc. Attach letters or email from all organizations on official letterhead granting permission or IRB approval from the organization. Attach all recruitment documents i.e., flyers, brochures, bulletin boards, media, electronic media, social media, etc. Formatted: Font color: Red 48 This quality improvement project does not require any recruitment of subjects. A random sampling of the clinic’s diabetic population charts will be reviewed for presence or absence of self-management goal documentation. The clinic providers at the CRMC teaching hospital based clinics are already fully informed participants of ongoing quality improvement projects as a regular and usual part of their practice in the teaching hospital setting. The proposed project is fully supported by the clinic’s chief of staff, and the clinic administration. The proposed chart review does not constitute any unusual or elevated level of scrutiny above the standard level of review of the provider’s documentation. The Chief of Family Medicine has the project and intent to fulfill the USDHHS initiative. Enthusiastic support for the proposed project has been received by the providers and clinic administration. Data Collection In-person Interview In-person Questionnaire Observation Mail Survey/Questionnaire Telephone Survey/Interview Experimental Procedure Biometric Data Archival Data Electronic Survey Audio/Video Recording Analysis Focus Group Interview Standardized/Educational Test List all instruments, assessments, tests, questionnaires, interviews or other materials developed specifically for this research. If no special assessments were developed and used in this study, state “non- applicable” or NA . In Part 6 of this application, attach copies of any materials listed here, and attach verification of permission to use the materials in this research. Participant Data Collection Form List the titles of all instruments, assessments, tests, questionnaires, interviews or other materials developed commercially or by a third party. If no commercially developed materials were used in this study, state “non-applicable” or NA. In Part 6 of this application, attach copies of any materials listed here, and attach verification of permission to use the materials in this research. PHQ-9 Webb Brilliance Assessment Tool Describe in detail and in sequence the study procedures that involve human participants, including tests, treatments and research interventions This quality improvement project has five basic phases: 1. Determine baseline self-management goal documentation rates and impl 49 EMR tool designed to assist in documentation of self-management goals 2. Obtain a random sampling of the CRMC Family Care Clinic’s diabetic population records, to be reviewed to determine whether or not a provider has documented selfmanagement goals for that patient. 3. Deliver a provider education program explaining the new EMR tool for documentation of diabetic patient self-management goals 4. Repeat sampling and evaluate implementation rate comparison. 5. Disseminate results to all CRMC stakeholders within the clinic and hospital system through staff and USDHHS Delivery System Reform Incentive Payment (DSRIP) meetings. Are you offering payment or other inducements to participants in this study? ☒ No ☐ Yes Describe the amount of the payment or inducement and how it will be received. Will participation in the study involve any cost to the participant? ☒ No ☐ Yes If yes, indicate the anticipated costs and rationale. Part 3 – Risks and Benefits Please select all of the potential risks that are involved in your study. ☐ Use of private records (such as educational or medical records) ☐ Manipulation of psychological or social state such as sensory deprivation, social isolation, psychological stress ☐ Probing for personal or sensitive information in surveys or interviews such as private behaviors or employer assessments ☐ Presentation of materials which some participants may consider sensitive, offensive, threatening or degrading ☐ Possible invasion of privacy of subject’s family ☐ Social or economic risk (reputation, cultural, employability, etc.) ☐ Identification of child, spousal, or elder abuse ☐ Identification of illegal activity ☐ Risk of injury or bodily harm ☒ None of the Above Please indicate other risks in the field provided above. What level of risk does this research present to dignity, rights, health, welfare, or privacy of the participants? ☒ Less than Minimal Risk to Participants – Justify your rating below 50 ☐ Minimal Risk to Participants – Justify your rating below ☐ More than Minimal Risk to Participants – Explain and specify risks below Describe the steps that will be taken to minimize risks or harms and to protect the welfare of participants. Include a description of how you will handle an adverse or unexpected outcome that could be potentially harmful against any risk. Minimal risk is expected. However, there may be an emotional reaction to perceived individual practice feedback. In the event that this occurs, the CRMC Medical Director will be called in for consultation and reassurance that the results will be reported in aggregate only. Describe any benefits that individuals may reasonably expect from participation. If there are none, state “None.” As a result of the use of the reminder in the EMR, it is anticipated that providers will include this within their visit/s with their patients leading to improved evidence-based practice. Since the literature supports that diabetic patient self-management goal setting leads to better disease management, it is further expected that this will lead to improved patient outcomes. Describe any anticipated benefits of this study to society, academic knowledge or both. This study will provide information related to a gap in the literature regarding the meaningful use of EMRs for documentation beyond standard of care. Publishing the results will fill a part of that gap and also meets one of the Healthy People 2020 Objective D-14: Increase the proportion of persons with diagnosed diabetes who receive formal diabetes education (USDHHS, 2016) and will benefit society by reducing health care costs in those patients who learn about, practice and meet self-management goals. Part 4 – Privacy and Confidentiality Will you or any member of your research team collect or have access to any of the personal identifiers listed below? Select all that apply. ☒ Name ☒ Date of Birth ☐ Mailing or email address ☐ Phone numbers ☐ Social Security number ☐ Medical records ☒ License ☐ IP address ☐ Photos/images/audio recording ☐ Signatures, handwriting samples ☐ N/A 51 Any unique identifier not mentioned above: Gender, Race/Ethnic group; Years in Practice and years in current practice at the clinic. Describe the procedures for how the subject’s privacy will be maintained during the study. What provisions have been made to protect the confidentiality of participants? Where will you securely store data and research records? How will you dispose of signed consent, data and research records after the research is completed? While there are no participant’s in this study, any provider demographics and collected data from the electronic medical records will be stored on a password protected laptop computer, accessible only by the principle investigator. Disposal of the recorded information will be deleted at the end of the study. Findings will only be reported in the aggregate, in compliance with HIPAA, IRB and other clinic protocols. Part 5 – Consent Process Include any of the following attachments applicable to this application: Informed Consent The entire informed consent process involves giving a subject adequate information concerning the study, providing adequate opportunity for the subject to consider all options, responding to the subject’s questions, ensuring that the subject has comprehended this information, obtaining the subject’s voluntary agreement to participate, and continuing to provide information as the subject or situation requires. Identify and describe the procedures you will use to obtain Informed Consent. Attach a copy of the informed consent form in Part 6 (see Brandman University requirements and Sample Informed Consent form) and include the script of oral explanations. Include any Informed Consent forms required by other participating organizations. ☐ Consent Required: Participant informed consent required ☐ Consent Required: Written assent for children and individuals under 18 ☐ Consent Required: Parent/Guardian permission for children and individuals under 18 ☒ Consent not required Write Informed Consent Procedures While written consent is not required since this is a Quality Improvement Project and Providers have signed a general release to the clinic to participate in such activities, however, all providers attended an information session, where the project plan was introduced and an opportunity was given for any questions to be answered. Part 6 – Attachments Include your NIH Certificate (found at https://phrp.nihtraining.com/users/login.php) and any of the following attachments applicable to this application: 52 • Consent/Assent Forms (All parental/guardian consent forms, Information sheets for Waiver of Consent, Internet Consents, Verbal Consent scripts, etc.) • Screening Materials (Demographic questionnaires or measures used in screening subjects for inclusion or exclusion) • Site Permission/Support Letters (Letters form agency or organization granting permission – on official letterhead) • Recruitment Materials • Data Collection Instruments (Questionnaires, copyrighted tests, focus group questions, interview questions, scripts, etc.) Part 7 – Assurance I agree: • To comply with all BUIRB policies, decisions, conditions and requirements. • This study protocol has been designed, to the best of my knowledge, to protect human participants engaged in research in accordance with the applicable principles, policies, regulations, and laws governing the protection of human subjects in research. • To obtain prior approval from the BUIRB before amending the research protocol or the approved consent/assent form. • To report to BUIRB any adverse event(s) and/or unanticipated problem(s) involving risks to participants. • To submit the Annual Review Form as needed. ☒ I have completed the NIH Certificate and included a copy with the proposal. [Please Check NIH Certificate box.] Researcher’s Typed Signature: Dora N. Proposal Date: 01-21-2018 53 Appendix G Leatherby Library Checklist for Manuscript/White Paper Formatting (fillable template available at: http://chapman.libguides.com/ld.php?content_id=35720472) 54 55 Appendix H Directions on How to Change a Grade in Banner Here are the step-by-step directions to change a grade by faculty, when students have successfully completed their coursework: 1. Access the Grade Change landing page through the Banner Faculty link 2. Enter the students i.d. (B00——) number and hit TAB 3. The student’s information will populate and you will want to scroll down to REQUEST INFORMATION section. 4. Looking at the TERM LEGEND, identify the term that the course was taken. 5. Use the drop down arrow on the “Session when enrolled in course:” box and click on the term code so it appears in the box. 6. Next, scroll down and click on QUERY FOR COURSES link. 7. After the program brings up the courses for that session, you will be able to click on the drop down arrow in the “Please select a course from the list” box. 8. Select the course and when you scroll down, the information about the grade and instructor will populate. 9. Data enter the new grade and a description that states that the student has completed all work to earn a “P” grade (or other grade if you are changing a grade for a letter grade course in the future) 10. Click on submit and you will see a page that shows all grade changes that you have submitted. 11. Look for a confirmation email that states that you have submitted a grade change. It may take up to 24 hours to get the grade to change and another 24 hours for the grade change to show on the student’s Degree Works audit, but they are even quicker about it on most days. 56 Appendix I Sample DNP CSP Manuscript (fillable template found at: http://chapman.libguides.com/ld.php?content_id=37639438) Full Title of Clinical Scholarly Project A Clinical Scholarly Project by John Q. Student Brandman University Marybelle and S. Paul Musco School of Nursing and Health Professions Irvine, California Submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice Month and Year of Manuscript Submission Committee in charge: Firstname Lastname, Chair, Credentials Firstname Lastname2, Credentials Firstname Lastname3, Credentials 57 The Clinical Scholarly Project of John Q. Student is approved. D _______________________________________ D ________________________________________ D _______________________________________ _ Month and Year of Defense 58 Full Title of Clinical Scholarly Project Copyright © 2018 (year of submission) by John Q. Student 59 ACKNOWLEDGEMENTS (optional page) Insert all your acknowledgement text here. 60 ABSTRACT Full Title of Clinical Scholarly Project by John Q. Student Abstract text goes here. Double spaced. No more than 250 words. Keywords: Listed here using semi-colon between words and no italics 61 TABLE OF CONTENTS (optional page) Chapter 1 1 Subheading 1.1 2 Subheading 1.2 3 Chapter 2 10 Subheading 2.1 11 Subheading 2.2 13 References 75 Appendices 76 62 Chapter 1 Here is some sample text to begin your chapter. If you wish to start a new chapter, you can either copy and paste the above chapter heading into the appropriate place and then adjust the text, or insert a new chapter heading by clicking the “Title” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.1 To add additional subheadings to your chapter, you can either copy and paste the above subheading to the appropriate place and then adjust the text, or insert a new subheading by clicking the “Subtitle” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.2 Once you are done adding new subheadings, be sure to go to the References tab above, then click “Update Table” on the Table of Contents tab to update your Table of Contents. You may need to manually readjust the spacing between chapters in your Table of Contents after doing this. 1 63 Chapter 2 Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nulla malesuada, massa quis posuere laoreet, nunc neque convallis diam, sagittis auctor nibh eros in eros. Integer dignissim elit quis ante efficitur, nec condimentum purus laoreet. Interdum et malesuada fames ac ante ipsum primis in faucibus. Donec pretium ante vel justo volutpat, commodo venenatis mi eleifend. Cras non ultricies lacus. Vivamus lacinia molestie semper. Nunc ullamcorper vulputate tortor, iaculis blandit nisi rhoncus sit amet. Maecenas facilisis quis enim id malesuada. Aenean vitae cursus nisl. Praesent interdum a velit venenatis eleifend. Vestibulum ac mi a lorem tincidunt tincidunt. Subheading 2.1 Nunc convallis leo ac blandit rhoncus. Curabitur convallis, urna ac porttitor interdum, ipsum nulla facilisis odio, in consequat ante magna porta risus. Fusce aliquet turpis sapien, in lobortis mi feugiat nec. Phasellus porttitor magna rutrum ligula efficitur lobortis. Nunc lacus lectus, sagittis non risus at, blandit feugiat orci. Suspendisse posuere nisl ac efficitur pellentesque. Aliquam malesuada, est sed condimentum convallis, metus purus egestas tortor, et blandit ante dui at nisi. Vivamus et arcu augue. Vivamus ligula ante, dictum ac erat sit amet, tincidunt consectetur justo. Suspendisse viverra nisl id hendrerit lacinia. Quisque metus orci, feugiat quis justo maximus, dignissim suscipit dolor. Suspendisse leo nulla, tincidunt sed interdum eget, sollicitudin a orci. Vestibulum vel eros ipsum. Quisque euismod turpis et laoreet laoreet. Pellentesque sem purus, eleifend vitae dapibus id, consequat quis ligula. Maecenas id imperdiet augue. Phasellus est orci, eleifend a dolor at, varius consectetur dolor. Mauris vel arcu vel libero gravida molestie ac sed odio. Phasellus id tempus velit, nec ultricies ante. Nam at iaculis est, vitae gravida augue. Etiam turpis leo, tristique quis 64 nisl id, sodales porta tellus. Cras aliquet erat eu odio porttitor vulputate vel sed magna. Ut et dapibus magna. Mauris eget justo non magna venenatis vulputate. Vivamus vitae sollicitudin lacus, quis tempus neque. Subheading 2.2 Etiam faucibus nisl ligula, molestie porta diam suscipit quis. Sed ut interdum diam, sed bibendum ipsum. Donec fermentum ultrices odio, at porta lectus accumsan nec. Nulla eleifend ex non faucibus tempor. In purus nisi, consequat in sodales non, varius sit amet diam. Nulla facilisi. Duis aliquet mi eget ante venenatis, nec feugiat lectus vestibulum. Ut eget mollis orci. Duis elit ipsum, dictum vitae odio vel, imperdiet maximus tortor. Vestibulum placerat rutrum diam, et consectetur lacus luctus in. Aliquam sem enim, volutpat ac malesuada eget, vulputate id tortor. Ut mi ligula, tincidunt sit amet condimentum a, eleifend sit amet tellus. Nulla venenatis sapien nunc, in malesuada enim tincidunt sed. Donec vel vestibulum nulla. 65 References 66 Appendix A Title of Appendix in Correct Upper and Lower Case Words 67 Appendix B Title of Appendix in Correct Upper and Lower Case Words 68 Appendix J Sample White Paper Template (fillable template found at: http://chapman.libguides.com/dissertations) Full Title of White Paper A White Paper by John Q. Student Brandman University Marybelle and S. Paul Musco School of Nursing and Health Professions Irvine, California Submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice Month and Year of Manuscript Submission Committee in charge: Firstname Lastname, Chair, Credentials Firstname Lastname2, Credentials Firstname Lastname3, Credentials 69 The White Paper of John Q. Student is approved. D ________________________________________ D ________________________________________ D Month and Year of Defense 70 Full Title of White Paper Copyright © 2018 (year of submission) by John Q. Student 71 ACKNOWLEDGEMENTS (optional page) Insert all your acknowledgement text here. 72 ABSTRACT Full Title of White Paper by John Q. Student Abstract text goes here. Double spaced. No more than 250 words. Keywords: Listed here using semi-colon between words and no italics 73 TABLE OF CONTENTS (optional page) Chapter 1 1 Subheading 1.1 2 Subheading 1.2 3 Chapter 2 10 Subheading 2.1 11 Subheading 2.2 13 References 75 Appendices 76 74 Chapter 1 Here is some sample text to begin your chapter. If you wish to start a new chapter, you can either copy and paste the above chapter heading into the appropriate place and then adjust the text, or insert a new chapter heading by clicking the “Title” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.1 To add additional subheadings to your chapter, you can either copy and paste the above subheading to the appropriate place and then adjust the text, or insert a new subheading by clicking the “Subtitle” option under the Styles menu on the home tab. You will probably need to adjust the font and font size to match the rest of your manuscript if you do it this way, however. Subheading 1.2 Once you are done adding new subheadings, be sure to go to the References tab above, then click “Update Table” on the Table of Contents tab to update your Table of Contents. You may need to manually readjust the spacing between chapters in your Table of Contents after doing this. 1 75 Chapter 2 Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nulla malesuada, massa quis posuere laoreet, nunc neque convallis diam, sagittis auctor nibh eros in eros. Integer dignissim elit quis ante efficitur, nec condimentum purus laoreet. Interdum et malesuada fames ac ante ipsum primis in faucibus. Donec pretium ante vel justo volutpat, commodo venenatis mi eleifend. Cras non ultricies lacus. Vivamus lacinia molestie semper. Nunc ullamcorper vulputate tortor, iaculis blandit nisi rhoncus sit amet. Maecenas facilisis quis enim id malesuada. Aenean vitae cursus nisl. Praesent interdum a velit venenatis eleifend. Vestibulum ac mi a lorem tincidunt tincidunt. Subheading 2.1 Nunc convallis leo ac blandit rhoncus. Curabitur convallis, urna ac porttitor interdum, ipsum nulla facilisis odio, in consequat ante magna porta risus. Fusce aliquet turpis sapien, in lobortis mi feugiat nec. Phasellus porttitor magna rutrum ligula efficitur lobortis. Nunc lacus lectus, sagittis non risus at, blandit feugiat orci. Suspendisse posuere nisl ac efficitur pellentesque. Aliquam malesuada, est sed condimentum convallis, metus purus egestas tortor, et blandit ante dui at nisi. Vivamus et arcu augue. Vivamus ligula ante, dictum ac erat sit amet, tincidunt consectetur justo. Suspendisse viverra nisl id hendrerit lacinia. Quisque metus orci, feugiat quis justo maximus, dignissim suscipit dolor. Suspendisse leo nulla, tincidunt sed interdum eget, sollicitudin a orci. Vestibulum vel eros ipsum. Quisque euismod turpis et laoreet laoreet. Pellentesque sem purus, eleifend vitae dapibus id, consequat quis ligula. Maecenas id imperdiet augue. Phasellus est orci, eleifend a dolor at, varius consectetur dolor. Mauris vel arcu vel libero gravida molestie ac sed odio. Phasellus id tempus velit, nec ultricies ante. Nam at iaculis est, vitae gravida augue. Etiam turpis leo, tristique quis nisl id, sodales porta tellus. Cras aliquet erat eu odio porttitor vulputate vel sed magna. Ut et 76 dapibus magna. Mauris eget justo non magna venenatis vulputate. Vivamus vitae sollicitudin lacus, quis tempus neque. Subheading 2.2 Etiam faucibus nisl ligula, molestie porta diam suscipit quis. Sed ut interdum diam, sed bibendum ipsum. Donec fermentum ultrices odio, at porta lectus accumsan nec. Nulla eleifend ex non faucibus tempor. In purus nisi, consequat in sodales non, varius sit amet diam. Nulla facilisi. Duis aliquet mi eget ante venenatis, nec feugiat lectus vestibulum. Ut eget mollis orci. Duis elit ipsum, dictum vitae odio vel, imperdiet maximus tortor. Vestibulum placerat rutrum diam, et consectetur lacus luctus in. Aliquam sem enim, volutpat ac malesuada eget, vulputate id tortor. Ut mi ligula, tincidunt sit amet condimentum a, eleifend sit amet tellus. Nulla venenatis sapien nunc, in malesuada enim tincidunt sed. Donec vel vestibulum nulla. 77 References 78 Appendix A Title of Appendix in Correct Upper and Lower Case Words 79 Appendix B Title of Appendix in Correct Upper and Lower Case Words 80 Appendix K MSNaHP DNP CSP Cover Sheet and Rubric for Oral Defense MSNaHP DNP CSP Rubric for Oral Defense -COVER SHEETStudent Name: ____________________________________ Date: ________________________ Title of project: ________________________________________________________________ ______________________________________________________________________________ Project White Paper Other: _________________________________ Project Chair: ______________________ Reviewer: ___________________________________ Recommendation: Pass Pass with revisions No pass i3 Award Category: N/A Inquire Innovate Inspire Additional Comments: ___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Student Name: __________________________________ Date: ________________________ Project Chair: _____________________ Reviewer: ________________________ 81 MSNaHP DNP CSP Rubric for Oral Defense MSNaHP DNP CSP Rubric for Oral Defense Content (as applicable) Exemplary (4) Proficient (3) Developing (2) Emerging (1) Comments and Points Awarded 1. Description of problem 2 points (8/100) Clear and concise Adequate and supported Incomplete or inaccurate Inappropriate or missing 2. PICOt 2 points (8/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 3. Lit review analysis 4 points (16/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 4a. CSP summary, including method, objectives and theoretical framework 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing -OR- 4b. Clear description of Position and activity 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 5a. Statistical methods, demographics and results 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing -OR- 5b. Clear description of argument against 3 points (12/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 6a. Implications (clinical significance, limitations, etc.) 2 points (8/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing -OR- 6b. Impact (social, health, financial, etc.) 2 points (8/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 7. Sustainability of outcomes and recommendations 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 8. Synthesis and application of the AACN Essentials (maximum of 3) 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 9. Plans for dissemination 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate 82 *Student must obtain 80% of the total points to pass the oral defense (i.e., 80/100)* Presentation Exemplary (4) Proficient (3) Developing (2) Emerging (1) Comments and Points Awarded 1. Organization: Logical sequence; easily followed 1 point (4/100) Clear and concise Adequate Incomplete or inaccurate Inappropriate or missing 2. PPT Appearance: Clear and professional font and graphics with correct APA format 1 point (4/100) Professional appearance with no visible errors Adequate appearance with minor errors Irregular font and/or other visible errors Inappropriate or poor format with obvious errors 3. Presentation Skill: Voice 1 point (4/100) Audible and Clear Minor errors or areas of confusion Multiple errors or inaccurate information Inarticulate 4. Professional Image 1 point (4/100) Professional Casual Disheveled Inappropriate 5. Knowledge: Answers additional question/s with clear and concise elaboration 1 point (4/100) Clear and concise answers Adequate answers Incomplete or inaccurate answers Inappropriate or unable to answer 6. Time: Maintained time limit of 20 minutes 1 point (4/100) ≤15 minutes <10 minutes or >20 <7 minutes or >25 <5 minutes or >30 Total: _____ 83 Appendix L PPT Template for DNP CSP Manuscript Defense template for dnp csp oral defense brandman.potx 84 Appendix M PPT Template for DNP White Paper Defense template for dnp csp white paper brandman.ppt