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Discussion

DNP Project proposal

So I have just recently started graduate school to attain my DNP degree with AGACNP specialty. I am only in my second semester of 8, and have to start thinking about what DNP project I want to present and defend. I work at a level 2 trauma center and work in the ICU. I usually float to all 4 units but also am involved in the Rapid response team. I really enjoy being in rapid response and would like to focus my topic on something in this arena, but need ideas on what i could narrow down to discuss.

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    What problems do you typically encounter at work? Could you do a lit review, measure it, and/or come up with a solution to that? This is what most of the students do in my program. Otherwise, when they start clinicals they see what issues their preceptors or sites have and work on those as a project. But man, the ICU and acute care is fertile ground for quality improvement projects.

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    What INTERESTS you?

    I would expect when someone gets to the doctoral level of education, they would have a better idea of what they would want the representation of their life's work to be than to need to ask a bunch of strangers on the internet.

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    Cleback very great direction and suggestion thank you very much. The reason I wanted to elaborate on Rapid Response was the very fact that nurses on the floor do not communicate or utilize the RR team until it is too late or a code has occurred. There is no "infrastructure" or guidance for the RR nurse. This is mainly do to the fact that the RRT is not well established, meaning there is no job description or policy. The hospital simply designates a person daily, that they think is competent and that nurse really does what they want, of course until they receive an alert via pager for a code (sepsis, stroke, code blue etc.) Ultimately, communication amongst other issues is a critical issue. You are absolutely right, the ICU is very fertile for QI, I am just simply new to this and only have my BSN, which i received many years ago. I appreciate your input greatly Cleback, thank you very much.

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    • Author

    You are absolutely right Klone, unfortunately I only have a BSN and am going straight to DNP after many years out of school. I am trying to get back in the "groove" and simply need suggestions or ideas. "All nurses" is more than just a place of strangers, it is a place full of experienced, inexperienced, knowledgeable and wise nurses wanting to empower nurses and the profession. I hope this is your intention on this website, and in your response to my post. I appreciate your resopnse.

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    • Experts
    Cleback very great direction and suggestion thank you very much. The reason I wanted to elaborate on Rapid Response was the very fact that nurses on the floor do not communicate or utilize the RR team until it is too late or a code has occurred. There is no "infrastructure" or guidance for the RR nurse. This is mainly do to the fact that the RRT is not well established, meaning there is no job description or policy. The hospital simply designates a person daily, that they think is competent and that nurse really does what they want, of course until they receive an alert via pager for a code (sepsis, stroke, code blue etc.) Ultimately, communication amongst other issues is a critical issue. You are absolutely right, the ICU is very fertile for QI, I am just simply new to this and only have my BSN, which i received many years ago. I appreciate your input greatly Cleback, thank you very much.

    I think you just answered your own question. Why not focus on a quality improvement project to disseminate information to the nursing staff on when it's appropriate to call the RR team? You can find evidence supporting early intervention in respiratory issues, cardiac, etc. I know we had issues with staff waiting too long to call RR when a pt has breathing issues. By the time you get there, it's an emergent intubation situation. If they would have called earlier, we might have had success with a Venti mask, NRB, or a BiPAP. Same with cardiac. Call us when you're concerned about chest pain and other cardiac symptoms so we can get the ball rolling with an EKG, check trops, give some nitro, etc. You could easily turn this into a great staff education plan and open the lines of communication between them and the RR team. I'm an ICU nurse as well, and we all too often see situations that could have been avoided if the floor staff had called us sooner.

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    • Experts
    Cleback very great direction and suggestion thank you very much. The reason I wanted to elaborate on Rapid Response was the very fact that nurses on the floor do not communicate or utilize the RR team until it is too late or a code has occurred. There is no "infrastructure" or guidance for the RR nurse. This is mainly do to the fact that the RRT is not well established, meaning there is no job description or policy. The hospital simply designates a person daily, that they think is competent and that nurse really does what they want, of course until they receive an alert via pager for a code (sepsis, stroke, code blue etc.) Ultimately, communication amongst other issues is a critical issue. You are absolutely right, the ICU is very fertile for QI.

    If what you are describing is true, and I have no reason to believe that it isn't, your RR program is substandard and dangerous. A good RR program has a clear set of responsibilities and guidelines both for providing care and for communication. Any nurse accepting that assignment is putting his/her license on the line. You couldn't pay me to do it even though the majority of my experience is in flight and CCT nursing. I think you have your project.

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    Cleback very great direction and suggestion thank you very much. The reason I wanted to elaborate on Rapid Response was the very fact that nurses on the floor do not communicate or utilize the RR team until it is too late or a code has occurred. There is no "infrastructure" or guidance for the RR nurse. This is mainly do to the fact that the RRT is not well established, meaning there is no job description or policy. The hospital simply designates a person daily, that they think is competent and that nurse really does what they want, of course until they receive an alert via pager for a code (sepsis, stroke, code blue etc.) Ultimately, communication amongst other issues is a critical issue. You are absolutely right, the ICU is very fertile for QI, I am just simply new to this and only have my BSN, which i received many years ago. I appreciate your input greatly Cleback, thank you very much.

    Sounds like a good problem to tackle. I'd meet with advisor to brainstorm how you'd want to measure the problem. I'd also get in touch with your work educators and basically let them know you're interested in that as a school project. They may have their own ideas on the issue. You may also want to meet with your librarian to help with the literature search. Your topic might be a bit challenging as I'm sure a lot of information out there is unpublished. Good luck!

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