Assignment: Translational Research Case Report

Assignment: Translational Research Case Report

Assignment: Translational Research Case Report DNP 820 Week 7

Nurses prepared in research and practice focused doctoral programs make important contributions to the development and implementation of the science that shapes nursing practice. This article explores the different, yet complementary roles that PhD and DNP prepared nurses make to the scholarship of discovery within the discipline of nursing. The impact of translational research, implementation science, and improvement science on the quality of healthcare is explored, along with the possibilities presented by big data. Examples of successful collaborations are highlighted, including opportunities for DNP and PhD faculty to advance scholarship and research. The authors consider the context of these roles in both research and practice and academia.

Case Report Translational Research and Evidence Based Practice

Details:

In this assignment, learners are required to write a case report addressing the personal knowledge and skills gained in the current course and potentially solving an identified practice problem.

General Requirements:

Use the following information to ensure successful completion of the assignment:

  • Use at least two additional scholarly research sources published within the last 5 years. Provide citations and references for all sources used.
  • Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
  • This assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the expectations for successful completion.
  • You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

CLICK HERE TO ORDER Assignment: Translational Research Case Report

Directions:

For a specific focus of patient practice (e.g., acute care hospital, clinic, primary care, long-term care, home health), select a particular disease process. Chose a topic of concern such as providing elements of care for a specific disease process or an administrative problem. This topic must be in need of progression or process improvement. Once identified, summarize the literature supporting proposed change. Identify an action plan to introduce change and potential barriers to implementing change. Finally, describe how you would propose evaluating the change.

Your case report must include the following:

  1. Introduction with a problem statement.
  2. Brief synthesized review.
  3. Description of the case/situation/conditions.
  4. Proposed solutions describing the validity and reliability of the research you have read.
  5. Conclusion.

Portfolio Practice Hours:

Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the learner, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network.

To earn portfolio practice hours, enter the following after the references section of your paper:

Practice Hours Completion Statement DNP-820

I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.

Case Report – Translational Research and Evidence-Based Practice Rubric

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Unsatisfactory
0.00%
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Less Than Satisfactory
74.00%
3
Satisfactory
79.00%
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Good
87.00%
5
Excellent
100.00%
70.0 %Content  
15.0 %Identification of Topic of Concern  Identification and description of topic of concern are not present. Assignment: Translational Research Case Report Identification and description of topic of concern are present but incomplete. Identification and description of topic of concern are present but done at a perfunctory level. Identification and description of topic of concern are clearly presented and in full. Discussion is convincing. Information presented is from scholarly though dated sources. Identification and description of topic of concern are clearly presented and in full. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
15.0 %Discussion of the progressions or process of improvement Discussion of the progressions or process of improvement is not present. Discussion of the progressions or process of improvement is present but incomplete. Discussion of the progressions or process of improvement is present but done at a perfunctory level. Assignment: Translational Research Case Report Discussion of the progressions or process of improvement is clearly present. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. Discussion of the progressions or process of improvement is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
5.0 %Introduction and Problem Statement An introduction with problem statement is not present. Assignment: Translational Research Case Report An introduction with problem statement is present but incomplete. An introduction with problem statement is present but rendered at a perfunctory level. An introduction with problem statement is present, clear, and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. An introduction with problem statement is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
5.0 %Brief Literature Review A brief literature review is not present. DNP 820 Week 7 Assignment: Case Report Translational Research A brief literature review is present but incomplete. A brief literature review is present but rendered at a perfunctory level. Assignment: Translational Research Case Report DNP 820 Week 7 A brief literature review is clearly present in full. Information presented is from scholarly though dated sources. A brief literature review is clearly present in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
5.0 %Description of the Case, Situation, or Conditions A description of the case, situation, or conditions is not present. A description of the case, situation, or conditions is present but incomplete. A description of the case, situation, or conditions is present but rendered at a perfunctory level. Assignment: Translational Research Case Report A description of the case, situation, or conditions is convincing and defines specific elements. Information presented is from scholarly though dated sources. A description of the case, situation, or conditions is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
5.0 %Detailed Explanation of the Synthesized Literature Findings A detailed explanation of the synthesized literature findings is not present. A detailed explanation of the synthesized literature findings is present but incomplete. Assignment: Translational Research Case Report DNP 820 Week 7 A detailed explanation of the synthesized literature findings is present but rendered at a perfunctory level. A detailed explanation of the synthesized literature findings is convincing and defines specific elements. Information presented is from scholarly though dated sources. A detailed explanation of the synthesized literature findings is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
5.0 %Case Summary A case summary is not present. Assignment: Translational Research Case Report DNP 820 Week 7 A case summary is present but incomplete. A case summary is present but rendered at a perfunctory level. A case summary is convincing and defines specific elements. Information presented is from scholarly though dated sources. A case summary is clearly present. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.
10.0 %Proposed Solutions to Remedy Identified Technology Gaps, Inefficiencies, or Other Issues Proposed solutions are not presented. Assignment: Translational Research Case Report Proposed solutions are presented but are incomplete. Proposed solutions are presented but are rendered at a perfunctory level. Assignment: Translational Research Case Report DNP 820 Week 7 Proposed solutions are clearly presented and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. Proposed solutions are clearly presented and thorough. Discussion is insightful, forward-thinking, and detailed. Information presented is from current scholarly sources.
5.0 %Conclusion A conclusion is not presented. A conclusion is presented but is incomplete. A conclusion is presented but is rendered at a perfunctory level. A conclusion is clearly presented and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. A conclusion is clearly presented and thorough. Discussion is insightful, forward-thinking, and detailed. Information presented is from current scholarly sources.
20.0 %Organization and Effectiveness  
7.0 %Thesis Development and Purpose Paper lacks any discernible overall purpose or organizing claim. Assignment: Translational Research Case Report DNP 820 Week 7 Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
8.0 %Argument Logic and Construction Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use) Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English. DNP 820 Week 7 Assignment: Case Report Translational Research
10.0 %Format  
5.0 %Paper Format (Use of appropriate style for the major and assignment) Template is not used appropriately or documentation format is rarely followed correctly. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style. All format elements are correct.
5.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment and style) No reference page is included. No citations are used. Reference page is present. Citations are inconsistently used. Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present. Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct. In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error.
100 %Total Weightage

Assignment: Translational Research Case Report DNP 820 Week 7

Advancing Scholarship through Translational Research: The Role of PhD and DNP Prepared Nurses

In March 2018, leaders from the nation’s nursing schools voted to endorse a position statement advanced by the American Association of Colleges of Nursing (AACN) on Defining Scholarship for Academic Nursing. The task force that prepared this document was charged with capturing the profession’s current consensus related to the scholarship of discovery or scientific inquiry; the scholarship of practice or application and integration; and the scholarship of teaching. Though often considered the domain of research scientists, the AACN position (2018a) recognizes that “in today’s academic setting, scholarship should be inclusive and applicable to scientists, as well as practice, education, and policy scholars” (para. 1). As a significant focus of healthcare research shifts toward translational research, it is important for faculty, graduate students, and other stakeholders within academic nursing to consider how the profession’s two terminal degrees incorporate this into their scholarship.

…nurses prepared at the doctoral level must serve as stewards of the profession with a responsibility to develop and disseminate scholarship. In keeping with the expectations of academia, and other health disciplines, nurses prepared at the doctoral level must serve as stewards of the profession with a responsibility to develop and disseminate scholarship. In today’s workforce, nurses with doctoral degrees represent only about 2% of the nursing population (Budden, Zhong, Moulton, & Cimiotti, 2013) despite great demand for these individuals to serve as Advanced Practice Registered Nurses (APRNs), assume faculty roles, embark on careers as research scientists, and pursue leadership roles (Howard & Williams, 2016).

Those considering a terminal degree in nursing must make a choice…Those considering a terminal degree in nursing must make a choice: focus on a career devoted to intellectual inquiry and conducting original research studies or concentrate on developing practice expertise and implementing evidence-based practice innovations at the macro or microsystems level. In the realm of translational research, nurses focus on either original research (PhD) or actual translation of evidence into practice (DNP).

In particular, PhD implementation scientists, implementation researchers, and translational research experts are seeking to understand: “1). What concepts predict better implementation?; 2) Which implementation metrics are reliable and valid?; 3) How should baseline assessments be conducted?; and 4) What system antecedents and readiness predict better adoption of evidence-based practices?” (Newhouse, Bobay, Dykes, Stevens, & Titler, 2013, p. S38). DNP prepared evidence based practice experts are implementing evidence into practice when systems demonstrate readiness, conducting assessments driven by data, applying research concepts to better implement evidence into practice, and evaluating implementation using reliable and valid metrics. Understanding the academic differences and individual attributes of DNP and PhD nurses, as well as areas for collaboration related to translation research, can help nurses both identify the correct academic path and, for those in the field, ways to incorporate scholarship into their career.

Complementary Approaches to Scholarship by Degree

PhD Prepared Nurse

The Doctor of Philosophy (PhD) in nursing represents the highest level of formal education for a career in research and the scholarship of discovery. Program graduates develop new nursing science, serve in leadership capacities, and educate the next generation of nurses. Designed to prepare nurse scholars, these programs focus heavily on scientific content and research methodology and typically require an original research project as well as the completion and defense of a dissertation. Attainment of the PhD (or the Doctor of Nursing Science/DNS at some institutions) requires a strong scientific emphasis within the discipline, an understanding of the science of related disciplines and translation science, dissemination of findings, and interprofessional collaboration. Currently, 136 nursing schools in the U.S. offer a research-focused doctorate (AACN, 2018b).

PhD prepared nurses are well versed in research methods. PhD prepared nurses are well versed in research methods. This includes not just design but also collecting, analyzing, and interpreting data to best answer questions about an identified phenomenon that informs implementation science and translational research (Williams, 2011). Qualitative, quantitative, and mixed methods research each have their own unique advantages, challenges, and data that support scientific inquiry (McCusker & Gunaydin, 2015). Each method is more or less appropriate, based on the phenomenon and question under investigation.

Quantitative research seeks to explain a phenomenon by collection of numerical data to test a theory or hypothesis. This method of research has its foundations in a positivist philosophy that advocates that there is one truth that can be tested by collecting this numerical data (Claydon, 2015). Qualitative research encompasses a broad range of inquiry that utilizes a wide variety of approaches and methods. A fundamental component of qualitative research is the focus on “what, why, and how” questions, as opposed to “how many,” that captures unique data that does not fit with traditional analysis strategies (Ormston, Spencer, Barnard, & Snape, 2014). Designing and evaluating studies that have strong reliability, validity, and generalizability, or in the case of qualitative research, measures of trustworthiness, are crucial components of the PhD nurses role as a nurse scientist.

In today’s complex healthcare system, utilization of big data is driving changes in practice.However, nurse researchers are filling roles in clinical and industry related fields as well. In today’s complex healthcare system, utilization of big data is driving changes in practice. Doctorally-prepared nurses with a full understanding of research methods and data analysis are uniquely qualified to fill roles as nursing administrators (Lewallen & Kohlenberg, 2011) to best answer practice problems and develop solutions that will improve quality and contain cost. The participation of nurses in big data science initiatives “is essential to ensure that the discoveries not only be shaped by our profession’s unique understanding of the patient experience but also that the discoveries lead to knowledge that is useful to nursing” (Brennan & Bakken, 2015, p. 477).

Big data serves the functions of initial inquiry and secondary analysis. Big data is complex in not just size, but also in characteristics such as alphanumeric, image, and continuous flow data, such as streamed video. These complex data require a unique understanding of clinical and practice relevance and impact, as well as the statistical implications. Big data serves the functions of initial inquiry and secondary analysis. The nurse researcher has the knowledge to be sure that the data collection, analysis, and reporting are accurate and valid to assure that all decision making is made based on the best possible evidence (Englebright & Caspers, 2016).

As an example of the importance that big data is playing in healthcare is the Patient-Centered Outcomes Research Institute (PCORI), which has funded two types of data collaboratives to advance the use of electronic health data (Fleurence et al., 2014). The first, Clinical Data Research Networks (CDRNs), are based on the electronic sources of very large populations receiving care within an integrated delivery system such as an electronic health record (EHR). The other collaborative is a Patient-Centered Research Network (PCRN), which is comprised of communities of patients with similar motivation who are interested in forming partnerships with researchers.

DNP Prepared Nurse

The Doctor of Nursing Practice (DNP) represents the highest level of preparation in nursing practice for those seeking careers focused on the scholarship of clinical practice, application, and integration. In 2004, nursing schools affiliated with AACN voted to move the level of education necessary for advanced nursing practice from the master’s degree to the doctorate. This action elevated the expected level of educational preparation from the master’s degree to the doctorate for the four APRN roles—Nurse Practitioners, Clinical Nurse Specialists, Nurse Anesthetists, and Nurse-Midwives—as well as for other nurses engaged in advanced specialty practice.

DNP programs focus heavily on practice that is innovative and evidence-based, reflecting the application of credible research findings. DNP programs focus heavily on practice that is innovative and evidence-based, reflecting the application of credible research findings. As a practice discipline, nursing scholarship informs science, enhances clinical practice, influences policy, and impacts best practices for educating nurses as clinicians, scholars, and leaders. Both post-baccalaureate and post-master’s DNP programs are available with 336 nursing schools nationwide currently offering the practice doctorate (AACN, 2018b).

… nurses with DNP preparation use their skills to assure that the best evidence reaches the bedside in the most effective and efficacious ways.  DNP prepared nurses hold a variety of roles with the healthcare system. As described in the DNP Essentials, nurses who complete a DNP program are prepared in either in an advanced practice nursing role (APRN) or with an aggregate/systems/organizational focus (AACN, 2006). In the healthcare arena, DNP-prepared APRNs also often serve in dual roles, concurrently practicing at the systems level to have a broader impact on patient and systems outcomes. With DNP preparation, APRNs are prepared to address complex issues that face patients and healthcare today. DNP-prepared nurses are also rapidly assuming roles focusing on leadership, nursing informatics, public health, knowledge translation, application of implementation science, application of improvement science, and quality improvement. Roles such as chief nurse officer (CNO), director of quality improvement, director of evidence-based practice, and chief information officer (CIO) are common positions where nurses with DNP preparation use their skills to assure that the best evidence reaches the bedside in the most effective and efficacious ways.

… improvement science, implementation science, and implementation research are relatively new disciplines.Focused on determining which interventions best support the integration of knowledge into routine practice, improvement science, implementation science, and implementation research are relatively new disciplines (Newhouse et al., 2013). While the disciplines themselves are research disciplines, the concepts are foundational to high level nursing practice. DNP-prepared nurses often find themselves involved with teams of researchers in this arena or in the application of this research. Nurses with DNP preparation are uniquely qualified to bridge the gap between research and the bedside, in part, because they have an in-depth understanding of key concepts in organizational systems, translation of evidence into practice, implementation science, and research.

DNP-prepared nurses possess the breadth and depth of knowledge to answer these questions and lead translational research efforts launched to improve care. Many DNP-prepared nurses oversee and oftentimes implement hospital quality improvement initiatives. According to the Institute for Healthcare Improvement (IHI) “the science of improvement is an applied science that emphasizes innovation, rapid-cycle testing in the field, and spread in order to generate learning about what changes, in which contexts, produce improvements” (2018, para. 2). With knowledge of implementation theories, frameworks, and process models, DNP nurses are leading quality improvement (QI) initiatives. They bring knowledge of complex adaptive systems, stakeholder engagement, project charters, logic models, driver diagrams, rapid cycle models, measurement, and data which are critical to the success of QI.

Many DNP-prepared nurses oversee and oftentimes implement hospital quality improvement initiatives. There are many examples of how DNP-prepared nurses use data to translate research into evidence-based practice innovations at the systems level. Data has become an integral part of any large healthcare organization and with growing electronic medical record use, big data is a new reality. Understanding how to effectively use big data, big data analytics, and big data tools to drive system improvement is now imperative for healthcare executives in the “c-suite” (Englebright & Caspers, 2016). Dr. Mary Blankson is a DNP prepared nurse who is the CNO of The Community Health Center (CHC) Inc. In her role as CNO, she is a leader in improvement within the organization’s more than 200 sites. Leading an organization with a $100 million-dollar annual budget and nearly 100,000 annual visits generates an immense data set (Blankson, 2017). One endeavor involved supporting primary care providers to improve the care of patients in pain. She used her expertise to develop a multipronged approach, which included: 1) developing and implementing standards of care; 2) employing electronic health record (EHR) solutions; 3) using data tools to measure progress and outcomes; 4) implementing technology and telehealth to improve care; and 5) educating and collaborating with providers, and putting in place oversight of the process from the beginning.

PhD and DNP Collaboration

PhD- and DNP-prepared nurses are natural allies when it comes to accelerating the pace at which new nursing interventions are translated from the bench to the bedside. Though nursing’s two terminal degrees differ in focus and prepare graduates with distinct sets of competencies, these programs represent complementary, alternative approaches to the highest level of educational preparation in nursing. PhD- and DNP-prepared nurses are natural allies when it comes to accelerating the pace at which new nursing interventions are translated from the bench to the bedside. In part, the relationship between a PhD-prepared nurse and a DNP-prepared nurses is reflected in this quote from Louis Pasteur, “To him who devotes his life to science, nothing can give more happiness than increasing the number of discoveries, but his cup of joy is full when the results of his studies immediately find practical applications” (Dubos, 1951, p. 85).

In practice, there is often a dependence on each other to best use unique skills to meet the overall goal of improving health. Both programs prepare graduates to develop new knowledge that will shape how nurses practice and advance scholarship in nursing. In a variety of settings, DNP graduates are serving as health system and hospital leaders who work collaboratively with nurse researchers to implement new nursing science and practice innovations. Together these leaders are ensuring that contemporary nursing practice remains relevant and pliable enough to meet evolving patient needs.

The collaboration that results when nurse researchers join with practice leaders is redefining the discipline’s approach to translational research and implementation science. The collaboration that results when nurse researchers join with practice leaders is redefining the discipline’s approach to translational research and implementation science. According to the National Institute of Nursing Research, translational research improves patient care and promotes public health by “[transforming] scientific findings or discoveries from basic laboratory, clinical, or population studies into new clinical tools, processes, or applications” (Grady, 2010, p.164). By working together, academic and practice leaders can accelerate the dissemination of shared knowledge, scientific inquiry, translational research, and policy advocacy that affect health and health outcomes (AACN, 20042016). The new AACN’s position statement on scholarship underscores the need for nurses holding a PhD or DNP to partner in order to translate newly generated knowledge into practices that improve health and healthcare.

To facilitate the translation of new science into practice, implementation science seeks to “identify barriers (personal, economic, and management) to effective evidence translation and examines the causal relationships of the interventions and the outcomes” (AACN, 2018a, p. 4). This branch of research inquiry seeks to understand the facilitators and barriers to incorporating new science into healthcare innovations. Taken together, implementation science informs best practices when translating new evidence in a manner that is most effective and most likely to lead to sustainable change in patient care delivery.

Research and Practice

DNP- and PhD-prepared nurses can use their individual skills to advance each other’s work. The power of research and practice collaboration in nursing is emerging throughout the U.S. healthcare system. A group of clinicians in Michigan, including a PhD- and DNP-prepared nurse, developed a regional collaborative to reduce 30-day heart failure readmissions, demonstrating that intra- and interprofessional teams can have a large-scale impact on quality (Pollard et al., 2015). DNP- and PhD-prepared nurses can use their individual skills to advance each other’s work. For example, a DNP-prepared nurse in a system level leadership role may be focused on using data to improve patient 30-day readmission rates. This individual may notice discrepancies between 30-day readmission rates between like-units or like-institutions. While novice nurse leaders might believe they have a clear understanding of the practices used to prevent 30-day readmission, an experienced doctorally prepared practice leader understands that there are often hidden nuances that may strongly impact outcomes. What are the specific practices used in various areas? To answer this query, a PhD nurse colleague could then design a study collecting data (both qualitative and quantitative) to describe variations in practice.

With knowledge of current practice, the DNP-prepared nurse can look to the literature to determine what interventions are supported by quality research. Knowledge of complex adaptive systems, leadership strategies, financial considerations, and interprofessional dynamics that the DNP-prepared nurse possesses can provide the PhD nurse researcher with informed insight into which interventions may or may not be deployable within their organization. This collaboration will strengthen the design of any research project that attempts to answer this practice inquiry. While a great deal of current research exists on interventions associated with this clinical issue, it may not be clear which interventions are best suited for this health system. These differently educated nurses may collaborate to answer the question, “which interventions work best within our unique healthcare system?”

The Plan, Do, Study, Act (PDSA) cycle ensures that including a collaborative effort between the two expert nurses will occur to evaluate change. As previously described, the use of big data increasingly contributes to understanding health phenomena and policy development. Early descriptive exploration and study to understand clinical problems and knowledge of tactics used throughout a complex system guides the work of the PhD-prepared nurse, who designs an interventional study or completes secondary data analysis to determine which interventions used in various system units and departments are most likely to reduce 30-day readmission. The DNP-prepared nurse is an appropriate person to lead an institutional shift in practice based on expertise in implementation frameworks and implementation process models, as well as specific intervention data from implementation researchers. The Plan, Do, Study, Act (PDSA) cycle ensures that including a collaborative effort between the two expert nurses will occur to evaluate change. This pilot work may develop into a larger scale, multi-center study, using implementation science as framework.

Academia

Collaboration is one of many strategies to increase productivity.Many PhD- and DNP-prepared nurses have careers in academia, contributing to research, practice, service, and education. In addition to collaboration with the more traditional roles in academia (e.g., teaching, course coordination, advising/mentoring students, serving on school or university committees and in professional organizations), DNP and PhD faculty collaborate on scholarship and research (Agger, Oermann, & Lynn, 2016). The work of designing practice projects and studies; writing grants; conducting practice change and research; and disseminating findings can be challenging for even the skilled academician. Collaboration is one of many strategies to increase productivity.

Together PhD- and DNP-prepared faculty can use their skills sets to grow and strengthen their practice and research portfolios. The role of primary researcher often hinders the ability of a nurse clinician to continue clinical practice. Likewise, clinical practice by a faculty member often hinders a highly productive research career. Together PhD- and DNP-prepared faculty can use their skills sets to grow and strengthen their practice and research portfolios. A faculty member practicing in an emergency room may identify a practice problem related to opioid use in patients presenting with dental pain. As an expert in research implementation, the DNP-prepared nurse may implement evidence-based practice guidelines for the setting. As the practice changes, the DNP clinician may gain a curiosity about the impact on recidivism or the impact of the practice guidelines on provider prescribing patterns. Together, they design a research study to gain a better understanding using several years of data to describe the phenomena.

Simply describing a change is valuable information, but other key data may help implementation researchers gather and design further research to improve health. For example, are there time points, critical events, or national policy changes that impact the prescribing practice of clinicians? Together these nurses write up the practice change and research. Rather than one individual serving in the often-overwhelming role of clinician researcher, they become a clinician researcher team.

Examples of how PhD- and DNP-prepared nurses are transforming research and practice are emerging throughout the landscape of academic nursing. The University of Maryland Baltimore serves as one example where this synergistic relationship is producing real results. Dr. Roseann Velez and colleagues, for instance, have studied appropriate prescribing of antibiotics for methicillin-resistant Staphylococcus aureus infections in an urgent care center (Velez, Becker, Davidson, & Sloand, 2014). This work helped to inform a group of academicians about the need to better prepare healthcare providers, including nurse practitioners, pharmacists, and medical students, on the topic of antibiotic use and prescribing practices. This interprofessional group is currently investigating the use of gamification to engage students in learning about antimicrobial management. Assignment: Translational Research Case Report

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