Critique of the Doctor of Nursing Practice (DNP)

Critique of the Doctor of Nursing Practice (DNP)

Critique of the Doctor of Nursing Practice (DNP)

DNP Scholarly Program Evaluation

School of Nursing, Northern Kentucky University

DNP 806: Program Development, Implementation, & Evaluation

Dr. Teresa Huber

September 20, 2020Critique of the Doctor of Nursing Practice (DNP)

DNP Scholarly Program Evaluation

Doctor of Nursing Practice (DNP) scholarly projects help to lead change and improve

patient outcomes within the healthcare industry. It is important to evaluate DNP scholarly

projects in order to determine if the project achieved expected outcomes. This paper uses the

goal-based model to evaluate the effectiveness of a care-team led patient mobility program. This

paper provides an evaluation of objectives, identifies how the financial aspect of the project will

be evaluated for effectiveness, and explains how data collected will be analyzed and how results

will be utilized.

Evaluation Model—Goal-Based Model

Program evaluation is an important part of completing a DNP scholarly project. Terhaar

& Sylvia (2015) explain that a project evaluation helps to support translation into practice,

replication, and dissemination. When evaluating programs, it is important to determine the

specific model for evaluation. The DNP scholarly project for using a care-team led mobility

program will be evaluated using a goal-based model.

Description of Goal-Based Model of Evaluation

The goal-based model of evaluation uses specific metrics to evaluate the effectiveness of

goals and objectives, and this model helps to identify if the intended goals are met or not met

(Pell Institute and Pathways to College Network, 2020). This model helps to answer questions

such as: 1) Did the program achieve intended outcomes? 2) What effect does the program have

on individuals involved? 3) Does the program impact individuals and populations on a larger

scale? (Pell Institute and Pathways to College Network, 2020). Furthermore, using this model of

evaluation helps to determine if the program needs modifications or improvements prior to

disseminating (Pell Institute and Pathways to College Network, 2020).




Rationale for Using Goal-Based Model of Evaluation

The goal-based model of evaluation is the best method to use for evaluating the

program’s goals for decreasing length of stay (LOS) and the increasing patient experience.

Inconsistency with using systematic evaluation tools is a common barrier for effectively

measuring the impact of quality improvement projects (Izumi, 2012). The rationale for using a

goal-based model of evaluation is to decrease inconsistencies for evaluating the program’s

effectiveness by providing quantitative data to support the need for continuing or modifying the

program. The goal-based model of evaluation is also the preferred evaluation method for the

hospital system where this project will be completed. Meeting or exceeding the expected goals

will support dissemination across the entire system.

Evaluation of Objectives

The purpose of well-designed DNP projects is to identify and evaluate measurable

outcomes that support EBP and nursing inquiry to improve patient care (Harris, 2020). Harris

(2020) explains that projects should identify key objectives and outcomes that determine the

level of success for executing and disseminating practice changes. The overall goals for

implementation of a care-team led mobility program are to decrease LOS and improve the

patient experience. Read further to learn more about these goals and the evaluation of objectives

associated with each goal.

Goal #1—Decrease LOS

One goal for implementing a care-team led mobility program is to decrease LOS by 0.3

days in the medical-surgical department performing the project. The goal itself is evaluated

based on comparative data. Pre-implementation data will include the previous 6-month average

LOS prior to implementation, and post-implementation data will include the 3-month average




LOS after implementation. The objectives to effectively meet this goal are as follows: 1)

Implement the usage of the Johns Hopkins Highest Level of Mobility (JH-HLM) tool; 2) Ensure

compliance with usage of the tool; 3) Educate staff on the steps to take if mobility declines.

Objective #1—Implement Usage of JH-HLM Tool

The JH-HLM tool is an EBP assessment that helps to identify the level of mobility for

patients in the hospital. The tool has an interrater reliability of 0.99 between physical therapists

and nurses (Hoyer et al., 2018). The process for implementing the usage of this tool will involve

in-person education during shift starters with all staff for a period of one month. Nurses and

patient care associates will be provided a copy of the tool and open discussions will be

encouraged to facilitate learning. Furthermore, the assistant nurse manager (ANM) and the nurse

manager (NM) will work alongside nursing staff and patient care associates when using the tool

for one month. This objective will also be evaluated by the ANM and NM on a daily basis in

real-time. Common questions and concerns voiced from staff will be collected, and needed

clarifications will be disseminated to staff.

Objective #2—Compliance with Usage of Tool

Compliance with using the JH-HLM tool will be monitored during department rapid

rounds which are completed by the nursing team, care management, and department hospitalist.

Patient mobility will be discussed using the JH-HLM tool, and all nurses will provide the score

according to the assessment. Compliance with using the tool will be identified during rapid

rounds, and an overall percentage of compliance will be calculated daily, monthly, and quarterly.

Appendix A, Data Collection and Evaluation Tools provides the instrument used to audit