Doctor of Nursing Practice project focuses on multidisciplinary collaboration to increase ICU patient early mobility
When considering a Doctor of Nursing Practice (DNP) as the next step in their education, many nurses share concerns regarding the program’s final project. Unlike a traditional doctoral dissertation, the goal of a DNP project is to allow students to showcase their ability to translate knowledge and research into practical applications and solutions to real-world problems, impacting health care outcomes at a systems or population level.
At UC College of Nursing, students work with faculty advisors to choose a DNP project topic that relates to their advanced-practice specialty. The nature of projects varies and can include:
- A quality improvement initiative
- Implementation and evaluation of evidence-based practice guidelines
- Policy analysis
- Design and evaluation of new models of care or health care programs
To provide additional insight into the planning and steps of a DNP final project, we interviewed Paige Dahlke, BSN, RN, CCRN, an adult-gerontology acute care DNP candidate whose project ranked top at the college’s Annual Doctoral Student Project Showcase.
Dahlke received her Bachelor of Science in Nursing from the University of Northern Colorado in 2016, before relocating with her husband to Dayton, Ohio where she worked closely with ICU nurse practitioners at Kettering Health Dayton.
“Watching my leadership exercise higher level thinking when making impactful decisions for patients inspired me to go back to school,” she says. “I enjoyed caring for critically ill patients and wanted to progress in my ability to care for them, so I decided the DNP in adult-gerontology acute care program was the path for me, since it allows me to not only care for patients at a higher level, but also implement quality improvement projects, teach and so much more.”
Given her previous work experience, Dahlke decided to pursue a quality improvement project focused on early mobility interventions for ICU staff.
“ICU patient care requires life-saving treatments that frequently relate to increased immobility. My literature review showed that prolonged immobility is detrimental to all systems and functional ability; even when patients recover from what landed them in the ICU, they’re still not doing great due to adverse effects such as ICU-acquired weakness,” Dahlke shares. “Getting patients up and moving leads to better patient outcomes, decreased length of stay, increased functional ability and better recovery after illness.”
Aware that the lack of collaboration among different disciplines providing patient care in the ICU is a consistent barrier to early mobility intervention completion, Dahlke decided to create and deliver an education module showcasing the safety and feasibility of early mobility interventions and shared a Level of Function Mobility (LOF) scale to assist in consistent care and seamless communication for care providers in the ICU.
Dahlke partnered with Kelsey Schweikert, BSN, RN, clinical nurse manager at Kettering Health, to present the education module and explain the LOF scale at the hospital’s ICU multidisciplinary meeting. She also showed where the LOF mobility scale and documentation for rating would be found in ICU patient rooms. To assess staff perceptions of the intervention and interdisciplinary collaboration, Dahlke collected surveys pre- and post-LOF scale use, in addition to data on length of stay and Morse Fall Risk Assessment before and after intervention and scale implementation. A statistical analysis showed an improvement in ICU length of stay, change in Morse Fall Risk and staff perceptions of early mobility. As the changes were not statistically significant, Dahlke concluded that, although the improvement in each of the metrics shows potential for the project, further evaluation—including longer implementation and additional resources—is necessary to potentially produce statistically significant results.
“My goal is to decrease the burden of one single discipline to complete early mobility interventions within the complex ICU,” says Dahlke. “A multidisciplinary approach will encourage collaboration and improve patient outcomes.”
When asked about her steps towards a successful DNP project, Dahlke praises the support she has received at the UC College of Nursing.
“Dr. Eilleen Werdman, my project chair, has been supportive of the project since day 1. DNP projects entail three well-defined phases—planning, implementation and data collection—each covered throughout the classes that walk you through the process for a successful project. You follow a well-defined process guided by faculty and your chair.”
Dahlke, who will welcome her first baby in July, graduate in August and move alongside her husband in September, is excited about her future professional options.
“I feel that the DNP has prepared me to do anything I want in my career. I may pursue cardiology or pulmonology, or another specialty. Even if I end up not going back to work in the ICU, I’m glad to have contributed to patient outcomes through my project,” she says.
Want to learn more about our DNP program? Let us know here.
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