NU806 Unit 5 DNP Contribution Seminar Reflection Example

Knowledge for One Hospital, or for Nursing? A Unit 5 Seminar Reflection on What a DNP Project Contributes to the Discipline

[Student Name]

Purdue University Global

NU806: DNP Project III

Unit 5 Seminar Reflection

[Instructor Name]

[Date]

The seminar, classmates and project details are composite; the sources cited are real.

Local Value or Contribution?

Our facilitator reminded us that the catalog describes the DNP project as a culminating experience that contributes to the discipline, and then asked how a project determined to be quality improvement, explicitly not designed to produce generalizable knowledge, could do that. I answered first and, I thought, honestly. My insulin bundle improved discharge at one hospital. Its main outcome did not reach statistical significance. Its value, I said, was to the patients and staff of that hospital, and claiming more would be overreach.

Several classmates agreed, and for a few minutes the seminar settled into a comfortable consensus that local value was enough. One said her project was "a good thing done well, not a contribution to science," and I liked that phrase.

The Question That Changed It

A classmate, Siobhan, who works in informatics, asked about something I had mentioned only in passing: the correction-scale finding. Nine of the first 27 patients who answered our day-one text said they were unsure of their dose, and eight of those nine had gone home with a correction scale. She asked whether anyone had published that. I said I did not know. She asked whether it mattered to nurses outside Dubuque. I had to say yes.

Then she asked a second question. If a nurse in another state read my project and changed how she taught correction scales, would that be a contribution to nursing, or only to that nurse's hospital?

I had measured my contribution by whether my main result was significant, when the most useful thing I learned was something I never set out to measure.

Reading Around the Question

Dols et al. (2017) describe the uncertainty within nursing about what the DNP project is and how it differs from research, and they note that its contribution is often framed in terms of practice rather than new theory. The AACN task force report on the DNP asks for a project that ends in a concrete product, evaluated and shared, and it does not ask that the product be knowledge that generalizes the way a study's findings do (American Association of Colleges of Nursing [AACN], 2015). Read together, the two suggest that a DNP project's contribution lies in knowledge about implementation: how a change was carried into a real setting, what got in the way and what was learned.

Lynn et al. (2007) make a related point about improvement work generally. Its findings may not generalize in the way research findings do, but sharing what was learned allows others to judge whether it applies to their setting. That is a contribution of a different kind, and an honest one.

Where I Now Stand

The seminar ended without agreement, which was probably right, since each project's contribution depends on what it found.

I think my project contributes three things beyond the hospital, each modest and each real. The first is a delivery model, resource nurses on each unit, pens on the first insulin day and texts in place of most educator calls, shown to be workable in a regional hospital at low cost. The second is the correction-scale finding, which raises a question that published discharge studies do not seem to have asked directly: whether patients newly on insulin can manage a scale in their first week at home. The third is an account of eleven adaptations, each recorded with its reason, which shows other teams where a bundle like ours bends when it meets real units.

None of these is proof. All of them are knowledge another nurse could use, and each is stated in the manuscript with the limits that keep it from being mistaken for more.

What I Will Do

I will add a section to my manuscript on the correction-scale finding, presented as an observation that needs testing rather than a result. I will include the change log as supplementary material, so others can see what we adapted. And in the defense, I will describe the project's contribution in these terms, rather than apologizing for a non-significant outcome.

Closing Thought

My plan going in was to defend the project as useful to one hospital and no more. I left thinking that a DNP project contributes to nursing when it reports what happened honestly enough for others to use it, and that the most useful finding may be one the project never set out to find.

References

American Association of Colleges of Nursing. (2015). The Doctor of Nursing Practice: Current issues and clarifying recommendations. Report from the Task Force on the Implementation of the DNP. https://www.aacnnursing.org/Portals/0/PDFs/Publications/DNP-Implementation-TF-Report-8-15.pdf

Dols, J. D., Hernández, C., & Miles, H. (2017). The DNP project: Quandaries for nursing scholars. Nursing Outlook, 65(1), 84-93. https://doi.org/10.1016/j.outlook.2016.07.009

Lynn, J., Baily, M. A., Bottrell, M., Jennings, B., Levine, R. J., Davidoff, F., Casarett, D., Corrigan, J., Fox, E., Wynia, M. K., Agich, G. J., O'Kane, M., Speroff, T., Schyve, P., Batalden, P., Tunis, S., Berlinger, N., Cronenwett, L., Fitzmaurice, J. M., Dubler, N. N., & James, B. (2007). The ethics of using quality improvement methods in health care. Annals of Internal Medicine, 146(9), 666-673. https://doi.org/10.7326/0003-4819-146-9-200705010-00155