Implications of the DNP Practice Change Project on Nursing and Healthcare Outcomes

Purpose

The purpose of this discussion is to explore the implications of the DNP practice change project on nursing and healthcare outcomes.

Instructions

Reflect upon your readings and professional experience and address the following 

1. Describe and evaluate the influence of your DNP practice change project on the stakeholders at your practicum site.
2. Examine the implications of your DNP practice change project on nursing and healthcare outcomes.
3. Describe and appraise how data-driven decision-making will be used to determine the sustainability or extension of your DNP practice change project.

Notes from my manuscript

PICOT: In adult patients with mild to moderate depression at an outpatient mental health clinic, does implementation of MBSR compared to current practice improve depression symptoms in 8-10 weeks?

Implications of the project

• Reduce depression symptoms and improve overall well-being in mild to moderate depressive patients.
• Maintain patients’ treatment compliance without dropping out due to high dose antidepressants side effects and helps to stay in remission instead of high-cost treatments. 
• Healthcare systems will have reduced health care costs and enhance community well-being.

Plans for Sustainability

Marciniak et al. (2020) showed that MBSR is a suitable long-term intervention for people with prolonged and recurrent depression. Sustainability requires staff training and development and encouragement to get certified in integrating the therapy into their expertise. MBSR should be modified into clinical protocols and used as a standard treatment for mild to moderate depression. Patient support groups will be created to foster long-term use of MBSR and provide online resources for self-directed practice. The program can be continually monitored and improved to meet the evolving needs of the patients. 

Some ongoing evaluation and modification strategies include longitudinal studies to assess the sustained impact of MBSR on participants and regular review meetings with stakeholders to evaluate program data and challenges and brainstorm potential modifications. Additionally, there should be continuous professional development, encouraging staff to engage in ongoing research and training on mindfulness-based interventions to stay up-to-date with developments in the field. Technological adaptation of telehealth and mobile services in delivering MBSR intervention can address patient preferences and maintain therapy adherence. The alternative intervention is designed to be culturally competent, catering to the diverse needs of the community the clinic serves. 

Analyzes data to describe the basic features of the data in a project or study

Intervention Plan- I, along with trained mindfulness instructors, will implement the Mindfulness Based Stress Reduction intervention to participating 18-65-year-old patients diagnosed with mild to moderate depression. The group sessions will occur twice weekly (45-minute sessions) with one 8-hour weekend class during the 6th week of the implementation period. The lessons on mindfulness meditation and Mindfulness Based Stress Reduction activities will be conducted at the clinic location and the participants can access the sessions through a combination of in-person sessions and Zoom web-conferencing platform sessions. The recommended daily self-directed activities can be completed by participants at their own homes or other location of choice. Week 1: Project Implementation begins with Participant recruitment and staff training. I will begin reaching out to potential participants to explain the Mindfulness Based Stress Reduction program, benefits, structure of the program, explain the time commitment, and obtain informed consent. Appointments will be scheduled for the in-person and virtual sessions. Staff training will occur which will include details of the project, timeline, and outline of training sessions. Weeks 2-9: The Intervention Implementation Begins. In the first in-person meeting, I will introduce the instructors, provide program materials to participants for mindfulness stress reduction activities are breathing exercises, meditation sessions, sleep support, mindful walking, and journaling. A baseline assessment of depression symptoms will be collected using the participant completed PHQ-9 surveys to assess pre-intervention data. I and a Psychiatric Mental Health Nurse Practitioner will be available to work in participant group sessions for 45-minute sessions twice weekly. These sessions, which focus on mindfulness principles and practices, will be conducted through in-person sessions at the clinic, but participants can also access the sessions through web conferencing via Zoom. Participants will be instructed on the daily 45-minute self-directed Mindfulness Based Stress Reduction activities and in logging their daily activities. During this intervention period for eight weeks, formative evaluations will take place. I will solicit and provide feedback through discussions with clinic leadership in meetings, biweekly huddles, and 1:1 weekly meetings with participants to discuss any challenges and experiences and get guidance. As the project manager, I will review the participant self-reported usage of the mindfulness activities and journal entries for week-to-week assessments. Besides the patients’ self-report, I will rely on in-person and Zoom meeting observations and participant attendance records for compliance assessments. Week 6: Participants will attend a virtual 8 hour mindfulness workshop conducted by a me and the Psychiatric Mental Health Nurse Practitioner. Topics will include yoga, mindful walking, and meditation to enhance their practice. Week 10: Conclusion. I will wrap up the project, administer post-intervention PHQ-9 screenings, and thank participants for being part of my DNP practice change project. I will conduct one-on-one discussions with participants to discuss post-intervention maintenance of mindfulness, and celebrate achievements. I plan to utilize this time to thank every participant for being part of the practice change project and for their support. Week 11: Analysis of data will begin. The aggregate project results will be disseminated.