NR703 Week 7 Assignment | Professional DNP Leadership Capacity

NR703 Week 7 Assignment | Professional DNP Leadership Capacity – Step-by-Step Guide With Example Solution

The first step before starting to write the NR703 Week 7 Assignment | Professional DNP Leadership Capacity is to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the paper’s audience and purpose, as this will help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, review its use, including writing citations and referencing the resources used. You should also review the formatting requirements for the title page and headings in the paper, as outlined by Chamberlain University.

How to Research and Prepare for NR703 Week 7 Assignment | Professional DNP Leadership Capacity

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify a list of keywords related to your topic using various combinations. The first step is to visit the Chamberlain University library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from the Chamberlain University Library, PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last 5 years and go through each to check for credibility. Ensure that you obtain the references in the required format, such as APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next, create a detailed outline of the paper to help you develop headings and subheadings for the content. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NR703 Week 7 Assignment | Professional DNP Leadership Capacity

The introduction of the paper is the most crucial part, as it helps provide the context of your work and determines whether the reader will be interested in reading through to the end. Begin with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NR703 Week 7 Assignment | Professional DNP Leadership Capacity

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence collected from the research, and ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance, as well as how it relates to the thesis statement. You should maintain a logical flow between paragraphs by using transition words and a flow of ideas.

How to Write the In-text Citations for NR703 Week 7 Assignment | Professional DNP Leadership Capacity

In-text citations help readers give credit to the authors of the references they have used in their work. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

“The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Morelli et al. (2024), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Alawiye (2024) highlights that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.”

How to Write the Conclusion for NR703 Week 7 Assignment | Professional DNP Leadership Capacity

When writing the conclusion of the paper, start by restating your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper by restating them. Discuss the implications of your findings and your arguments. Conclude with a call to action that leaves a lasting impression on the reader or offers recommendations.

How to Format the Reference List for NR703 Week 7 Assignment | Professional DNP Leadership Capacity

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically, and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Morelli, S., Daniele, C., D’Avenio, G., Grigioni, M., & Giansanti, D. (2024). Optimizing telehealth: Leveraging Key Performance Indicators for enhanced telehealth and digital healthcare outcomes (Telemechron Study). Healthcare, 12(13), 1319. https://doi.org/10.3390/healthcare12131319

Alawiye, T. (2024). The impact of digital technology on healthcare delivery and patient outcomes. E-Health Telecommunication Systems and Networks, 13, 13-22. 10.4236/etsn.2024.132002.

NR703 Week 7 Assignment | Professional DNP Leadership Capacity

Purpose

NOTE: This assignment must use the provided Paper Template which is found in this Link (Word doc): Week 7 Assignment Paper Template. Have a look at NR703 Week 8 Discussion | Reflection on Learning and Practice Readiness.

The purpose of this assignment is to demonstrate your leadership capacity to manage a practice change project. You will create a collective manuscript that incorporates the revised Week 2 and Week 5 assignments with an additional section that you will create this week.

This assignment will allow for the assimilation of professional leadership competencies in project management as a DNP-prepared nurse. Assignment content supports professional formation, communication, and dissemination skills relevant to the DNP-prepared nurse.

Please note that this is the third part of a 3-part assignment submitted in Weeks 2, 5, and 7. You have received feedback from your course faculty on the Week 2 and Week 5 assignments, which you should use to revise and prepare the Week 7 assignment.

NOTE: All NR703 assignments and their requirements should be discussed in relation to your proposed or hypothetical DNP practicum project.

Instructions

Use the provided Week 7 Assignment Paper Template and include the following:

1. Introduction: The organizing introduction is the first paragraph that does the following:
   1. Introduce the paper’s topic and establishes its importance.
   2. Present a clear purpose statement.
   3. Create a brief overview (outline statement) for the combined paper using the three primary Level 1 headings.
2. Integrate the Week 2 corrected content under the first Level 1 heading, “Organizational Needs Assessment.”
   1. Don’t forget to include the discussions of Table 1 (Organizational Needs Assessment: Practice Gap Identification) and Table 2 (Johns Hopkins Individual Evidence Summary Tool). Both tables must be referred to in the paper’s content.
   2. Include the required level 2 headings (as they are on the template):Practice Gap
      1. Problem
      2. Practice Gap
      3. Practice Question
   3. Integrate the Week 5 corrected assignment content under the second Level 1 heading, “Leading the Practice Change Project,” using the following level 2 headings (Note: level 3 headings for sub-topics are recommended):
      1. Interprofessional Collaboration in Leading Project Teams
      2. Communicating Comportment in Project Management
      3. Leadership Ethics
   4. Create the content to place under the third Level 1 heading, “Leading Practice Change Teams with Innovation and Effective Management,” using the following level 2 headings:
      1. Leading Through Innovation
      2. Integrating Leadership and Management Models
      3. Managing Materials and Human Resources
   5. Conclusion
      1. Recap the paper’s purpose statement and brief overview (outline statement) for the combined paper using the three level 1 headings (don’t include “conclusion”).
      2. Draw major conclusions from the body of your paper.
      3. Summarize the paper’s relevance to the practice change project.
   6. References (minimum of 4 scholarly, peer-reviewed sources)
      1. Create a reference page.
      2. Include the references from the first two papers that you have used in this paper if they are still used.
      3. Ensure each reference has a matching citation.
      4. Support your paper by using evidence from at least four (4) scholarly peer-reviewed journal article sources (preferably research or systematic reviews) that are retrieved from the Chamberlain library databases. Do not use the internet, textbooks, government sources, or organizational websites for these four sources in this assignment. However, you may use other gray materials for additional sources if you need them.
   7. Attach the revised Table 1 (Organizational Needs Assessment: Practice Gap Identification) and Table 2 (Johns Hopkins Individual Evidence Summary Tool) from the Week 2 assignment as displayed on the Week 7 Assignment Template

Review the rubric for the grading criteria.

APA Guidelines

Use the current Publication Manual of the American Psychological Association (APA Manual) and the Chamberlain Guidelines for Writing Professional Papers: Graduate Programs (located in the APA Basics section of the Writing Center) to complete this assignment. Follow these guidelines when completing each component. Contact your course faculty if you have questions.

1. Use the NR703 Week 7 Assignment Template provided to insert your content for this assignment.
   1. Link (Word doc): Week 7 Assignment Paper Template.
   2. Personalize the title page by adding your name and the session month and year of the course where indicated.
   3. The title is already provided for you in the template.
2. Turn on Grammarly to check the correctness of the grammar and punctuation as you write. (Note: if you have not already done so, please download the free version at Grammarly.com before the construction of the assignment.)
3. Note: Because this assignment builds on the materials used in the Weeks 2 and 5 assignments as well as several discussions, similarities are expected; therefore, Turnitin will not be routinely used in this cumulative assignment. However, papers may be reviewed in Turnitin if the instructor deems it necessary.
4. Use the following prescribed Level 1 and Level 2 headings, which are already provided in the template, for this paper (level 3 headings are encouraged where needed):
   1. Organizational Needs Assessment
      • Problem
      • Practice Gap
      • Practice Question
   2. Leading the Practice Change Project
      • Interprofessional Collaboration in Leading Project Teams
      • Communicating Comportment in Project Management
      • Leadership Ethics
   3. Leading Practice Change Teams with Innovation and Effective Management
      • Leading Through Innovation
      • Integrating Leadership and Management Models
      • Managing Materials and Human Resources
   4. Conclusion

Writing Requirements (APA format)

• Length: 8-12 pages for accumulated paper (not including the  title page, references page, or tables)
• Use the Week 7 Assignment Paper Template that is formatted with the following APA conventions
  • 1-inch margins
  • Double-spaced pages
  • 12-point Times New Roman
  • Headings & subheadings
  • Title page
  • Reference page
  • Table 1 and Table 2
  • In-text citations
• Standard English usage and mechanics
• CARE Plan paragraph development structure
• Revisions based on course faculty feedback from Week 2 and 5 Assignments

Program Competencies

This assignment enables the student to meet the following program competences:

2. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
3. Appraises current information systems and technologies to improve health care. (POs 6, 7)
4. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This assignment enables the student to meet the following course outcomes:

1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
5. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

NR703 Week 7 Assignment | Professional DNP Leadership Capacity Example

Professional DNP Leadership Capacity

Leadership capacity entails assessing an individual leader’s approach to leading to develop a more effective way of leading and achieving results. DNP-prepared nurses are trained to be leaders in their practice settings. Developing leadership capacity for DNP nurses is therefore essential. A solid understanding of the leadership expectations and the team being led is also required for the leader to develop their leadership capacity effectively. This essay assimilates the professional leadership capacities and project management in managing practice change projects. The essay will include an organizational needs assessment, leading the practice change project, and leading practice change teams with innovation and effective management.         

Organizational Needs Assessment

An organizational needs assessment identifies and determines how an organization can fill particular needs gaps. It also entails determining the organization’s current and desired states to identify what the organization requires to achieve the desired state. The barriers to achieving the organizational goals and objectives are also identified in an organizational needs assessment. The DNP-prepared nurse must possess the organizational needs assessment skill and competency to play the project management role effectively. The organizational needs assessment process is an integral part of strategic planning, enabling the organization to focus on its strategic goal by identifying potential areas for improvement. The organizational needs assessment, in this case, will help identify the problem and the practice gap and thus inform the development of a practice question.       

Problem

The healthcare organization of focus is a long-term care facility. The facility is a medium-sized facility that serves approximately 500 patients. It offers patient care and other social and physical services to facilitate daily living. Many of the long-term care facility patients are geriatric patients with terminal and chronic illnesses, ranging from diabetes, cancer, liver disease, and kidney disease to psychiatric disorders. The institution has integrated long-term care and skilled nursing services to ensure it serves a broader range of patients, including those who do not require specialized clinical/medical services. Additionally, it has skilled nurses, nurse aides, and other support staff to ensure it provides the best quality services to all patients.

The organizational needs assessment conducted revealed that pressure ulcers are one of the most significant practice problems impacting the organization. According to Cowen et al. (2019), pressure ulcers, also known as bed sores, are injuries to the skin and other underlying tissues resulting from prolonged pressure in the current position. In addition, Cowen et al. (2019) note that long-term care facilities have a high prevalence of pressure ulcers since most of their patients have neurodegenerative conditions and paraplegia, which increase immobility and the risk of pressure ulcers.

Different stakeholders are the decision-makers in the long-term care facility. The stakeholders include nursing unit leaders, general managers, nurses, physicians, nurse aides, patients and their families, as well as institutional leaders. The decisions of these stakeholders affect how the pressure ulcer practice problem is prevented, managed, controlled, and addressed. For example, research indicates that nurses play a crucial role in preventing, managing, and controlling pressure ulcers (Kim & Lee, 2019). Nurses work with the institution’s nursing unit leaders and managers to develop and suggest interventions to address pressure ulcers.   

The practice problem is identified as a patient safety and quality issue that negatively impacts patient outcomes and the quality of life for the patients. It also increases the family’s healthcare expenses. Additionally, the problem is identified by the number of pressure ulcer cases reported within the organization and the associated costs of treating and managing these cases.     

Practice Gap

A practice gap is an existing skill and knowledge or an opportunity for improvement in an organization. According to the organization’s needs assessment, the practice gap is that it lacks adequate methods to prevent pressure ulcers. For example, many pressure ulcer cases are reported in the organization, mainly resulting from inadequate prevention interventions. Ideally, long-term care facilities are expected to have low cases of pressure ulcers by ensuring high standards of intervention for pressure ulcer prevention are put in place.

However, the practice gap is seen when there is a deficit in these interventions, and the facility reports a high number of pressure ulcer cases. The factors contributing to the practice gap include potential issues related to a need for more knowledge in pressure ulcer prevention and inadequate prevention measures within the organization. The practice gap is evident in the comments made by nurses in the facility, pressure ulcer case reports, and nurses’ reports of a desire to play a more effective role in preventing pressure ulcers.    

Practice Question

 The target population includes male and female adult patients admitted to the facility for more than six months. The proposed intervention uses readily available ripple mattresses. Ripple mattresses prevent pressure ulcers by relieving the pressure on the joint areas. According to Shi et al. (2020), bed and mattress interventions effectively prevent pressure ulcers in immobile patients. In addition, research shows that ripple mattresses, as a preventive intervention, have been tested as effectively in pressure ulcer prevention (Shi et al., 2021). The current practice involves routine two-hour repositioning of the patient. Additionally, the outcome is a reduction in the facility’s new pressure ulcer cases. The project intervention will be implemented over a 10-week period.

The practice question developed to address the practice gap is as follows: For patients hospitalized for more than six months, does using ripple mattresses, compared to routine care, reduce the number of new pressure ulcer cases, as measured before and after the intervention, over a 10-week period?   

Leading the Practice-Change Project

As mentioned earlier, DNP-prepared nurses play a significant role in leading practice change projects in their organizations/practice settings. They utilize their leadership skills, strengths, and competencies, as well as management skills, to guide the implementation of practice change projects. Interprofessional collaboration, effective communication, and leadership ethics are essential considerations when leading practice change projects.   

Interprofessional Collaboration in Leading Project Teams

Interprofessional collaboration brings together members from different disciplines to work together throughout all phases of the project, thereby enhancing adequate involvement and promoting project success (Wei et al., 2022). The professional teams involved in the project include institutional leaders, executive management, nurses, nurse assistants, doctors, social workers, and caregivers. First and foremost, I will select a team comprising representatives from all professional teams involved. I will work closely with the team to lead the other professional members, ensuring they are informed about the way forward, decisions, roles/expectations, and to enhance timely communication. Nachbagauer (2022) notes that decision-making is easier when working with a smaller team than with a larger one. Secondly, I will emphasize role clarity and ensure that feedback from all teams is welcomed and incorporated into the practice change project.

Creating an Environment of Mutual Respect and Shared Values

As a project manager, fostering an environment of shared values and mutual respect is essential, thereby promoting effective collaboration and project success. Mutual respect and shared values also enhance collaboration. I intend to create an environment of mutual respect and shared values by demonstrating that all teams are equally important and their contributions are valued. In addition, we will lay out the project’s core values at the beginning of the project implementation. These values will be respected by all and guide all teams toward working in harmony.

Facilitating Team Roles and Flexibility to Perform Effectively

I will intentionally facilitate team roles by ensuring that the roles and expectations of every team are clear and distinct. Additionally, the teams’ contributions and expected outcomes will be clearly outlined. The roles will be delegated based on the teams’ scope of practice, specialty, and what they do best. The teams will be more engaged while assigning roles, enhancing flexibility, and improving performance.           

Communicating Comportment in Project Management

Alvarenga et al. (2020) state that project managers must be professional while communicating with the project team and stakeholders. Project managers need to have clear communication guidelines to guide them throughout the project. The communication guidelines I will apply in the project include six steps: selecting a communication format, setting a communication goal, identifying stakeholder recipients, selecting a communication method/channel, determining the communication frequency, and identifying the person responsible for providing communication updates. All the steps will differ depending on the communication content and the intended recipients. For instance, meeting invitations to the executive can be sent through emails, while clarifications to nurse assistants can be made through verbal communication.

Verbal and Non-Verbal Communication Competencies

 Effective leadership requires possessing both verbal and non-verbal communication skills and competencies at a doctoral level. Communicating leadership using verbal communication involves using spoken words to convey a message to the team members. The professional competencies in verbal communication will include speaking clearly, being concise and precise, and being prepared to make clarifications. Additionally, the competencies I will apply in non-verbal communication include maintaining eye contact, nodding when conversing, and showing a desire to speak using the raised hand gesture.

Written Professional Communication

Effective leadership requires possessing both verbal and non-verbal communication skills and competencies at a doctoral level. Communicating leadership using verbal communication involves using spoken words to convey a message to the team members. The professional competencies in verbal communication will include speaking clearly, being concise and precise, and being ready to make clarifications. Additionally, the competencies I will apply in non-verbal communication include maintaining eye contact, nodding when conversing, and showing a desire to speak using the raised hand gesture.

Leadership Ethics

Leadership ethics involves maintaining ethical conduct as a leader, developing standards, and fostering an environment that encourages other followers to uphold high ethical standards. I intend to create a consistent image of ethical behavior while implementing the practice change project by leading as an example, utilizing a transformational leadership style, and demonstrating high ethical conduct, thereby empowering my team to uphold the same standards. My team is expected to employ the principles of leadership ethics, including honesty, integrity, respect, transparency, trust, and fairness.

Balance an Ethic of Justice with an Ethic of Care

According to Juujärvi et al. (2019), the ethic of justice focuses on maintaining equity and fairness by applying ethical principles, while the ethic of care focuses on maintaining relationships by meeting the needs of others and avoiding hurt. Using the transformational leadership approach, I will balance the two by treating project team members equally and promoting respect and dignity among interprofessional teams, thus maintaining their relationships.

Conflict Resolution Approach

Project managers should be equipped with conflict management skills and competencies, as conflicts are inevitable when working with a diverse team. The conflict resolution approach that will be used among the project team in cases of bullying or disagreements is the collaboration approach. The collaboration approach will be employed in bilateral and multilateral negotiations, where conflicting parties will engage in dialogue to identify a mutually beneficial solution.

Lead Social Justice Change within the Project Environment

Leading social justice change entails leadership that reduces discrimination and bias by employing equitable treatment for all (Warner, 2020). I intend to ensure that the project intervention is implemented for patients from minority groups to address bias, counter inequities, and combat social injustices. Additionally, the project team will not discriminate against professionals based on cultural differences and will thus apply cultural humility.

Leading Practice-change Teams with Innovation and Effective Management

Leadership in practice change projects requires creating an environment that fosters innovation and utilizing effective management skills to enhance success. Project managers should foster a working environment where team members are encouraged to be creative and innovative. Additionally, the manager should select and integrate leadership and management models that are in leading practice for change projects. Developing an approach to manage human and material resources efficiently is also essential.   

Leading Through Innovation

There are various ways in which a leader can foster an environment of innovation and creativity. First and foremost, I will ensure that my team is allowed to work individually and that suggestions and feedback are welcomed and acted upon. Weintrub and McKee (2019) note that leaders can use individuality, anonymous feedback, and suggestions to cultivate innovation and creativity. Secondly, I will ensure that the best talent is incorporated into the team and that the team has a diverse range of talents.   

Adaptive leadership is the practical approach that prepares individuals and organizations to remain agile even in challenging environments. Applying the adaptive leadership framework in my practice change project will positively impact my leadership identity by enhancing my leadership character and capabilities to embrace change and guide my team members in adapting to organizational changes.

I intend to enhance my leadership communication capabilities across interprofessional teams by selecting a suitable communication channel and medium for all team members. Additionally, I will employ different communication forms to ensure that the communication message reaches all the team members. Two-way and top-down communication from one source will also be applied to avoid miscommunication and message duplication.

Integrating Leadership and Management Models:

Incorporating leadership competencies and behaviors is also essential when working with an interprofessional change team to implement the practice change. I will employ the leadership and behavior competencies of influence, agility, and emotional intelligence. I will lead change by example using influence. I will also act quickly in making decisions and ensure my emotions do not affect my leadership roles and activities. 

Furthermore, I will use management and leadership skills to sustain the practice change and describe the critical components of the practice change project. I will integrate my leadership competencies and management skills to influence and motivate my team members, while also controlling the process and the team to enhance achievement of the set objectives. 

Managing Materials and Human Resources

Human resources and materials are essential in implementing practice change projects. It is, therefore, vital to manage them efficiently to minimize waste and enhance project success. Buljac-Samardzic et al. (2020) note that project managers should develop a strategic approach to managing human and material resources to ensure they are efficiently used to facilitate practice change. I intend to maximize the available material resources while minimizing waste. I will also encourage team members’ productivity to ensure that human resources are maximized, thereby enhancing the effective implementation of the project. The best talent and skill set required to implement the project will also be selected.  

Conclusion

Assimilating professional leadership capacities and project management in managing practice change projects is vital in enhancing project success. The discussion above has explored how a project manager can conduct an organizational needs assessment, lead the practice change project, and lead practice change teams with innovation and effective management. The needs assessment identified pressure ulcers as a significant problem in the focus institution. The practice change project will introduce an evidence-based intervention to prevent pressure ulcers. The practice change project will be led through innovation and effective management. The paper outlines the leadership and management framework for the practice change project and identifies the essential considerations for implementing the project.

References

Alvarenga, J. C., Branco, R. R., Guedes, A. L. A., Soares, C. A. P., & e Silva, W. D. S. (2019). The project manager’s core competencies contribute to project success. International Journal of Managing Projects in Business. https://doi.org/10.1108/IJMPB-12-2018-0274

Buljac-Samardzic, M., Doekhie, K. D., & van Wijngaarden, J. D. (2020). Interventions to improve team effectiveness within health care: a systematic review of the past decade. Human resources for health, 18(1), 1-42. Https://doi.org/10.1186/s12960-019-0411-3

Cowan, L. J., Ahn, H., Flores, M., Yarrow, J., Barks, L. S., Garvan, C., Weaver, M. T., & Stechmiller, J. (2019). Pressure Ulcer Prevalence by Level of Paralysis in Patients with Spinal Cord Injury in Long-term Care. Advances in Skin & Wound Care, 32(3), 122–130. https://doi.org/10.1097/01.ASW.0000553109.70752.bf

Juujärvi, S., Ronkainen, K., & Silvennoinen, P. (2019). The ethics of care and justice in primary nursing of older patients. Clinical Ethics, 14(4), 187-194. https://doi.org/10.1177/1477750919876250

Kim, J. Y., & Lee, Y. J. (2019). A study on the nursing knowledge, attitude, and performance towards pressure ulcer prevention among nurses in long‐term care facilities in Korea. International Wound Journal, 16, 29–35. https://doi.org/10.1111/iwj.13021

Nachbagauer, A. (2022). Resilient project management. The Journal of Modern Project Management, 10(1), 03–17. https://doi.org/10.19255/JMPM02901

Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., & McInnes, E. (2020). Beds and mattresses for treating pressure ulcers. The Cochrane Database of Systematic Reviews, 2020(5), CD013624. https://doi.org/10.1002/14651858.CD013624

Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., McInnes, E., Goh, E. L., & Norman, G. (2021). Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta‐analysis. The Cochrane Database of Systematic Reviews, 2021(8). https://doi.org/10.1002%2F14651858.CD013761.pub2

Warner, T. L. (2020). Leading for Social Justice: A Call to Action to improve society. Journal of Organizational and Educational Leadership, 5(1), 2. https://files.eric.ed.gov/fulltext/EJ1247349.pdf 

Wei, H., Horns, P., Sears, S. F., Huang, K., Smith, C. M., & Wei, T. L. (2022). A systematic meta-review of systematic reviews about interprofessional collaboration: facilitators, barriers, and outcomes. Journal of Interprofessional Care, 36(5), 735–749. https://doi.org/10.1080/13561820.2021.1973975

Weintraub, P., & McKee, M. (2019). Leadership for Innovation in Healthcare: An Exploration. International Journal of Health Policy and Management, 8(3), 138. https://doi.org/10.15171%2Fijhpm.2018.122

Table 1

Organizational Needs Assessment: Practice Gap Identification

What is currently happening in the practicum site that causes clinical problems?	What should be happening in the practicum site based on current evidence?	What do the stakeholders (decision-makers) and the evidence identify as the gap between what is currently happening and what should be happening (this is your practice gap)?	1. Why is there a gap in practice?   2. What factors are contributing to the gap in practice?	What evidence do you have to demonstrate there is a practice gap (NDNQI, AHRQ Quality Indicators, National Hospital Quality Measures, CAHPS Hospital Survey, Joint Commission ORYX®, etc.)?
A high number of new pressure ulcer cases are reported in long-term care facilities.	Nurse Practitioners (NPs) should use evidence-based pressure ulcer prevention strategies to reduce the number of new cases.	Approximately 35% of the patient population has reported pressure ulcers; however, there are no clear guidelines for pressure ulcer prevention beyond routine care.	Potential issue with the lack of knowledge associated with pressure ulcer prevention   Inadequate prevention measures in the facility	Comments provided by the Nurses.   NPs report that they want to be better able to prevent pressure ulcers, especially among elderly patients.
PICOT Problem Statement: For patients hospitalized for more than six months, does using ripple mattresses, compared to routine care, reduce the number of new pressure ulcer cases as measured before and after the intervention in 10 weeks?   P (Population – example: For critical care patients in X hospital ICU)   I (Intervention – example: Does the implementation of the medical sepsis protocol)   O (Outcome, measurable – example: Reduce the incidence of medical sepsis as measured before and after)

Table 2

Johns Hopkins Individual Evidence Summary Tool

Article Number	Author and Date	Evidence Type	Sample, Sample Size, Setting	Findings That Help Answer the EBP Question	Observable Measures	Limitations	Evidence Level, Quality
2021 (8)	Shi (2021).	Review of Meta-analyses	Four reviews with 68 studies and 18174 participants	Bed overlays and mattresses were found effective in preventing pressure ulcers as compared to routine care	The article reviewed articles with bed overlays, and mattresses, pressure ulcer prevention interventions	Other prevention interventions were not considered in the comparisons	Shi et al. (2021) appraised Level I  evidence with grade A quality. The study has generalizable results, and the sample size is sufficient for the study design.
32(3)	Cowan (2019).	Quasi-experimental study	Seven thousand five hundred forty patients with quadriplegia, 11,614 patients with paraplegia, and 32,510 patients with hemiplegia in LTC facilities.	Patients with paraplegic issues are at a high risk of pressure ulcers, thus a need to implement prevention interventions.	The study aimed to assess the prevalence of pressure ulcers in long-term care facilities.	The study only focused on patients with paraplegic issues, leaving out other important factors such as neurodegenerative factors.	Cowan et al. (2019) were appraised at Level II grade A Quality. The sample size is sufficient, and the results are generalizable.
2020 (5)	Shi (2020)	Systematic review	32 studies with 9038 participants from acute care settings	Alternating pressure in ripple mattresses reduced the proportion of participants developing new pressure ulcers	The observable measures included the prevalence of pressure ulcers and the number of new cases	The studies included in the review have an average of 80 participants, which is a small number. The methods used in these studies were also likely to produce errors	Shi et al. (2020) were appraised at the level I grade B quality since the sample was inadequate
16	Kim (2019)	Experimental study	282 registered nurses in long-term care facilities	Nurses were found to play a major role in the prevention of pressure ulcers using various nursing interventions	Registered demonstrated a positive attitude, knowledge and skills toward the prevention of pressure ulcers	The study’s primary limitation is the failure to include other factors of pressure ulcers prevention	Kim and Lee (2019) were appraised at level II grade A quality The sample is adequate, and the results are generalizable to similar populations.