The DNP Project: Data Management, Project Management and Ethical Issues

The DNP Project: Data Management, Project Management and Ethical Issues

Data Management Plan

The data management plan articulates the outcome measure analysis to determine if the translation of the 4AT is effective in impacting restraint usage at the practicum site. The level of data outcome is ratio level (number of restraints). It is ratio level because it contains a true “0” value (no restraints). The planned analysis will include descriptive statistics (n, %) to measure the compliance of nurses and others using the 4AT by gathering daily paper forms of the assessment tool of all the admitted patients. The n, % of admitted patients that were assessed would be computed. To measure the compliance of nurses to document delirium in nursing care plans once associated risks are identified, descriptive statistics (n, %) will be computed. Assess barriers and comfort level of staff using the new 4AT, which will be queried and recorded by the DNP student during scheduled staff meetings and interviews, a qualitative content analysis of the staff statements about barriers will be conducted and categorized into themes. Comfort level will be presented using descriptive statistics (n, %) for the comfort levels of high, moderate, and low comfort regarding using the new 4AT. 

To examine restraint use, the average daily restraint episodes will be compared between pre and post using an independent samples t-test. This test allows for a comparison of two independent groups (pre/post) on a continuous outcome (number of daily restraint episodes).  IBM SPSS version 28 will be used to conduct the independent t-test with a significance level of p < .05. Additionally, the restraint use rate per 1,000 inpatient days will be computed and presented for the pre and post intervention. A percentage change calculation will be presented for the rate comparison at pre and post intervention. Descriptive statistics and inferential statistical analyses will be presented in narrative and chart format. 

Project Management Plan and Gantt Chart

The implementation of the 4AT will be implemented over 10 weeks. The detailed project proposal, planning, data management and analysis, and dissemination plan can be found in the 32-week Gant chart (Appendix C).

Pre-Implementation Phase

            The 4AT will be part of the daily charting of nursing staff. The DNP student must assess and review the SJMC delirium process and protocols during the pre-implementation phase. The DNP student will meet with stakeholders and unit staff to ensure multidisciplinary involvement for the implementation of the 4AT. The DNP student will also prepare educational resources and set-up meetings with stakeholders for the entirety of the project.

Week One of Implementation

            Pre-implementation data collection will consist of restraint usage for patients in 4West within the since January 1st, 2022. Information session on the implementation of 4AT will be held. The DNP student will train the staff and 4AT champions to lead the other staff during the implementation phase. Weekly discussions will be held with hospital leaderships, stakeholders, and members of the multidisciplinary team to ensure effective communication between DNP student and the implementation team related to weekly assessment and updates during the implementation stage. Educational seasons to the implementation staff will also include proper utilization and documentation of the 4AT form, and re-education will be planned as needed.

Week Two through Nine of Implementation

The implementation of the 4AT will occur during weeks two through nine. The DNP student will gather and assure completion of the delirium form daily for eight weeks of all the admitted patients in 4West. The project champions will also ensure the completion of the organizational restraint form per patient per event and online document restraint usage via Google document daily. If identified as at-risk or positive delirium, the DNP student will perform chart audits to ensure utilization of nursing care plans and identification of risk factors or precipitating factors that will prompt a follow-up with hospitalists or specialist providers. The DNP student will meet with the 4AT champions and have weekly discussions every Wednesday to receive feedbacks and modifications as needed. In week nine, the DNP student will conduct scheduled meetings and interviews of nursing staff and supervisors of 4West on barriers encountered with the utilization of the 4AT. In the same week, the DNP student will also gather data regarding the comfort levels of using the 4AT in the unit.

Week Ten through Eleven

Post-intervention data collection and analysis will occur from week ten through eleven. In week ten, the DNP student will compile all the data from week two through nine and provide the Statistician all necessary information for analyzes. Week Eleven will involve dissemination of information to stakeholders and wrap-up with staff. Week Eleven will also involve the discussion for sustainability in the organization.

DNP Project Budget

Expenses

 The creation of a detailed budget for the DNP project is an essential strategy for effective progression and risk management of the project. Expenses include salary and benefits, supplies, services, statistician, and project manager. The DNP student will need to allocate 1000 hours with a rate of $0 per hour, which will lead to zero salary and expenses. The project mentor will also allocate around 400 hours for zero cost. The supplies and services are covered by the organization. The statistician will cost around $500 in the analyses and evaluation of data for the project.

Revenue Sources

            Revenue sources include hospital sources and the DNP student. The hospital will be covering supplies, services, and overhead costs. The DNP will cover the necessary hours needed for completing the project in addition to paying for the statistician, which will be around $500. The revenue is equal to the total expenses of the project.

Table 1

Budget