Reflective inquiry allows for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals. Each week, you will reflect upon what you have learned and complete a reflective journal assignment: Reflection on Learning. Each weekly reflection is placed in one document
- Provide one specific example of how you achieved one of the weekly objectives.
- reflect upon what you have learned
- write 1-2 paragraphs reflecting on your experience for each week
Week 1
The discussion for this week is focused on the data you have collected, analyzed, and are using to evaluate the effectiveness of your project. Describe or attach any tool that you are using for your project evaluation. Describe your plan for data analysis and how you will evaluate your project outcome.
PICOT question will serve as the basis for the proposed DNP project: For adult patients with uncontrolled hypertension, what is the impact of implementing the 2022 American Heart Association(AHA) Standard Seventh Report guidelines via tele-monitoring have on blood pressure control compared to current practice within eight to ten weeks?
According to Lindholm (2002), monitoring blood pressure and intervening promptly could be one method to help control it. An excel spreadsheet will be used as a data collection tool, where each patient will be coded by their EHR number and their baseline blood pressure during the first week of a project will be compared to blood pressure values measured during week ten.
Changes in systolic blood pressure will be analyzed separately from changes in diastolic blood pressure. Using mean, standard deviation, and hypothesis testing, a one-tail t-test is planned to be used to determine a statistically significant change. The assumption of a null hypothesis is that the week one and week ten blood pressure means are equal.
Pearson Correlation Coefficient Calculator will be used (https://www.socscistatistics.com/tests/pearson/default2.aspx) to calculate the strength and direction of the relationship between systolic/diastolic blood pressure before and after implementation. Then, P-value will be calculated with a significance level of 0.05.
Lindholm, L. (2002). The problem of uncontrolled hypertension. Journal of Human Hypertension, 2002(16), 3–8. https://doi.org/10.1038/sj.jhh.1001433
Week 2
Welcome to Week Two! In our collaborative discussion this week, we are exploring the implications of the DNP project on nursing and healthcare outcomes.
What was the impact of your project at the practicum site and what are the implications of this project on nursing and/or healthcare outcomes?
Project Impact
The telemonitoring method will improve the management of uncontrolled hypertension, leading to enhanced blood pressure control in hospitals and other care facilities. Telehealth and telemonitoring techniques would ensure that facilities use fewer doctors, nurses, medical assistants, and technicians to care for patients with uncontrolled hypertension (Guirguis-Blake et al., 2021). Besides, this project would improve health outcomes for patients with uncontrolled hypertension. The condition requires prompt and efficient attention (Oliveros et al., 2020). Through the technological method, patients will receive timely care while doctors can easily know when there is an emergency ( Hare, et al., 2021). Improved healthcare or treatment outcomes is one of the priorities for every healthcare facility.
Guirguis-Blake, J. M., Evans, C. V., Webber, E. M., Coppola, E. L., Perdue, L. A., & Weyrich, M. S. (2021). Screening for Hypertension in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 325(16), 1657–1669. https://doi.org/10.1001/jama.2020.21669
Hare, A. J., Chokshi, N., & Adusumalli, S. (2021). Novel Digital Technologies for Blood Pressure Monitoring and Hypertension Management. Current cardiovascular risk reports, 15(8), 11. https://doi.org/10.1007/s12170-021-00672-w
Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical cardiology, 43(2), 99–107. https://doi.org/10.1002/clc.23303
Week 3
The discussion for this week is focused on identifying individuals who provided professional support and mentoring throughout your DNP program. Describe 2-3 individuals who provided professional mentoring or who helped guide you throughout the DNP program. These individuals may include your preceptor, course faculty members, or others with whom you developed a relationship, and who assisted you in finding the right direction in your course work, practicum experience, and project.
Individuals Who Provided Professional Mentoring or Guidance
I have and will receive support from different parties during this project, including my professors, the facility’s doctors, and health technicians. My professors have provided timely academic and professional guidance (Soto et al., 2017). They also equipped me with valuable online data collection skills that are useful in gathering data. The facility’s doctors provided exceptional medical expertise that will supplement the data gathered from external sources (Lee, 2007). I was assigned two doctors who provided exceptional mentorship in the medical field, especially in hypertension management. It is essential to note that the knowledge gained during DNP journey helped perform a comprehensive literature review. My parents, spouse, and colleagues have provided emotional and material support. And I thank God for the ongoing care and wisdom.
Lee A. (2007). How can a mentor support experiential learning?. Clinical child psychology and psychiatry, 12(3), 333–340. https://doi.org/10.1177/1359104507078455
Soto Núñez, C., Avilés Reinoso, L., Lucchini Raies, C., & Soto Fuentes, P. (2017). In-depth Knowledge of the Role of the Clinical Mentor. Investigacion y educacion en enfermeria, 35(3), 356–363. https://doi.org/10.17533/udea.iee.v35n3a12
Week 4
The collaborative discussion this week is focused on your practice readiness and professional identity as a DNP practice scholar and nurse leader. As you reflect on your professional growth during your DNP program, how has your work equipped you to practice as a DNP practice scholar and healthcare systems leader?
The following PICOT question will serve as the basis for the proposed DNP project: For adult patients with uncontrolled hypertension, what is the impact of implementing the 2022 American Heart Association(AHA) Standard Seventh Report guidelines via tele-monitoring have on blood pressure control compared to current practice within eight to ten weeks?
The DNP program has provided me with exceptional exposure to the healthcare systems and the need to improve care for chronic illnesses, including hypertension (Ratnapalan & Lang, 2020). The program helped me identify the necessity for change in the healthcare systems, particularly in evidence-based interventions and technology. As a healthcare systems leader, I understand that technology provides the best approach to managing illnesses like hypertension (Noorbakhsh-Sabet et al., 2019). For instance, I now know that clinics need to integrate telemonitoring and telehealth into their healthcare systems to improve disease management. Again, I have understood the significance of constant research to ensure that I recommend and implement evidence-based interventions for my patients (Santana et al., 2018). It would also be significant in aiding my work in medical research to influence change in practice.
Noorbakhsh-Sabet, N., Zand, R., Zhang, Y., & Abedi, V. (2019). Artificial Intelligence Transforms the Future of Health Care. The American journal of medicine, 132(7), 795–801. https://doi.org/10.1016/j.amjmed.2019.01.017
Ratnapalan, S., & Lang, D. (2020). Health Care Organizations as Complex Adaptive Systems. The health care manager, 39(1), 18–23. https://doi.org/10.1097/HCM.0000000000000284
Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person-centred care: A conceptual framework. Health expectations : an international journal of public participation in health care and health policy, 21(2), 429–440. https://doi.org/10.1111/hex.12640
Week 5
Welcome to Week 5! The collaborative discussion this week is focused on your career goals as a DNP practice scholar and healthcare systems leader. The course outcome that guides your learning this week is:
CO 3: Engage in a process of self-assessment and career planning through the development of an electronic professional portfolio to demonstrate growth and development, achievement of program outcomes, and DNP sub-competencies as designated in the AACN DNP Essentials (PO 6).
Please provide a summary of your career goals upon completion of your DNP education. You may include short and/or long-term goals.
After completing my education, I plan to focus on my clinical practice, advocacy in the political arena, and research (Scott & Scott, 2021). My goal is to work on improving lives by alleviating suffering through practice to generate new ideas and strategies based on evidence (Hanks e al., 2018). In the short term, I will work in a community health facility to complement the existing healthcare staff to provide patients with quality care and complete my project. The aim is to improve patient healthcare outcomes by suggesting and implementing the best evidence-based interventions (Warner, 2017).
Hanks, R. G., Starnes-Ott, K., & Stafford, L. (2018). Patient Advocacy at the APRN Level: A Direction for the Future. Nursing forum, 53(1), 5–11. https://doi.org/10.1111/nuf.12209
Scott, S. M., & Scott, P. A. (2021). Nursing, advocacy and public policy. Nursing ethics, 28(5), 723–733. https://doi.org/10.1177/0969733020961823
Warner S. L. (2017). Getting political about patient advocacy. Nursing, 47(11), 47–49. https://doi.org/10.1097/01.NURSE.0000525989.51732.b6
Week 6
This week, along with your response to the collaborative topic question, I am also asking you to share how your preceptor has supported your work this session. Please answer these two short questions for your preceptor and answer these separately for your mentor, if you have a mentor. Please share your thoughts on the following:
- How did your preceptor/mentor provide you with timely feedback when you had questions?
- How did your preceptor/ mentor serve as a professional role model as you implemented your project?
I look forward to your feedback regarding collaboration with your preceptor and your mentor.
My preceptor has been helpful throughout the project. He provided me with professional and technical assistance, guiding me from the start of the project (McLaughlin, 2010). He monitored me throughout the project to ensure I stayed on the right path. The preceptor gave me feedback on every question through telephone calls, emails, and face-to-face interactions. He provided me with exceptional knowledge in the healthcare field, including using technology to improve care (Burgess & Mellis, 2018). In addition, I was introduced to a new level of patient care, which is advocating for patients through policy development (Anders, 2021). I am grateful for his support throughout my journey toward becoming a DNP scholar.
Anders R. L. (2021). Engaging nurses in health policy in the era of COVID-19. Nursing forum, 56(1), 89–94. https://doi.org/10.1111/nuf.12514
Burgess, A., van Diggele, C., & Mellis, C. (2018). Mentorship in the health professions: a review. The clinical teacher, 15(3), 197–202. https://doi.org/10.1111/tct.12756
McLaughlin C. (2010). Mentoring: what is it? How do we do it and how do we get more of it?. Health services research, 45(3), 871–884. https://doi.org/10.1111/j.1475-6773.2010.01090.x
Week 7
The collaborative discussion this week is focused on a summary of your DNP project. It is important to be able to articulate the message of your project in a concise and brief message. This is often referred to as an ‘elevator speech’.
PICOT:
What is the impact of implementing the 2022 American Heart Association (AHA) Standard Seventh Report guidelines via tele-monitoring for adult patients with uncontrolled hypertension on blood pressure control compared to current practice within eight to ten weeks?
The project investigates the impact of implementing the 2022 American Heart Association (AHA) Standard Seventh Report guidelines through telemonitoring on blood pressure control compared to current practice within eight to ten weeks. It is essential to note that hypertension is one of the primary risk factors for cardiovascular disease (Monahan et al., 2019). Using a systematic literature review, the project found that telemonitoring is cost-effective and improves patient healthcare outcomes, satisfaction, and motivation (Yue et al., 2021). However, the study revealed that telemonitoring is associated with cost constraints, absence of integration in healthcare systems, lack of validation and testing standards, and absence of concrete implementation into the medical workflows (Margolis et al., 2020). The project suggests that healthcare organizations and systems should embrace telemonitoring to improve BP monitoring for effective hypertension management (Zullig et al., 2013).
Margolis, K. L., Dehmer, S. P., Sperl-Hillen, J., O’Connor, P. J., Asche, S. E., Bergdall, A. R., … & Maciosek, M. V. (2020). Cardiovascular events and costs with home blood pressure telemonitoring and pharmacist management for uncontrolled hypertension. Hypertension, 76(4), 1097-1103. https://doi.org/10.1161/HYPERTENSIONAHA.120.15492
Monahan, M., Jowett, S., Nickless, A., Franssen, M., Grant, S., Greenfield, S., … & McManus, R. J. (2019). Cost-effectiveness of telemonitoring and self-monitoring of blood pressure for antihypertensive titration in primary care (TASMINH4). Hypertension, 73(6), 1231-1239. https://doi.org/10.1161/hypertensionaha.118.12415
Yue, J., Yang, X., Wang, B., Hu, H., Fu, H., Gao, Y., & Sun, G. (2021). Home blood pressure telemonitoring for improving blood pressure control in middle‐aged and elderly patients with hypertension. The Journal of Clinical Hypertension, 23(9), 1744-1751. https://doi.org/10.1111/jch.14341
Zullig, L. L., Dee Melnyk, S., Goldstein, K., Shaw, R. J., & Bosworth, H. B. (2013). The role of home blood pressure telemonitoring in managing hypertensive populations. Current Hypertension Reports, 15(4), 346-355. https://doi.org/10.1007/s11906-013-0351-6
