DNP capstone (PMHNP)

[DrCOVID, DNP]

Hey... well I'm not sure why there is no DNP forum, considering seems as if this is going to be the new standard. Not sure if this is the right place but I digress...

I have selected an idea; I want to encourage contraceptive use for patients with psych illness since most every drug (mood stabilizer/antipsychotic) has been shown to be somewhat teratogenic. However, where I come up short is measurement. These capstone projects have to demonstrate some sort of measurable variable to track over time.

Seems like most capstone projects are just some education project which measure scores of a basic test to assess for improvement of understanding the topic. I'm drawing a blank as far as what I could measure outside the clinic or patient based. Maybe pregnancy rates? I don't have that much time though. What else could I possibly measure in this case?

[SopranoKris, MSN, RN, NP]

Here's the link to the DNP forum: https://allnurses.com/doctoral-degrees-c215/

DNP is only the recommended standard, just like BSN is recommended. However, not going to be mandatory any time soon unless all states adopt the consensus model. Even then, there would be grandfathering of experienced MSN NPs.

As far as your project, I'm sure you understand the difference between qualitiative and quantitative approach to research. What exactly do you want to measure? That will point you in the right direction ?

[DrCOVID, DNP]

Thanks for linking that I'm going to check it out. Well... in my city, the Universities are getting rid of the master's programs. Even if it isn't "mandatory," I can see it going that direction. I mean to have masters for this type of work was kinda silly in the first place, not to mention our curriculum is a joke. But I digress.

I really don't have any preference on what is measured I just want something. These projects are so silly... lol. Look at some on the vanderbuilt website. Most of them feature samples of around 10. I guess you change the world one patient at a time.

[llg, PhD, RN]

You have to keep in mind that purpose of such school projects is not to change the world and/or win a Nobel Prize for research ... but rather to demonstrate that the student has learned the principles and processes of doing evidence-based projects. If you do a great job and your project does a little good in the world, so much the better.

[DrCOVID, DNP]

Don't you usually check for learning by administering a test? ? Most of us are a little upset, since this is supposed to be a practice focused degree and we aren't focusing on providing patient care. We don't feel that (Almost done with year 2 of 3) we have been prepared to take care of patients. Our curriculum has had 2 statistics courses and 2 research courses and we've had 1 class per each big P which isn't even close to enough. Then of course half of the clinic time is doing a QI projects... It's just not respectable. My only bargaining power when I start work will be twisting the truth to say I have had 1200 hours of clinic time therefore I deserve $1XX,000.

[umbdude, MSN, APRN]

It sounds like you want to put in some sort of educational program for patients taking psychotropics about the use of contraceptives to avoid pregnancy (if the patients wish). I guess you can measure rates of contraceptive use among your population, before and after your educational program.

I do think this might be a touchy subject, however. Imagine if a patient mistaken you for trying to "push" contraception on her...that might come across (for some) as you trying to keep psych patients from having kids because they have a mental illness. I would tread this very carefully. Also, in the real world, providers find ways to work around pregnancy issues based on the individual patient, and it's done all the time.

[DrCOVID, DNP]

That's a really good idea, but the thing is there is no way to measure that. The clinic doesn't collect that type of data, and I'm not even sure how you would. You can't make someone take/use BC.

As you have noted this is a touchy subject. I am becoming convinced I am limited to simply providing education and measuring pre and post education learning via survey because of ethical issues.

Oh yeah man - if there is anything clear about being back in school, it's how unrealistic and theoretical it is. Just trying to graduate so I can have a better quality of life and more $$$!!

[llg, PhD, RN]

On 10/15/2019 at 11:35 AM, adammRN said:

Don't you usually check for learning by administering a test?

No. Giving a standard test is not the only way to evaluate whether or not someone has learned something. When teaching a skill (whether it is a technical skill as one would do with a patient) or teaching how to be a leader and conduct a project that might improve practice ... a "return demonstration" is often a better form of evaluation.

Just as you would not explain how to draw blood and then give a quiz on your lecture to "teach how to draw blood," ... it would not be good educational practice to explain how to conduct a project and then conduct a written exam to test whether or not the students were capable of conducting a project in real life.

Maybe your particular DNP program is a bad one. If that is the case, I am sorry you chose such a bad school. But the idea of teaching people who want to attain a doctoral level degree and be leaders in nursing how to conduct a project that has the potential to improve practice is a good one. Yes, clinical skills also needs to be included in the curriculum ... but that doesn't make the leadership aspects of the degree wrong or bad. That aspect of the doctoral degree need to be included, too.

[DrCOVID, DNP]

The most common form of knowledge assessment is question and answer. Not return demonstration. Of course return demonstration is more effective debating that is not the point.

Me and a 100 other alumni and students chose a bad school!! Seeing as you have a PhD, your opinion aligns with the theoretical philosophy. I can tell you in our class, none of us care about these projects. We are doing the DNP because we don't wanna have to go back to school, don't want a PhD, and want to be providers.

Also, there are DNP tracks for Leadership/management. That is not why we chose the program. We chose it because nursing is going to doctor only, and we wan't to make money and be providers. We choose either FNP/PMHNP DNP tracks. Doctor of NURSING PRACTICE, not Doctor of Implementing free QI in a place where most people don't know what DNP means. I have talked to most of the staff and I am given this blank stare eventually, like "why are you even talking to me?" All of the providers all told me to do a "workflow" project, since pts wait around for hours often. Guess what? Can't do that bc it's "not DNP level."

My clinic is a new FQHC, they already use standardized tools and are following federal laws. My adviser is telling me I have to use a standardized tool somehow to implement. I am forcing a project on this place and there is no obvious gap in their care... Again, you will probably blame me for picking a "bad clinic," yet we don't know what the problem is till you have spent time there. Just like the program itself.