Ethical Considerations for DNP Projects
PICOT: in community clinic nursing staff, how does the introduction of National Institute for Health and Care Excellence (2016a) guidelines within ten weeks affect the accuracy of diagnosing and quality of managing depression in the older population as compared to the staff’s performance before the intervention?
The ethical considerations for the proposed project are minimal. The National Institute for Health and Care Excellence (2016a) guidelines predominantly affect the activities of nurses and other healthcare professionals; in other words, no vulnerable patients are going to be involved in the process of change directly. Similarly, since the guidelines are evidence-based, the innovation is highly unlikely to decrease the quality of care, which is why the change is ethical.
The data collection tool, which is the National Institute for Health and Care Excellence (2016b) depression management quality standards, does not require obtaining personal patient information; mostly, it tracks the activities of nurses (for example, the correctness of the assessment procedure). Therefore, no confidential patient information is going to be required for the study. Nurses, who are the participants of the study, are going to be protected in a similar way: no confidential and personal information about them is going to be collected, disclosed, or transferred to the final report; they will not be identified in the report. Moreover, all the nurses will be recruited on a voluntary basis and provided with all the information on the study before they can sign the informed consent form. The risks of the project are almost non-existent: it is acknowledged that the nurses might experience psychological discomfort connected to the nature of change, its specifics, or processes involved in it. The nurses will be encouraged to share their concerns with the help of the project’s feedback channels; any issue will be addressed individually.
In summary, the study ensures the protection of the rights of the stakeholders, including the rights to self-determination, privacy, confidentiality, and freedom from harm and discomfort (Burns, Grove, & Gray, 2015; Polit & Beck, 2017). Apart from that, the project presupposes very few risks, and the ones that can be identified are controlled. Thus, the project will involve ethical and protective processes.
Project Implementation Plans
PICOT: in community clinic nursing staff, how does the introduction of National Institute for Health and Care Excellence (2016a) guidelines within ten weeks affect the accuracy of diagnosing and quality of managing depression in the older population as compared to the staff’s performance before the intervention?
The project’s milestones include the ones that have already been achieved (problem and solution determination) and the future ones. The latter may consist of the project plan finalization, project implementation and completion, report finalization, and the presentation of the results. The completion of data collection and analysis processes can also be viewed as milestones. The project implementation part will contain the recruitment of the required number of participants (ten) and the introduction of the guidelines as the milestones. Similarly, the weekly meetings with the nurses, which will be used for formative assessments, feedback, and motivational purposes, can also be seen as the milestones that signify the progress of the project.
The use of change models will help in achieving the milestones. The change process is guided by the Iowa Model of Evidence-Based Practice (White & Spruce, 2015), which is complemented by the innovation diffusion theory developed by Rogers (2010); the two have been shown to be compatible (Hanrahan et al., 2015). The former will assist in providing the framework for most activities (from planning to results dissemination), and the latter will ensure the engagement of stakeholders, which is exceptionally crucial for the project’s progress. Other than that, careful planning and diligent work should help in milestone achievement.
Concerning the revisions of the plan and schedule, they have not been very extensive. However, as more materials about DNP projects and organizational change are reviewed, more elements are added. For instance, the initial schedule did not specifically mention meetings with faculty, although the then-included feedback on the project incorporated this element. Now the meetings are specifically pointed out to highlight their importance for the process. Also, some changes might be made in the future to adjust the schedule to the actual duration of activities. Since the present schedule is quite flexible, it should not be a problem (see Appendix A).
References
Burns, N., Grove, S., & Gray, J. (2015). Understanding nursing research (6th ed.). Amsterdam, Netherlands: Elsevier.
Hanrahan, K., Wagner, M., Matthews, G., Stewart, S., Dawson, C., Greiner, J.,… Williamson, A. (2015). Sacred cow gone to pasture: A systematic evaluation and integration of evidence-based practice. Worldviews on Evidence-Based Nursing, 12(1), 3-11. Web.
National Institute for Health and Care Excellence. (2016a). Depression in adults: Recognition and management. Web.
National Institute for Health and Care Excellence. (2016b). Depression in adults: Quality Standards. Web.
Polit, D.F., & Beck, C.T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Rogers, E.M. (2010). Diffusion of innovations (4th ed.). New York, NY: Simon and Schuster.
White, S., & Spruce, L. (2015). Perioperative nursing leaders implement clinical practice guidelines using the Iowa Model of Evidence-Based Practice. AORN Journal, 102(1), 50-59. Web.