The purpose of this reflective journal essay is to analyze personal experiences during the course DNP 820A. Like many other advanced practice courses, DNP 820A prepares nurses to handle complex patient issues by implementing evidence-based practice. The reflections in this essay are an honest evaluation of personal journey in accomplishing the course objectives aligned with the American Association of Colleges of Nursing (AACN) Essentials of Doctoral Education for Advanced Nursing Practice (2022). The essay describes how learning occurred to achieve AACN Essentials.
DNP 820A expands the nurse student’s competencies of translating research into practice acquired in DNP 815A. Through it, the nurse student examines scientific evidence to guide improvements in practice and care outcomes. Generally, the reflective journal describes the core learning experiences that were pivotal in the course completion. They include DPI project-related activities, literature review and appraisal, and weekly learning experiences. This course’s diverse and insightful experiences and learning involved the following essentials.
Essential I: Scientific Underpinnings for Practice
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Nursing focuses on actions that impact population health positively. Advancing knowledge allows the DNP nurses to acquire expertise that allows them to translate knowledge to achieve better patient outcomes (AACN, 2022). From the first week, it was evident that the course prepared the DNP student to translate research into practice through activities such as submitting the final PICOT-D and exploring the role of the research translator and evidence-based practice. Other activities during weeks 1-3 included identifying and evaluating literature for proposed DPI intervention and exploring the importance of critical appraisal and levels of evidence. The appropriate nursing theory and change theory were presented along with the literature review. A nursing theory describes the scope of the nursing practice, while change theories explain how to implement change based on the best available evidence (Gasaba et al., 2021; Harrison et al., 2021). The critical appraisal process ensures that scientific evidence is valid and relevant to practice.
Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking
Essential II focuses on the nursing competencies vital in eliminating health disparities and optimizing practice experience. Accordingly, the DNP program prepares nurses to better address current and future health needs (McCauley et al., 2020). Learning experiences that helped to achieve these competencies included an in-depth exploration of how different components of a care bundle for pressure ulcers achieve different outcomes. These components include skin care, preventive dressing, and repositioning (Yap et al., 2021; Zhang et al., 2021). Successful implementation of practice change also requires the DNP nurse to serve as a change leader and embrace systems thinking since practice change is a collaborative practice.
Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice
Health improvement leads to better population health through new discoveries that address complex practice problems. The course prepared the DNP nurse to apply relevant findings from EBP and research to enrich practice leading to improved health outcomes (AACN, 2022). Learning experiences to accomplish Essential III included critically appraising literature related to the effectiveness of a preventive care bundle for pressure ulcers and discussions on how incorporating EBP leads to higher quality health care during weeks 4-6. Other relevant learning experiences to achieve this Essential included the assignment exploring a gap between research findings and implementation in week five and the literature synthesis for a preventive care bundle for pressure injuries.
The DNP 820A course focuses on knowledge application activities for translating research into practice using appropriate nursing and change theories. The purpose of this reflection essay was to describe the course activities that helped the DNP nurse to achieve the course’s objectives and AACN’s Essentials. They included weekly discussions, assignments, and project-related activities, primarily literature synthesis and appraisal.
AACN. (2022). DNP Essentials. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Gasaba, E., Ntiranyibagira, B., Joseph, I., Uwamariya, T., Nkurikiye, E., Hategekimana, P., … & Niyongabo, E. (2021). Nursing theory and its practices in two health care facilities of Bujumbura. Open Journal of Nursing, 11(9), 757-771. https://doi.org/10.4236/ojn.2021.119064
Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13, 85-108. https://doi.org/10.2147%2FJHL.S289176
McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M., … & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track. Nursing Outlook, 68(4), 494-503. https://doi.org/10.1016/j.outlook.2020.03.008
Yap, T. L., Horn, S. D., Sharkey, P. D., Zheng, T., Bergstrom, N., Colon-Emeric, C., … & Kennerly, S. M. (2021). Effect of varying repositioning frequency on prevention of pressure injuries in nursing home residents: TEAM‐UP cluster‐randomized clinical trial results. Research Square, 1-21. https://doi.org/10.21203/rs.3.rs-717425/v1
Zhang, X., Wu, Z., Zhao, B., Zhang, Q., & Li, Z. (2021). Implementing a pressure injury care bundle in Chinese intensive care units. Risk Management and Healthcare Policy, 14, 2435–2442. https://doi.org/10.2147/RMHP.S292579